A doctor speaks from experience when she says good communication is essential, even when you're a student

'Is this the gullet?'

In what circumstances would you expect to ask this question? In your first anatomy class? When trying your hand at interpreting x-rays? Playing Operation?

Any or all of the above are acceptable. But absolutely, definitely not when you are referring to a patient with oesophageal cancer. In her hearing. Just before as she is about to go in for surgery.

As well as being an MDU medico-legal adviser, I am a consultant anaesthetist. Several years ago, I was preparing this particular patient for surgery in the anaesthetic room when two medical students charged in, laughing and jostling each other. One of our heroic duo saw the patient being helped on to the operating table and asked me... you've guessed it...'Is this the gullet? We're here to observe.'

So wrong. On so many levels.

First, the patient was seriously ill, frail and scared. She was about to undergo a serious operation to remove a life-threatening tumour.

Tip 1 - remember empathy: never talk about a patient in the third person when they are in the same room, or in such a disparaging way.

Second, the first words the students should have uttered were their names, as they introduced themselves to the anaesthetic team. Then they should have asked if they could observe.

Tip 2 - remember to ask: it is always a good idea to communicate with the doctors you are working with or wish to shadow. Do not assume you can just barge in and observe - ask permission!

Third, they should then have spoken to the patient directly, asking her if she minded them watching the procedure.

Tip 3 - remember manners: the patient has the final say in whether you can watch her operation.