Medical student shows are a prominent feature of medical student life around the world. Following a traditional vaudeville format of skits and songs, the shows are notorious for their exuberance, bawdiness, and lack of political correctness. Despite their widespread prevalence and sometimes hostile reactions, there has been no previous study of these shows. Based on research of scripts, programs, reviews, and oral history, this article explores their history and content and argues that, far from being irrelevant frivolities, these shows serve several important functions. These include the fostering of communal spirit, the development of skills in teamwork, and the collective ventilation of emotional reactions to the process of becoming a doctor. They are one offshoot of the ancient and important tradition of misrule in Western society.