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Alex is an eager and competitive intern, traits that are important to be an excellent surgeon. However, Alex can also be self-absorbed and overconfident; he also only wants to work on cases that he feels are interesting. His offensive behaviour and poor attitude cause him to be extremely disliked by doctors and patients alike, and he is dubbed “frat boy” by the other interns.
Alex prides himself on his honesty, which often lacks tact and can verge on being crude, brutal, and insensitive. This contributes to his poor bedside manner. However, Alex does have a moral code and is the only doctor who tells the truth to patients who make bad decisions about their health, at the risk of offending patients and getting kicked out of surgical cases.
Alex is also the first intern to decide on his specialty plastic surgery. While it seemed at first that he chose that specialty due to “frat-boy” superficiality, the real reason was because plastic surgery patients sign up for the pain they get. It is this soft side to himself that Alex actively plays down, adopting a brash and cocky attitude to project to other people. Izzie, Meredith and subsequently Addison are able to see through this fade, and recognize him to be the loyal and honest person that he is. However, he has unwittingly been drawn to obstetrics and gynecology after having several bad experiences in plastics. Alex seems to have some talent in OB/GYN and Neonatal surgery (babies) after serving as Addison’s intern for a while.