What residents and medical students should wear in the hospital

At a recent meeting I attended, a vigorous discussion broke out about what medical students, residents and attendings should wear, and more importantly what they should not wear.

Interestingly, patients have been asked to weigh in on this discussion. What to wear is also on the mind of many current second year medical students who may find themselves trying to take study breaks from USMLE 1 to go buy clothes for the wards. I also remember doing this as a rising third year student and wondering what to get.

1. Don’t break the bank. Stores like Target, Marshalls, Sears or JCPenney are all fine places to get clothes for the hospital. You’ll be wearing your white coat over your clothes. Save your money for your fourth year interview suit.

2. The hospital is a messy place. Buy clothes which you wouldn’t mind throwing out if you were drenched in body fluids. (Not likely to happen but would be devastating if you’re wearing Prada or Valentino).

3. Buy comfortable shoes. You’ll be on your feet most of the day. There are actually studies that demonstrate that residents (who you’ll be following around) may walk up to 6 miles when on call! It’s hard to answer “pimp” questions if you’re developing bunions and wondering when the heck you can take off those shoes. You’re feet will thank you.

4. Get a waterproof, inexpensive watch. You’re going to be washing your hands a lot. Being late to rounds is never good, but you may also lose your watch after you take it off to scrub in. A watch with an alarm can be very handy when you have to get up at 4 in the morning to pre-round for surgery.

5. Scrubs are for the hospital not for home. As a New York Times article pointed out, no one wants to sit next to someone on the subway wearing scrubs, particularly those with uncharacterizable stains on them. Scrubs are there, in part, to keep you from taking hospital germs into the community. It’s also hospital policy. Unless a resident or student is staying overnight or involved with procedures, scrubs are a ‘dressed down’ look. So plan to change from scrubs to regular clothes before you wander around outside the hospital.

6. Stock up on detergent, soap and deodorant. You’re going to be getting up close with your patients and if your clothes (or you) smell, they will feel even sicker than they already do.

7. Buy a bleach pen. This is very helpful for spot cleaning blood stains until you can get your coat back to your house for laundering. Peroxide works too.

8. White coats (and ties for men) are still part of the uniform. Yes, there are studies showing white coats and ties spreading infection. In the UK, they are already banning white coats. However, for now in the US, they are considered part of the standard attire for physicians and medical trainees and what patients have come to expect. In addition to washing your coat often, washing your hands is the #1 thing you can do to prevent infection.

9. Wash that white coat. Those aforementioned uncharacterizable stains are really gross on white coats. Not a great way to instill confidence in your abilities with patients or attendings.

10. No perfume or cologne. Remember the triggers for asthma? Perfume is one of them. Stick to “eau de soap and water.” Beware the overly scented deodorant too. Unscented soaps are typically the best for combating malodors while avoiding elicitation of bronchospasm.

And some more tips especially for women

1. Save the ‘Hospital Honey’ look for Halloween. Buy clothes for the hospital, not for going out: cover your cleavage, make sure your skirts reach at least mid-knee when you sit; shirts and pants/skirts should cover your midriff even when you raise your arms above your head. Remember, you are not dressed to kill, but dressed to heal. A patient actually called one of our attendings out for wearing loud, high heeled boots. An embarrassing reminder that we’re dressing for our patients not for each other.

2. Minimize jewelry. Make sure you don’t wear anything too expensive to work especially if you know you’ll have to take it off (e.g. engagement ring gets taken off whenever you put on gloves). Get a safety deposit box if you’re worried about leaving your jewelry at home. Stay away from hoop or dangling earrings. Your stethoscope will pull off the hoops and kids will pull off the danglers. Besides, you’ll get germs on anything that’s not attached closely to your body (e.g. stud earrings).

3. Wear OSHA compliant shoes (no open toe). We know this is especially hard in the summer, when all the high fashion sandals and pedicured feet aching to show themselves. Do everyone a favor and keep your toes covered and save your fashion forward footwear for an evening out with friends.

One of us actually took care of a female healthcare worker who had an IV pole run over their foot and contracted a MRSA foot infection – not fun! As a result, every summer, we are on the hunt for comfortable but good looking pair of “OSHA shoes”- it’s harder to find that it looks! DSW shoe warehouse is a good bet and won’t break the bank. Dansko clogs are also a safe bet and Crocs are now making comfy shoes without holes. Stay away from Crocs with holes which just provide pores for body fluids and needles to get to your feet.

4. Hold off on the fancy manicures. Your nails have to be short and you’ll be washing your hands often. Nail polish does not stand up well to frequent hand washing/Purell.

Vineet Arora is an internal medicine physician who blogs at FutureDocs, and Shalini Reddy is an internal medicine physician.

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