The White Coat Ceremony and its effect on medical students

by Timothy Dempsey and Pamela Savitz

Last month, the National Football League inducted seven of its all-time great players into its Hall of Fame in a ceremony filled with nostalgia and memories of legendary careers long-finished.

While this was going on, there was another type of induction ceremony taking place around the country. Yet, these celebrations lacked recollections of past achievements by retired legends finally receiving their due. There weren’t even any bronze busts awarded to the participants (although that would have been awesome). No, this ceremony was less about past accomplishments and more about future potential as physicians.

I speak of course about the White Coat Ceremony, an event put on by medical schools around the country to indoctrinate its new students into the world of medicine by providing the students with the ultimate symbol of doctoring, the white coat.

For many students, dreams of putting on the white coat begin the day they are accepted into medical school. This coat finalizes our hard-fought journey toward gaining admittance as years of constant, rigorous work have finally paid off; all of the pre-requisites of high school, SATs, college, MCATs, AMCAS, and every other acronym you can think of are behind us; and becoming a doctor seems to be in sight at last. These feelings accurately describe the way I felt in preparation for receiving my white coat. Yet the moment I actually put on my coat, I could not have taken it off fast enough. This weird feeling of apathy toward my “dream coat” left me terribly conflicted. Yes, this was one of the most exciting moments of my life, something I had looked forward to since 6th grade. But just because I get a shiny (and absurdly short) white coat doesn’t mean I automatically become a doctor. No, my classmates and I will not receive our true indoctrination into the world of medicine until we have created our own experiences: interviewing our first patient, pulling our first all-nighter, and witnessing our first death. Perhaps then I will feel less awkward in my white coat and more at home as a physician in the making.

Conversely, not every first year medical student in the country receives a white coat to start. A number of schools around the country take different approaches toward welcoming their students into the medical world. These institutions subscribe to the belief that students must earn the honor of having a white coat bestowed upon them. My fellow blogger, Pamela Savitz, is at one of those medical schools and shares her thoughts below:

“As a first year student at a different medical school, I must complete my first two years comprised of rigorous study before receiving a white coat, a symbol of the transition to the clinical world. At first, I was somewhat disappointed in the notion of having to wait, but hopefully I can feel much more at ease and at home in my coat when that day comes. The incentive to succeed now has some tangible reward, one that will visibly distinguish me as a medical professional.

Unlike Tim’s ceremony, I experienced an initiation to the medical world and medical school quite differently. Occurring at the end of our week-long orientation in August, my induction ceremony symbolized the transition from freshly accepted students to official doctors in training. During our ceremony we eagerly stood in front of our dean, who proudly placed upon our shoulders not a white coat, but instead, a stethoscope. Afterward, the class recited the pledge of honor that declares our loyalty and passion toward medicine and patients, along with our professional and academic duties as students. I must say it initially seemed quite corny, but while I was reciting the oath with my 114 classmates, I felt a strong sense of unity – we were all facing the journey ahead together. Any fears I had about classes, practicing medicine, and lacking the proper skills an excellent physician should demonstrate, were all momentarily set aside. We were one step closer and just a little bit more prepared now that we felt the weight of the stethoscope resting on our shoulders.”

A few days after the white coat ceremony and hearing Pam’s story, I found myself thinking back on my ambivalent feelings toward what should now be considered my prized possession. I realized then that these feelings were not so much a reflection of the ceremony or the white coat itself, as I was very grateful toward my school for giving us such a wonderful welcoming party. No, my real issues were with my anxieties about starting medical school, my fear of failing to become a great physician, and myself. Upon further reflection, the apathy I felt toward my white coat was really directed toward my own fear that I will be unable to fill it well enough.

This realization brought me back to the NFL Hall of Fame inductees and the fact that they were honored for their incredible, yet long crafted skills. At the start of their careers, the same talent that would eventually lead them to Hall of Fame greatness probably seemed unattainable and reminded them of their inadequacies, just as my induction ceremony reminded me of my own. Remembering that every great player has to start somewhere reminded me that every physician starts out just like Pam, my classmates, and I – as a scared student staring up at a seemingly impossible task – a 4th and long if you will- with nothing protecting us but a short white coat.

Timothy Dempsey is a medical student who blogs at Playing Doctor: The Journey From Med Student to MD, and Pamela Savitz is a medical student.

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