The white coat symbolizes 2 important commitments

A white coat ceremony address to the University of California, Riverside School of Medicine, August 4, 2017.

“It takes a village” is one of my favorite proverbs, an African proverb, that resonates with each of us on this monumental day. There is without a doubt that every one of you worked very hard to get into medical school. However, this difficult journey was supported by dozens of important individuals: teachers, professors, counselors, advisors, mentors, family members and loved ones.  Let us also remember our communities and thank the countless strangers who shaped who we have become. Let us bring our village, pueblo, or city and these great individuals into the room for today’s white coat celebration.

Congratulations to each of you on accomplishing such an exciting milestone in your medical careers! Those trying pre-medical years are over; and as each of you walks across the stage to receive your white coat today, your journey as a medical student and doctor in training begins.

I began medical school in 2002 and completed my medical training, including residency and fellowship, in 2014. More than a decade of medical training. I mention this because my parents are in the audience and like many of our family members- they began to ask me to diagnose and treat their medical problems well before I become a “real” doctor.

But mom and pop, I’m only a first year … then second year … and so on … and they soon lost track of all the years I was in school.  They did, however, keep track of all the loans piling up.  They also began to ask me when I would finish. When I would get a real job? When I would pay my bills? Are you really going to be in school forever? I mean no offense to my family or anyone who will ask you these questions.

As the first in my family to go to college, medical school and beyond, I learned to appreciate the journey, not only as “mine,” but instead as “us.” A family journey where “are we there yet?” can at times be annoying, funny, and just a great reminder of how special of a journey we are on. As I reflect more on my life and the privileges we receive in becoming physicians, I better appreciate the need to embrace a growth mindset, one where you truly believe you can grow, improve and continue to learn no matter what. Sharing this growth mindset with friends, loved ones and our community has allowed us to grow stronger together. This growth mindset will allow you to stay focused and not lose sight of the investments needed in cultivating great physicians for our communities.

As a physician and physicians in training, we share and will continue to share so many life experiences. It is an honor and privilege to welcome you to this demanding, humbling and greatly rewarding journey.

The white coat ceremony officially began in 1993 by Dr. Arnold P. Gold at the Columbia University College of Physicians & Surgeons to introduce medical students to the Hippocratic Oath before beginning medical school. The white coat ceremony is an important ritual that welcomes students, families and their mentors to the practice of medicine, and elevates the value of humanism as the core of health care. The white coat ceremony is a rite of passage. This rite of passage is symbolic and a constant reminder of our professional duties to our patients and communities. Your white coat is a constant reminder, as prescribed by Hippocrates, to lead honorable and righteous lives.

Our white coats symbolizes the:

  • Transition to a scientific approach to medicine
  • Commitment to our patients
  • Commitment to each other, as colleagues
  • Commitment to our faculty, staff, advisors and mentors
  • Commitment to our families
  • Commitment to our communities
  • Commitment to ourselves

Today, I will focus on two of these critically important commitments.

Commitment to our patients

While the short length of the white coat is a long-standing tradition used to identify the role of a medical student, our patients will remind us otherwise. You will play a vital role in the care of your patients. Your team and patients will depend on you.

This reminds me of my time in medical school when I was on-call late into the night caring for Maria. Maria had advanced breast cancer with many complications, and we would care for her until she took her last breath. When I first began to care for her, I was afraid to tell her I was a medical student. She sensed my lack of self-confidence. I would nervously share with her after every encounter that I was just a medical student. Maria was gentle. I went on to form a special bond with Maria and her family. And they made it a point to let me know that I was not just a medical student, but a doctor, a great doctor in training. As a professor in medicine, this is an early lesson I share with my students. You must embrace your role as a medical student in the classroom, and one of a student doctor when caring for patients.

Commitment to each other

Your white coat will signal to your colleagues the path you have chosen. It’s a symbol of togetherness in the struggle to improve health and to prevent, treat and cure disease. But you must not forget the togetherness in this journey. Your commitment to each other will seem impossible when you begin to study, and study more, and then study some more. I ask all of you to always remember your commitment to each other every time you wear your white coat. Support each other through times of struggle and success.

One of my mentors, Dr. Jorge Garcia, during residency helped me better appreciate the limitations of our white coat. As we cared for patients, he would ask if our white coat made us invincible to the challenges that our patients face. He would make it clear that while we had the privilege of caring for others, and we also had to care for ourselves. So, do not feel bad when your loved ones ask you if you had enough to eat. Or they check on you to make sure you are doing OK. Cherish this care and seek out support regularly.

Our white coats are not only symbols but also have some important practical uses. For example, carrying your diagnostic equipment: stethoscope, penlight, reflex hammer. They also serve as a repository for all your notes and important information- your time capsule for each patient, each rotation. Most importantly, these white coats will get increasingly soiled and will need to be washed, a good washing and good pressing.

While at first, you may not want your loved ones to wash your white coat, I am sure some of you will be more resistant than others. The washing of our white coats can be an opportunity for our loved ones to catch a glimpse of our lives. It may not be the best opportunity, but nonetheless and opportunity for your loved ones to wash your coat and relive your commitment to human kind and to relive today’s celebration. The washing of your white coat can also be an opportunity to ask you questions about your journey, and most importantly share in your struggles, challenges, and growth.

As we profess today’s oath, in front of our families and communities, we acknowledge our central obligation of always caring for patients with compassion and excellence.

Let me leave you with an important reflection adapted from one of my favorite writers, Junot Diaz:

“Everyone is telling you to hurry, while our patients are telling us to take our time. Always listen to our patient.”

Efrain Talamantes is an internal medicine physician.  He can be reached on Twitter @TalamantesDr.

Image credit: Shutterstock.com

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