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Deconstructing the White Coat

William T. Branch Jr., MD
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Emory University School of Medicine; Atlanta, GA 30322 Requests for Reprints: William T. Branch Jr., MD, The Emory Clinic, 1525 Clifton Road NE, 4th Floor, Atlanta, GA 30322.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(9):740-742. doi:10.7326/0003-4819-129-9-199811010-00012
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White coat ceremonies of one kind or another have long marked the entry of medical students into clinical work. As donned by physicians in the late 19th century, the white coat signified the scientific method and the adoption of aseptic techniques. The white coat ceremonies now in vogue emphasize the humanistic values also symbolized by the coat. Adoption of these ceremonies for entering students by 93 medical schools in the United States in 1998 suggests that both students and faculty find the ceremonies uplifting and meaningful. After all, science, medicine, and humanism are intertwined in western history and culture. Yet as we look at traditional ceremonies in medicine from the perspective of today's diverse student body and faculty, we can also see the extent to which elitism and professional hierarchy have been present in the medical profession. It should not surprise us, therefore, that when a thinker like Wear deconstructs the meaning of the white coat ceremony in this issue [1], she perceives a darker symbolism hidden behind the altruism, compassion, and excellence embraced by the ceremony's participants. She questions “whether the ceremony … is the best vehicle through which to encourage compassionate and humble caregiving.” As an alternative to the white coat ceremony, she proposes “first Fridays” on which students would visit community sites, such as free clinics, domestic violence shelters, rape crisis centers, and drug treatment programs. Such visits would give students access to the perspectives of disadvantaged persons.

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