The White Coat Ceremony marks the official entry of matriculating AUC students into medical school. The ceremony signifies the start of a medical student’s journey to become a physician. At AUC, we hold three white coat ceremonies annually to welcome incoming students in the fall, winter, and spring.
Medical schools across the United States commemorate students’ entry into the medical profession by presenting them with their first white coat—a short version of the long coat they’ll wear as a physician. Although the ceremony itself is a relatively recent tradition, the symbolism of white coats in medicine dates back over a century. Let’s take a look at how white coats have come to symbolize a physician’s dedication to their profession.
THE HISTORY OF THE WHITE COAT
Before physicians dressed in white coats, most physicians in the Western world wore black, according to the American Medical Association’s Journal of Ethics. Until the late 1800s, physicians in the United States wore black formal wear—similar to a modern-day tuxedo. Thomas Eakins’ masterwork The Gross Clinic, painted in 1875, shows Philadelphia surgeons in natty black attire performing thigh surgery.
Revolutionary advancements in medicine and scientific research in the late 1800s transformed medicine and medical education. Before germ theory ushered in the era of modern medicine, Western medicine wasn’t strongly rooted in scientific theory. There was little professional oversight until the AMA was founded in the mid-1800s.
Scientists and physicians first started wearing white lab coats in the late 1880s. Some historians suspect that the appearance of white coats coincided with Joseph Lister’s discoveries in antiseptic surgery and germ theory. By 1889, Thomas Eakins’ painting The Agnew Clinic showed Philadelphia surgeons in white coats.
As medical schools adopted a rigorous and standardized curriculum based on science, historians believe that licensed physicians embraced the white coat to differentiate themselves from doctors without formal credentials, homeopathic practitioners, and quacks peddling potions. By 1915, almost all licensed physicians in the United States wore white coats.
THE WHITE COAT CEREMONY
The White Coat Ceremony for incoming medical students began in 1993 when Dr. Arnold P. Gold instituted it at the Columbia University College of Physicians and Surgeons in New York. Dr. Gold initiated the practice because he believed that medical students should recognize the profession’s standards and responsibilities before they began formal training. He said students should declare their commitment and accept their obligation to the profession before starting medical school.
Now, the White Coat Ceremony takes place in 20 countries, including at nearly all AAMC-accredited U.S. medical schools. The Gold Foundation funds the program through grants.
At the AUC White Coat Ceremony, incoming students typically receive their first white coats from AUC faculty as family and friends cheer them on. The entire incoming class then recites the Oath of Physicians, a modern version of the Hippocratic Oath. During the COVID-19 pandemic, AUC is holding virtual ceremonies.
Most medical students wear short, hip-length white coats until they enter residency when coats reach down to the knee. The short length of the white coat worn by medical students and the full-length ones worn by most physicians is a long-standing tradition and a way for patients to identify the role of each care provider, according to Dr. James Feinstein, author of “Short White Coat.”
WHITE COATS AND PATIENT PERCEPTIONS
In a study of 4,000 patients, researchers at the University of Michigan found that a doctor’s clothing impacts how patients view their physician and how satisfied they are with their care. The study asked patients their perceptions of doctors in white coats compared with doctors in scrubs and those in business attire with no white coat. Three-quarters of patients ranked doctors in white coats as the most caring, trustworthy, knowledgeable, and approachable, followed by 20% preferring physicians in scrubs, and only 5% choosing doctors in business suits.
Not every physician or medical institution agrees that white coats are the best fashion choice, according to the American Academy of Medical Colleges. Many psychiatrists and pediatricians avoid white coats because their patients find them threatening. Mayo Clinic asks its physicians to wear business attire because the institution believes that the dress code breaks down barriers between doctors and patients.
Also, there have been multiple studies on “white coat syndrome,” which was first reported in 1896, around the time doctors started wearing white coats. White coat syndrome is characterized by anxiety that escalates a patient’s blood pressure when they see a doctor. However, the anxiety can be caused by many factors—including fear of bad health news—and could have little to do with the color of their doctor’s coat.
Regardless of whether a physician decides to wear a white coat after medical school, the symbolism and excitement of the White Coat Ceremony will remain a hallmark of your medical journey. Get started on your path to earning a white coat by applying to AUC.
Join us for AUC’s White Coat Ceremony on February 5, 2021, honoring the January 2021 first-semester students. Learn more by visiting our White Coat Ceremony events page.
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