White Coat Ceremony
The White Coat Ceremony (WCC) is a relatively new ritual in the USA that marks entrance into medical school and now also pharmacy school. It originated in Columbia University's College of Physicians and Surgeons in 1993 [1] and involves a formal "robing" or "cloaking" of incoming medical students in (laboratory) white coats, the garb physicians have traditionally have worn for over 100 years. [2]
WCCs typically address the issue of medical ethics and praise the incoming students for their success in gaining admission to medical school [1], the first step to entering the profession of medicine and often a significant accomplishment. Family and friends are typically invited. Over 100 medical schools in the USA now have a WCC and many students now consider it a rite of passage when entering medicine.
The ritual is thought to reflect the American tradition of pledging allegiance to the flag [3]. According to some, it has taken on a quasi-religious significance, that symbolizes a "conversion" of a lay person into a member of the medical profession and is similar to a priest's oath to priesthood.
The Spread of White Coat Ceremonies
Since starting in the USA, several medical schools in countries outside of the USA (Israel, Canada, UK) have also started holding WCCs. Starting in 1995, US pharmacy schools started holding WCCs. In 2003, a survey found that the majority of US pharmacy schools hold WCCs. [4]
Criticisms of the White Coat Ceremony
Some have criticized WCCs as events of congratulation and self-congratulation and have suggested that WCCs underline the significance and power associated with the white coat, while de-emphasizing the responsibilities and obligations of the physicians which wear them. A number of critics believe WCCs create a sense of entitlement to trust and respect that is unhealthy and in turn may foster an elitism that separates patient from care giver.[5,6]
References
1. Huber SJ, "The white coat ceremony: a contemporary medical ritual." J Med Ethics 2003;29:364-366. http://jme.bmjjournals.com/cgi/content/full/29/6/364
2. Jones VA, "The White Coat: Why not Follow Suit?" JAMA. 1999;281:478. http://jama.ama-assn.org/cgi/content/full/281/5/478
3. Sritharan K et al., "Medical oaths and declarations." BMJ 2001;323:1440-1441. http://bmj.bmjjournals.com/cgi/content/full/323/7327/1440
4. Brown DL, Ferrill MJ, Pankaskie MC., "White coat ceremonies in US schools of pharmacy." Ann Pharmacother. 2003 Oct;37(10):1414-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14519030
5. Russell PC., "The White Coat Ceremony: turning trust into entitlement." Teach Learn Med. 2002 Winter;14(1):56-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11865752
6. Veatch RM, "White coat ceremonies: a second opinion." J Med Ethics 2002;28:5-6. http://jme.bmjjournals.com/cgi/content/full/28/1/5