White coat ceremony

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The white coat ceremony (WCC) is a relatively new ritual in some medical schools and pharmacy schools that marks a medical student's or student pharmacist's transition from the study of preclinical to clinical health sciences. At some schools, where students begin meeting patients early in their education, the white coat ceremony is held before the first year begins. It originated in Columbia University's College of Physicians and Surgeons in 1993Huber SJ, "The white coat ceremony: a contemporary medical ritual." J Med Ethics 2003;29:364-366. Full Text. and involves a formal "robing" or "cloaking" of students in white coats, the garb physicians have traditionally worn for over 100 yearsJones VA, "The White Coat: Why not Follow Suit?" JAMA. 1999;281:478. Full Text. and other health professions have adopted.WCCs typically address the issue of medical ethics and praise rising 3rd year students for their success in completing the basic science portion of medical school. A reading of the Hippocratic Oath is common, and 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 in the journey toward a medical career.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 ordination to priesthood.

The spread of WCCs

Since starting in the US, several medical schools in other countries outside of the USA (such as Israel, Canada, UK, Dominican Republic and Poland) have also started holding WCCs. The ceremony is no longer limited to medical students; starting in 1995, US pharmacy schools started holding WCCs, and in 2003 a survey found that the majority of US pharmacy schools hold WCCs.Brown DL, Ferrill MJ, Pankaskie MC., "White coat ceremonies in US schools of pharmacy." Ann Pharmacother. 2003 Oct;37(10):1414-9. PMID 14519030.

Criticisms of the WCCs

Some have criticized WCCs as events of self-congratulation and self-promotion 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 who 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 caregiver.Russell PC., "The White Coat Ceremony: turning trust into entitlement." Teach Learn Med. 2002 Winter;14(1):56-9. PMID 11865752.Veatch RM, "White coat ceremonies: a second opinion." J Med Ethics 2002;28:5-6. Full Text.

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