I have been studying for my next two board exams. One is an 8-hour computerized behemoth, the other is equally long but involves encounters with simulated patients. When I bring my white coat to the testing center next month, I will have emptied the pockets (no more jingle-jangle), and the proctors will use white tape to cover my name (, PhD) and school insignia. I will be Anonymous Medical Student #12. We are not allowed to talk about the exam ("The first rule of fight club..."), so instead I will leave you the observations I have gathered over the last year about when and why one might (not) want to wear a white coat and its attendant paraphernalia (name tag, pins, pens, pockets full of stuff), as it is by no means a necessary part of the clinical experience.
When you do want to wear a white coat:
- On morning rounds, so you can stash second breakfast in your pockets (yogurt +/- banana +/- granola bar +/- travel mug of tea).
- In the summer when you're dressed for the walk to and from the parking lot, but not for the chilly conference room.
- To warm up in PACU after 3+ hours of surgery--especially if you didn't scrub in. If you scrub in you wear one of those big blue wrap-around disposable gowns. If not, it's just you in your short-sleeved monochromatic pajamas. Students don't get long-sleeved scrub jackets like the staff do.
- For the Step 2 Clinical Skills exam, the first time you're allowed to introduce yourself as a doctor (i.e. as an intern).
When wearing a white coat is equivocal:
- At the pediatrician's office, where the parent sees the coat as a sign of authority, and the child sees the coat as a sign of authority.
- When running an errand outside the hospital on a cool day when you don't have other outerwear on hand. Doff the jacket and hope you're not too cold, or keep it on and look plum out of place?
- When your patient on the psych ward has a long history of bad encounters with physicians.
- While delivering a baby.
- When a father offers to let you hold his newborn son because his arm has gone numb.
- At a summer camp for kids with disabilities.
- When holding down a patient so the surgical resident can place a chest tube at bedside.
- While delivering a Grand Rounds talk on your not-that-kind-of-doctor-al research.
- When a young woman whose mother is about to be taken off life support needs a hug.