Each August, the incoming class of the Duke Physician Assistant Program finishes their orientation week with a ceremony to celebrate the significance of health care's ubiquitous white coat.
Usually, the white coat ceremony is a private event that takes place in the classroom, with faculty advisers symbolically helping students into their white coats for the first time. This year, it took place via Zoom and was live-streamed to friends and family.
In her opening remarks, Program Director Jacqueline S. Barnett, DHSc, MHS, PA-C, stressed the importance of the program's mission.
"The white coat ceremony symbolizes the induction of each of our students into the field of medicine as health care providers. Today we will reflect on the mission and legacy of the program and virtues and symbolism of the white coat. [. . .] At the Duke PA Program, we are very clear about what we stand for. The legacy of this program is built upon our mission, and we continue to weave it into the very fabric of everything we do."
In a recorded presentation, PA program Medical Director Kenyon Railey, M.D., gave a lesson on the background of the white coat and his thoughts on what it has come to represent.
According to Railey, the tradition was started in 1994 by the Arnold P. Gold Foundation and soon spread from medical schools to all branches of medical education.
"Prior to the Gold Foundation's efforts, the white coat has long been a symbol. Depending on the era, it has meant different things ranging from sterility to nobility, safety to responsibility. The white coat, therefore, has many positive associations, but the truth is that for some--especially if you care for children around vaccination time, or perhaps if you have a loved one who is ill, or if you have been involved in activism around initiatives like Moral Monday or White Coats for Black Lives -- the white coat can also symbolize struggle, suffering and loss."
Railey emphasized that students must understand the power of the white coat in order to wear it responsibly.
"[E]ntering a patient or family's illness narrative is an awesome responsibility--even though your coat is just a little shorter than mine as a faculty member--you will quickly see that patients and people trust you more with it on. Wearing it creates opportunities for insights into the intimate parts of total strangers; not just their bodies but also their stories and their psyches, their faiths and their fears. [. . .]
"We also encourage you not to use [the white coat] as an insignia of exclusivity, as a symbol of power or prestige, or as a way to shelter and distance yourself from the fundamental humanity that you are going to encounter. Our hope is that you will instead use your white coats to their highest advantage in your role as a student physician assistant."
While faculty could not be physically present to hold the white coats open wide, the program highlighted each student in turn. The students slipped into their new white coats in living rooms, bedrooms, and kitchens--one of many activities that, while carrying the same meaning, will look different this year.