“We couldn’t be more proud.” “You earned this and cannot wait to see you in your white coat.” “Calling dibs on being your first patient.” These are samples of the many congratulatory and supportive comments that family, friends, and Yale School of Medicine (YSM) faculty and staff shared, using the Zoom “chat” function, during the August 28, 2020, White Coat Ceremony for the YSM MD Class of 2024. The in-person ceremony was live-streamed for guests because of COVID-19 related restrictions on the size of gatherings.
While not there physically, members of the audience were very present in spirit—through their “chat” comments and in the remarks of Nancy J. Brown, MD, Jean and David W. Wallace Dean of the Yale School of Medicine and C.N.H. Long Professor of Internal Medicine. Brown noted, “For most of you in this tent, your families are the reason you are here. They have instilled in you a love of education and science, and qualities of compassion and empathy that have led you to choose the profession of medicine. They have nurtured you, encouraged your aspirations, challenged you to reach higher, and supported you when the reach seemed impossible. Many have immigrated or worked long hours to make it possible for you to be here.”
Brown added, “We take a moment to honor our families. You will go on to honor your family through your actions as a physician.”
Traditionally at the White Coat Ceremony students sit side-by-side under a tent, with many guests nearby. And students, one-by-one, are called to the stage, where members of Medical Education leadership help them don their white coats.
This year, 99 of the 100 members of the class did sit under a tent, but they were spaced at least six feet apart. They all wore masks, many adorned with the Yale “Y.” As Brown explained, one member of the class could not be present, and is starting his learning remotely, because of COVID-19 travel restrictions. She also acknowledged 14 Medical Education leaders and student academic advisors who could not attend in person because of the attendance limits.
And while students were called to the stage one by one, they all carried their own white coats, which they put on themselves—with an occasional collar-straightening assist from Brown—before posing for a socially-distanced photo with the dean. YSM Office of Admissions Director Ayaska Fernando, the only member of the Medical Education team to accompany Brown on stage, read the name of each student, along with where they received their undergraduate degree and if they were pursuing an MD-PhD degree.
In her remarks, Brown spoke about the history of the white coat. She explained that in the mid-19th Century, as scientists were discovering the importance of handwashing and aseptic surgical techniques and learning about the germ theory of infection, the white coat was adopted to protect against contamination.
Brown explained that in the latter part of the 19th and early 20th centuries, the white coat came to symbolize the importance of science in medicine. She emphasized how the COVID-19 pandemic reminds us of the importance of science in medicine and stated, “there is unfortunately an anti-science thread in our society today. Scientific skepticism has led to anti-vaccination campaigns that have and will cost lives. As a student under the Yale System, it is paramount that you learn the basic mechanisms of disease and that you hone your curiosity and your critical thinking skills. You will find that the best of intentions, without science, can cause harm. Commit to your patients to be rigorous.”
Brown then spoke of another symbolic meaning of the white coat—medical ethics and professionalism, emphasizing that “just as good intentions without science can cause harm, science and medicine without ethics can also cause injury.” She noted the students were not receiving their white coats on the first day of school, but after they completed their first professionalism course.
Brown then shared advice with the students about the importance of taking time to know your patients by listening to their stories and understanding their family backgrounds, even when feeling tired and overwhelmed. She suggested that if students do this, they will be less likely to objectify patients and will give them the best care. “Your own life will be enriched,” she noted.
Brown also referred to patient care in the context of the stethoscope, the traditional White Coat Ceremony gift from YSM alumni to first-year students. Acknowledging there are now newer technologies, she said, “I challenge you to learn how to use that stethoscope if only as a symbol of listening,” asking them to “pause to remember to think critically and to listen to your patients with curiosity.”
Brown also commended the diversity of the class, whose backgrounds represent cultures from across the country and the world. Once the students had all received their white coats, Brown addressed them as a single unit, asking them to stand so that everyone could recognize the YSM Class of 2024. After the students recited the Human Relations Code of Conduct, Brown delivered closing remarks, including stating “on behalf of Yale University and the School of Medicine, I congratulate the newest class of doctors of Yale School of Medicine. I wish you the best in your education, and pledge on behalf of all of us to be present to you, and we know that you will bring much joy and pride not only to our school, but to your families.”