On White Coats and Professional Development: The Formal and the Hidden Curricula

I marveled at the dignified, solemn ceremony that sought to join the materiality of a white coat with the virtues of altruism, accountability, excellence, duty, honor, respect for others, and compassion, and began to puzzle over the multiple and contradictory meanings of professional development embedded in this particular ritual.

Abstract

White coat ceremonies are a recent phenomenon in medical education. Selected as a symbol by the Arnold P. Gold Foundation to impress upon medical students the importance of compassion and humility, the white coat has had a long association with all things medical, scientific, and healing. It is also associated with the attributes of purity and goodness traditionally symbolized by the color white. Thus, its selection as the material focus of the white coat ceremony seems natural. This article situates the white coat ceremony as a curricular event and suggests that, in addition to having the meanings cited above, the white coat has other meanings that fall into the realm of the hidden curriculum--it can symbolize caregiving hierarchies and spheres of practice, the social and economic privilege of physicians, and medicine's well-established practices of determining membership in the profession. Finally, this paper suggests several other ceremonies or rituals that may be better than the white coat ceremony for encouraging compassion and humility in medical students.