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The meaning of the white coat ceremony

The Utah Physician Assistant Program (UPAP) at the University of Utah is part of the Department of Family and Preventive Medicine, which is my home department. Many colleagues and friends work there, and they have led health sciences for decades in diversity, equity, and inclusion. To this day, the PA program has more student diversity than any other program in health sciences—and its accomplishments have been documented in the medical literature, in a publication that has already been cited multiple times. I was recently honored by the program leaders with the opportunity to address the UPAP students at their white coat ceremony, which, coincidentally, is always held on the first day of school. I have captured those remarks here, and I hope that these words are inspiring to you.

Darin Ryujin and José Rodríguez with newly coated PA student Gabriela Hernández.
Darin Ryujin (left) and José E. Rodríguez (right)
with newly coated PA student Gabriela Hernández.

I am pleased and honored to address the class of 2025 on this most momentous occasion. I am a family physician, so I work very closely with talented physician assistants, most of whom are graduates of this program. Your presence enriches our practice, and we are happy to have stellar physician assistants on our team. 

Today we will be coating each one of you with a white coat—a symbol of our career as healthcare professionals. The white coat ceremony was established in 1993 by the Arnold P. Gold Foundation. On their website, they say, “The iconic ritual provides an important emphasis on compassionate, collaborative, scientifically excellent care.” It was not that long ago that health professions students were just given their coats in a bag with all of their books on the first day of school. I remember because that is exactly how I got my first white coat. They also asked me to iron the school logo onto the shoulder—as you can imagine, that did not go so well. We have come a long way since then! 

In fact, a white coat is what unites most healthcare professionals. Today, colleges of nursing, pharmacy, dentistry, and medicine perform annual white coat ceremonies to welcome new learners into the clinical portion of their training. It symbolizes our shared mission to provide the best healthcare to those who need it the most. But [the white coat] can, unfortunately, also be a barrier and cause of anxiety for patients. The white coat was never designed to separate us from our patients, so as we go through the ceremony today and as you move through your career, remember that it is a symbol of unity with each other and with our patients, and you can use it for that purpose. 

The University of Utah Physician Assistant Program is a magnificent program—it is the highest-ranked program within the Spencer Fox Eccles School of Medicine and occupies the number two position in public institution PA program rankings nationwide. Your class is the most diverse of any class we have matriculated—and your diversity expands beyond gender, race, or ethnicity. Many of you come from rural areas, from immigrant and refugee backgrounds, or from economically and educationally disadvantaged backgrounds. Yet you have overcome. We chose you, especially for who you are, and are honored that you chose us for your PA education. We were impressed by your commitment to vulnerable communities and your desire to end health inequities. We will help you realize those desires. 

Donning the white coat is also a symbol of taking on a new professional identity. As you can imagine, in my job, I work with the highest-ranking officials in our health system. They are wonderful people who have your best interests at heart, and they are the ones who set culture. They care about your identity. Dr. Good, the dean of the School of Medicine has told me on more than one occasion: “Culture is shared values exhibited with daily behaviors.” In other words, we show our culture by how we behave. I have worked in many medical schools and many health systems. Like every health system, we are committed to providing the best care available to our patients—the best care, anywhere, if you will. But there is a secret that few will tell you about us that is a major factor in how we have led the nation in quality over the last decade.  

This is the secret: we provide the best care for our patients because we care about each other. Period. We care for all of those who work with us, whether it be students, residents, environmental services, food services, etc. I repeat, we care about each other.  

When you put on this white coat, you agree to care for your fellow healthcare team members. At a time when compassion is waning and burnout is threatening to consume all of us, remember to care for those who are in this work with you. Caring for your colleagues will make your work more joyful and will help to heal a profession that is suffering from the effects of the devastating COVID-19 pandemic.

As is customary, this is an opportunity for me to give advice. 

  1. First of all, trust your colleagues. They are as smart as you and will become your lifelong friends. They will help you get through this, and you will help them. You are not in competition with them. Learn from them and teach them. I learned more about treating Puerto Rican patients from my Puerto Rican classmates than from anyone else. Diversify your inner circle. Now is an excellent time to find people who aren’t exactly like you to study with. It will help you fill in your knowledge gaps, and you will help them with theirs. 

  1. Treat your schooling as your job. Study as much as you can, but take some time to take care of yourself and spend time with those you love. 

  1. Take this time to adopt your “better self.” For some of us, this may mean examining and eliminating our racial and gender biases. For others, it means becoming more of a collaborator. For all of us, it means adopting the identity of a University of Utah PA Student. A University of Utah PA student is kind, compassionate, friendly, nice, skilled, just, merciful, anti-racist, anti-sexist, inclusive, and outstanding. These qualities existed in you before you came here. Make sure others see them. 

  1. Practice gratitude. When you were accepted, you were given an opportunity to positively affect the lives of your patients and your fellow students. You were chosen because of your accomplishments. Be grateful that you got this far. As gratitude sets in, it will make the difficult times ahead a little less painful. 

  1. Take time out to serve. Learn who needs your help the most. Love them. Commit to serving them during and after PA school. Remember that providing needed service does just as much for you as the provider as it does for the patient. 

  1. Go outside. You are surrounded by some of the most beautiful terrain in this country and on this earth. Appreciate it. Experience it. And then get back to studying. 

Today is your first day with your white coat, and tomorrow will likely be your first day wearing it as you learn in the clinical space. I encourage you to live your profession in a way that honors the trust that your patients and your colleagues have put in you.  

And I personally welcome you into this important phase in your education. I know that it seems scary and overwhelming at times, but know that we have your back. We will teach what we know, and we will—believe it or not—learn from you. I want to thank you for allowing me to address you on this most important occasion. I look forward to working alongside you to forge a better healthcare system that eliminates health inequities!

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José E. Rodríguez, MD, FAAFP

May 25, 2023 7:29 AM