Requiem for the White Coat & Other Things Past

October 2026 | Vol. 70, No. 3
By Katherine E. Galluzzi, DO, WVSOM '84

The end of summer is synonymous with back-to-school. Shorter days and cooler evenings bring reminiscences of our own autumn rituals: new textbooks (now electronic), notepads, pens and pencils, a new pair of shoes (saddle shoes, loafers? Nope – sneakers).

Medical school initiation rituals include orientation, signing up for clubs, establishing study groups, and, of course, The White Coat Ceremony. PCOM’s White Coat Ceremony took place on August 7, 2026, at the Drexelbrook Event Center for the 270 first-year medical students and their families. The PCOM Physician Assistant program held its white coat ceremony for the class of 2026 at the same venue on August 17, 2026.

I don’t remember my white coat ceremony. That’s because, as PCOM Provost Dr. Ken Veit reminded the assembly at Drexelbrook, the tradition originated in 1993 at Columbia University’s College of Physicians and Surgeons at the behest of the Arnold P. Gold Foundation; I graduated in ‘84. Dr. Gold’s “white coat” vision was a response to concerns at the time that medical education was relying more and more on technology at the expense of connecting with patients. (Sound familiar?) The white coat was meant to symbolize professionalism, empathy, and trust.

My first white coat was short, blazer-length, to signify that I was an “extern” (OMS-3/4 terminology came later). I was required to purchase it from the bookstore prior to my clinical rotations. It wasn’t until my intern year (now PGY-1) that I was given my first long white coat, signifying that I was finally a physician. It was our own responsibility to have our names embroidered over the left breast pocket. What a thrill to see your name in flowery blue cursive followed by the hard-won credential, “D.O.!”

That long white coat had plenty of pockets to accommodate the tools of the trade: portable Welch Allyn oto-ophthalmoscope, Littmann cardiology stethoscope, and my prized neurologic hammer, which was a stainless steel and rubber tomahawk onto which my father had etched our last name. Pens, penlight, tongue depressors, and index cards (ersatz chart notes) fit nicely into the top left-hand pocket. And as Dr. Mike Becker, PCOM Dean for Clinical Education, pointed out to the class of 2030, some long white coats had inside pockets so you could carry even more stuff. He reminded us of our treasured, pocket-sized reference, The Washington Manual, as well as The Scut Monkey’s Handbook. And let’s not forget the ubiquitous Obstetrical Wheel, laminated Kidney Card, or the latest ACLS Guideline cards. Most valuable (to me, anyway) was the small blue plastic-bound 3-ring binder with my initials in gold lettering on the cover where I jotted essential knowledge and took notes from visiting lecturers on Grand Rounds. I came to think of that little blue book as my “blue brain” – always handy for recalling how to calculate creatinine clearance using the Cockcroft-Gault equation or checking ranges for normal lab values.

Yep. This proves it; I am a dinosaur. No one needs any of those values encoded in a notebook any longer because it is all at one’s fingertips! To wit: “Siri, what is the ICD-10 code for Senile Flatulent (aka ‘old fart’)?”

Medicine has irrevocably changed, and just as the EMR has replaced paper charts, ultrasounds and cardiac MRIs have replaced abdominal exams and cardiac auscultation. No one has a pocket ENT kit anymore, and few, if any, medical students carry reflex hammers. Which begs the question: can they do a full, focused neurologic exam without first consulting Sketchy? Let’s hope so! It is our job as mentors to show them the value of physical examination so that when they type “WNL” it means “within normal limits” rather than “we never looked.”

As I look around at residents and young attendings, it is clear that THE WHITE COAT is becoming a dinosaur, too. Professional apparel now consists of scrubs, sneakers, and in many cases, clothes that I would refer to as Athleisure. The white coat has been replaced with the ubiquitous Patagonia zip-front jacket. Dr. Becker used to admonish the incoming freshmen upon receiving their white coats to “keep it clean.” This year he mentioned to the 2030 class that his daughter, Claire, a PM&R PGY-4 resident at Mt. Sinai in Manhattan, recently told him that “No one wears a white coat anymore, Dad.”

I remember watching in horror as my own daughter Claire, prior to leaving for her residency, efficiently sliced her embroidered name out of every white coat before she tossed them in a bag to donate to Goodwill. “I don’t need anyone masquerading as me!” she explained. (BTW, congratulations to our Claires!)

At the August 7th ceremony, I spoke with several members of the class of 2030 to see how they felt about the event and what the white coat meant to them. I quote several of them here:

Makayla Egolf said, “One small coat, one big step towards the rest of our lives!” Kayla McHugh, who was doubly celebrating, said it was “the best birthday gift ever!”  Ashley Sabia & Emma Marshall shared the sentiment that it was “the moment we have been waiting for,” and Logan Marshall said, “Excited for it to begin! Can’t wait for it to be over . . .”

(I couldn’t help but notice how many women are present in the PCOM class of 2030, which is now over 50% female. One small step for feminism, one giant step for medicine – IMHO, that is.)

OMS-1 Andrew MacWilliams added, “This is the most expensive coat I have ever bought!” That was prior to POMA President Dr. Angela Zawisza’s well-wishes to the class, in which she reminded them that the new white coats they received that evening were gifts from the POMA Foundation. She hoped that they would remain involved with the state osteopathic association whose “letters are embroidered on the sleeve of your coats.”

Tradition and ritual aside, the white coat has utility for reasons other than storage of “tools”, not least of which is that it kept your professional wardrobe free of – well, you know – unwanted substances. But we are now in the era of scrubs – not only in the OR, but in every clinical setting. If you were hospitalized, you used to be able to discriminate between the “orderlies” (how’s that for an obsolete term, huh?) and the attendings. But no more. Everyone wears comfy scrubs with embroidered zip-ups, the now ubiquitous “Pata-Gucci.”

Yep. The days of professional medical attire layered with a clean white coat are gone, except for us elderly flatulents.  May ye rest in peace, White Coat.