Outgrowing My Short White Coat

Ryan, Fourth Year Medical StudentMy white coat doesn’t seem to fit anymore.  I haven’t gotten any larger through medical school, so it’s not that.  My wrists stick out at the sleeves, the hem rests roughly at my hip bones, and the pockets are up so high that putting my hands in them makes me look like I’m doing the Chicken Dance.  But it’s always been that way, and that’s not what I’m referring to.

I know what orders I should write, but I can’t write them.  I can write a fantastic progress note, but it doesn’t go in the chart.  Nurses ask me management questions and I know the answer, but I have no authority to give the answer.  I can form an air-tight assessment and plan, but no one can bill for it.

It seems I have outgrown my short white coat.

It didn’t used to be this way. I remember trying on my first white coat, on the first day of medical school, in that little room underneath the Dean’s Office. It was perfect, a pristine symbol of learning, of caring, of healing. And it didn’t fade for awhile. I loved physical diagnosis labs, freshman ward experience, and continuity clinic during first and second year. I looked up to the third and fourth year students in their white coats, which were actually embroidered with their names. They would come in to Centennial Complex for their OCSE practical exams, and I knew that they were stepping back into the simulator from the real thing, the opposite of what I was doing.

And at the end of second year I picked up my two brand new, pressed, embroidered, personalized white coats, ready to start clinical rotations. That was an even more meaningful symbol for me than the original white coat. I had arrived. After two years of basic science study, I was actually learning how to take care of patients. It felt good to put on that white coat and to wear it around. It meant something.

Now, that symbol is old. I don’t like wearing my short white coat anymore. I feel like it’s holding me back. I’ve done all of my clinical rotations, been in the surgeries, learned the operative indications, repaired the lacerations, counseled the patients, and passed the exams. I’ve matched into an orthopedic surgery residency. Now when I put on my white coat, it feels way too short.

It’s not that it’s bad to be a student; I couldn’t have gotten to this point without going through it. And it’s not that it’s bad to have a short white coat; I could only learn how to be a resident by being a student. It’s just that I’ve outgrown it.

And that’s the way it should be.