Lab coats in med school?

[medhopeful64]

Just wanted to ask a quick question to all the med students here - do you guys need lab coats/lab goggles? I just wanna know if I should bother keeping mine or try to sell it (or if they would even let me use my own from first year chemistry). thanks!

[Karma]

In my school, you need a lab coat for anatomy labs, not the glasses though.

[rmorelan]

Just wanted to ask a quick question to all the med students here - do you guys need lab coats/lab goggles? I just wanna know if I should bother keeping mine or try to sell it (or if they would even let me use my own from first year chemistry). thanks!

 

We did need the coat - glasses are optional but at time can be useful in the anatomy lab (enough said)

[medhopeful64]

In my school, you need a lab coat for anatomy labs, not the glasses though.

 

We did need the coat - glasses are optional but at time can be useful in the anatomy lab (enough said)

 

Oh ok, thanks for letting me know! i guess I shall keep my 1st year chemistry lab materials! thanks guys

[rmorelan]

ok, as of this year the glasses are not optional for the anatomy class at western

[shannn]

Anyone know where I can get a lab coat for cheap (i.e. under $20)?

 

I, well...let's just say I don't have a lab coat anymore.

[cgardiner]

Anyone know where I can get a lab coat for cheap (i.e. under $20)?

 

I, well...let's just say I don't have a lab coat anymore.

 

The chemistry department in my school has a store that sold them for $21 each. I'd check your chem department.

[Wut?]

You'll need a labcoat during clerkship. Keep it.

 

Some places, like Mac, make students wear short white coats. It's a stupid, denegrating tradition that needs to be stopped. Nurses can wear long white coats. So can everyone else. But not med students. They're beneath all of the unionized ancillary staff....pardon my rant.

 

Obviously, I am going to medical school to wear a long white coat. Why else would I do it

[The Ace of Spades]

Obviously, I am going to medical school to wear a long white coat. Why else would I do it

 

Remove yourself from the teat of sanctimoniousness and think about the big picture.

 

You're probably pre-med, or at the most a pre-clinical medical student. Until you get out there and see how things are in practice, you have no clue what you are talking about. The quicker you realize this, the better.

 

I'm usually pretty bad at detecting online sarcasm, but I'd bet money that's what Wut was doing.

[The Ace of Spades]

Anyone know where I can get a lab coat for cheap (i.e. under $20)?

 

I, well...let's just say I don't have a lab coat anymore.

 

Most university bookstores should carry them somewhere too. Or, if you want a REALLY cheap coat, check out the chemical supply store - usually by the chemistry or biochemistry departments. They do dry cleaning of lab coats for the entire university, and they have tons of unclaimed coats every week that's usually up for grabs...

[cheech10]

Remove yourself from the teat of sanctimoniousness and think about the big picture.

 

You're probably pre-med, or at the most a pre-clinical medical student. Until you get out there and see how things are in practice, you have no clue what you are talking about. The quicker you realize this, the better.

 

Sensitive about the short coat? Maybe you'll rethink this later on, when you see med students for what they really are: trainees, who are allowed to work with patients to learn medicine, and not an integral part of the medical team like nurses and allied health staff. So I don't see the issue with having them wear a different coat (disclosure: my med school did not have short coats for med students, so maybe I wasn't exposed to the terror of wearing a coat that exposed my thighs).

 

But what's the big deal with coat length, or white coats at all? I've seen only a few attendings actually wear white coats, same with senior residents. Wearing a coat is pretty much just for the advanced practice nurses and the pharmacists where I work. I haven't worn a coat for years, since I was a 1st year resident. I guess it was useful in the day when people carried a lot of books and equipment around, but now I've got more handbooks on my smartphone, and the only equipment I carry are a stethoscope and (more importantly) a pen. Anything else you can find around the clinic or ward, generally, or if you really want to carry stuff, a small messenger back does the trick and is pretty unobtrusive.

 

What makes me a physician rather than one of the allied health staff is the way I practice medicine, not the uniform. None of my patients has ever mentioned the lack of a white coat to me or my colleagues.

[thebouque]

Some places, like Mac, make students wear short white coats. It's a stupid, denegrating tradition that needs to be stopped. Nurses can wear long white coats. So can everyone else. But not med students. They're beneath all of the unionized ancillary staff....pardon my rant.

 

Keep in mind than nurses are full fledged healthcare practionners and are arguably more useful in the team than the clerkship student. I do agree though that this whole long coat short coat thing is ridiculous.

[itimebomb2]

Many if not most doctors don't wear white coats at all anymore. Evidence has shown that they're cesspools for infectious disease. Not to mention they never fit quite as sexily as they do on TV, so most people look like dweebs in them.

 

I wouldnt keep my first year lab coat - the ones you get in med school (for free, I think, at least at Mac) have the med school logo on them and are therefore cooler. If you're lucky enogh to be able to get cash for a used coat/goggles, definitely part with them.

[A-Stark]

Many if not most doctors don't wear white coats at all anymore. Evidence has shown that they're cesspools for infectious disease. Not to mention they never fit quite as sexily as they do on TV, so most people look like dweebs in them.

 

That's true in community practice or something like peds, but not in adult hospitals... not at all.

[cheech10]

That's true in community practice or something like peds, but not in adult hospitals... not at all.

 

Don't know what adult hospital you're talking about, but I see ~10% of the staff at Sunnybrook in white coats (mostly the older physicians), and it's one of the largest adult hospitals in the country. In the ICU where I work, white coats are not allowed at all due to the infection transmission rates. Few of the staff at the other Toronto hospitals wear white coats either.

 

Public perception is half of what medicine is.

 

If everyone wears the long coat, then doctors lose their classic uniform and what it represents. In the past, the white coat represented medical expertise and professionalism. It was a sign of respect to patients, a way for them to know they were in good hands, and the patients respected the medical profession in return.

 

Studies have shown that patients are most at ease when physicians are wearing the white coat, regardless of the quality of medicine that is practiced. So the white coat does indeed have a function, same as how a military uniform has a function, or a business suit, or a priest's collar etc - It is to represent an profession through a uniform.

 

I don't know about you, but a lot of what I saw in medical school and even in residency is other health professions trying to put doctors "in their place". The short white coat is an example of that.

 

Correction, the short coat is an example of putting medical students "in their place". Which is not necessarily a bad thing: I've seen many trainees that are a bit arrogant at the start of clerkship, and a touch of humility/reminder that they are still very junior trainees might be helpful for some of them.

 

Why all the antagonism with allied health staff? Apart from advanced practice nurses trying to practice semi-independently (still a very small movement here in Canada, compared with the US), I've found the vast majority of my interactions with allied health to be pleasant and collegial, especially once you get out of the residency setting.

 

And I understand the uniform angle, but it's a bit outdated (holds true mainly for older patients - correlated with those over 70 years old in a 2004 survey). While I agree, patient comfort and trust is important, I find infection transmission a much stronger argument against white coats.

[A-Stark]

Don't know what adult hospital you're talking about, but I see ~10% of the staff at Sunnybrook in white coats (mostly the older physicians), and it's one of the largest adult hospitals in the country. In the ICU where I work, white coats are not allowed at all due to the infection transmission rates. Few of the staff at the other Toronto hospitals wear white coats either.

 

By staff you mean staff physicians? They seem common enough at the two largest hospitals in the Maritimes (QEII in Halifax and Saint John Regional). Not so common at the IWK, but then white coats scare kids.

 

Correction, the short coat is an example of putting medical students "in their place". Which is not necessarily a bad thing: I've seen many trainees that are a bit arrogant at the start of clerkship, and a touch of humility/reminder that they are still very junior trainees might be helpful for some of them.

 

Uh-huh. I'd say that enforcing use of stupid looking short coats is outright abuse of authority, a sort of hazing re: "humility". Perhaps you're simply getting arrogant UofT students (no offence intended... really), but a week of clerkship so far is more about being confused about what you're supposed to be doing and where and having to deal with, say, staff who fail to notify clerkship administrators about cancelling a whole day of clinics.

 

In fact, this sort of attitude really pisses me off. We are (rightly) expected to show up on time and account for any absences, yet notifying housestaff scheduled for clinics or other service of cancellations seems to be too much to ask. We do not need to be subjected to further arrogance about putting us "in our place" when basic professionalism is often lacking among staff themselves. FFS.

 

Why all the antagonism with allied health staff? Apart from advanced practice nurses trying to practice semi-independently (still a very small movement here in Canada, compared with the US), I've found the vast majority of my interactions with allied health to be pleasant and collegial, especially once you get out of the residency setting.

 

Oh, well, I think you just need to read more of brooksbane's posts. It's a recurring theme.

 

And I understand the uniform angle, but it's a bit outdated (holds true mainly for older patients - correlated with those over 70 years old in a 2004 survey). While I agree, patient comfort and trust is important, I find infection transmission a much stronger argument against white coats.

 

Short of actually draping them over open sores or fluids, what exactly would be prevented? If there are contact measures in place then, well, white coats have little to do with them. I was required to wear one during all clinicals last year.

[cheech10]

By staff you mean staff physicians? They seem common enough at the two largest hospitals in the Maritimes (QEII in Halifax and Saint John Regional). Not so common at the IWK, but then white coats scare kids.

 

Fair enough. I did mean staff physicians. There's probably some regional variation in white coat use.

 

 

Uh-huh. I'd say that enforcing use of stupid looking short coats is outright abuse of authority, a sort of hazing re: "humility". Perhaps you're simply getting arrogant UofT students (no offence intended... really), but a week of clerkship so far is more about being confused about what you're supposed to be doing and where and having to deal with, say, staff who fail to notify clerkship administrators about cancelling a whole day of clinics.

 

In fact, this sort of attitude really pisses me off. We are (rightly) expected to show up on time and account for any absences, yet notifying housestaff scheduled for clinics or other service of cancellations seems to be too much to ask. We do not need to be subjected to further arrogance about putting us "in our place" when basic professionalism is often lacking among staff themselves. FFS.

 

Not sure I'd call wearing a short coat hazing. And I have no problem with having med students wear a short coat: they're trainees and are expected to identify themselves as such at each patient encounter. If a school wants to use a short coat as a uniform to help with this identification, then I don't think that's a big deal. The fact is that they have more limited clinical responsibility than housestaff and staff physicians, so why not have a different uniform?

I'll admit the administrative issues could use some work on some rotations.

 

 

Oh, well, I think you just need to read more of brooksbane's posts. It's a recurring theme.

 

I'm quite familiar with his posts, thanks. As a fellow and practicing physician, I have seen very little encroachment by allied health staff into physician practice. Advanced practice nurses and CRNAs are still uncommon here; the situation is quite different in the US. Maybe we get there eventually, but it seems a long way off, and our professional groups are quite influential here, so I'm not worried yet.

 

 

Short of actually draping them over open sores or fluids, what exactly would be prevented? If there are contact measures in place then, well, white coats have little to do with them. I was required to wear one during all clinicals last year.

 

The issue is that it takes time to identify patients with antiobiotic resistant organisms and institute precautions, even with routine screening on admission. It's quite easy to transmit, for example, MRSA from a patient's nares or skin to another patient via lab coats, stethoscopes, even neckties. There are quite a few papers that describe what a cesspool of bacteria lab coats, stethoscopes, and ties are. And direct contact is not necessary for transmission: just introducing it into the patient's immediate environment puts them at risk for infection. Physician attitudes are slow to change, however, otherwise we'd all be wearing a fresh set of laundered scrubs daily for our clinical work (and not wearing them outside the hospital - yuck).

 

Anyway, back to the original topic. I guess my point is that (IMO) the white coat is an outdated uniform that we should give up as a profession because it puts our patients at risk. Looking at my colleagues and coworkers, I see that this is becoming an increasingly prevalent position.

[A-Stark]

Fair enough. I did mean staff physicians. There's probably some regional variation in white coat use.

 

Not sure I'd call wearing a short coat hazing. And I have no problem with having med students wear a short coat: they're trainees and are expected to identify themselves as such at each patient encounter. If a school wants to use a short coat as a uniform to help with this identification, then I don't think that's a big deal. The fact is that they have more limited clinical responsibility than housestaff and staff physicians, so why not have a different uniform?

 

Why have a different uniform at all? NPs and specialty nurses often wear white coats too, yet their roles and responsibilities differ too. And, if the idea is to "teach humility", then if not hazing, it's certainly attempting to enforce a subordinate appearance and status which is redundant. There's little about clerkship that'd make one feel especially important or integral to practice.

 

I'll admit the administrative issues could use some work on some rotations.

 

Yes.

 

I'm quite familiar with his posts, thanks. As a fellow and practicing physician, I have seen very little encroachment by allied health staff into physician practice. Advanced practice nurses and CRNAs are still uncommon here; the situation is quite different in the US. Maybe we get there eventually, but it seems a long way off, and our professional groups are quite influential here, so I'm not worried yet.

 

I agree, and most of the arguments surrounding the issue make silly assumptions about phenomenon X in the US causing the same thing here. The structure of management and funding of the Canadian system is so drastically different that extrapolating trends from the US here is effectively pointless. Brooksbane harps on them a lot, though, for reasons I don't understand, along with other such apparent problems as inpatients (gasp! patient care!) and taking call.

 

The issue is that it takes time to identify patients with antiobiotic resistant organisms and institute precautions, even with routine screening on admission. It's quite easy to transmit, for example, MRSA from a patient's nares or skin to another patient via lab coats, stethoscopes, even neckties. There are quite a few papers that describe what a cesspool of bacteria lab coats, stethoscopes, and ties are. And direct contact is not necessary for transmission: just introducing it into the patient's immediate environment puts them at risk for infection. Physician attitudes are slow to change, however, otherwise we'd all be wearing a fresh set of laundered scrubs daily for our clinical work (and not wearing them outside the hospital - yuck).

 

Anyway, back to the original topic. I guess my point is that (IMO) the white coat is an outdated uniform that we should give up as a profession because it puts our patients at risk. Looking at my colleagues and coworkers, I see that this is becoming an increasingly prevalent position.

 

Bacteria is everywhere all the time - to what degree is the transmission of nosocomial infections attributable to things like white coats? I always wipe off my stethoscope following patient contact. This is an interesting issue, though, as in countries like Austria at least there are much more stringent regulations about dress. The sort of "business attire" common in Canadian hospitals is unheard of there and a generic white T-shirt, pants and pair of white (!) shoes is required. Scrubs are not to be worn outside the OR suite unless special white coats are used. As a further aside, personal scrub caps were just banned at the QEII - same at Sunnybrook?

 

But it does seem like contact measures for new unscreened patients with suspected resistant infection or colonization are a simpler approach.

[Lactic Folly]

Upon starting residency at a new institution, I was a little surprised to see that relatively few internal medicine staff and residents wore white coats. Unprotected dress clothes acquire microorganisms the same way as lab coats, without the ease of exchange for a freshly laundered piece. Plus, the extra pockets are a great boon.

[A-Stark]

I'd be lost without the pockets.

[Lactic Folly]

I'd have to end up wearing a fanny pack like some of the people I've seen who don't wear coats

[cheech10]

Why have a different uniform at all? NPs and specialty nurses often wear white coats too, yet their roles and responsibilities differ too. And, if the idea is to "teach humility", then if not hazing, it's certainly attempting to enforce a subordinate appearance and status which is redundant. There's little about clerkship that'd make one feel especially important or integral to practice.

 

I'm not advocating FOR the short coat (my med school didn't have short coats anyway), but they never seemed to be the dehumanizing oppressive force that some have implied them to be.

 

Bacteria is everywhere all the time - to what degree is the transmission of nosocomial infections attributable to things like white coats? I always wipe off my stethoscope following patient contact. This is an interesting issue, though, as in countries like Austria at least there are much more stringent regulations about dress. The sort of "business attire" common in Canadian hospitals is unheard of there and a generic white T-shirt, pants and pair of white (!) shoes is required. Scrubs are not to be worn outside the OR suite unless special white coats are used. As a further aside, personal scrub caps were just banned at the QEII - same at Sunnybrook?

 

But it does seem like contact measures for new unscreened patients with suspected resistant infection or colonization are a simpler approach.

 

I don't know if personal scrub caps have been banned (I work in ICU, not the OR), but I suspect not yet. Our current policy is no lab coats in the ICU, no long sleeves, and no jewellry on wrist or fingers - similar to the recent UK guidelines.

 

As for the degree to which infection transmission is attributable to our attire, there have been no studies to definitively show this, but surveillance of hospital staff have shown that >30% of lab coats had Staph aureus on them (similar figures for stethoscopes and neckties in other studies), and a study using pigskin confirmed biological plausibility of transmission by isolating the organism from pigskin that had contacted a coat with Staph on it. At this point, I'd err on the side of caution rather than waiting for a definitive study (ditching the lab coat has minimal downside).

[A-Stark]

I've never even seen the short white coats apart from (I think) some nursing students working in clinics. But if you'll forgive my soapbox-climbing - I admit I'm new to this whole "1 in 4" thing. The scrub cap ban just came into effect some time during the summer... some staff are "unhappy" about it, but it remains to be seen how lasting a policy it will be.

[rmorelan]

side note - is there anything special about the labcoats that cause this spread? I mean is somehow a regular shirt less vulnerable?

[Lactic Folly]

Reasonably flattering on the petite; shrug-like on the big and tall.