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P&S Journal

The P&S Journal: Spring 1998, Vol.18, No.2
The Gold Standard

The Doctors Gold-Arnold, M.D., and Sandra, Ed.D. -have a date every year to welcome new P&S students and thousands of other students just starting medical school around the country. But instead of participating in the usual neighborhood orientations, getting-to-know-you barbeques, photo sessions, and other rituals traditionally associated with an incoming medical school class, the Golds introduce students in a more meaningful and, they hope, more long-lasting way.

In what is quickly becoming a tradition, P&S students participate in the annual White Coat Ceremony. The Golds, as representatives of the Arnold P. Gold Foundation, sponsor the ceremony. It has become a new rite of passage that encourages what the foundation describes as a "psychological contract" the students enter to commit themselves to recognizing humanism in the doctor-patient relationship and embracing the ideals of professionalism and empathy. "The ceremony is designed to clarify that a physician's responsibility is not only to take care of patients, but also to care for patients," says Arnold Gold. "It encourages students to consciously seek to be excellent in science, to be compassionate, and to lead lives of uprightness and honor," adds Sandra Gold.

Now 10 years old, the Gold Foundation is steadily bringing the new rite of passage to more and more medical schools. First launched at P&S in 1993, the ceremony was conducted at seven medical schools in 1995. Nearly 50 schools had ceremonies in 1996, and last year, 83 of the 142 U.S. accredited medical and osteopathic schools held the new rite of passage. The program has also gone international: Three medical schools in Israel have held white coat ceremonies sponsored by the Gold Foundation. Other schools have developed unique alternative events to emphasize the importance of compassionate patient care.

The ceremony is best known for changing the clock on two time-honored traditions: donning the white coat and reciting the Hippocratic Oath. Presenting incoming medical students their white coats before they begin their medical studies instead of when their clinical training starts in earnest (usually near the end of the second year) is intended to help students start thinking and feeling like doctors from day one of their medical education. The same reasoning applies to the Hippocratic Oath, traditionally taken for the first time at graduation from medical school. Reciting the oath in front of family and friends both before medical school and again when graduating is meant to reinforce a medical student's commitment as she or he becomes a doctor. Last spring's graduating class-the Class of 1997-was the first class "cloaked" in a white coat and sworn to uphold the Hippocratic Oath before beginning P&S classes.

The Gold Foundation has become best known for the white coat ceremony, but its impact is considerably broader. The Golds' impact on medical education was recognized last fall when P&S gave the foundation the Dean's Award for Distinguished Service. The award acknowledges the foundation's mission to foster humanism in medicine and recognizes the many programs the Gold Foundation has created and supports to emphasize the tradition of compassion in the doctor-patient relationship:

  • Home visit programs for pediatric and internal medicine residents at P&S, the University of Virginia, and New Jersey Medical School. The residents and their mentors form teams to visit homes of their clinic patients.
  • Student-initiated programs on medical ethics and other topics at P&S, the University of Arizona, and UCLA.
  • Research into attitudes of medical students toward humanism. Currently, 35 medical schools have participated.
  • National symposia for experts in medical school curricula to address and challenge the barriers to sustaining humanism in medicine and to explore innovative routes to reinforce the humanistic values introduced at white coat ceremonies.
  • Four assistant and associate professorship grants to encourage P&S junior faculty role models who demonstrate humanistic care, technical expertise, and outstanding teaching ability.
  • Summer research fellowships for students studying community health issues at P&S, Cornell, New York University, New Jersey Medical School, and the University of Chicago.
  • Commencement awards each year to a P&S faculty member and a graduating senior who best represent excellence in science and in compassionate patient care.

Dr. Arnold Gold, professor of clinical neurology and clinical pediatrics at P&S, and Dr. Sandra O. Gold, a nationally certified counselor, joined their professional colleagues, dedicated community leaders, and other philanthropists to establish the Gold Foundation as a way to re-emphasize the importance of the doctor-patient relationship at this period in health care delivery evolution. The foundation has raised funds for educational experiences that strive to influence the way a physician is trained, from the very first day of medical school through residency training.

The foundation's work has been aided by contributions from other foundations and from individuals, including parents moved by the white coat ceremonies they attend for their sons or daughters.

copyright ©, 1996 Columbia-Presbyterian Medical Center

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