What Happens at a White Coat Ceremony?

The first one was held in August 1993 at Columbia University's College of Physicians and Surgeons, for an incoming class of 150. It was the idea of Dr. Arnold P. Gold, a pediatric neurologist. The Gold Foundation's history explains his reasoning: students traditionally recited the Hippocratic Oath at graduation, and Gold thought that came about four years too late. He wanted the commitment made at the start of training. His wife, Dr. Sandra Gold, helped coat students that first year, according to Columbia Medicine magazine.

The Arnold P. Gold Foundation, which Gold co-founded in 1988, spread the ceremony from there. Besides U.S. schools, the foundation counts medical schools in 19 other countries that hold one. In 2014 it partnered with the American Association of Colleges of Nursing to adapt the ceremony for nursing students, and more than 450 nursing schools have taken part. Osteopathic, dental and physician assistant programs hold them too.

Every school runs its own version, but the Gold Foundation says all of them share three parts: an oath or pledge, speakers, and something to mark the moment, which is usually the coat. Wayne State University School of Medicine's ceremony FAQ lays out a typical program:

1. Welcome and introductions
2. Remarks from school leaders
3. A keynote speaker
4. The coating, where each student's name is called and they're helped into the coat on stage
5. The class reciting its oath together, which Wayne State calls the Declaration of Commitment
6. Closing remarks

The coating is the part families come for. At Wayne State, a student can choose one physician to coat them, and that person has to hold an MD or DO. Students without a physician coater are coated by a faculty member. At Rocky Vista University's Utah campus, faculty coat every student, according to its ceremony FAQ. At Liberty University's osteopathic school, 25 of the 161 students in the Class of 2030 were coated by a relative who's a practicing or retired physician, per Liberty's news report.

You may also get a lapel pin. The Gold Foundation provides "Keeping Healthcare Human" pins to medical, nursing and allied health students.

Probably not the original Hippocratic Oath. A 2009 survey of 135 U.S. and Canadian medical schools, reported by STAT, found that 33 percent used Lasagna's 1964 oath, the most popular choice, and 11 percent used a classical Hippocratic version. Most schools work from one of three texts: the Hippocratic Oath, Lasagna's version or the Declaration of Geneva.

Many schools use their own words. Harvard Medical School has each class write an oath for its white coat ceremony and another for graduation. Creighton students revised their school's oath to add a pledge not to discriminate based on sexual orientation.

A 2018 study in Academic Medicine surveyed AAMC member schools in 2015 and heard back from 111 of them, a 70.2 percent response rate. Those schools sent in the full text of 72 white coat oaths. More than half of graduation ceremonies used an oath unique to the school or written by the class. The wording varies, but three commitments appear in as many as 80 percent of oaths: keeping patient confidences, avoiding harm and upholding the integrity of the profession.

At an osteopathic school, you may recite the Osteopathic Oath instead, as Liberty's Class of 2030 did to close its ceremony. The MD vs DO guide covers the other differences between the two paths.

The Gold Foundation designed the ceremony for first-year students, and it often takes place during orientation. The exact timing still varies by school.

So if you're starting this summer, check your orientation schedule. Some schools hold the ceremony before the first lecture, and others wait until you've settled in.

Doctors wore black for patient visits until about 1900, according to a history in the AMA Journal of Ethics. Two paintings by Thomas Eakins show the switch. The Gross Clinic, from 1875, shows surgeon Samuel Gross and his assistants in black formal clothes. The Agnew Clinic, from 1889, shows D. Hayes Agnew's team in white.

The change followed antisepsis. As Joseph Lister's methods for preventing bacterial contamination spread, medicine began to present itself as a laboratory science, and white stood for cleanliness and purity. The 1910 Flexner report pushed medical education further toward the lab and led to the closing of many borderline schools.

The coat has its critics. The same article notes that pediatricians and psychiatrists generally avoid it so they don't make patients anxious. "White coat syndrome" describes the high blood pressure readings some patients get when they see a doctor in one.

More than you might expect. In a 2018 BMJ Open study of 4,062 patients at 10 U.S. academic medical centers, 53 percent agreed that how their doctor dresses is important to them. Formal clothes with a white coat was the top choice, picked by 44 percent, and scrubs with a white coat came second at 26 percent. Support for the coat depended on the setting.

Surgeons were the exception. For surgeons and emergency physicians, 34 percent of patients preferred scrubs alone and 23 percent preferred scrubs with a white coat, according to Michigan Medicine's summary of the study. The coat counted for more in the South and West, where about half of patients picked formal clothes with a white coat, than in the Northeast, at 38 percent.

At many medical centers, coat length signals rank. Medical students, interns and residents wear short white coats, and attending physicians wear long coats with their names embroidered on them. So the coat you get at your ceremony will likely be a short one. A column in The Hospitalist points out that the rule isn't universal: in many places all residents wear long coats, and some hospitals have attendings in short ones.

Getting to an attending's long coat takes years of residency after medical school, and the physician pay guide shows how those training years line up with salaries.

• Count your tickets early. Guest limits vary. Wayne State allowed up to four guests per student, with one or two extra tickets on request. Rocky Vista gave each student seven. At both schools, a child who needs a seat needs a ticket.
• Line up your coater. If a relative is an MD or DO, ask whether your school lets family coat you and when the RSVP is due. Wayne State's deadline was more than a month before the ceremony.
• Dress for an interview. Wayne State asked for professional attire with no suit jacket or blazer under the coat, and told students to carry the coat in instead of wearing it. Rocky Vista required business professional dress.
• Don't count on a livestream. Neither Wayne State nor Rocky Vista streamed its ceremony live. Rocky Vista posted a recording afterward, and both schools had a professional photographer there.
• Read the oath ahead of time. Wayne State gives students a copy backstage, so you don't need to memorize it. If your school's oath is written by the class, you may get a say in the wording.

• Is the white coat ceremony mandatory? At Rocky Vista it is for incoming students. Check your school's orientation materials.
• What if the coat doesn't fit? Ask your student affairs office. Wayne State lets students exchange a coat that doesn't fit.
• Do MD and DO schools both hold one? Yes. Liberty and Rocky Vista are both osteopathic schools, and Columbia, where it started, is an MD school.
• Is it the same as graduation? No. In the Academic Medicine survey, schools sent in 72 white coat oaths and 80 graduation oaths, so many schools have you take an oath at each.

If you're still a few years from your own ceremony, start with the premed requirements, and if you're changing careers, the guide for nontraditional applicants covers starting medicine later in life. Once you have practice scores, see where they put you with the PurpleCAT MCAT score guide.

Last verified October 30, 2026, against the Gold Foundation's ceremony background page.