Ceremony marks beginning of studies for physician assistant students

The white coat that physicians and physician assistants wear is a powerful symbol with good and bad connotations, said Ian Nelligan, MD, associate medical director of Stanford’s master of science in physician assistant studies program.  

Speaking Aug. 20 to students at a ceremony marking the start of their three-year program, he noted that the quintessential medical uniform can conjure anxiety in patients who are fearful of sickness or who have faced discrimination from medical professionals. In addition, it can suggest that its wearer holds a position of superiority.

But it can also symbolize caring, he said: “I choose to wear the white coat in clinic because it symbolizes my dedication to my patients’ health,” said Nelligan, who is a clinical assistant professor in primary care and population health. He added that the wearers of white coats have a duty “to address the valid, negative associations with the white coat.”

At the ceremony, each member of the incoming class of 29 students received a white coat with their name embroidered on it, along with a stethoscope, as family members and friends looked on. Everyone wore masks at the outdoor event, and guests were required to be vaccinated for the coronavirus or to show a recent negative COVID-19 test.

“You represent such collective expertise and talent and, most importantly, dedication to the profession,” Lloyd Minor, MD, dean of the Stanford University School of Medicine, told the class of 2024.

Susan Fernandes, LPD, PA-C, the program’s director and associate dean for physician assistant education, praised the students for being among the 2% of applicants who were accepted to the program. She added that their choice was a good one: The job of physician assistant is the No. 1 career in the United States, according to U.S. News and World Report.

“You will have the honor of caring for patients, and we are confident in your ability to be successful throughout your career,” she said.

The keynote speaker, Robert Califf, MD, professor of cardiology and medicine at the Duke University School of Medicine, referring to vaccine skeptics, noted that “we are in a world where a large part of the population has lost its faith in institutions and expertise.”

The antidote is excellent listening skills, he said: “You’re going to need to understand why they believe what they do.”

Those conversation skills take time to develop, said Lily Johnson, a third-year physician assistant student who related a story about her first year. While interviewing a “patient” — an actor playing the part — during her Practice of Medicine class, she asked about alcohol use. The patient replied that she and her husband enjoyed drinking wine.

Instead of trying to discern how much the patient drank, to determine if she had a substance-abuse problem, Johnson responded, “Oh, nice. Do you prefer red or white?”

“The point is,” she continued, “this stuff takes practice. Show yourself a little grace.”