White coats and words of wisdom for new UC medical students

CINCINNATI—Stay curious. Remain humble. Never forget that wearing the White Coat is a privilege. 

A wise sage offered this advice to new medical students during the 24th annual White Coat Ceremony held by the University of Cincinnati (UC) College of Medicine Aug. 9 at Aronoff Center in downtown Cincinnati.

“I highly recommend pursuing what makes you curious,” said Tiffiny Diers, MD, associate professor in the Department of Internal Medicine. “Whether it is in what you are studying, in a patient story or career opportunities that come your way, curiosity and exploration yield discovery.”

“The expansion of your own knowledge, what you can bring to your patients, and ultimately to our field, these are also antidotes to burnout in a challenging profession helping you to maintain a sense of meaning and engagement in your work,” said Diers.

Diers, associate program director for the UC Internal Medicine Residency Program and a UC Health physician, offered the keynote address at the White Coat Ceremony. Her message was aimed at one of UC’s largest medical classes in recent years, and the most racially and ethnically diverse ever.  The College of Medicine welcomed 185 newly admitted medical students during the ceremony.

Each member of the class of 2023 was presented with a white coat symbolizing entry into the medical profession. UC College of Medicine alumni, faculty and staff provided the coats as a gift. The white coat is also a symbol of the patients the students will treat and the compassion, honesty and caring to which the students should always aspire. College of Medicine Interim Dean Andrew Filak Jr., MD, and UC President Neville Pinto also offered welcoming remarks to the class.

“President Pinto has dubbed the university’s strategic direction ‘Next Lives Here’,” explained Filak. “Powered by knowledge, ideas and minds, Next Lives Here amplifies our core missions of teaching, research and service—from preparing faculty to teach tomorrow to pioneering the next cure to solving human-centered problems in the far corners of the globe. It is a culture that is owned, not rented and it is changing the way we live, work and learn. You are what is ‘Next’ for the College of Medicine. Our next class, our next generation of physicians, our next medical leaders who will impact the world.”

Most diverse class

Twenty-three percent of this year’s class (43 students) are from ethnic backgrounds that are underrepresented in medicine—the highest percentage ever in the college’s history. There is an almost even split among men and women enrollees. Men account for 50.3% (93 students) of the incoming class while women are 49.7% (92 students). 

First-generation college students account for 14% (26 students) in the incoming class. Ohio residents account for 52% (96 students) while non-Ohio residents are 48% (89 students) of the incoming class. The average cumulative undergraduate grade point average for the class is 3.75 while the average Medical College Admission Test (MCAT) score is 515.

This is also the first year UC has asked medical students if they identify as LGBTQ+ during an admissions survey and 7% identified as such.

“Even in your early days with us, when much of your time will be spent in the classroom I hope you will allow yourselves to become fascinated by what you are learning and to keep a close eye on why you are learning and what motivated you to be here in the first place,” said Diers.

Diers spoke of her experiences as a medical student learning from residents, who themselves where still new to the medical profession. She recalled a second-year resident dubbed the ‘mole’ who supervised her and a fellow student during the delivery of a newborn.

Learning from the first steps

A young Diers and her fellow medical student were asked to prepare for labor and delivery, but neither know where the delivery room was located and what exactly they were supposed to be doing. They were saved by a helpful nurse who found the pair wondering throughout the hospital they were doing rotations in at the time.

“Medical training is like (drinking from) a firehose,” said Diers. “As soon as you get comfortable with one unit or task or setting you are on to the next one. You can become too focused on your own experience or inexperience to consider the perspective of people even one step behind you in training, much less that of patients or other health professionals. This can lead to medical jargon slipping into patient conversations and lack of clarity and treatment orders to health care teammates or the appearance of not caring about the people you are supervising and their learning curve.”

“Now I look back and I understand the mole was a first month second-year resident, likely supervising students and delivering babies on her own for the very first time. It took me a while to find ways to pause, step back from my own experience and consider the perspectives of others around me. I mentioned that period of not knowing the answers will last a very long time and by that I meant basically forever.

“But it is one of my favorite things about medicine. The more you learn the more you realize that there is to know. There are endless opportunities for reinvention,” said Diers.

Diers reminded students that while the white coat accords a measure of respect for health professionals, trust must still be earned.

“Early in my career I attended a community meeting focused on reducing our city’s infant mortality rate, which is very high. While I was a practicing pediatrician at the time I didn’t know much about population health or the matter at hand. I was, however, the only doctor in the room and because of that credential it made me an expert among the participants,” said Diers.

“That reinforced for me that people trust us not just to keep them healthy as individuals but as whole communities. Checking ourselves about what we can do to merit that trust is important. Sometimes mistrust must be overcome and I have experienced that too. In particular in caring for patients with sickle cell disease, a genetic disorder that is common in African-Americans and characterized by recurrent pain episodes and many complications.

Diers noted many of these patients spent so much of their lives in hospitals, managing pain and other concerns and dealing with outright racism that trusting healthcare workers was difficult.

 “I was able to experience this close up when in 2009 a senior faculty member left UC and I was selected to take his place as leader of a sickle cell research collaborative. This seemed like an unusual choice since the grant was up for renewal and I was not formally trained in research and had not lead the writing of a federal grant.

“But after some waffling I took the position and dove in. In the process I became the primary doctor for most the patients with sickle cell at UC Health and leaders of an interprofessional team that had much more experience in sickle cell care than I had,” said Diers. “Both in my relationships with patients and integration into the team caring for them trust had to be earned.

“There was a nurse practitioner who had been on the team for multiple years and engaged with the sickle cell community and knew many of the families outside of work as well,” said Diers. “For the first couple of years in my new role, patients would routinely check with her before agreeing to any of my treatment plans. Really, especially in the beginning, I did too. Developing those patient and team relationships took a lot of time and humility. I look back on that period as one of my hardest work experiences, but also the greatest with professional growth.”

Diers said those first steps can feel overwhelming, but they are well worth the risks.

“Each first you experience over the coming years will provide another opportunity to strengthen your ability to figure things out and your belief in that ability,” said Diers. “I encourage you to tackle the hard stuff.”

Medical students ended the White Coat ceremony by reading their own unique “Oath of Professionalism” written by the students during Orientation Week. President Pinto urged them earlier during the ceremony to remember the legacy of the College of Medicine’s founder Daniel Drake, MD.

“As you take your oath today, you become part of a university that carries on Drake’s ideas by looking beyond the present, leaning into the future, and providing clinical care and pursuing innovations that are life-changing and world-changing," said Pinto.

Photos by Colleen Kelley/UC Creative Services