Student Clinician's Ceremony
The Student Clinician's Ceremony (SCC) is a transitional experience designed to provide guidance, information and support to medical students beginning their clerkships. Created by the Gold Foundation, the event is developed by students with the assistance of a faculty mentor and aims to address some of the anxiety felt by students entering their clerkships. By providing insight, discussing fears and expectations, and revisiting the oath taken during the White Coat Ceremony, the SCC provides a forum for collective and reflective discussion of the students' experiences in medicine to date. The ceremony also underscores the challenges and imperatives to providing humanistic care to patients at the same time as they are pressed to demonstrate high standards of skill performance.
Components of the Student Clinician's Ceremony
- recitation of an oath, pledge or credo to reaffirm values of relationship-centered, compassionate and professional care (often the same oath taken during the White Coat Ceremony, but may also be a specially written student oath).
- selection of up to six residents by the outgoing 3rd year class for the Gold Foundation's Humanism and Excellence in Teaching Award. A cash prize, certificate, and specially designed lapel pin are presented. A poster with pictures of the awardees is displayed in high traffic areas of the hospital and school.
- opportunities for current 2nd year students to work collaboratively with current 3rd year students to generate this event, often incorporating some artistic group project such as a video, skits or the creation of a survival guide.
- selection of a keynote speaker known as an outstanding role-model by members of the outgoing 3rd year class to give an inspiring address to the incoming class.
- presentation of a gift to each member of the incoming 3rd year class, such as a book, journal or survival guide to encourage students as they advance into their clerkships.
- a reception, luncheon or dinner following or during the ceremony.
Humanism and Excellence in Teaching AwardThird year students select up to six residents to receive the Gold Foundation Humanism and Excellence in Teaching Award, based on their demonstration of commitment to teaching and compassionate treatment of patients and families, students and colleagues. Each award winner is presented with a certificate, a specially designed lapel pin and a check for $250 from the Gold Foundation. The awardees are also showcased on the Accreditation Council for Graduate Medical Education (ACGME) website.
Components of CeremonyOaths, credos and pledges
As students transition to their clerkships and heightened interaction with patients, it is important that they reflect upon and acknowledge the responsibilities of the medical profession and their willingness to assume such obligations. The communal taking of an oath provides for both a private moment of reflection as well as a public acceptance of these values. Traditional oaths such as the Hippocratic Oath, the Oath of Maimonides, the Declaration of Geneva and the Oath of Louis Lasagna are often used at commencement ceremonies, White Coat Ceremonies and now at Student Clinician's Ceremonies to help students with this reflection.
The Student Clinician's Ceremony is designed to provide ample opportunity for students already involved in their clerkships to offer insight, encouragement and information to the incoming 3rd year class. Throughout the year, a planning committee of 2nd and 3rd year students works collaboratively to organize the SCC under the guidance of a faculty mentor. After the first year, we suggest that the planning committee be selected in time for the members to witness one ceremony prior to planning for the next year's ceremony. All subcommittees should include student representatives from both years. There are numerous creative ways for the outgoing 3rd year (or even 4th year) students to provide guidance and support to the rising 3rd year class. Often the outgoing 3rd year students hold panel discussions or present humorous skits during or around the time of the SCC illustrating various aspects of life as a student on the wards. One school compiles a book of reflective "letters" written by the outgoing class to the entering class, with several of the letters read aloud as part of the ceremony.
The planning committee polls students to identify a faculty member to give the keynote speech at the Student Clinician's Ceremony. The speech should provide the students with a chance to reflect on the many aspects of delivering compassionate, humanistic care to their patients.
Gifts for Rising Third Year Students
The presentation of a gift to the students entering their clerkships is a tangible symbol of support from the medical school. The gifts need not be costly to have a valuable impact on the students. Following are several suggestions.
- Journal: The students receive a pocket sized notebook for important notes on patients and experiences. A bookplate can serve as a daily reminder of the commitment to humanistic doctoring made during the SCC.
- Book: Students receive an inspirational book dealing with issues surrounding the doctor patient relationship. These may be "physician as patient" books, writings by students and residents, books by patients about their experience with disease and the medical establishment, and/or books which help to sensitize the students to issues of cultural competency. Some examples include The Spirit Catches You and You Fall Down, by Anne Fadiman, The Anatomy of Hope: How People Prevail in the Face of Illness, by Jerome Groopman, M.D., Let Me Listen to Your Heart: Writings by Medical Students, edited by David Svahn, M.D. and Alan Kozak, M.D., Life with Sam, by Elizabeth Hall Hutner, Equal Partners, by Jody Heymann, M.D., One Hundred Days: My Unexpected Journey from Doctor to Patient, by David Biro, M.D., or My Grandfather's Blessings, by Rachel Naomi Remen.
- Survival Guide: Students receive a survival guide prepared and edited by the outgoing 3 rd year students. The survival guide includes relevant information on all of the clerkships and practical advice on how to perform core skills. The survival guide should also offer words of wisdom and encouragement.
- Pharmacopeia: Students receive a pocket sized Pharmacopeia, which may be inscribed with a bookplate, as a daily reminder of the commitment to humanistic doctoring.
- Business Cards: Students receive business cards with their name and medical school affiliation, to give to their patients.
A celebratory reception for the students, resident award winners, faculty, family and friends provides a chance to commemorate this important and exciting transition in the students' medical education and to honor the resident role-models. Traditionally, the reception is held directly following the Student Clinician's Ceremony; however, a number of schools hold the ceremony itself during a formal, sit-down luncheon or dinner.
Suggested Additional Activities
Orientation activities for rising 3rd year students vary from school to school. These activities may take place on the day of the SCC, during an orientation week prior to the ceremony or even throughout the year leading up to the SCC. Following are some examples of these activities from medical schools:
- A student-made video presentation of interviews with patients and hospital staff
- Case diskcussions with residents and faculty that highlight the need to respect the unique needs and perspectives of the patient
- Presentations from patients describing their experiences with illness and their health care providers
- Skits illustrating doctor-patient issues
- Lectures or shows, such as "Evan Handler: One Man Show," a monologue on one man's illness
The outgoing 3rd year students can develop any number of ways to reflect on their clinical experience, which can then be shared with the incoming class. These may include:
- A survival guide, or written reflections to be published for the class in a small booklet (also given as the SCC gift at several schools)
- Video revealing the trepidation of students as they approached that first day in the hospital (these videos often have both serious and humorous aspects and can be enormously entertaining while offering support and genuine assistance)
- Panel discussion about the impact of 3rd year rotations on students' personal lives
- Presentation of other creative means of reflection, including photographs, art, poetry, film or music
- Skits or discussions related to building productive relationships with all members of the healthcare team (fellow students, residents, attendings, nurses, and ancillary hospital staff)