Advice Wanted--What do physicians most often wear in a hospital setting under whites?

[The Knize]

My son just started medical school--in a major lower mid-West city, in case this varies with geography--and tells me he needs some dress shirts, ties, and at least somewhat dressy slacks (I did not think to ask about shoes) to wear on "rounds" (I hope I am using the right nomenclature) under "whites."

What do physicians/interns/students typically wear under whites in general (for instance, non-surgery, non-emergency room) settings under their whites? I mean, I know, dress shirt and tie, and slacks of some sort. (I really have no idea re shoes.) But more precisely what kind and color dress shirt. And, actually, what color and type of tie. (For instance, I wear a suit every day, generally dark, and I find I do not wear dark blue ties all that often because they tend to blend in with the suit. And I was thinking maybe traditonal blue Oxford shirt with red or burgundy striped ties for him, but his very funny quip was that he did not want to look like he was dressing as the American flag. He has a point. Given a brilliant while coat, maybe a red tie stands out too much. Maybe a pure Oxford blue shirt is too much blue against the white coat. Maybe the shirt is better pure white, too, or subtlely patterned.)

Re shirts: I would say long sleeves, with barrel not French cuffs, or am I wrong and are short sleeves somehow okay? I assume button down collars are okay, but should they be a first go to choice? I am thinking regular not spread collars, if not button down. What about shirts in subtle patterns? Are they somehow better or do they take away from some formality or respectfulness the physician is seeking to establish. Does traditional light blue Oxford in fact look jarring against a white jacket? Are white and lue stripes out for one reason or another? Is a pure white shirt over doing it/too formal? Are dark blue ties too funeral? Should one choose ties that are rather boardroomish or something softer maybe even non-silk so as to seem "warmer" to patients? Four-in-hand tie knots I am thinking, unless physicians have some obsession with Windsors and half-windsor knots that I do not know about!

Are khakis about the right level or are dressier slacks better, I assume gray or khaki so as not to appear that one is wearing the bottom part of a business suit and again so as not to present such a dramatic contrast with a white coat? I take it jeans really are out, right?

Is there anything about potential stains or anything I am overlooking?

How about shoes? I take it physicians are on their feet a lot, so something with some cushioning to it may be acceptable. Or because we seem to be adding some formality, should we be talking standard lace business shoe? Black, brown, tan, oxblood? Or are we talking topsiders or weejuns?

Again, am I overlooking anything as to what might get spilled on shoes even in a general hospital setting, which might call for something more waterproof or even, heaven help us, non-slip!

Who knows whether I am right but I sort of have in mind Wilson on "House" as something of the archtype for this. Sort of put together, but still approachable. Nice, I bet expensive, but not austere, ties. Generally darkish and not starkly/boldly striped. Generally lightly patterned, mostly white shirts. No idea re slacks or shoes, frankly.

Thanks! I know we have lots of physicians on these fora!

 

[mdevine]

When I was in medical school, my budget didn't allow much in the way of options. I tended to wear Docker style dress pants which could easily be washed at home. I stuck with white and blue shirts with a button down collar and conservative ties that could be easily paired with just about anything. The most expensive item I wore were my shoes. Because shifts could last over 36 hours, comfortable shoes were very important. For medical students just starting their clinical rotations, neatness and comfort are the most important elements in how they dress. Although attending physicians can get away with "dress casual" and wear khakis and a golf shirt, I would expect students to wear a shirt and tie. When I finally had an income as a resident, I frequently wore cuff links and/or braces under my white coat. As long as he is neat and appears professional, any clothes that reflect his personal style should be fine.

 

[beachape]

Try not to stand out or be overly fashionable. You want your clothes to be comfortable but professional. Remember that you're often working with older docs that may be more conservative. For his first 2 years he may only need a couple shirts/slacks for maybe once weekly activities. For 3rd and 4th year he'll need a whole week's rotation.

Personally I prefer synthetic dress pants with cotton dress shirts (...no cufflinks). If he doesn't have time to iron, go for wrinkle free dress shirts. Being a poor student means having a small selection of comfortable clothes that can match together in a number of ways.

For shoes, nothing too fancy...but professional and comfortable. I like oxfords. Try to focus on shoes that wipe off easily...should something spray/splatter on you.

Oh and another good investment may be a tie clip. Something to keep your tie from falling all over a patient if you're not wearing a coat.

 

[Kouros]

The same thing judges wear: Rolex.

 

[Go West Young Man]

As the old joke goes :

Nothing is worn under my kilt ....... it's all in perfect working order!

 

[The Knize]

Thanks for the input/advice.

Sounds like solid color dress shirts work.

Am not quite clear what wipes off easily in a shoe. No "broguing," for instance? Preference for shoes that lace up higher, as opposed to say weejuns that, open to lower on the front of the front.

Why a preference for slacks of a synthetic material? Also, not sure I am getting the difference between docker type dress slacks that can be laundered at home and khakis. I do not think one can really launder any wool slacks at home! And cotton and or cotton/synthetic blended slacks, especially anything by Docker, are pretty much in the realm of "khakis" to me, unless, I suppose, one were going hood hip with Dickies or something, which seems unlikely.

No problem with this son erring to the overly fashionable. My guess is that he will be absolutely content and comfortable to dress to a conservative norm. My impression is that at this med school no professor is wearing a golf shirt on rounds. (I guess I am not 100% sure what an "attending physician" is. Can an attending physician be from outside the school and thus not be charged with providing the perfect model for the students? I was surprised and pleased really that dress shirt and tie seemed to be the baseline.)

Braces and cufflinks, really? Probably a little ostentacious for first year med student! But I like cufflinks myself and am happy to know that they might be properly worn with whites. Also happy to know that short sleeve shirts are not somehow de riguer!

<If he doesn't have time to iron, go for wrinkle free dress shirts.>

It has been a while since I have been involved in this discussion, but I have opined fervently before that no one of my or his ironing skills has enough time to iron a tradtional all cotton dress shirt, much less him as a med student! And this is from someone who is in fact kind of intrigued with the idea of being actually able to adequately iron a dress shirt at all! I do not see anything disadventageous about the modern all cotton non iron dress shirt, except initial cost, whether laundered at home or sent out. A lot easier to touch up one of those laundered at home if one has to.

As far as cost/quality, I do not think the kind of clothing we are talking about is going to go out of style, and I generally think it is worth seeking out good quality, which I also think is readily available at decent prices these days. I may be controversial, but I do not think anyone really needs bespoke shirts, unless one is Shaq or someone, and I sure cannot see bespoke slacks, or every heavy tailoring on any of this clothing. Otherwise, I think an efficient amount of whatever clothing one needs is a good thing to have. His time is pretty structured and anything that saves effort and time is probably worthwhile. Again, nothing crazy, but I do not think this is the kind of clothing one has to replace very often and I expect he will get a lot of use out of it over the years.

This is a kid that, absolutely of his own volition, seemed to get by on the same two or so tee shirts and pairs of jeans his entire undergraduate years. And he is a very clean, neat, and well-groomed guy, with a long-turn lovely girlfriend who has an even more developed since of neat, clean, and orderly, so it is not like he was some smelly nerd!

Thanks for the help, Gentlemen!

 

[wilsonent]

Nothing is worn under the whites. Everything works just fine thank you.


Jeff

 

[Hagbardr]

I recommend wearing a bow tie, or at least a tie clip.

Bow ties are cool. Fezzes are cool too.

http://online.wsj.com/article/SB125859205137154753.html

 

[The Knize]

I recommend wearing a bow tie, or at least a tie clip.

Bow ties are cool. Fezzes are cool too.

http://online.wsj.com/article/SB125859205137154753.html

Wow. Amazing article. Worth a read by everyone. Thanks.

I did not get far enough into it yet to get the fez reference!

I notice reading something from Brooks Brothers today, that BB recommends tie clips for all of us as way of keeping ties out of our plates, etc.

I admit that I have not worn a tie clip since high school. Maybe they are coming into style again!

 

[jumpo64]

I might actually have some good input on this question.

I come from a family of doctors, 5 in my immediate family to be exact. We generally wear a solid color dress shirt under whites, with black pants. Generally no brown pants or striped shirts. However, it wouldn't be entirely out of place to wear a striped shirt, but it's kind of up to your own discretion.

Now, this is somewhat dependent on the locality. My dad is a small town doctor, he rarely wears whites when checking in on patients. He dresses more casually, and often incorporates more brown/khaki pants and striped shirts. But he's also been practicing in the same small town for almost 30 years. He has an extensive patient base, and really has no need to impress anyone at this point.

On the other hand, my brother is a chief resident in a major US city. He's more likely to follow my initial guidelines. Especially since he is a young doctor. You don't want to give your patients the impression you're 16, or unprofessional. A tie can be optional. Some wear one, some don't. It may or may not get in his way when leaning over a bed or doing various other tasks.

Now, this all goes out the window when you're on call, or in scrubs. In which case, anything goes for the most part.

 

[steveclarkus]

Hopefully more than Scotts wear under their kilts.

 

[Go West Young Man]

Hopefully more than Scotts wear under their kilts.

I thought we covered that already.....

 

[beachape]

For the shoes, just imagine that you sprayed them with blood or a variety of other bodily fluids...would you be able to wipe them off easily? So yeah...avoid broguing, soft leathers, or suede. Probably shoot for a shoe that can take a wax polish so they wipe off real easy. Shoe covers will protect you in most situations...but not all.

For shirt color/pattern, make sure it isn't too crazy or loud and he should be fine. About ironing...i just prefer cotton ironed shirts for comfort, but if you like non-iron then there is no reason not to wear them. I prefer synthetic dress slacks to wrinkle free khaki's because i find they fit better and appear more professional. Definately would not wear wool pants. No one would complain if he had dress khaki's on.

Also make sure he has a belt to match his shoes.

About ties, he can decide if he wants to wear ties when he is a doc, but until then you dress professionally until a specific doc tells you that you should/can dress down when you work with them.

 

[The Knize]

Again, thanks for the help and the clarifications.

I understand re shoes now, although I am having trouble thinking that a coat of shoe polish is sufficient protection for my typical Allen-Edmonds or similar dress shoes, even the plainest toed versions! In fact, I can imagine that if certain bodily fluids spilled on some of my shoes I might "never stop cleaning them", much less just "wipe them off"!

(There is a well-known, supposedly witnessed by a reporter true story about Eddie Murphy, the comedian when he was first hitting it big, where he was wearing some very fashionable, high end, pricey pair of brand new shoes, and he stepped out of a limonsine, right into, let us describe it this way a pile of dog "pooh" left on a New York sidewalk. (This was years ago. I think NYC policse clean up after dogs much more intensively these days.) Anyway, without a second's delay or any hesitation, without lifting the soiled shoe out of the dog pile, he reaches down and unties and loosens both shoes, steps out of them, and simply walks away in his socks, leaving thousands of dollars worth of shoes abandoned on the sidewalk! Given the right bodily fluids, I would be tempted to do just that with a typical pair of my business type shoes!! They do not make shoe polish that is good enough! Now some crocs, or LL Bean duck shoes, or say Tim's or Doc Martin's, not the same problem!!!)

Why "black" slacks in particular? I can see where brown slacks might be seen as more casual, but wouldn't gray, even medium dark gray as opposed to say charcoal (or even dark blue) be as dressy? I am not found of solid purely "black" slacks for business/professional, anyway--I guess they seem sort of waiterish or black tie to me as a general matter--and they would seem to contrast a little starkly with the white jacket, and black seems utterly prone to highlight and emphasize any and all specks, spills, etc. of anything they pick up in the environment, including--horrors--spills of "bodily fluids" of any and all types!!

My impression is that that for the purpose we are talking about, "rounds" (I sure hope I am using that term properly), where he is, ties are de riguer, and not optional a this med school/hospital, and I do not know that the specific attending (again I hope I am properly using the "term") doc has the "authority" to waive them for students. (I assume individual docs do as individual docs want to do, which is kind of an univeral truth and probably part of the problem with the health system, but I digress!) We are talking major teaching hospital here. I suspect that the tie requirement might vary hospital to hospital and/or geographically. I am learning as I go along, but I suspect that whites are never optional in this situation. As far as I can tell, whites (and maybe a stethescope) in these situations is the equivalent of a uniform on an army base. It signifies who you are to everyone else and that is an important thing in the circumstances. Seeing patients at a private office is a very different situation! My physicians are in the Washington, DC area, and my parents physicians were, too. At their offices, I think I have seen physicians wear quite a variety of clothing in different levels of formality, with my ear, nose, and throat guy, of all specialties, being dressed the most formally consistently. (I hate to say it but I am a little impressed by that. On the other hand, his overall demeanor/personality, maybe you would call it bedside manner, is very impressive. He absolutely projects expertise, wisdom, caring, precision, meticulousness, careful observation, and whatever else one wants from their physician! So it is way more than the way he dresses, but the way he dresses, again I hate to say it, probably helps. Meticulous in one area, meticulous in others. I guess I do not mind the idea that my physician is more meticulous and precise about things than I generally am!)

And certainly on call, or in scrubs is very different than these apparently relatively formal teaching rounds. Emergency room is different, too, from what I understand!

I do not think students wear ties to class or in labs, either.

I am not understanding why no wool slacks. Aren't most slacks that are not all cotton or "synthetic," wool or at least a blend of wool or cotton and synthetic? I actually cannot imagine wearing slacks that were 100% synthetic, and am not fond of wool synthetic blends for my purposes. So what is the issue with wool? Thanks. I am probably being dim!

<About ironing...i just prefer cotton ironed shirts for comfort, but if you like non-iron then there is no reason not to wear them.>

An "argument' better for a separate thread and one I have engaged in previously, probably ad nauseaum, for which I apologize , but I wear a dress shirt and tie every day to the office, and most of my shirts are regular 100% cotton with no "non iron" qualities, which I personally absolutely have to send to a professional laundry, but I also have relatively recently acquired some modern 100% cotton "non iron" shirts by Brooks Brothers and certain other shirt makers. I would certainly agree that the old poly-blend permanent press shirts were less comfortable than all cotton and less satisfactory in other ways. But I find it very hard to feel a different comfort level in these relatively new 100% cotton "non iron" shirts and 100% cotton shirts are not treated to be "non iron." And this is something I have paid particular attention to! In fact, without looking to see how wrinkled it is in say the sleeves I could not tell you whether the shirt I am wearing right now is non iron or not, and it is getting pretty stuffy at this time of evening in my office!

At this point, I think I will avoid buying any more shirts that are not non iron. I just do not see any down side to them at this point, if you get the right brand, and in my opinion they look better at the end of a day, not that a cotton shirt has to look completely unwrinkled in order to look good! (The earliest version of these shirts at least by Brooks Brothers seemed to wear rather quickly and may have required quite a bit of ironing. Some brands of non iron shirts still really do need a lot of ironing compared to BB's, at least these are my experiences!)

Ymmv, of course, but I am trying to pay very close attention to the comfort factor re non iron shirts!

Thanks, again!

 

[jumpo64]

Sorry about the confusion when I said Black pants. I typed black, but in my head I was thinking medium to darker gray and charcoal as well. I've been known to group all those together from time to time

 

[beachape]

Brown slacks are perfectly fine. I own two pairs of shoes one brown one black. I alternate between black pants w/ black shoes and brown pants with brown shoes. That way I rotate my shoes.

I wouldn't wear wool because of the cleaning involved. You would have to dry clean them way too often. I wear all synthetic wrinkle free slacks which i find very comfortable but YMMV. Pop them in the wash and then hang dry. Wool pants are good if you're in a generally clean environment and you can wear then several times before sending them in for cleaning...at least thats why i'd do... A hospital is probably not the best place for wool pants.

Also remember that at most med schools you wear casual clothes to classes (...if you even go to classes) for the first 2 years. With the advent of lecture capture, online classes etc. he may be able to wear pajamas. There will likely be days that he will need to dress up but not every day. So you've got time to fill out a whole wardrobe.

 

[The Knize]

Thanks. I am up to speed with you all now!

Again, much appreciated.

 

[Born2bwire]

I just had some minor surgery done by a general surgeon a few days ago. If I recall correctly, he wore an impeccable tailored shirt with matching cufflinks and tie. Tailored dark pants and leather dress shoes. It was at this point that I started feeling a bit uneasy about the impending bill.

 

[The Knize]

Good post. I suppose that is part of the picture. Part of why dressing the part is worthwhile. No one wants to pay too much, but everyone wants the guy that is successful enough to be paid tons of money by other people!

But I bet in Hong Kong one can get some truly well-tailored clothing, for not nearly as much as it would cost State-side! And aren't you in the land of the $70 a night hospital room and the $125 MRI?

And how does the charge for a minor surgery by the best general surgeon in Hong Kong compare to the same surgery by any random surgeon surgeon in the US? You do not have to answer that obviously!

 

[Stubblefield]

He should wear what his boss wears.