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Nonfiction NYC

East vs. West: So Serious!

When I was a medical student in California, many of my classmates expressed relief that we weren’t in a medical school on the East Coast.

“Everyone is so serious over there,” they said.

The stories we heard about medicine back East!

  • “The medical students have to give all of their patient presentations from memory during rounds!”
  • “You have to wear a coat and jacket all the time! It doesn’t matter if you are on call! You change into scrubs after 9:00pm and then, before rounds in the morning, you clean up and put your suit back on! The attendings never see medical students or residents in scrubs!”
  • “If attendings ask you a question you can’t answer, they throw you out of (rounds, the operating room, the cafeteria)! They scream things like, ‘DON’T COME BACK UNTIL YOU KNOW THE ANSWER!!!’”
  • “They have to keep their white coats buttoned all the time! ALL THE TIME!”

These stories must have trickled down from the interns and residents who attended medical schools on the East Coast. Funny, though: I did not hear these tales directly from them.

During my surgery rotation, one of my residents attended a medical school in New York City. This surgery resident had olive skin, dark brown hair, and manicured fingernails. He smiled only once during the month-long rotation.

“Medical students don’t have any respect for the attendings here,” he once complained to the chief resident. The chief was a young man who was almost bald, had grey-purple bags under his eyes, and always carried a travel mug full of coffee.

“Back where I went to medical school,” the resident continued, “everyone called the attending surgeon ‘sir’. We all stood up when an attending walked into the room. If the attending asked us a question, we always finished our sentences with ‘sir’. You only spoke when you were spoken to. And our white coats were always buttoned.”

My classmates and I shot knowing glances at each other.

We then shoved our presentation notes for rounds into the pockets of our short white coats that were hanging open over our green scrubs.

During my time in New York City, I rotated through three different hospitals as a fellow. I visited many wards as the roving consult psychiatrist: I noticed the internists rounding in the hallway, saw the obstetricians rushing to labor and delivery, observed the surgeons dashing down the stairs, peeked at the radiologists staring at films on computer screens, spotted the pediatricians cooing at toddlers, and glanced at the internists still rounding two hours later.

From my observations at these three hospitals in New York City, I can say the following with confidence:

  • The medical students do not give presentations from memory. They read from their notes. Their voices are infused with anxiety and self-doubt. They are just as nervous as medical students out West.
  • I never saw any medical student, intern, or resident wearing a suit. If they were post-call, they were wandering around in their wrinkled scrubs and sneakers. If they were not on call, many men did not wear neckties! The occasional attending would wear a suit to work, but that was an uncommon sight.
  • Though I saw many floundering medical students, I never witnessed an attending throw a student out of rounds or the cafeteria. (I can’t comment about the operating room.)
  • Many physicians, regardless of their position in the hierarchy, did not button their white coats.

Nonetheless, I do believe medical training and medicine is more formal on the East Coast. More to follow.