Professional dress: does it matter any more?

Sorry, I have been absent for a couple of weeks.

We started a new class of students off on their medical journey last month. The first year students arrive on campus bright-eyed and bushy tailed as it were. At our school most are fresh out of college. They have spent the last four or five years as Biology or Chemistry majors. They went to class or maybe they didn't. Most college courses don't have attendance requirements. They are generally allowed to dress however they want, this time of year shorts, flip flops and ball caps are the norm.

In 2005, there was a big flap (or should I say flip/flap) when the national championship women's Lacrosse team from Northwestern University was invited to the White House to meet President George Bush.  The scandal began when several people noticed that a picture taken of the ladies showed four of the nine players in the front row wearing flip flops.  Now these ladies were dressed up in skirts and nice clothes. After all they were meeting the President, but dressing up apparently did not include changing shoes.

 

So here we are with another class of new medical students. I am the co-director of the first module so I am sitting there in class most every day. The students are polite, they almost always address me as Dr Delzell, and so far I have not seen any rude behavior in class. But at least half the class is wearing flip flops. T-shirts are the norm. Many extolling their undergraduate school or their fraternity/sorority. Many of the guys wear ball caps. 

Now don't get me wrong, I like to dress casual. As soon as I get home from work I put on shorts and a t-shirt. I love to wear flip flops. I would love to have a job at a medical school that is located on the beach so I could wear casual Hawaiian-style shirts and flip flops every day.  But I don't.  And neither do our students. 

I know that there are some schools that require professional dress whenever the students are on campus. Dr. David Steele, Senior Associate Dean for Medical Education at the Paul L Foster Texas Tech School of Medicine in El Paso has told me that at their new medical school the faculty decided to require students to dress professionally every day. Even during the basic science lectures. And last year, we were invited to be visiting professors at the Yerevan State Medical University in Yerevan Armenia. We visited the campus and toured one of their large lecture halls that would hold about 600 first year medical students. It had hard wooden benches and no air conditioning and the students were required to dress up (suit and tie for the men) each day for lecture.

I don't know if it makes a difference. We talk all the time about how Millennials-Generation Y is different from past generations. I am sure that in the sixties when the hippies started their first day of medical school, they were wearing bell bottoms and tie-dye shirts. I am sure the professors were concerned about the lack of professionalism that those students displayed.  This is to some extent a generational issue that is seen every year. But where is the line?  When is it a generational issue-where the younger generation have a different set of internal rules and values that guide them in different ways than a previous generation? And when is it a maturation issue-where you need to learn behavior from those that are your teachers and mentors?

New Salina med school campus unique in U.S.

The following is an excerpt (posted with permission) of an article by Dave Ranney from the Kansas Health Institute News Service that was originally posted on July 5, 2011 on the KHI website. Dave Ranney graciously gave permission for this reposting.

SALINA — Next month (actually tomorrow), the University of Kansas School of Medicine will open a four-year, fully accredited school – officials prefer to call it a campus – next door to the Salina Regional Health Center.

“This will be the smallest medical school campus in the country and Salina will be the smallest city in the country - outside of a few major suburbs - to have a medical school campus,” said Dr. Heidi Chumley, senior associate dean for medical education at KU Medical Center.

The first class will have eight students, seven of whom are from Kansas.  KU Medical Center officials said they plan to add eight students a year at the campus in each of the next four years.

More primary-care docs

“The goal is to develop more primary care doctors for rural Kansas,” Chumley said. “We’re shooting for 75 percent (of the new school’s eventual graduates) choosing primary care, and 75 percent rural.” Much of the new school’s curriculum will be tied to the classroom offerings at the KU Medical Center’s campuses in Kansas City and Wichita. “We completely redid our curriculum about six years ago. It’s very computerized now,” said KU Medical Center Executive Vice Chancellor Dr. Barbara Atkinson. “All the lectures are podcasts. They’re all going to be teleconferenced (in Salina), though some will be generated on-site.”

The cost of remodeling the three-story building has been picked up by Salina Regional Health Center. And the hospital’s foundation and several private donors are covering many of the operational costs and scholarship offers. “So far, we’ve not asked the state for any money for this because we understand the financial situation the state is in,” Atkinson said. “But we have asked donors to support it and they’ve been very, very generous. Incredibly generous.” Salina-area benefactors, she said, hope to raise $2.5 million over the next four years. They’ve already raised $1.5 million with $1 million coming from the Salina hospital.

Salina Regional Health Center has hosted a residency program for KU Medical School graduates for about 30 years.  Most of its residents went on to start or join rural practices.

Model for other states

“What the University of Kansas is doing, I think, will be a template for having a positive impact on the number of medical practitioners in rural communities,” said Brock Slabach, senior vice president at the National Rural Health Association. “Other universities will be watching because, really, for a major medical school to commit itself to meeting rural-community needs like this is truly novel. It shouldn’t be, but it is.”

Slabach said he’s long been baffled by the fact that medical school officials in many rural states’ fail to see the connection between their states' shortages of health care providers and their students leaving for big cities in other states. “I wouldn’t include Kansas in that group,” he said. Last year, a national survey of how well medical schools were fulfilling their “social mission to train doctors…” ranked KU School of Medicine fifth in the nation. The school was ranked eighth for its percentage of graduates (44 percent) practicing in underserved areas.

Earlier this year, a Kansas Department of Health and Environment survey found that 51 of the state’s 105 counties had less than one physician per 2,695 residents and were considered medically underserved.

Looming retirements

“The shortage of health care professionals has been a critical issue for a long time,” said Dr. William Cathcart-Rake, director at the KU-Salina campus. “It’s not new, but what is new is that now we have a number of physicians who are nearing retirement age, and a good number of them are practicing in the rural communities.” Generating enough new doctors to replace those who are retiring – especially in rural areas - will be difficult, he said. “We have to do something,” Cathcart-Rake said. “We can’t keep doing what we’ve always done. It’s not enough.”

The Salina campus, he said, will be geared toward allowing students from small towns to complete their studies and residencies in a small-town environment. “There is evidence that shows that if someone is trained in a rural area they are more likely to stay in a rural area,” he said. “So the idea is that from day one we’ll be training our students in in non-metropolitan settings and exposing them to all the good and the bad that comes with life in rural Kansas. After that, we’ll hope for the best.”

Cathcart-Rake, who grew up in small town in Orange County, Calif. (“…back when there was still a small town in Orange County”), has been practicing medicine in Salina for 32 years. “The perception is that if you go to a small town you’ll work yourself to death, you’ll never get a vacation and you won’t get to spend time with your family,” he said. “The way to get around that is to be with a group of physicians so you can cover for each other so you don’t have to do everything for yourself.