For schools that have established the SCC and HETA program, click here for online form for this year's Humanism and Excellence in Teaching Awards.
The Student Clinician's Ceremony (SCC) is designed to provide guidance, information and support as medical students transition into their clinical years. 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 or another oath, the SCC provides a forum for collective and reflective discussion of the students' experiences. 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.
The SCC also recognizes outstanding residents through the Gold Foundation's Humanism and Excellence in Teaching Award. Third year students choose up to six residents who have exhibited particularly strong teaching skills and are role models for compassionate, relationship-centered care. At the ceremony, students describe why each resident was chosen and the residents then briefly address the class of incoming 3rd year students. For schools establishing a SCC, the Foundation's support consists of a one-time grant of up to $5,000, with continuing annual support for the resident awards for any school holding an SCC.
A keynote speech by a prominent and humanistic physician role model is followed by a reception for students, faculty, friends and family. This event is student-generated and encourages 2nd year students to work with 3rd year students and residents. Many schools conclude week or day-long orientation sessions with the SCC.
The links below provide more detail on the SCC, the planning and application process for establishing the SCC, and the Humanism and Excellence in Teaching Awards.
Components of the Student Clinician's Ceremony
As a student-generated event, a planning committee of 2nd and 3rd year students, under the guidance of a faculty advisor, is selected to coordinate the SCC and incorporate the six following components.
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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).
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selection of 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.
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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.
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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.
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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.
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a reception, luncheon or dinner following or during with the ceremony.
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Humanism and Excellence in Teaching Award
Third 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.
Selection Process
Nominations are usually solicited from the 3rd year class at the end of each clerkship and at the end of the clinical year. Each school creates a fair and objective method of selecting the resident award recipients. For example, at one school, the top 20 are further pared down by a second vote of the 3rd year class. An impartial committee of 2nd year students leads this process. In other schools faculty program directors are involved in the process. Alternatively, awards can be based on a simple vote of the 3rd year class, adapting explicit criteria for humanistic behavior as teachers and role models, such as:
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consistently demonstrates compassion and empathy in the delivery of care to patients
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serves as a role model—illustrates professional behavior by example – for students and colleagues
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is approachable and accessible to students, welcoming opportunities for teaching and one-on-one mentorships with students
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exhibits enthusiasm and skill in professional and personal interactions with students
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shows respect for everyone he/she comes in contact with
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demonstrates cultural sensitivity in working with patients and family members of diverse ethnic or religious backgrounds
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displays effective communication and listening skills
Notification and Presentation of Awards
A letter is sent to relevant Chairpersons and Program Directors informing them of the resident winners and nominees in their department, and inviting them to the ceremony. All residents are informed about the honorees and appropriate publicity is sought to inform the local medical community of the honor bestowed. Schools create posters and flyers with pictures of the winners announcing the award and the ceremony, displaying them in high traffic areas of the hospital and school.
Presentation of the awards takes place during the Student Clinician's Ceremony. Usually a few words are said, or written in the program, about why each resident was chosen by his/her students, and the resident then has a few moments to address the incoming 3rd year students. Some schools also print the names of additional residents who received substantial numbers of nominations. The meaning of the award should be explained to all present as well as each item they will receive (frameable certificate, specially designed lapel pin, and check for $250).
Once a Student Clinician's Ceremony has been established at a medical school, the Gold Foundation will continue to provide up to six Humanism and Excellence in Teaching Awards each year. Grant agreements are sent out to participating schools in late winter, schools should submit an on-line form for the awards at least four weeks prior to their SCC.
Example of poster displayed in the Columbia University College of Physicians and Surgeons and in the hospital announcing the Humanism and Excellence in Teach Award winners.
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Oaths, 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.
Many schools write oaths and pledges specifically for doctors in training, and student-crafted oaths are also often used. Following are several examples of other oaths and pledges taken at Student Clinician's Ceremonies.
Medical Student Pledge of Ethics (adapted from the UT- Houston Medical School “Student Ethical Pledge”), used at the Medical College of Ohio
I publicly acknowledge and accept the privileges and responsibilities given to me today as a physician in training and dedicate myself to provide care to those in need. I will approach all aspects of my education with honesty and integrity, embracing opportunities to learn from patients, teachers and colleagues. I will always maintain the highest standards of professional conduct. I will certify only that which I have personally verified, and I will neither receive nor give unauthorized assistance on examinations. I will value the knowledge and wisdom of the physicians who have preceded me. I will recognize my weaknesses and strengths and strive to develop those qualities that will earn the respect of my patients, my colleagues, my family and myself. I will respect the humanity, rights and decisions of all patients and will attend to them with compassion and without bias. I will maintain patient confidentiality and be tactful in my words and actions. I will value the diversity of patients' experiences, cultures and beliefs because it enhances my ability to care for them and enriches my education. I will not forget that there is an art to medicine as well as a science and that warmth, sympathy and understanding are integral to patient care. I will strive to earn the trust my patients place in me and the respect that society places upon my profession. I will recognize the privileges afforded to me as a physician-in-training and promise not to abuse them. Even as a student I have a responsibility to improve the standard of health in my community, to increase access to care for the underserved and to advance medical knowledge. As I accept these new responsibilities, I will not forget the importance of my own health and well-being. I will continue to value my relations with those who have supported me in the past, those who will share in my future. Knowing my own limitations and those of medicine, I commit myself to a lifelong journey of learning how to cure, relieve and comfort with humility and compassion. I make these promises solemnly, freely and upon my honor.
SUNY Buffalo School of Medicine
I swear to fulfill, to the best of my ability, this covenant: I will respect the scientific gains of those physicians and scientists in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will remember that there is both art and science to medicine. I will pursue the expansion of knowledge throughout my life for the benefit of my patients. I will practice medicine with conscience and dignity. I will respect the privacy of my patients and not judge them. I will prevent disease whenever I can; for prevention is preferable to cure. Most especially I will tread with care in matters of life and death. If it be merely within my abilities to help ease suffering at the end of a life, may I face this awesome responsibility with humility and awareness of my own frailty. I vow always to act to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
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Student Collaboration
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.
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Keynote speaker
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.
Robert Miller, MD, MBA, speaking at University of Nevada School of Medicine SCC
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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.
Students receive gifts during SCC
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.
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Reception
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:
Patient's Perspective
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A student-made video presentation of interviews with patients and hospital staff
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Case discussions with residents and faculty that highlight the need to respect the unique needs and perspectives of the patient
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Presentations from patients describing their experiences with illness and their health care providers
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Skits illustrating doctor-patient issues
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Lectures or shows, such as "Evan Handler: One Man Show," a monologue on one man's illness
Third Year Student Experience
The outgoing 3 rd 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:
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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)
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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)
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Panel discussion about the impact of 3rd year rotations on students' personal lives
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Presentation of other creative means of reflection, including photographs, art, poetry, film or music
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Skits or discussions related to building productive relationships with all members of the healthcare team (fellow students, residents, attendings, nurses, and ancillary hospital staff)
Mentoring Program: Current 3rd year students orient 2nd year students to the hospital throughout the year, culminating with the SCC.
3rd year students present skit during SCC
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Planning for an SCC
Planning schedules and activities for the SCC vary widely from school to school. Below are planning suggestions which should be tailored to suit each school's individual needs.
Each school should select a faculty mentor and convene a planning committee of 2nd and 3rd year students to plan and carry out the Student Clinician's Ceremony. After the first year, we suggest that the working group be selected in time for the members to witness one ceremony prior to planning for the next year's ceremony.
The Planning Committee can be organized into smaller working groups which might include:
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Ceremony: responsible for keynote speaker, invitations, programs, and overall format of the ceremony.
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Awards: responsible for soliciting nominations, assuring equal access to nominations for all students, overseeing the process and communicating to the class, the nominees and their respective faculty.
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Practical Skills and Orientation: responsible for aspects of the event that enhance the practical skills of the incoming 3 rd year students. This may include the survival guide and orientation activities, such as workshops, mentoring of junior students by senior students and faculty, and panel discussions by senior students or faculty.
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Patient's Perspective: responsible for developing programs or parts of the ceremony that represent the patient's point of view.
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Group Project: responsible for organizing and creating the collaborative group project which might be a survival guide, or an artistic endeavor such as a video or skits.
Checklist items for resident awards:
• Prepare and distribute nomination information (students should be given multiple opportunities throughout the year to nominate)
• Choose and notify winners and their department heads
• Submit Gold Foundation on-line application (at least 4 weeks prior to ceremony)
• Print poster and flyers of winners to display in high traffic areas of hospital and school
Checklist items for ceremony:
• Reserve ceremony location
• Notify Dean, faculty and clerkship directors to reserve date and ensure no conflicts
• Select keynote and other speakers and faculty to lead class in oath
• Choose and order class gift
• Make catering plans
• Arrange for music and flowers
• Print invitations and programs
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SCC Grant Guidelines and Application
For schools establishing a Student Clinician's Ceremony, the Foundation's support consists of a one-time grant of up to $5,000 which may provide for:
• Catering, music and flowers for the reception
• Student gifts (such as a pharmacopeia, survival guide, journal)
• Printing of invitations and programs
• Poster and flyers announcing the Humanism and Excellence in Teaching awardees
In addition to the one-time grant, the Foundation will annually provide up to six Humanism and Excellence in Teaching Awards for outstanding residents. These awards include a certificate, specially designed lapel pin, and a $250 cash award.
To be eligible for a grant, the school must apply to the Foundation in writing stating the school's intent to adhere to the following criteria:
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Recognition by the school that this is an important and required part of the curriculum
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Designation of a faculty mentor who provides consistent program development, organizational and supervisory responsibility
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Creation of a student planning committee (of 2nd and 3rd year students) to plan and coordinate the ceremony with the faculty mentor
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Recitation (or discussion) of an oath, credo or pledge to reaffirm values of relationship-centered, compassionate and professional care (it is usually the same oath taken during the White Coat Ceremony)
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Selection of six residents by the current 3rd year class for the Gold Foundation 's Humanism and Excellence in Teaching Award
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Presentation of a gift to each member of the incoming 3rd year class
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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
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Organization of a reception, luncheon or dinner associated with the ceremony
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Cooperation by the school with any future evaluation of the program conducted by the Gold Foundation or its agents
SCC applications should be sent to proposals@gold-foundation.org.
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