At Saba University School of Medicine, all first semester students undergo the rite of passage known as the White Coat Ceremony—you don a short white coat, a symbol of your status as a full-fledged medical student. Upon graduation from Saba, that short coat will be replaced by a long one, a sign of your status as a full-fledged physician. End of story? Not by a long shot.

 For starters, a lot of professionals in the medical world now wear long white coats. To an anonymous, young, female physician blogging on KevinMD, this is troubling: “As a female physician I often will enter a room and introduce myself as Dr. (last name), and I cannot tell you how many times the patient or family member will remark to another person in the room or on the phone, and say “Oh, the nurse is here.”

 This physician isn’t putting down non-physician colleagues—simply wondering if there isn’t a way that other medical practitioners can acquire a distinctive, professional attire, symbolizing the dedication and skill they bring to healthcare, without it being the long white coat traditionally worn by physicians.

 For Shivam Joshi, MD, the issue is not who wears the white coats, but where. Writing in his blog AFTERNOONROUNDS, he reports being aghast at running into a fellow physician wearing his white coat at the grocery store.

 Dr. Joshi cites studies showing how much bacteria has been found on white coats and notes that Britain’s National Health Service now bans doctors from wearing white coats in the hospital and the United Arab Emirates’ Ministry of Health bans them outside the hospital.

 The Society for Healthcare Epidemiology in America (SHEA) recently recommended that healthcare providers should possess two or more white coats, launder them regularly and have access to hooks where the white coat (or other long-sleeved outerwear) could be placed prior to patient contact.

 So, that first-semester White Coat ceremony? It’s a rite of passage into the world of healthcare in more ways than you might have realized.