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attire for males
- Thread starter bruins2007
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bruins2007 said:
You wear whitecoat so whether your sleeves are up or down doesn't matter - mine are always up. There is a separate thread on comfortable shoes.
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I'll be wearing my birkenstock clogs with my slacks and dress shirt. Looks a little weird but I'm pretty sure that comfort while outrank appearance. Af riend of mine says that his class eventually just wore sneakers even with dress clothes.
D
deleted87716
bruins2007 said:
If you're wearing a lab coat, you should roll your shirt sleeves down, otherwise they bunch up under the coat sleeves and look like hell. Don't wear short-sleeved dress shirts unless you want to look like Dr. Dilbert. 😉
Since you're otherwise wearing professional attire, I'd stay away from athletic shoes, unless you like the "standup comic" look.
Rockports, Mephistos, Clarks and other "sport/dress" shoes are popular choices. You can get away with clogs, but IMO, they work better with scrubs.
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There *are* nice dress shoes like KentW stated that ARE comfortable and can be worn for long hours. Clogs specially Crocs look like **** with a suit IMHO.
M
Mr. McDuck
Aw man. Rockports are so damn comfortable. I have a slip-on pair and a pair with laces, and I have to say that they are definitely the best pair of dress shoes I own as far as looks/comfort goes. 👍
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Ties, arms rolled down so you can see the cuff beyond your white coat, and slacks.
As for shoes, I wear either my black danskos (yes they look different-but I only wear them with dark slacks) or my streetcars, which look good.
No one has ever given me crap about my shoes. In fact, I got one attending to buy a pair, and now he wears them everyday. Or he used to, havn't seen him in 6 months. Do not sacrafice your feet for style. Sacrafice for a stuffy shirt or something, but at night when you get home, your feet CANNOT hurt your gonna hate life.
As for shoes, I wear either my black danskos (yes they look different-but I only wear them with dark slacks) or my streetcars, which look good.
No one has ever given me crap about my shoes. In fact, I got one attending to buy a pair, and now he wears them everyday. Or he used to, havn't seen him in 6 months. Do not sacrafice your feet for style. Sacrafice for a stuffy shirt or something, but at night when you get home, your feet CANNOT hurt your gonna hate life.
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something I found entertaining was the ever so subtle degeneration of formal attire as third year progressed. It was especially noticeable among those (like myself) who *hate* formal attire. My own personal downslide went a little something like this.
At the beginning:
Shirt: professionally pressed, only button-down business wear
Tie: also pressed, matched perfectly
Pants: suit-quality, dark colors as a rule
Shorty white coat: professionally pressed, flawlessly white, buttoned up
Halfway through the year.......................
Shirt: you know, a few minutes in the dryer and that shirt is perfectly presentable
Tie: will only wear if made to, and in this case, will not match to subtly broadcast my annoyance
Pants: why am I wearing $100 pants only to get **** on them? Khakis are perfectly serviceable
Shorty white coat: wrinkled, kind of ochre-colored, too full of crap to button up
Towards the end of 3rd year...................
Shirt: as an experiment, I would wear a casual button down or polo, if no reaction, the flood gates are open!
Tie: yeah right
Pants: usually khakis or casual pants, dewrinkled in the dryer for a few minutes - hey, if I had my way I would wear jeans
Shorty white coat: probably somewhere around here, I could produce it if needed
As a 4th year....................................
Shirt: T-shirt or scrub top, T-shirt may be borderline inappropriate
Tie: likely will not resurface again until I go on the interview trail.
Pants: scrub pants, sagging because they're not really meant to fit anyone, but also because that's where I keep all my crap now
Shorty white coat: crumpled somewhere on the floor of my closet
I know a fashion nazi out there will read my post and have a seizure: in my defense, everything was always clean and presentable, I'm just a fan of "functional" attire. I almost had a seizure myself when I read on SDN that someone suggested dropping 4G's on clothes. Jeez, that's my budget for 3 months. My advice for current third years is to "test the waters" as I did before reverting to a preferred attire. Good luck.
At the beginning:
Shirt: professionally pressed, only button-down business wear
Tie: also pressed, matched perfectly
Pants: suit-quality, dark colors as a rule
Shorty white coat: professionally pressed, flawlessly white, buttoned up
Halfway through the year.......................
Shirt: you know, a few minutes in the dryer and that shirt is perfectly presentable
Tie: will only wear if made to, and in this case, will not match to subtly broadcast my annoyance
Pants: why am I wearing $100 pants only to get **** on them? Khakis are perfectly serviceable
Shorty white coat: wrinkled, kind of ochre-colored, too full of crap to button up
Towards the end of 3rd year...................
Shirt: as an experiment, I would wear a casual button down or polo, if no reaction, the flood gates are open!
Tie: yeah right
Pants: usually khakis or casual pants, dewrinkled in the dryer for a few minutes - hey, if I had my way I would wear jeans
Shorty white coat: probably somewhere around here, I could produce it if needed
As a 4th year....................................
Shirt: T-shirt or scrub top, T-shirt may be borderline inappropriate
Tie: likely will not resurface again until I go on the interview trail.
Pants: scrub pants, sagging because they're not really meant to fit anyone, but also because that's where I keep all my crap now
Shorty white coat: crumpled somewhere on the floor of my closet
I know a fashion nazi out there will read my post and have a seizure: in my defense, everything was always clean and presentable, I'm just a fan of "functional" attire. I almost had a seizure myself when I read on SDN that someone suggested dropping 4G's on clothes. Jeez, that's my budget for 3 months. My advice for current third years is to "test the waters" as I did before reverting to a preferred attire. Good luck.
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You know there's a guy on service with me now who at least once a week flagrantly violates the dress code. He'll skip a tie or wear some blatantly athletic shoes (we're talking like Nike running ones, not the quasi-dress shoe with the stripes on them). I doubt if it's affecting his eval at all, he's a great dude and works his butt off. His patients rave about him, if you come in they'll say "where's x?"
That being said, i've seen data that said that patients DO care about what their docs are wearing, and what they want is professional attire.
Also: As I have said before, I don't buy this argument that the hospital is a violent storm of bodily fluids all trying to attach to your white coat and nice clothes. You can work plenty hard and stay clean, I'm not saying accidents don't happen - just that it's no excuse to look bad.
My favorite on this is people who act like if they're in the ED they simply MUST have on scrubs. Trauma aside (those can be pretty messy) I would argue that a day on the floors has just as much potential to dirty you up and most of us still manage to get our clothes through the year.
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We are (or soon will be) physicians. Scrubs ARE professional attire. Ties are just disease vectors and as soon as administrators get their heads out of their asses (when hell freezes over) they will no longer be required.
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Just do what feels right. I rolled up my sleeves before I walked out the door. One roll, that is; not the up-to-the-elbow look. Same with shoes. Do you like clogs? athletic shoes? From my experience, if you shine on the wards, none of this will matter. I'm not saying I shined, but I viewed all my evals at the end of the year, and none said
"questionable combination of white socks and clogs with scrubs"
"wears Asics, though I clearly told him I preferred Nike"
"click of his Dansks down the hall reminded me of my ex"
"his tie collection was directly implicated in the outbreaks of Hepatitis, psoriasis, pytariasis and amoebiasis during the two weeks on my service"
If your attending/resident wears a tie, wear a tie. If not (or if female), ask them what they prefer. And if they're even LOOKING at your shoes, it's probably because you are stumbling to respond to their pimp questions.
By the way, can someone who believes this tie-as-vector theory please post a link to a clinical article citing this item of clothing as being responsible for transmitting an infection? I haven't done a search, mostly because I don't believe it, but I'd love to be wrong about this 🙄
"questionable combination of white socks and clogs with scrubs"
"wears Asics, though I clearly told him I preferred Nike"
"click of his Dansks down the hall reminded me of my ex"
"his tie collection was directly implicated in the outbreaks of Hepatitis, psoriasis, pytariasis and amoebiasis during the two weeks on my service"
If your attending/resident wears a tie, wear a tie. If not (or if female), ask them what they prefer. And if they're even LOOKING at your shoes, it's probably because you are stumbling to respond to their pimp questions.
By the way, can someone who believes this tie-as-vector theory please post a link to a clinical article citing this item of clothing as being responsible for transmitting an infection? I haven't done a search, mostly because I don't believe it, but I'd love to be wrong about this 🙄
D
deleted87716
I've never seen a study that actually implicates neckties as disease vectors, although this is always implied simply because somebody has been able to culture bacteria off them. Of course, you could culture pretty much anything worn or used in the hospital (belts, pens, eyeglasses, jewelry, staplers, the charts themselves, etc.) and get the same results. The world isn't sterile. That's why you're supposed to wash your hands a lot. 😉
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The idea is popular because people, for some reason, hate ties. I don't understand what's so terrible about them myself, I think they look nice.
I'm not aware of any study that actually demonstrated that removing physicians neckties from the workplace decreases nosocomial infections.
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ties should be banned.
they are fustian and over rated
they are fustian and over rated
As far as I am aware, no study has been done to compare the number of infections in patient population treated by physicians who wear ties and those who do not. A study has been done to compare the number of times S. aureus could be cultured from the neckties of physicians versus the neckties of security guards. About 50% of the physician ties and 10% of the security guard ties grew bacteria. It's not a direct linkage between ties and disease, but it's close enough for my self-serving purpose. 😉
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Study: Doctors' ties may be health threat
Neckwear can harbor disease-carrying bugs
By Roni Rabin
Newsday Staff Writer
May 24, 2004, 3:39 PM EDT
New research suggests doctors should dress down, and not just on Fridays. A small study of neckties worn by doctors at a Queens hospital found almost half the 42 ties tested harbored microorganisms that can cause illness. By comparison, only one of ten ties worn by security guards tested positive for a disease-carrying microorganism. The study is being presented Monday at the American Society for Microbiology meeting in New Orleans. Steven Nurkin, one of the authors, says the findings aren't entirely new:
Earlier studies have found bacteria on everything from doctors' stethoscopes to pagers and pens. But there's a critical difference, said Nurkin, who graduates from medical school in two weeks: Neckties need to be dry cleaned.
"Most people don't do that every time they wear a tie," he said. "You come home and throw the tie on your tie rack and a week or so later, you wear it again. It's rarely clean." Nurkin, a native of Brooklyn studying medicine in Israel, said he got the idea for the research while doing a surgery elective at the New York Hospital-Queens. He noticed the doctors' neckties because in Israel, physicians rarely wear ties.
"I watched the doctors come over for a physical exam or procedure and saw the neckties would swing in front of the patient's face, or patients would cough on them," he said. Occasionally a doctor would wash his hands -- and then adjust his tie, Nurkin said. "I thought: maybe that's a point of interest." Nurkin emphasized the ties tested did not harbor any multi-drug resistant bacteria, but said, "The potential is there."
Of the 42 physician neckties sampled, 20 contained one or more microorganisms known to cause disease, including 12 that carried Staphylococcus aureus, five a gram negative bacteria, one that carried aspergillus and two ties that carried multiple pathogens. Staph bacteria, which often live harmlessly on the skin, can cause serious wound infections; Aspergillus, a mold, is an opportunistic infection that threatens vulnerable patients. Gram negative bacteria refers to a type of staining in the lab.
Of the 10 security guards' ties, only one grew Staphylococcus aureus. Some 5 to 10 percent of all hospital patients acquire an infection in the hospital, which translates into over 2 million infections, 90,000 deaths and over $4.5 billion in annual costs, the study notes.
While being well-dressed is encouraged by hospital administrators and may add to "an aura of professionalism" and inspire patient confidence, the authors note, "As the clinician moves from patient to patient, the tie may serve to carry microorganisms from patient to patient as well." Physicians may also unwittingly carry microbes from the hospital into the community. "This study brings into question whether wearing a necktie is in the best interest of our patients," the authors conclude.
Nurkin, 27, graduates in two weeks from medical school at the American-Technion Program of the Bruce Rappaport Faculty of Medicine in Haifa, Israel.
--------------------------------------------------
Study: Doctors' ties may be health threat
Neckwear can harbor disease-carrying bugs
By Roni Rabin
Newsday Staff Writer
May 24, 2004, 3:39 PM EDT
New research suggests doctors should dress down, and not just on Fridays. A small study of neckties worn by doctors at a Queens hospital found almost half the 42 ties tested harbored microorganisms that can cause illness. By comparison, only one of ten ties worn by security guards tested positive for a disease-carrying microorganism. The study is being presented Monday at the American Society for Microbiology meeting in New Orleans. Steven Nurkin, one of the authors, says the findings aren't entirely new:
Earlier studies have found bacteria on everything from doctors' stethoscopes to pagers and pens. But there's a critical difference, said Nurkin, who graduates from medical school in two weeks: Neckties need to be dry cleaned.
"Most people don't do that every time they wear a tie," he said. "You come home and throw the tie on your tie rack and a week or so later, you wear it again. It's rarely clean." Nurkin, a native of Brooklyn studying medicine in Israel, said he got the idea for the research while doing a surgery elective at the New York Hospital-Queens. He noticed the doctors' neckties because in Israel, physicians rarely wear ties.
"I watched the doctors come over for a physical exam or procedure and saw the neckties would swing in front of the patient's face, or patients would cough on them," he said. Occasionally a doctor would wash his hands -- and then adjust his tie, Nurkin said. "I thought: maybe that's a point of interest." Nurkin emphasized the ties tested did not harbor any multi-drug resistant bacteria, but said, "The potential is there."
Of the 42 physician neckties sampled, 20 contained one or more microorganisms known to cause disease, including 12 that carried Staphylococcus aureus, five a gram negative bacteria, one that carried aspergillus and two ties that carried multiple pathogens. Staph bacteria, which often live harmlessly on the skin, can cause serious wound infections; Aspergillus, a mold, is an opportunistic infection that threatens vulnerable patients. Gram negative bacteria refers to a type of staining in the lab.
Of the 10 security guards' ties, only one grew Staphylococcus aureus. Some 5 to 10 percent of all hospital patients acquire an infection in the hospital, which translates into over 2 million infections, 90,000 deaths and over $4.5 billion in annual costs, the study notes.
While being well-dressed is encouraged by hospital administrators and may add to "an aura of professionalism" and inspire patient confidence, the authors note, "As the clinician moves from patient to patient, the tie may serve to carry microorganisms from patient to patient as well." Physicians may also unwittingly carry microbes from the hospital into the community. "This study brings into question whether wearing a necktie is in the best interest of our patients," the authors conclude.
Nurkin, 27, graduates in two weeks from medical school at the American-Technion Program of the Bruce Rappaport Faculty of Medicine in Haifa, Israel.
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I agree up to this point...
Past that? Its a small study and besides, how much s. aureus was cultured from their respective sleeves? or shirts? or hands?
Its all idle speculation unless you do a large study with an endpoint that means something-- rates of infection.
Past that? Its a small study and besides, how much s. aureus was cultured from their respective sleeves? or shirts? or hands?
Its all idle speculation unless you do a large study with an endpoint that means something-- rates of infection.
True. The main differences noted between ties and other articles of clothing/instruments/hands would be that they are rarely washed. You wash your hands as you leave a room, you swab your stethescope with alcohol between patients, and you wash your shirts (hopefully). Now, the tie is a dangling accessory that can brush against patients and their beds as you are doing a standard exam. So, it may be a small study and it may not be direct evidence, but if washing hands has cut down on infections/deaths, it makes sense that eliminating another source of bacteria could do the same thing. I would rather err on the side of caution and wait for a good study to come out which indicates what the effect of removing the tie is.
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Slightly off topic, but the only place where I consistently see stethoscope cleaning is in the newborn nursery. . . sometimes in an ICU setting.
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maybe....but there is no shortage of things in medicine that make sense but aren't actually true.
And I've yet to run into a single person on my IM rotation who swabs their stethoscope with EtOH after every patient encounter...or, hell, even once a day. The closest thing I see is not using your scope on a pt with contact precautions
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It's most certainly a small observational study, not a controlled experiment. And it was never published in any ASM journal by my search, only presented at a conference. And newspapers don't print articles because they are necessarily true; they print articles that will be read and stimulate purchase of future newspapers. I think they are actually a rather careless bunch.
As for clinical situations, I wash my hands because they have come in direct contact with the patient. My tie does not. Yes, it may brush up against the bedsheets, etc., but now you are talking about multiple latent vectors between hosts, which drastically reduces the inoculation load. Believe me, I am Monk-like when it comes to my clothing. It bothers me more than anyone else if my tie comes into contact with items outside my control.
Yes, I wash my shirts after each wear, but I don't wash them between rooms. That's when I would be most worried about nosocomial transmission, not the next week when I recycle my tie with another blue shirt. If I look at my actual behavior, I would guess that, after my hands, my white coat is what contacts the patients most frequently. That's good, because it keeps my tie safe. But I would guess I am somewhat vigilant in washing my white coat once a week. I know several people in my class who did not wash it for the first three years of medical school.
In full disclosure, however, I have stopped wearing my white coat except when absolutely required by certain rotations. it's got nothing to do with S. aureus, though. I just hate short white coats. Probably like some people hate neckties 😉
