Choosing what to wear during clinical rotations, residency and beyond

Medicine is one of the most respected professions. This respect has allowed physicians to maintain a high degree of social standing for generations, and it has led professionalism to be the foundation of the medical field. As individuals participating in the most intimate and stressful moments of patients’ lives, building rapport and trust with patients is key to providing the best care. While professionalism encompasses both tangible and intangible factors, attire remains one of the most visible and impactful aspects of a physician’s professionalism.

Over the years, physician attire has evolved, shaped by cultural expectations, practicality, developments in materials and symbolism. The white coat has become synonymous with the medical profession; many patients understand that individuals wearing white coats hold authority within health care settings. Yet, while the white coat continues to hold this power, expectations of professional dress have shifted over generations, which can make choosing what to wear a complicated choice for younger health care professionals.

Also, many physicians see patients from different generations, and these patients maintain different expectations for professional attire based on their lived experiences. Young physicians must navigate the dichotomy of working with peers, who often value a more casual approach to professionalism and put less emphasis on attire, with treating patients.

In this article, I share my recommendations for choosing your attire as a medical student or young physician, based on my own experience of completing rotations and my prior medical workplace experiences. I also share some information about how physician attire has evolved over the years and how physician attire can impact patient and peer perceptions.

Recommendations for medical students and young physicians

As a third-year medical student, I have personally worked in various specialties and health care settings during my rotations and prior medical experiences. At my medical school, we switch locations every four weeks, which means we are entering a new hospital or clinic monthly. This puts us in the unique position of guessing how professional our attire should be every few weeks. While starting over so often can be petrifying, I can confidently say I have my professional wardrobe down to a science.

Here are my best tips for dressing professionally as a medical student on rotations or a young physician entering an unfamiliar environment:

• Start with business casual attire and adjust accordingly: Unless otherwise specified, business casual attire with a white coat is always the safest option for the first day of a new rotation or job. It is easier to scale back than to overcome a poor first impression. Showing up in clothes that are on the more professional side shows the staff and other physicians that you take your position and appearance seriously.
• Know your setting: Scrubs might be the ED’s and the OR’s best friend, but they can look out of place in outpatient clinics—not every setting is right for scrubs.
• Build rapport beyond clothing: While attire matters, professionalism also includes communication skills, empathy and reliability. These qualities ultimately solidify patient trust and colleague respect.
• Be mindful of your accessories: Dangly earrings, sparkly necklaces and stacks of bracelets might complete your outfit outside of work, but swapping those pieces for a stethoscope, pen and notepad will set you up for success. Anything that could be considered distracting to you or your patients should be left at home to allow for the best patient care possible.
• Keep your hair up: Even Rapunzel had to braid her hair in order to function. It’s best to keep your hair up and out of your face anytime you’re in a setting that might involve procedures, bodily fluids or surgery.
• Walk a mile in these shoes: As a health care professional, you will be on your feet for the majority of your day. Choosing supportive, comfortable shoes is a must. If you’re in an environment where you can wear scrubs, you can choose sneakers, Crocs or clogs. When wearing business casual, leather sneakers have become commonplace as they are both professional and comfortable, and loafers are another great professional-yet-functional shoe. 
• Layers: We all know how cold hospitals can get, so don’t set yourself up to freeze all shift. Wearing layers allows you to adjust your clothing to fit the temperature of your environment. Leaving a fleece or under-scrub top in your locker or work bag will ensure you’re never cold.
• Do not disturb: Don’t be the person whose phone starts ringing during rounds. Wearing a smart watch is a great way to count your steps and always know the time, but make sure to put your notifications on Do Not Disturb. You wouldn’t want an unprofessional text to pop up on your wrist while you’re taking a patient’s blood pressure or presenting to an attending.

Attire is just one facet of professionalism, but it plays a crucial role in shaping perceptions in the medical field. For young physicians, navigating generational and cultural differences in expectations can be challenging, but thoughtful clothing choices can enhance your credibility and foster trust. As medicine continues to evolve, so too will the standards of dress.

Breaking down the historical context

Physician uniforms have undergone significant transformation over the centuries. Early medical practitioners often wore dark robes, signifying knowledge and authority, similar to academics of this era. Through the 1400s–1800s, physician attire remained the same—all-black, wax-coated leather outfits fitted with a bird beak mask reminiscent of infamous Black Plague art. These uniforms were believed to protect physicians from disease, repel bodily fluids and allow them to breathe purified air.

As physicians at the time were all male, women’s role in health care encompassed nursing. Their uniforms were based off religious habits, meant to show humility and rejection of material goods, not designed with hygiene in mind.

As medicine transitioned into a more science-driven discipline, the attire shifted to reflect sterility and hygiene. In the latter half of the 19^th century, physicians adopted the white coat to further differentiate themselves from other professions. Nursing uniforms also evolved, removing religious motifs and restrictive elements of the uniform to focus more on efficient care. Health care uniforms have continued to evolve, maintaining the focus on efficiency, safety and functionality, but the white coat has remained.

Today, the white coat’s symbolism persists: It is a universally recognized sign of safety and aid. However, not all physicians choose to wear a white coat, and for those who do, what they wear underneath differs depending on their specialty, setting and age.

Patient perceptions

Large health care facilities employ dozens of different types of health care workers, ranging from scribes and nursing aides to physical and occupational therapists, physician assistants, midwives and nurse practitioners. Those familiar with the health care sphere understand the differences in training and job duties these various careers have. However, patients do not always have this same understanding. While name tags and badges can be helpful, many patients and their families still look for the white coat in the crowd when they need help.

A study by BMJ Open highlighted how patients’ perceptions of their physicians are influenced by their outward appearances. A systematic review regarding patient perceptions of physician attire shows that business casual attire, particularly when paired with a white coat, is often associated with greater trust, competence and professionalism. Older patients tend to prefer more traditional, professional dress, while younger patients are often more accepting of casual attire. Younger physicians, residents and medical students may need to adhere to stricter standards to establish credibility, whereas older physicians are often afforded the benefit of assumed competence regardless.

These assumptions of intelligence and qualifications are also impacted by the difference in age of the physician compared to the patient. Based on my own experiences, I’ve noticed that an older patient is more likely to feel comfortable and confident in their physician when they believe their physician has decades of experience.

Beyond patient preferences, attire can impact tangible outcomes. Studies suggest that patients are more likely to follow treatment recommendations and report higher satisfaction when their physician dresses in a way they perceive as professional and trustworthy. This highlights the importance of attire not just as a superficial concern, but as a factor influencing the patient-physician relationship.

Peer and supervisor perceptions

Clothing choices also affect how physicians and medical students are perceived by their peers and supervisors. Unsurprisingly, in many fields, attire subconsciously influences assumptions of competence and professionalism among colleagues, including those in health care. For medical students and residents, erring on the more professional side can help mitigate biases from colleagues. However, aiming to match senior staff’s level of professionalism in attire can be an even better choice. Young professionals who dress more formally than their attending’s idea of appropriate attire for the workplace could stand out negatively.

As younger generations are stepping into their careers, they bring a different set of expectations to the table. Much higher percentages of young medical students, residents and physicians prefer scrubs and fleece jackets over business casual attire and white coats. Valuing personal comfort over public perception is new to the world of health care, but the switch to less formal attire has been spreading quickly.

Many doctors have taken to social media to educate the public about health care, the process of becoming a physician and the differences in education and training between those in different health care roles. Many of these doctors post pictures and videos of themselves in their scrubs, creating positive associations with a more casual uniform. The more patients see physicians in scrubs, the more comfortable they become with them.

While professional dress preferences have varied throughout the decades, it’s clear that it’s important for medical students and physicians to project a professional and trustworthy image. Assess your own preferences and your environment to determine the wardrobe choices that are right for you.

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