For the first time in its 137-year history, students at the University of Pittsburgh School of Medicine (Pitt Med) updated the oath they make at their white coat ceremony, replacing the standard Hippocratic oath with one that acknowledges the lives lost to Covid-19 and pledges to combat racism and inequity in health care. 

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Background

According to the Washington Post's "Inspired Life," nearly all medical schools in the United States use an oath—commonly a variation of the Hippocratic oath—at their white coat ceremony or at graduation, and some use it at both. While some schools have a unique oath, others permit students to help write and finalize the oaths they make during these ceremonies.  

Pitt Med has used the same oath since it was founded in 1883—until this year, that is, when Chenits Pettigrew, associate dean at the medical school, proposed allowing the incoming class to collaboratively write a new pledge for their white coat ceremony.

According to "Inspired Life," the class readily accepted the proposal, forming an oath committee in collaboration with advisors and student affairs leaders that dedicated 80 hours to writing the "Oath of Professionalism" during orientation week.

According to Tito Onyekweli, a first-year medical student involved in drafting the new oath, the writing process "was an exercise in displaying the values we want to exhibit as doctors." He explained, "We worked collaboratively but disagreed at times, we brought up topics that were triggering for some but did not push the status quo enough for others. We were diverse in the most collective sense."

Once the draft was completed, the committee submitted it to the entire first-year class for review and feedback and then—the Friday before their white-coat ceremony on Aug. 23—they formally presented it to Anantha Shekhar, senior vice chancellor for health sciences and dean of the school of medicine. 

According to Pittwire, going forward, incoming students at Pitt Med will be permitted to collaboratively write their own oath during orientation week to help them establish their identities as doctors. 

A new oath

According to Pittwire, the new oath acknowledges that the class is launching its "medical journey amidst the Covid-19 pandemic and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery."

It goes on to "recognize the fundamental failing of our health care and political systems in serving vulnerable communities," and situates itself as "the first step in our enduring commitment to repairing the injustices against those historically ignored and abused in medicine: Black patients, Indigenous patients, Patients of Color and all marginalized populations who have received substandard care as a result of their identity and limited resources."

In addition to pledging to support their professional colleagues, commit to lifelong scholarship, and care for their own health, the students also promised to "champion diversity in both medicine and society," ally themselves with all "underserved groups … to dismantle the systemic racism and prejudice that medical professionals and society have perpetuated," and "restore trust between the health care community and the population in which [they] serve."

Reflecting on the new oath, Shekhar said, "At Pitt, we challenge our students to change the world—and the future of medicine—for the better. This class didn't wait." She added, "Their class oath, the first of its kind in our program's history, speaks to the power and importance of clinical care and research in creating a more inclusive and just society, and I am excited to watch them put this promise into practice" (Onyekweli, "Inspired Life," Washington Post, 9/26; Pittwire, 9/11).