Untied

Dress code in medicine has always been important, perhaps dating from the 1856 Medical Act when barber surgeons needed to establish their respectability and equal standing with their Harley Street colleagues. For me, as an unreconstructed scruff, it has been a problem since medical school days. As London clinical students in the 1960s we heard dark tales of students being sent home from St Thomas's down the road for not wearing suits with matching shoes. At liberal University College Hospital we were not exactly flower power, but we prided ourselves on a relaxed attitude towards jackets and woolly jumpers. For the men, though, ties were still de rigueur on the wards.

Evidence based medicine reveals that patients like their doctors to look respectable (bmj.com/cgi/content/full/320/7230/S3-7230). It would have been unthinkable for a male doctor progressing through the hospital grades …