Metonyms in Medicine: Town Versus Gown

John M. Purvis, MD

“Town versus Gown”—what does that phrase mean to you? Often that question leads to blank faces instead of answers. In the medical world, the phrase represents the sometimes prickly relationship between university physicians and community doctors. Those who practice at or near an academic medical center may recognize the phrase and its connotations but perhaps be unaware of its origin or history.

The distinction—and possibly a mutual suspicion—between academic institutions and their surrounding communities has been around for ages. During the medieval period, European university students and teachers wore scholars’ gowns with hoods that distinguished them from the other townspeople. The gown provided warmth in the cold, drafty halls of learning and evolved into a tradition. The colors of the colleges were often added to the hood, adding to their distinction. The gowns were social symbols and certainly hampered any potential physical work.

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