To the Editor:
As one of the secretaries for the Liaison Committee on Medical Education (LCME), I have the privilege of visiting many medical schools in the United States and Canada. When I started that job in 2007, I began a practice of visiting each school’s bookstore and purchasing a coffee mug picturing the school logo. (Rule number one in accreditation is no gifts, so feel free to inventory my collection of receipts.) Now, when school representatives visit my office at the Association of American Medical Colleges (AAMC), I offer them coffee in cups from my collection, which allows me to say that the LCME serves the schools. However, as the collection expanded and began displacing books on my shelves, I noticed that some schools had logos with an image of a staff with wings at the top and two serpents entwining the staff, while others had logos with the staff, no wings, and one entwining serpent. In a decidedly flawed methodology to understand the prevalence of these two versions, I discovered that of the 91 cups collected to date, 12 have two serpents and wings at the top of the staff, and 13 have a single serpent entwining a staff and no wings. The rest of the cups have no version of this symbol.
Turning to the literature,1,2 I learned that in 1902 the Secretary of the Army assigned a junior officer to design a shoulder patch for his new Army Air Medical Corps (thus the wings at the top of the staff). The officer, however, did not know his Greek mythology and chose the two-serpent version, which is the caduceus, the staff carried by the ancient Greek god Hermes. Unfortunately for the officer (and now us), the caduceus is the symbol of business and, some would say, of deception. Instead, he should have used the single serpent around the staff, which is associated with Aesculapius, the god of medicine in Greek mythology, and is a widely accepted symbol of healing.
If you look through the kitchen cabinets of the AAMC, you can occasionally find a pre-2005 coffee cup, and there, in full glory, is the image of two serpents around a staff. This served as the logo of the AAMC for many years until someone pointed out the error. When I gently mentioned the history of the AAMC’s logo to a faculty member at a school whose logo proudly displayed the caduceus, my statement was met with disbelief and I was assured that the caduceus had been part of the school’s logo for 120 years. One month later, I received an e-mail from that individual telling me that the school was changing its logo.
So what are we to think about those schools that seem to be announcing with the caduceus symbol on their cups that business is their mission? Do they realize the message they are sending? Whatever their reasons for using the caduceus, rest assured, the LCME has no plans to develop a new standard related to logos.
Dan Hunt, MD, MBA
Co-secretary for the LCME and senior director for accreditation services, Association of American Medical Colleges, Washington, DC; firstname.lastname@example.org.
1. Wilcox RA, Whitham EM. The symbol of modern medicine: Why one snake is more than two. Ann Intern Med. 2003;138:673–677
2. Bunn JT. Origin of the caduceus motif. JAMA. 1967;202:615–619