Sir William Osler occupies a revered place in the mythos of the history of medicine, medical education, and medical practice. Because he is celebrated as the “father of internal medicine,” his legacy and practice have been claimed by hospitalists, specialists, and generalists alike. Throughout his career, he blended inpatient care and bedside teaching and promoted continuous learning. In this regard, he may be clearly viewed as a proto‑hospitalist even though his career spanned an era when inpatient care, bedside teaching, and longitudinal physician‑patient relationships were not yet distinct domains but were intertwined expressions of the nascent professional identity of physicians.
Understanding where he truly fits requires looking beyond the mythology to the practical realities of his work—how he spent his time, what responsibilities he prioritized, and how he conceptualized the role of the physician and the relationship of physicians to patients, trainees in medicine, institutes of higher learning, communities, and society.
This Flipside considers these viewpoints as seen through the eyes of SHM member trainees, hospitalists, and medical educators, and sets the stage for a closer examination of Osler as a clinician, educator, and system builder, and what his example reveals about the evolving identity of hospitalists, generalists, and internal medicine specialists everywhere.
Osler Was an Archetype and a Prototypical Hospitalist
A hospitalist, as defined by Drs. Wachter and Goldman, in 1996, is a specialist in inpatient medicine who are uniquely positioned to focus on clinical quality improvement and research, development of practice guidelines, and teaching clinical medicine.1 By this definition, Osler exemplified the quintessential hospitalist.
Osler lived during a time when quality improvement and practice guidelines did not exist as they do today. While he did not conduct quality improvement or research experiments by modern standards, Osler’s scientific methods contributed greatly to the advancement of medicine. As his career progressed, he continued to gain clinical experience in hospital settings in Montreal, Boston, Philadelphia, and Baltimore.2 It was in his work in the hospital where he refined the concepts of time management and compartmentalized bedside rounding, opening a new chapter in medical education that connected medical knowledge learned in classrooms to lived clinical experiences. Although practice guidelines did not exist at the time, Osler drew on his advanced knowledge and experience to write his classic textbook, “The Principles and Practice of Medicine,” and to set standards for medical school education and clinical training programs.2
While all these accomplishments are impressive, Osler’s dedication to all phases of education stands the test of time. His teaching methods, which are centered on learning from patients at the bedside, became the precursors to medical students’ clinical clerkships and the medical residency system that still exists today. Thus, as a dedicated lifelong learner, an expert diagnostician and clinician, and a beloved educator, Sir William Osler was one of the first hospitalists.
Osler Was a Classic Generalist, Medical Educator, and Humanitarian
Osler was not limited to the practice of hospital medicine; instead, he was a scientist and architect of the profession. After finishing his medical school training at McGill University in Canada, he spent a year observing the emerging clinical practices of anesthesia and surgery and set his sights on becoming an ophthalmologist, only to be edged out by the competition, which prompted an entry into what resembled today’s primary care as a local physician. Given his skills, he was recruited to join the teaching faculty at McGill University as a clinical professor of medicine. There, he performed thousands of autopsies and helped bridge the gap between pathology and histology for his students and in his practice. Demonstrating his dedication, he volunteered to be the smallpox doctor, using leftover funds to purchase more microscopes for his students.3,4
The next phase of his career was foundational—literally. Osler was the first chair of clinical medicine at the University of Pennsylvania; he founded the Association of American Physicians and co-founded the medical school at John Hopkins. These roles cemented his profound influence on medicine. Apart from writing his famous textbook, Osler actively brought the bedside to life for young medical students, modeling not only from books but also from patients. His role as professor of medicine led to the development of the concept of residency training and today’s journal clubs. As a leader of the school, Osler was instrumental in opening the door of medical admissions to women. Later in his career, he convinced his peers that having women doctors only benefited the success of the institution and advanced the profession.3
Perhaps it is his kindness and equanimity that truly define the Oslerian spirit in defining his legacy. While serving as the Regis Professor of Medicine, his home in England was affectionately named the “Open Arms,” serving as a gathering place for all to enjoy his home and personal library. As a person, he remarked on the importance of having a “clear head and kind heart,” aiming to be the best at everything he did as a physician, an educator, an advocate, and a true humanist.5 Though he spent many hours at the bedside practicing hospital medicine, his roles and responsibilities extended well beyond and shaped medicine for generations to come.
Osler Is for Everyone to Claim
Today’s medical students are all too familiar with arriving on the first day of a new rotation, seeking the correct preceptor, and working hard to make the right impressions with the team as quickly and unobtrusively as possible. How would Osler approach this today? Luckily, we have access to Osler to help inform and inspire us.6
Hospitalist or not, Osler provides all of those in medicine essential non-academic advice that can help, regardless of specialty or level of training. Osler strongly believed that punctuality and “running on time” are the prime essentials of the physician. Everyone knows the importance of timeliness, yet it regularly falls through the cracks in medical practice. Patients, fellow learners, and attending physicians alike will be satisfied (and maybe even impressed) by routine punctuality.7 Similarly, Osler emphasized the importance of appropriate bedside manner in an 1885 address to graduates of medicine at McGill University. He advised students that every patient will form an opinion of you based on your conduct at the bedside, even if the interaction does not reveal the extent of your medical knowledge.5 It is often paraphrased in the quote by Theodore Roosevelt, “They don’t care how much you know until they know how much you care.” These basic principles of patient-centered care make patients feel well cared for and will not go unnoticed by seniors from all specialties.
Osler is quoted as saying that “the education of the heart … must keep pace with the education of the head.”8 All physicians, from student doctors in their clerkships to board-certified senior attendings, can improve their practice by adopting Osler’s philosophy of compassionate care, which starts with something as simple as arriving on time. We encourage everyone in medicine to “find your inner Osler,” embrace kindness and charity, and above all, possess equanimity.
Ms. Wardrop
Dr. Spaeth
Dr. Ramelb
Dr. Wardrop
Ms. Wardrop is a third-year medical student at the West Virginia University School of Medicine in Morgantown, W.Va. Dr. Spaeth is a third-year resident at OhioHealth Riverside Methodist Hospital in Columbus, Ohio. Dr. Ramelb is a hospitalist and assistant professor of medicine at the University of Nebraska Medical Center in Omaha, Neb. Dr. Wardrop is the chief medical officer and professor of medicine and pediatrics at Northeast Ohio Medical University Healthcare in Rootstown, Ohio, chair of the American Board of Internal Medicine’s board, and an American Board of Internal Medicine council member.
References
- Wachter RM, Goldman L. The emerging role of “hospitalists” in the American health care system. N Engl J Med. 1996;335(7):514-7. doi:10.1056/NEJM199608153350713.
- National Library of Medicine. Profiles in science: William Osler biographical overview. NLM website. https://profiles.nlm.nih.gov/spotlight/gf/feature/biographical-overview. Accessed April 24, 2026.
- Stone R. Sir William Osler: science & the art of medicine. American Osler Society YouTube website. https://youtu.be/UxxZDePeeK0?si=Fe_k7aoUoGxfD0_Y. Published April 20, 2023. Accessed April 24, 2026.
- American Osler Society. The American Osler Society. AOS website. https://www.americanosler.org/content/about/the-aos-and-its-history. Accessed April 24, 2026.
- Osler, W. Aequanimitas: with Other Addresses to Medical Students, Nurses and Practitioners of Medicine. 2nd ed. London: HK Lewis; 1914. https://archive.org/details/aequanimitas00osle. Accessed April 24, 2026.
- VanderVeer JB, Bryan CS. Osler for White Coat Pockets: A Vade Mecum for Medical Students and Residents. Morgantown, Pa.: Masthof Press; 2017.
- Osler, W. Osler’s “A Way of Life” & Other Addresses, with Commentary & Annotations. Hinohara S, Niki H, eds. Durham, N.C.: Duke University Press; 2001.
- Spaulding WB. Osler-as much heart as head: The importance of compassion. Can Fam Physician. 1992;38:1617-21.