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Generalists as Clinical Physiologists: Bringing Science Back to the Bedside



Few generalists engage in basic science research or feel comfortable teaching physiology at the bedside. This may reflect a lack of understanding or confidence teaching physiologic principles.


To inspire general internists to relearn and teach physiology in clinical practice.


An active biomedical research laboratory.


We educated 67 faculty participants (4 primary care, 59 hospitalists, and 4 other specialties) from 24 medical centers, representing 17 states.

Program Description

The 5-day course was structured around re-learning basic physiology principles and developing teaching skills. Participants engaged in hands-on experiments through 4 modules using aquatic species, each paired with a physiology content primer. Participants also developed teaching scripts based on their experiments.

Program Evaluation

Post-course surveys revealed that 97% felt confident teaching physiology at the bedside, 100% felt the course enhanced their understanding of the mechanisms of disease, and there was a significant improvement in self-reported teaching ability.


An immersive, hands-on faculty development course that integrated physiology with clinical decision-making increased participants’ comfort level and self-rated ability to teach and incorporate physiology in their clinical work. We believe faculty development is one potential solution to the growing chasm between clinicians and scientists in general medicine.

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The authors are extremely grateful for to the work of Deborah DeWaay, MD, and Stephanie Call, MD, in helping launching the first course in 2015. The authors would also like to express their deep gratitude for the numerous faculty who tirelessly volunteer their time to make this course possible every year, including Tony Breu, MD; Rich Schwartzstein, MD; Mark Tuttle, MD; Jeff William, MD; Melanie Hoenig, MD; Eric Osborn, MD PhD; Rick Solomon, MD; Rushad Patell, MD; Warren Hill, PhD; Bryce MacIver, PhD; Patricio Silva, MD; and Kate Spokes, BA, and the MDIBL staff including Jane Disney, PhD, and Chris Smith.

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Corresponding author

Correspondence to Daniel N. Ricotta MD FHM.

Ethics declarations

Ethical Approval

Ethical approval has been granted by the MDI Biological Laboratory IACUC board: protocol number c18-02.

Conflict of Interest

Drs. Ricotta, Hale, Freed, Zeidel, Scribner, and Herzig all receive nominal honorariums from the Mount Desert Island Biological Laboratory (MDIBL) for teaching in the Physiology on the Fly faculty development course.

The Mount Desert Island Biological Laboratory is an independent, non-profit biomedical research laboratory and all course proceeds are applied to course operating expenses and participants’ room and board. None of the authors have any financial affiliation with MDIBL. None of the authors’ affiliated institutions receive any financial benefit from the course.

Dr. Herzig reports grants from the Agency for Healthcare Research and Quality, outside of the submitted work.

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Ricotta, D.N., Hale, A.J., Freed, J.A. et al. Generalists as Clinical Physiologists: Bringing Science Back to the Bedside. J GEN INTERN MED (2021).

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  • quality improvement
  • faculty development
  • mechanistic thinking
  • comparative physiology