William Osler

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Lore & Background

William Osler was born in Bond Head, Canada West (Ontario), on July 12, 1849, and raised after 1857 in Dundas, Ontario. He was named after William of Orange, who won the Battle of the Boyne on July 12, 1690. Initially intending to follow his father into the ministry, he entered Trinity College of the University of Toronto in the autumn of 1867. Under the influence of James Bovell and the Rev. William Arthur Johnson, he switched to medicine. In 1868, he enrolled in the Toronto School of Medicine and lived with James Bovell for a time; through Johnson, he was introduced to the writings of Sir Thomas Browne, whose Religio Medici caused a deep impression on him. He left the Toronto School of Medicine after being accepted into the MDCM program at the McGill University Faculty of Medicine in Montreal in 1870, receiving his medical degree in 1872. After post-graduate training under Rudolf Virchow in Germany, he returned to McGill as a professor in 1874. There he created the first formal journal club, showed interest in comparative pathology, and is considered the first to have taught veterinary pathology in North America. In 1884, he was appointed Chair of Clinical Medicine at the University of Pennsylvania in Philadelphia, and in 1885 was one of the seven founding members of the Association of American Physicians. In 1889, he became the first Physician-in-Chief of the new Johns Hopkins Hospital in Baltimore. In 1893, he was instrumental in creating the Johns Hopkins School of Medicine and became one of its first professors of medicine. In 1905, he was appointed Regius Professor of Medicine at Oxford, which he held until his death. In 1911, he was named a baronet in the Coronation Honours List for his contributions to medicine.

Reader's Guide

Osler's greatest influence on medicine was his insistence that students learn from seeing and talking to patients and the establishment of the medical residency. The residency system spread across the English-speaking world and remains in place today in most teaching hospitals. Its success depended on a pyramidal structure with many interns, fewer assistant residents, and a single chief resident. At Hopkins, Osler established a full-time, sleep-in residency system where staff physicians lived in the administration building; the residency was open-ended, with physicians spending as long as seven or eight years in a restricted, almost monastic life. He pioneered bedside teaching and clinical clerkship—having third- and fourth-year students work with patients on the wards. Soon after arriving in Baltimore, he insisted medical students attend at bedside early in their training; by their third year they were taking patient histories, performing physicals, and doing lab tests. He reduced the role of didactic lectures and once said he hoped his tombstone would say only, "He brought medical students into the wards for bedside teaching." His best-known saying was "Listen to your patient—he is telling you the diagnosis." He also wrote in an essay, "Books and Men," that "He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all." He was a prolific author and great collector of books on the history of medicine. He founded the History of Medicine Society at the Royal Society of Medicine, London, and was instrumental in founding the Medical Library Association of Great Britain and Ireland and the (North American) Association of Medical Librarians (later the Medical Library Association) along with three other people, including Margaret Charlton. He left his own large history of medicine library to McGill, where it became the Osler Library.

Did You Know?

• Osler was named after William of Orange, who won the Battle of the Boyne on July 12, 1690.
• His father, Featherstone Lake Osler, turned down an invitation to serve on HMS Beagle as the science officer for Charles Darwin's voyage because his own father was dying.
• While at McGill, Osler created the first formal journal club and is considered the first to have taught veterinary pathology in North America.
• Osler's farewell address when leaving Philadelphia was titled 'Aequanimitas,' about the imperturbability and equanimity necessary for physicians.
• He left his large history of medicine library to McGill, where it became the Osler Library.