A Wake-Up Call from Nobel Prize in Physiology or Medicine

Each year, over many decades, around the months of September and October, like many of my colleagues in the global physiology community, I would eagerly await the announcement of the laureates for the Nobel Prize in Physiology or Medicine. The 2018 announcement is no exception but is particularly emotionally draining for me as the President of IUPS. I am mindful that this prize is intended to be awarded “. . . to the person who shall have made the most important discovery within the domain of physiology or medicine . . .” (https://www.nobelprize.org/prizes/medicine/). I am also mindful that the Nobel Prize in Physiology or Medicine is now generally taken as the “Medicine Prize,” even on the official Nobel Prize website. This comes again as a wake-up call that reiterates my concern in my previous editorial that physiology is falling off the center stage of contemporary medicine (1). Instead of shying away, the Executive Committee (ExCo) of IUPS and the Board of General Assembly (BGA) have been making major efforts at the management level to rectify this situation. Personally, I think it is high time for all of us in the global physiology community to face this reality head on, and I have some thoughts toward this end, which I would like to share with the readers.

As I outlined in my previous editorial (1), there are two extrinsic reasons that move physiology away from the center stage of contemporary medicine. First, elimination of the traditional Department of Physiology and integration of physiology into a preclinical medical program has resulted in the loss of identity for physiology, both in medical school and biomedical research. Whereas it is infertile for us to argue the pros and cons of restructuring medical school, we can turn this current trend to our benefit. For example, in the implementation of problem-based learning (PBS) and case-based learning (CBS), another new trend in medical education, we can emphasize the importance of physiology by showing that medical students must first learn the normal functions of the body that have become abnormal in a particular disease before they are taught the strategies to reverse this abnormality. In this juncture, I am glad to report that, as the first IUPS Initiative as recommended by the BGA, a Physiology Education Workshop with an aim “to facilitate exchange of knowledge about best practices in physiology teaching” was held in November in India. Another Educational Workshop to reflect on “current practices & chart the way forward” sponsored by the African Association of Physiological Sciences is scheduled for December this year. It is my understanding that several workshops aiming at upgrading physiology teaching are being planned for 2019.

Second, the increasing dominance of cellular and molecular biology in contemporary biomedicine has again relegated physiology away from the limelight. Again, we can turn this trend to our benefit by embracing the mountains of molecular, immunological, and genetic data into the realm of physiology, and spearhead the notion that those biochemical data are an integral foundation of normal and abnormal functional expression of the body. After all, the essence of precision medicine is to return patho-physiology to normal physiology based on individual genetic makeup. To achieve our goal, it is imperative that IUPS reaches out to other communities of preclinical and clinical disciplines to represent the global family of physiologists. Toward this end, the IUPS ExCo is in the process of setting up an “IUPS Academy.” The idea is to actively seek opportunities for physiologists to present their work at major congresses of other disciplines. The sole purpose is for these speakers to showcase how physiology is relevant to, for example, spontaneous gene deletion or mutant, or to the etiology of acute myocardial infarction.

In my previous editorial (1), I also emphasized that returning physiology to center stage is in fact in our own hands. As a community, submitting our best work to, and citing recent articles from, physiological journals is a straight-forward strategy to boost the discipline of physiology in terms of the scientometric measurement known as Impact Factor. In this editorial, I wish to specifically urge the editors-in-chief, associate editors, and members of editorial boards of the major physiological journals to set an example by taking the lead in this task. It is through this exercise, I believe, that we will inspire other members of our community to contribute their major work to physiological journals.

In the report Physiology: Current Trends and Future Challenges (http://www.iups.org/news/iups-news/39/) published in 2017 during the GA Meeting of IUPS in Rio de Janeiro, physiologists across the globe were challenged to bring integrative physiology to the forefront in research and education. With the implementations of the initiatives recommended in that report by the IUPS ExCo and BGA and the conscientious support of the physiology community at large, I am confident that the day will come when physiology returns to the center stage of medicine.