Clinical physiology: a successful academic and clinical discipline is threatened in Sweden

Clinical physiologists in Sweden are physicians (the majority with a PhD degree) with thorough training in system physiology and pathophysiology. They investigate patients in a functional approach and are engaged in basic and applied physiology teaching and research. In 1954, clinical physiology was founded as an independent academic and clinical discipline by the Swedish government to ensure "contact between routine clinical work and the scientific progression." Up until 2008, clinical physiology was an independent clinical discipline but was then made a subdiscipline to radiology, a fundamentally different discipline. Individuals wishing to become clinical physiologists are required to be trained and certified as European radiologists, after which training and certification as clinical physiologists may be pursued. This means that radiologists without training in clinical physiology have become gatekeepers for future clinical physiologists. Unfortunately, this development takes place at a time when research and education in preclinical integrative physiology have diminished in favor of other organizational levels, such as cellular and molecular biology. The responsibilities for education and research in integrative human physiology have therefore mainly been transferred to clinical physiologists. Clinical physiology has been a successful independent clinical discipline in Sweden for the past 55 years and could serve as a model for other countries. Unless clinical physiologists regain control over their own discipline, systems physiology as a knowledge base and resource for patient care, education, and research will be severely impaired.