Students in Harvard Medical School's M.D.-Ph.D. program have a lot going for them: a state-of-the-art medical education, research training in the labs of top investigators, preparation for distinguished careers—and Nancy Andrews. Andrews, the program's director since January 2000, has deep feeling for the aspirations of student physician-scientists and a direct knowledge of their ups and downs, having lived them herself. She is an alumna (1987) of the program, an experience she says has served her well.

"Survival skills that I learned from my training—organizing time and being able to jump back and forth from one way of thinking to another—have been tremendously useful," says Andrews. "You're always encountering new situations, so you have to figure things out as fast as you can. You learn to be comfortable with feeling uncomfortable, and I think that's part of what has made it easier for me to take risks in science."

The goal of the M.D.-Ph.D. program is to give students grounding in both scientific investigation and clinical medicine. Some graduates go into research, bringing a clinical perspective to their work; others become innovative clinicians, using the tools and techniques of basic science to better serve patients.

The program begins each July with a course called Molecular Biology of Human Disease, which runs concurrently with the students' first laboratory rotation. The summer course is also the first step in a community-building process that Andrews especially values. Bonds formed among classmates during that first summer are regularly reinforced throughout the program. An annual retreat, which offers poster sessions, guest speakers, hikes, a lobster bake and a DJ-hosted dance, is the event of the year.

During the first two years of the program, students follow one of two medical curricula: the more-or-less traditional Health Sciences and Technology or the alternative, New Pathway in General Medical Education, which emphasizes self-directed, problem-based learning. While completing lab rotations and choosing a thesis laboratory, students also take graduate courses. After a core clinical rotation in medicine or pediatrics during the third summer, students concentrate on finishing the Ph.D. first, and then the M.D.

Combining two demanding degree programs can be daunting to students just starting out, as the pressures on that career track appear intense. Not so, says Andrews. "I'd say the pressures are different from those of doing just one or the other, but I wouldn't say that they're greater." The rewards, however, may well be greater—and not just to the physician-scientists themselves, but to those who benefit from their work.

"Clinical medicine and science are very different kinds of specializations, so to be able to speak both languages—think about things in both ways, see things from both perspectives—shapes your approach," says Andrews. It also shapes attitude. "My work means more to me," she adds, "knowing that it's the first step toward something that, down the road, will improve patient care in some way." —NRF

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Reprinted from the HHMI Bulletin,
March 2002, pages 18-21.
©2002 Howard Hughes Medical Institute