By Minnie Glymph

From the legendary Wilburt C. Davison to the recently promoted R. Sanders Williams, the six former deans of Duke University School of Medicine have, to a man, been exceptionally talented physician-scientists, educators, and leaders -- passionate advocates for the advancement of medicine in general and Duke medicine in particular.

Dean No. 7 is no exception.

Called "a leader who is able to take programs, organizations, and people to new heights" by her mentor David Nathan, MD, president emeritus of Dana-Farber Cancer Institute, "one of the nation's most accomplished physician-scientists," by Williams, now senior vice chancellor for academic affairs at Duke, and "the best candidate in the country for this position," by Chancellor Victor J. Dzau, MD, Nancy C. Andrews brings to her new post a record of experience and accomplishment that clearly establishes her place in the pantheon of Duke Med deans.

There is, of course, one notable difference between this dean and her predecessors: she's a woman.

As the first female dean not only of Duke’s medical school, but at any top-10 medical school in the United States, her appointment created a buzz that expanded beyond academic circles to over 200 media outlets nationwide, from the Wall Street Journal to NPR.

DukeMed Magazine recently talked with Andrews about all the attention -- and where she’ll be focusing her attention as Duke’s next dean.

After two decades at Harvard and inquiries about deanships at other institutions, why did you decide to accept the position at Duke?
"From my first visit, it was clear that Duke has a very special character -- a real spirit of innovation and entrepreneurialism. I had the feeling that this was a place where big things could happen -- where somebody could have a great idea and if it was compelling, something would come of it.

"Some of the large New England schools are so big and there's so much process around everything that it can be hard to start new initiatives. It’s like trying to change the direction of the Titanic. Here, doing new things seems to be part of the culture.”

Were you surprised at the level of media attention your appointment received?
"Kind of -- initially, I don't think any of us had really thought about my being 'the first.'

"I think it's another wake-up call for academic medicine. Women and members of underrepresented minority groups are still not on equal footing at the highest levels, even though medical school classes are more representative. I hope that it will help to have more women leaders who not only understand what the issues are for young female faculty, but are also in a position to do something about them."*

You've gotten to know Duke better since becoming dean in October. What do you see as this institution's differentiating strengths -- and its major challenges?
"Duke has a great tradition of collaboration, especially across traditional academic boundaries. Duke has remarkably strong clinical research and basic science engines, and is ready to take full advantage of where they intersect to do translational work.

"Duke also has a strong core value of being of service to society, which I think is really important. I like the fact that Duke is aggressively thinking about its global role, and reaching out to establish collaborations with academic and industry partners and other countries and governments.

It is always a challenge when there are more great ideas than there are resources to support them in terms of building space and money. So we're not in a position to do all the things that we’d like to. It's unfortunately a fact of academic life right now, especially while the NIH budget is in so much trouble."

What are your main priorities as dean?
"Education always has to be a top priority for our medical school. I want to put a lot of my attention early on into strengthening the MD/PhD program. We have very fine students and committed faculty, but we need to continue to increase the size and quality of our applicant pool, diversify the kinds of research experiences students choose, and bring more visibility to the physician-scientists who are role models for those students.

"We also want to be continuously rethinking education for all of our students, because the needs change over time.

"Another priority is to find better mechanisms and incentives for interdisciplinary work. The traditional departmental structure can pose logistical barriers for interdepartmental collaborations, and if we can fine-tune ways to manage these intersecting enterprises, that will be important not only to Duke but on a national scale.

"We're now working on the 2010 strategic plan, exploring possibilities for a new student learning center, research building, and imaging facility and contributing to Duke's initiatives in global health, genomics, translational medicine, brain sciences, and others.

"We want to make sure Duke is well-positioned not only for what’s hot today but also for the next waves in medicine."

*For more perspectives, see Dean Andrews’s editorials "The other physician-scientist problem: where have all the young girls gone?" (Nature Medicine, May 2002) and "Climbing through Medicine's Glass Ceiling" (New England Journal of Medicine, November 8, 2007).

This article was first published in the Winter 2008 edition of DukeMed Magazine.