Harvard to offer joint MD-MBA degree

Harvard University's medical and business schools plan to begin a joint master's degree program next year, underscoring the growing influence of private sector approaches to healthcare.

The program will admit only a dozen or so graduate students annually who will earn MD and MBA degrees after five years, but its introduction shows how both the professional schools want to train doctors who can wield more clout within the health maintenance organizations and other business entities that have come to guide medicine.

W. Carl Kester, a business-school professor helping to organize the program, said role models for its students might be doctors like Peter L. Slavin, the president of Massachusetts General Hospital, or Daniel Vasella, chief executive of drug maker Novartis AG.

"These are the kinds of people we're starting to see rise to the top of major healthcare companies, and it shows the virtues of blending leadership and healthcare management," Kester said.

Said medical school dean Joseph B. Martin: "To prepare our medical students for the realities of modern medicine, and to emphasize the great contributions they can make, it's appropriate we offer physicians in training an opportunity to study management."

The five-year program is meant to save students a year's time and tuition compared to the regular four years usually needed to earn an MD degree and the two years for an MBA. It won't be the first such program. One at the University of Pennsylvania drew a lot of attention in the 1970s.

But other schools are adding these programs at an increasing pace. The Association of American Medical Colleges now lists such programs at 41 universities including Dartmouth and Tufts. Howard P. Forman, who directs a joint MD-MBA program at Yale University, said most are meant for budding doctors aware that economic forces are doing much to shape their profession.

"For a long time physicians have known they lack a lot of the skills and language to communicate with the people who are running the business of health," Forman said in a telephone interview yesterday.

Other programs, including one at the University of California at Irvine, have reputations for channeling students into biotechnology start-ups, a hot area in New England as well, drawing increased interest from students, he said. "Harvard needs this, absolutely, if they're going to compete" for students, Forman said.

Martin publicly discussed the program for the first time in a speech before the Greater Boston Chamber of Commerce yesterday morning at the Boston Harbor Hotel.

Growing private-sector considerations are helping prompt a major rethinking of the school's medical curriculum, he said. In addition to the joint MD-MBA program, he also mentioned reviews of the school's core medical curriculum, efforts to make practitioners more aware of patients' cultures, and ways to reduce the average $90,000 debt that follows each doctor after graduation.

The school has also begun a broader review of how it licenses technologies developed by its faculty, aiming to stimulate more commercial partnerships. "We want to do better, and we want you to hear we want to do better," Martin said.

In all, a total of 26 companies have been spun out of the medical school, generating $21 million in annual royalty payments and bolstering the school's $1 billion annual research budget, Martin said. But more high-profile advances in medicine are coming from private developers, he noted, such as a new building that Merck & Co. is set to open adjacent to the medical school's main campus this year to research obesity, cancer, and Alzheimer's disease.

Both Harvard's medical and business schools already offer other joint-degree programs with Harvard's Kennedy School of Government and other institutions. According to Kester and to Ronald Arky, a medical school professor, students seeking to enter the joint-degree program will have to be admitted through the regular admissions process of both schools, among the most selective and expensive in the nation.

They will take the regular courses of the first three years of the medical school curriculum, though with some electives such as an introduction to healthcare policy and a healthcare management seminar. Then they will take the regular first-year courseload of the business school. The newest material will come in the summer before their fifth year.

The exact curriculum hasn't been worked out, but the goal is to have students combine some clinical work with patients with some kind of business analysis, perhaps a cost-benefit analysis of the treatments they delivered, Kester said.

Another goal is to create management courses for traditional medical students, Arky said. Stan N. Finkelstein, a senior lecturer at the medical school and a health economics researcher at MIT who chaired the task force that started working on the program in September of 2002, added he hopes some of its graduates will be drawn to smaller companies such as start-up biotechnology manufacturers.

"Our hope is for graduates to have the opportunity to become leaders in all aspects of medicine or biomedical fields. That could include managing hospitals or HMOs, but it could also include entrepreneurial activities," he said.

Ross Kerber can be reached at kerber@globe.com.