 Educated at Bedales and Marlborough College, she qualified as a doctor in 1985 at the University of Cambridge School of Clinical Medicine, having studied at Trinity College, Cambridge, then trained as a general physician in London, and is a Fellow of the Royal College of Physicians.Since 1990 she has written on a broad range of issues for BMJ, including the impact of environmental degradation on health, the future of the World Health Organization, the ethics of academic publication, and the problems of editorial peer review.In 1994, she spent a year at Harvard University as a Harkness Fellow evaluating efforts to bridge the gap between medical research and practice.