M,EEE,D,I,T,RR,AA,NN
\underset{_}{R} \underset{_}{} \underset{_}{} \underset{_}{E}
Two empty places can filled with identical letters [EE,AA,NN] ⇒ 3 ways
Two empty places, can be filled with distinct letters [M,E,D,I,T,R,A,N] ⇒8P2
∴ Number of words 3+8P2=59