The new medical school announced yesterday by Seton Hall University and Hackensack University Health Network may bring the former Hoffman-La Roche campus in Clifton and Nutley back to life.
But it will face challenges in achieving one of its stated goals: increasing the number of primary-care doctors practicing in the state.
The yet-to-be-named institution, scheduled to open in the fall of 2017, will have 500 to 600 students, occupying two buildings and roughly 13 acres on the sprawling, 110-acre campus.
The medical school will focus on training doctors in specialties that are in “acute shortage right now and will continue to be through the years,” including internal medicine, family practice, pediatrics, obstetrics and gynecology, according to the hospital network’s CEO and president, Robert C. Garrett.
New Jersey is particularly thin in family and general practice doctors, ranking 45th in the United States in the number of sch doctors per capita, according to an analysis by NJ Spotlight.
Garrett noted projections that the state will have a shortage of roughly 2,500 doctors by the end of the decade, adding: “We think this school of medicine will significantly curb that trend.”
But a primary challenge in trying to get more doctors who attend medical school in the state to then practice in the state is the step in-between — medical residencies.
While the state ranks slightly above the national average in the number of medical residents in proportion to population, the amount of federal funding for those positions is likely to remain flat for the foreseeable future. And while Gov. Chris Christie has increased state support for training doctors from $60 million to $100 million annually, any more large increases in state funding are not likely.
“That’s going to be a challenge,” Garrett said of finding residencies in New Jersey for the new medical school’s graduates. “So we’re going to continue to advocate for additional residency slots, if you will, both at the state level and the federal level.”
If Hackensack’s proposed merger with Neptune-based Meridian Health is completed, the combined health system will have roughly 400 residencies in its hospitals, presenting a significant opportunity for graduates of the school, who will have already spent time in the system as part of their education.
“We’ll have a significant number, but there still is going to be more that’s going to be needed in our state,” Garrett said.
Higher pay for specialists is part of problem
In addition to the limited number of residency slots, the state also faces a particular challenge in attracting primary-care-focused doctors, since the pay gap between them and other medical specialties is particularly wide.
Advocates for family doctors have said that the state’s high cost of living – combined with large medical school debts – have forced some graduates and medical residents to practice elsewhere.
But Garrett said strategic use of grants and other financial incentives could attract students with a focus on primary care, reducing their potential debt load.
“We’re going to be very innovate in every which way on this new school of medicine, and the incentives are going to be an important piece of it,” Garrett said.
Another way the financial incentives could help is by attracting students from cities, who are more likely to choose to practice primary care in urban areas.
Garrett added that while the tuition schedule is still being finalized, the school will offer financial incentives for students from disadvantaged backgrounds.
“We recognize, you know, that it’s a private school, but we also want to be able to offer this education to folks that come from different socioeconomic backgrounds,” he said.
He also noted that when medical students are educated and trained in the state, they’re twice as likely to stay to practice in the state.
State Health Commissioner Mary E. O’Dowd said larger social factors also influence what specialties doctors choose to practice. She said healthcare appears to be moving away from a primary focus on earnings potential that has led many doctors to highly paid specialties, with more of an emphasis on contributing to society through primary care.
“Long ago, when my grandfather went into medicine, there wasn’t the same focus on economic reward relative to the profession of medicine — that came later, in the following decades,” O’Dowd said. “I think now, as we look to the future, the marketing of healthcare is a little less focused on financial reward, and you may be seeing that different people are choosing that profession.”
Team approach to education, training
One of the school’s strengths in being able to shape its graduates is expected to be its interdisciplinary curriculum.
Both Garrett and Seton Hall President A. Gabriel Esteban emphasized that the school could integrate Seton Hall’s existing nursing and allied health programs, allowing students to experience from the start of their studies the team-based approach to medicine that is becoming predominant in healthcare.
“I can see the value of having a nursing student sitting in the atrium, having a cappuccino with a med student, a physical therapist and a speech pathologist, talking about a common clinical case,” Esteban said. “I mean, can you imagine? Because that’s the way healthcare should be provided.”
Garrett said the current system of educating different healthcare professionals separately leads to inefficiency in healthcare delivery.
“It’s really going to be a team sport – and really educating these different disciplines under one roof in the same setting, I think really makes a lot of sense,” said Garrett.
“When they are educated (as a team), they understand each other’s specialty and proficiency, and when they are out in the community and treating patients, they know how to use their partners in a more effective and efficient way,” leading to benefits for patients and a more efficient healthcare system, she said.
Garrett expressed confidence that the school, which will be the only private medical school in the state, will “attract the best and brightest.”
Esteban said that some students who attend private undergraduate colleges prefer to attend private medical schools. He added that Seton Hall’s emphasis on personal interaction and research opportunities with faculty members would carry over into the medical school.
“This is exciting from our standpoint,” Esteban said. “We get to create a new school of medicine from the ground up.”
A key person in shaping that future will be the school’s dean. While Esteban said the financial arrangements between the university, health system and Roche first must be worked out, he anticipates that discussions regarding the search for a dean will start by this summer, so the person hired can be on the job well ahead of the school’s scheduled launch.
Esteban said the ideal candidate will be someone who understands the team-based approach to medical education that the school will be founded upon.