Another Step Toward Controversial Merger of Med Schools

Lilo H. Stainton | February 7, 2020 | Health Care
Rutgers University Senate is being asked today to allow the combining of Rutgers’ medical schools to be explored
Credit: EVG photos via Pexels
Rutgers Biomedical and Health Sciences Chancellor Brian Strom made a case for the merger in a Jan. 31 letter to the executive committee of Rutgers University Senate.

A controversial proposal to merge the two Rutgers University medical schools into a single entity spread over two cities 30 miles apart may be gaining momentum, despite concerns among some faculty and staff about the process and potential risks involved.

The Rutgers University Senate is scheduled today to consider permitting leaders at Robert Wood Johnson Medical School (RWJMS) in New Brunswick and New Jersey Medical School (NJMS) in Newark to start exploring what is needed to unify these colleges under a single mission and governance structure with one educational system, research agenda and clinical practice.

Rutgers Biomedical and Health Sciences Chancellor Brian Strom, who oversees both medical schools, made a case for the merger in a Jan. 31 letter to the executive committee of the senate, a legislative body with some regulatory functions. Strom said a combined school would increase Rutgers’ access to research dollars and provide new opportunities for students, scientists and patients. Faculty and students at the two schools treat patients at teaching hospitals, clinics and private offices in both cities.

“I believe we have the opportunity to pursue a bold and transformational change in medical education at Rutgers University that may prove to be an influential model across the United States,” the RBHS chancellor wrote. He also stressed that if the schools were combined, one campus would not be a satellite or subordinate of the other.

In his letter, Strom underscored that no final decision has been made, but he asked for the senate’s input before faculty committees are appointed to dig into the mechanics of a merger; it is not clear how long the senate executive committee will take to make a decision. His letter does float a possible name for the combined entity — “Rutgers Medical School” — and hints that it could attract a “transformational philanthropic gift.”

If the Senate panel does give its go-ahead, and the faculty can find a way to make it work, the final decision would essentially be left to the Liaison Committee on Medical Education (LCME), a national committee that accredits medical schools, according to the letter. Strom’s team has already been in touch with the liaison committee about the potential change, which could result in the largest medical school in the U.S. (Each program now includes more than 700 students and thousands of faculty and staff.)

“Thus, my request to the Senate is to approve the merger now, with the explicit recognition that we are continuing a process where the end result may be the integration of RWJMS and NJMS into a single accredited school, the final arbiter of course being the LCME. However, an irrevocable decision to merge has not yet been made, pending that work by the faculty,” he wrote.

More transparency, impact on University Hospital

The process outlined in Strom’s letter raised concerns for some medical school faculty and staff, who believe there should be more transparency around the planning and greater input from the Rutgers community and the public. And elected officials representing Newark are particularly concerned about the impact any merger would have on clinical care there, including at the city’s University Hospital, north Jersey’s only Level 1 trauma center.

“The merger of Rutgers medical schools should not take place without input from the public, bargaining with unionized workers and oversight from New Jersey regulators,” said Debbie White, a nurse and president of the Health Professionals and Allied Employees union, which represents close to 1,000 clinicians and other staff at the two schools.

“New Jersey made a commitment to preserve the medical school in Newark and promote the institution as a premier teaching facility. We must hold Rutgers and the state to that commitment before allowing a merger to move the future of health care in a direction that puts Newark in the back seat,” White said.

Diomedes Tsitouras, executive director of the American Association of University Professors chapter that represents some 1,500 faculty in Rutgers’ biomedical program, has urged the chancellor to take his time with any decision, especially given all the other changes the schools are currently experiencing. (Some of the AAUP units are engaged in contract disputes with Rutgers.)

“The (university) senate should put a hold on this until details can be figured out,” Tsitouras said. “There’s no rush to go to the LCME.”

But Strom and other Rutgers officials insist that there is now a unique opportunity for change. “Our intention is to facilitate a bold transformation of medical education at Rutgers and to set a new standard for the country,” said Associate Vice Chancellor Zach Hosseini, who handles marketing and communications. “To do that, we are engaging with key partners, like the Rutgers University Senate and the Liaison Committee on Medical Education (LCME), to ensure we follow the necessary and appropriate steps to explore the transformation that the committee envisioned,” he added, referring to a faculty panel report unveiled last week. 

The current system is the result of former Gov. Chris Christie’s reform in 2012 that dismantled the former University of Medicine and Dentistry of New Jersey, in Newark, and restructured medical education across the state. That led to the creation of NJMS in Newark and RWJMS in New Brunswick, which were united under Rutgers’ umbrella biomedical program with five other health-related colleges. (The reform also shifted an osteopathic program in Camden from Rutgers to Rowan University.)

In recent years, the two Rutgers medical schools have grown closer, collaborating on a number of clinical institute programs, and they now share a single leader. In January 2019, NJMS Dean Dr. Robert L. Johnson was also appointed interim dean at the New Brunswick school RWJMS when the previous dean departed. The two schools are also combining their graduate medical education programs. In 2017, RBHS signed an agreement with RWJBarnabas Health, one of the state’s largest provider networks, to improve the university’s clinical practice.

Research funding, scientific expertise

Strom has suggested that integrating the two medical schools would enable the state’s university to attract more research funding and scientific expertise, while making the program more attractive to potential students, health care employers, and other partners. In his letter to the senate panel, he notes that Rutgers is now one of only five universities in the country with more than one medical school, and the other four are separated by hundreds — not dozens — of miles.

“Further, this separation hurts our national rankings substantially, since our grant portfolio, a large part of the ranking, is divided between the schools,” Strom wrote.

To explore the future options, Strom created a 12-member commission (six from each school) to study various scenarios, from maintaining the status quo to a full merger with two “co-equal” campuses. In a report distributed last week, the committee focused on two choices: remaining as two schools, but with greater collaboration, or combining into one entity. It did not endorse one option over the other, but warned that any change would be costly, complicated and require significant planning and stakeholder input.

Strom insists that no decision has been made in his letter to the senate panel, but in framing the work to come, he focuses almost exclusively on efforts needed to explore and carry out a merger. There is no mention of a process to determine if that path is preferable to more limited collaboration.

“Based on the recommendations of the (12-member) Committee, our next steps are to continue and expand careful and thorough deliberations on the potential structure, governance, curriculum, research, and clinical care of a future combined ‘Rutgers Medical School.’ (The final name of a combined school remains to be decided),” Strom wrote. Incidentally, a worksheet provided to the senate panel included the same potential name and noted that a merger would not require additional funding, at least early on.

“If this change is viewed as sufficiently transformational, we may be presented with an opportunity for a potentially transformational philanthropic gift,” he wrote. No additional information on the potential gift was available Thursday afternoon.

“Please consider accepting this process and with it the possibility that we will completely integrate the two medical schools into a single model school and the potential to create the brightest future for academic medicine, one that will serve our students, patients, and communities while advancing our scholarship, research, and the profession of medicine,” Strom wrote.