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Rutgers Weighs Pros and Cons of Medical School Integration

Consolidation could translate into more research funding, but some professional staff members at both schools counsel taking it slow

Rutgers NJ Medical School
Credit: rutgers.edu

Rutgers University leaders are considering merging some or all aspects of its two medical schools as part of an ongoing quest to improve — and increase research funding for — New Jersey’s largest provider of healthcare higher education.

Rutgers Biomedical and Health Sciences Chancellor Dr. Brian Strom said Monday he had charged a committee with developing a plan to guide the future of the two schools — New Jersey Medical School, in Newark, and Robert Wood Johnson Medical School, in New Brunswick. The current system was established under a statewide medical education reform adopted in 2012.

Brian Strom
Rutgers Biomedical and Health Sciences Chancellor Dr. Brian Strom

Strom said the options could include anything from no changes to full integration, in which the two schools would become a single accredited body. The initiative is rooted in the previous reorganization, which was meant to boost the system’s status nationwide and improve clinical care statewide. Any new plan will need approval of the university’s legislative body, which won’t happen before the end of 2019, he said.

Satellite campus a ‘nonstarter’

“The only thing it won’t be is one (school) becoming a satellite campus of the other,” Strom told NJ Spotlight, something that has been a concern for a number of stakeholders, particularly in Newark, which relies heavily on Rutgers medical programs for community care. “It’s not one taking over the other. That’s a nonstarter,” he said.

In addition, Strom said any evolution must protect NJMS’s mission to support Newark’s University Hospital — the embattled 500-bed teaching hospital that provides critical care to city residents — which was codified in the 2012 reform. “We have an absolute commitment to University Hospital,” he said; Rutgers is also building a new academic facility in the city, an investment it does not plan to abandon.

Separated by barely 30 miles, NJMS and RWJMS have grown together in a number of ways since they were created from pieces of the former University of Medicine and Dentistry of New Jersey, Strom explained; they now share several department chairs, and, as of earlier this year, a dean.

The Biomedical and Health Sciences program was created in 2012 to serve as an umbrella entity for the medical schools, plus nursing, dental, and four other clinical programs. According to a report prepared for then Gov. Chris Christie, who oversaw the reform, UMDNJ then ranked 92nd nationwide in terms of research dollars. As its first chancellor, Strom has long sought to identify possible collaborations.

Unique strengths

Both current medical schools excel in different areas, Strom said. Newark receives high marks for its infectious diseases and surgical programs, as well as the ethnic diversity of its student body — a critical element in creating better care for communities of color. The New Brunswick school exceeds in its primary care and neuroscience programs.

But as independent schools — each with about 750 full-time medical and doctoral students — NJMS and RWJMS have struggled to attract significant research dollars, Strom said. The schools tied for 75th in U.S. News and World Report’s 2019 rankings of medical schools, scores heavily influenced by such funding.

Working together more closely could give students more options for courses and practice, help the state develop expertise in subspecialties — some of which now require patients to travel to New York or Philadelphia — and also attract more dollars for in-depth studies, Strom said. “We’re on that trajectory already,” he said of the expanding collaboration. “The question is, what is the right level of integration.”

To explore this dynamic and plan a course forward, Strom assembled a 12-person panel, the Committee on the Future of Medical Education at Rutgers, co-chaired by Dr. Maria Soto-Greene, the executive vice dean at NJMS, and Thomas Hecker, executive vice dean at RWJMS. The panel has been meeting since January, and he expects it will complete its recommendations this fall. Their plan will then go to the Rutgers University Senate for final approval.

Concerns and questions

The development has raised concerns for some of the 1,500 faculty members at the Biomedical and Health Sciences program, according to the local chapter of the American Association of University Professors, which has urged Rutgers leaders to take their time. Diomedes Tsitouras, the union’s executive director, said questions include the makeup of the committee, lack of transparency for the process, and what any changes would mean for Newark and University Hospital. (Rutgers University has recently been engaged in historic struggles with full- and part-time faculty over pay and other contract issues.)

In addition, in comments released earlier this year, the AAUP chapter worried about the impact of “multiple ongoing and simultaneous changes to the landscape” for the medical schools. In 2017, Rutgers closed a deal to join forces with RWJ Barnabas Health, one of the state’s largest hospital and provider networks, to boost research funding and improve clinical care in New Jersey. According to the union, faculty members are still working through what these changes will mean for their work and their future.

“Further concurrent change would be unsettling, destabilizing, and demoralizing to the faculty,” AAUP-BHSNJ (Biomedical and Health Sciences of New Jersey) wrote, noting it opposed any plan to reduce staff as part of a transition. “While there are some theoretical benefits to combining the two medical schools, we strongly believe that it is premature to do so at this time.”

Chancellor Strom said the agreement with RWJ Barnabas, which he said is already paying off in dollars and top-notch faculty, is independent of any proposal to integrate aspects of the two medical schools. But the two processes are consistent in their mission to strengthen medical education and clinical practice in New Jersey, he added.

“They are separate but very complementary,” he said.

Officials at the Medical Society of New Jersey and the New Jersey Hospital Association declined requests to comment on the proposal Monday afternoon.

While New Jersey’s two medical schools developed under separate universities, they were combined in 1970 under a state statute that created UMDNJ, which had facilities in Newark, New Brunswick, Camden, and several other sites. At the time, it was the nation’s largest standalone healthcare university, with some 6,000 students.

When UMDNJ was dissolved, the agreement gave primary control of the South Jersey programs to Rowan University.

Blueprint for consolidation

When UMDNJ was eliminated, the Newark and New Brunswick programs were reconstituted as New Jersey Medical School and Robert Wood Johnson Medical School, and consolidated with the other clinical programs under the Biomedical and Health Sciences umbrella. The model was designed to enable additional collaborations and, in 2014, UMDNJ’s two nursing education programs were combined to become what is now the Rutgers School of Nursing.

“The establishment of (Rutgers Biomedical and Health Services) within Rutgers provides an opportunity to create an integrated infrastructure that will support the education and training of biomedical/health sciences research teams of the future, break down traditional silos, and enhance opportunities for interdisciplinary and translational research training,” Strom wrote in a strategic plan released in November 2014.

On Monday, Strom said that some of the changes now under consideration could be achieved without integrating the two schools under a single accredited banner. For example, students could be provided more flexibility to study at either campus, he said, and the academics could work together to recruit more shared department chairs, or educators with unique subspecialties.

And even if the two entities do join forces under one flag, Strom said they could even maintain separate names, admissions processes, and diplomas. The challenge for the committee is to determine what makes sense to integrate and what does not.

“This is an absolute natural evolution from the journey we started on” in 2012, Strom said. “How far it goes remains to be seen.”

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