Envisioning the Future of Academic Medicine: Chancellor's Charge to the Committees

November 14, 2022

Dear Colleagues,

As you begin your work to answer questions from the University Senate about the future of academic medicine, I would like to provide you with the following guidelines and historical context.

Historical Context of Medical Schools

New Jersey Medical School and Robert Wood Johnson Medical School were originally set up by Dr. Stan Bergen to compete with each other. That model, to foster rapid regional growth and development, was apt for its time.

We have succeeded in so many areas under this model: Our students are consummately prepared for residency and achieve placements in top programs across the nation. Our research portfolio has been expanding rapidly and in some areas we can claim national leadership status like infection and inflammation, microbiome, and cancer. Clinical programs like the liver transplant unit, trauma centers, etc. are highly regarded for providing world-class care equal or superior to regional competitors. For other world-class initiatives we have built institutes to cut across our schools successfully, e.g., cancer, infection/immunology, and neuroscience.

Changes in Academic Medicine Today

Is our current model sustainable in today’s health care climate? Today, the health care payer and provider markets are consolidating rapidly and across much wider swaths of geography than were contemplated at the inception of medical education in New Jersey. Our competition is not from within, but from other New Jersey hospital systems, newer local medical schools, and aggressive and expansive academic health centers based in New York, Philadelphia, and in some instances even farther afield. Patients are leaving NJ to get the most advanced care, as too often it is not available in NJ. This out-of-network care is much more expensive, and especially hurts patients who cannot afford to go elsewhere for such care.

Telemedicine is erasing local licensing restrictions; previously unimaginably large data sets move instantaneously across the world; dissections can be virtual; lectures are asynchronous and can be (and are) played by the students at double speed; and diagnostics, monitoring, and follow ups are no longer exclusively dependent upon the physical presence of patients at clinical sites. Medical care is shifting from inpatient sites to outpatient sites, with important implications as well to the future of medical education.

We also are in the fortunate situation with substantial investment newly available for major capital construction, in both cities, and for broad-based faculty recruitment. Given this, our immediate task is to develop responses to the questions posed by the University Senate in the areas designated for each committee.

Committees’ Charges

The three committees will focus on:

• Admissions: Would the admissions processes in the schools need to change at all, recognizing that medical school admission processes of course naturally evolve over time?
• Curriculum: Would the curriculum in the schools need to change at all, recognizing that medical school admission processes of course naturally evolve over time?
• Culture and Identity

I ask you to contemplate a hypothetical administrative structure where New Jersey Medical School and Robert Wood Johnson Medical School can attain the maximum level of cooperation and coordination, i.e., if they were placed under one LCME accreditation, while still maintaining their unique campus identity and culture.

Let me set a few parameters on how I envision this:

• I do not envision a future for the medical schools where one is ever subordinate to the other.
• I do not envision a scenario that results in the loss of jobs (union or otherwise) among the faculty or staff, at either school; rather I see growth and investment in clinical care, research, and educational opportunities.
• I do not envision a scenario where either school will be expanding its student body, since the inpatient clinical capacity could not sustain that.
• I do see that each campus will benefit from the hands-on presence of a local dean working collaboratively with a colleague similarly situated 26 miles away.
• I do see a scenario where we can offer new tertiary and quaternary services at Robert Wood Johnson University Hospital in New Brunswick and University Hospital in Newark to meet more of our patients’ needs within the State of New Jersey.

My hope is that our medical students will be able to take advantage of the best educational opportunities that each school can offer and pursue their interests and ambitions seamlessly across schools without undue impediments. How can we achieve this and maintain our high admissions standards across the two schools, and enroll classes that reflect our state’s diversity? How can we provide a thorough and comprehensive curriculum to meet the needs of our future physicians and their patients? How can we retain the unique and valuable contributions and culture that distinguish and enhance the faculty, staff, student, and patient experience at each school, which is and will continue to be reflective of their principal teaching hospital?

If you can, contemplate these questions with the hypothetical construct that NJMS and RWJMS will in some way integrate their operations and activities more closely than we do today.

Next Steps

Dean Johnson, Dean Murtha, and I will also be developing responses to those questions that are administrative in nature, and we will be working with the RBHS Office of Research to answer those questions particular to research. In addition, we will be setting up a web-based survey instrument to collect comments from across the medical schools and across the state.

ECG will collect and distribute all the responses and we will share this document with you, our medical schools, the community, and the University Senate for their review. We plan some forums in each city to obtain input from our host communities and local leaders. Following the Senate review a formal proposal will be drafted for President Holloway and the Boards to review.

We all seek a medical education program that best delivers on the promises made to our communities, the people of New Jersey, our professions, and our patients. I welcome your thoughts, perspectives, experience, and knowledge as we contemplate a structure that will optimally deliver on our missions.

Sincerely,

Brian L. Strom, MD, MPH 
Chancellor, Rutgers Biomedical and Health Sciences 
Executive Vice President for Health Affairs, Rutgers University