^[1]

First the [former Merck CEO Roy] Vagelos Commission ^[2]; then the [former Governor Tom] Kean Commission ^[3]; just this past week, the final report ^[4] of the UMDNJ Advisory Committee ^[5]. Here’s a recap of what’s happening with the reorganization of public medical education in New Jersey, and my own evaluation of the outcome, emphasizing the impacts on research budgets (a matter which is underplayed in the advisory committee report).

Since 2003, New Jersey has moved in fits and starts to undo the damage done more than four decades ago under former Gov. William Cahill, who in 1970 — perhaps angered by what he saw as gold-plated research facilities or maybe for more prosaic political reasons following the 1967 Newark riots — severed the Rutgers Medical School from the state university and attached it instead as the new Robert Wood Johnson Medical School (RWJMS) to what was then called the College of Medicine and Dentistry of New Jersey (CMDNJ).

That move placed under different institutional ownership facilities that were actually across the street from each other, requiring crippling negotiations between two bureaucracies for any major bioscience research projects, significantly constraining both public universities’ abilities to contribute to regional economic development.

Beyond that, what eventually became UMDNJ was a unique beast, a health-sciences university spread across four widely separated campuses. Among its eight graduate and professional schools were no fewer than three different medical schools, two allopathic and one osteopathic (don’t ask), and one university-owned teaching hospital. It was truly an ungovernable nightmare, and one that soon and unendingly got into trouble ^[6].

This week, the third advisory panel in a decade recommended an unraveling of this arrangement, apparently with the support of Gov. Chris Christie:

• reuniting Rutgers and its Medical School, along with the School of Public Health, thus fully re-integrating the New Brunswick/Piscataway core of Rutgers;
• separating Rutgers’s Camden campus and attaching it instead to Rowan University (the former Glassboro State College) which had (perhaps somewhat unwillingly) become the institutional home for a fourth medical school created at Cooper Hospital in Camden at the instigation of all-powerful South Jersey Democratic boss George Norcross;
• shrinking UMDNJ down to a new New Jersey Health Sciences University (NJHSU), focused mainly on the Newark-based New Jersey Medical School (NJMS) and schools of biomedical sciences, dentistry, nursing, and allied health (partly in Scotch Plains, too);
• attaching two Newark-based institutes and the South Jersey-based School of Osteopathic Medicine to NJHSU as “substantially autonomous” units (whatever that means); and
• attracting a private-sector partner to co-venture with NJHSU on operating University Hospital in Newark.

What got lost in the progression from the Vagelos Commission (which had proposed a new University of New Jersey with three campuses recombining elements of all three old public institutions) to the current plan was any equivalent integration in Newark, where the three main research institutions in town (Rutgers/Newark, the remaining components of NJHSU, and NJIT) will remain independent. Sadly, the advisory committee contented itself with vague language exhorting more collaboration among these parties.

Now, let’s look at the implications for the R&D budgets that drive innovation. This analysis cannot be done directly from public sources, since both Rutgers and UMNDJ have historically reported to the National Science Foundation a consolidated all-university figure, encompassing expenditures across all campuses. But if you dig deeply enough into university documents, you can get a rough estimate of the campus breakdowns. I did this for 2009, and here’s what my estimates say:

When the constituent schools of the two universities in New Brunswick/Piscataway are “recombined,” this will create a single research institution of impressive size. The Rutgers schools resident in town ($355 million in annual R&D expenditures) will combine with RWJMS ($110 million) and the School of Public Health, resulting in a total annual research spend of close to half a billion dollars. Under unified management, Rutgers will at last enter the ranks of the large public research universities.

In Newark, by contrast, there will remain three separate sub-critical mass institutions: NJMS and the School of Biomedical Sciences (totaling well more than $100 million); NJIT ($93 million); and Rutgers/Newark ($27 million). If these three had been joined (and there are all sorts of Newark-centric political reasons why they have not been) it would have instantly created an institution (think of it as the “University of Newark”) spending at least $225 million on research annually, or more than Princeton ($200 million — and that includes the federal lab it manages for DOE).

My own evaluation of this plan is as follows:

• Institutionally, Rutgers comes out a huge winner. It gets to re-integrate the disunited assets in New Brunswick/Piscataway, shuck a Camden campus in which it never really believed or invested, and stay independent in Newark;
• The impact on New Brunswick/Piscataway should be substantial, as the region’s main R&D assets are at long last re-rationalized;
• The jury is out on the impact on Camden and South Jersey, especially if alumni of Rutgers Camden and/or Rowan fight the merger, or the distance between Glassboro and Camden proves an overwhelming barrier to integration, but the total amount of R&D at stake is small, below $12 million annually, and the School of Osteopathic Medicine stays outside the picture either way; and
• Failure to create a research institution of critical mass in Newark is a huge forgone opportunity.

What do you think? Any errors in my numbers? Or conclusions?

• UMDNJ Advisory Committee Final Report ^[4]
• NJ Vagelos Commission Report ^[2]
• NJ Kean Commission Report ^[3]

^[10]