For the last two months, two academics at Indiana University and Purdue University have been passing notes.
Dr. Craig Brater, dean of IU's School of Medicine, and Vic Lechtenberg, Purdue's interim provost, have been swapping e-mails, trading phone calls and meeting face to face.
Their topic? How the institutions can work together to rev up research in medicine and life sciences and, in the process, boost Indiana's economy. At the same time, IU officials are launching talks with administrators from universities around the state on how the medical school can train more physicians to cure a shortage, particularly in the state's doctor-depleted hinterlands.
"We want to say, 'How can we do this most effectively?'" Brater said of advancing the unversities' life sciences efforts in ways that benefit the entire state.
These talks are a bit of homework assigned by key members of the Indiana General Assembly during the 2007 session, during which the IU medical school asked for $80 million over two years to boost its life sciences initiative and beef up medical education.
The Legislature instead gave $15 million to IU and $5 million to Purdue, routing the money through the Indiana Economic Development Corp., the state's main economic development agency. Legislators also demanded more details on how IU's life sciences work would include other schools and other regions of the state.
While the IU medical school operates campuses around the state, its research occurs predominantly at its main campus in Indianapolis. Its regional medical education centers offer years one and two of medical school, but send students to Indianapolis for years three and four.
"We didn't mind dumping all that money into Indianapolis, but we ought to see where it's going to help the rest of the state," said Sen. Bob Meeks, R-LaGrange, who chairs the Senate Appropriations Committee.
The medical school will make no requests of the Legislature during the 2008 session, said J.T. Forbes, IU's vice president of government relations. But it likely will pitch a new proposal in 2009--when the next biennial budget is written.
IU officials are watching closely the performance of the state economy and any property tax fixes approved this year. If tax revenue falls or if the Legislature uses up cash to alleviate rising property taxes, funds might dry up for IU's project.
Still, there's no time to waste, Forbes said, because nearly every state in the nation boasts a life sciences initiative of some sort.
"Every day that Indiana doesn't step up and get into the game is another day that another state gets ahead of us," he said.
Building on strengths
An infusion of $80 million would allow the medical school to recruit 100 scientists to Indiana over two years, IU officials claimed last year.
If substantial state support kept up for 10 years, IU predicted, it could help start or attract 100 life sciences companies, create 2,500 life sciences jobs, and bring $2.4 billion in federal and private research grants to Indiana.
Central Indiana lags other regions of the country in life sciences research capacity, said Perry Wong, senior managing economist at the Milken Institute, an economic think tank in California. But because the area already boasts substantial life sciences assets, he said, it could catch up with life sciences clusters in Boston, San Diego and the San Francisco Bay area, if it wants to.
"Late, but not too late, because they still have a base," Wong said. He cautioned, however, that luring top-notch researchers is "a tough game."
Central Indiana has a number of life sciences strengths to build on--including the corporate headquarters of pharmaceutical giant Eli Lilly and Co., the North American headquarters of Roche Diagnostics, and the headquarters of DowAgroSciences, along with many smaller firms.
The Indianapolis area claimed 24,000 "biosciences" jobs, according to a 2007 study by the Ohio consulting firm Battelle. That ranked it the ninth-largest cluster of "biosciences" activity in the nation.
IU will make a proposal this month to the IEDC for how to spend the $15 million it was appropriated last year. IU hopes to use the money as leverage to obtain other funds, Forbes said, most of which will go toward hiring and providing facilities for new researchers.
For example, in November 2006, IU lured away brain-imaging researcher Andrew Saykin from Dartmouth College. Saykin brought along three other researchers who had worked with him at Dartmouth, as well as sizable research grants from the National Institutes of Health.
Saykin said he was impressed by the "willingness of the institution to make a substantial investment" for equipment and faculty in his field of neurosciences.
Purdue is preparing its own proposal to the IEDC for how to use the $5 million appropriated to it, Lechtenberg said.
Both he and Brater hope to build on existing research relationships between IU and Purdue, as well as between those schools and the University of Notre Dame in South Bend. In March, for example, the IU medical school added two researchers to its medical education center in South Bend. The pair is collaborating with scientists at Notre Dame's Walther Cancer Research Center.
Lechtenberg envisions research partnerships with even more state schools.
"This is not a new conversation," he said. "There are already many areas of collaboration."
What's new, however, is talk about using joint research as an engine for economic development. So far, each university has tried to advance economic development largely within its own system.
Last year, IU officials promised lawmakers they would partner with Purdue, the University of Notre Dame and other state schools. But the legislators wanted more details.
"There was nothing formal. We had discussions with Purdue leadership and said, 'Look, if we go forward, we would like to collaborate,'" Brater said. But, he added, "As you would expect, people wanted more specificity."
Training more doctors
They also wanted more details on how the IU medical school can heal a physician shortage in all parts of the state.
The shortage of physicians is already acute in Indiana. A study by the medical school's Physician Workforce Task Force found that the state already has about 3,500 fewer physicians than it should. Indiana had 12,534 doctors in 2005.
Over the next 20 years, demand for physicians will rise as baby boomers age. Based on current trends, Indiana will narrow but not eliminate the gap unless it starts training more doctors now.
In 2025, Indiana still will have 1,300 fewer doctors than it needs, according to task force projections. However, if IU--the state's only medical school--expands its annual enrollment 30 percent--or about 85 extra students each year--the state could lack just 240 doctors by 2025.
Yet the state's needs go beyond the number of doctors. It requires the right number in the right places. Rural Hoosiers, especially, suffer from a shortage of family doctors.
About half the 280 students the medical school enrolls each year spend their first two years at one of IU's eight regional campuses. They're in Bloomington, Evansville, Fort Wayne, Gary, Lafayette, Muncie, South Bend and Terre Haute.
Keeping students in those areas throughout medical school would lead more graduates to set up their medical practices there, Brater said. That's particularly true if the students hail from those areas to begin with.
Brater would like to ramp up and possibly replicate the Rural Health Program the school started in Terre Haute 10 years ago. The program recruits talented students from rural high schools, promising scholarships and admission to medical school (if they keep their grades up)--all in hopes that they work as doctors in a rural area.
The Terre Haute regional campus is hosted by Indiana State University and receives support from the local hospital and doctors. Brater said IU officials must get input from leaders of the schools and communities that host the medical school's other regional campuses before plowing ahead with specific plans.
But IU does have strong evidence to back up the goals of the Terre Haute program.
A study by IU researchers published in 2007 found that past IU medical graduates were nearly five times as likely to set up practice outside a metro area if they grew up outside a metro area.
"If you take a student out of Linton and he or she attends school in Indianapolis, discovers Broad Ripple and the city, what are the chances of that student wanting to come back to Linton?" asked Peter Duong, interim director of the IU medical school's Terre Haute campus, in a statement released last year by the school. "I would say the chances are less than 50 percent."