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Safety Net Collaborative a win-win for VCU and Richmond

When three safety net primary care clinics in Richmond found they could not fully meet the mental health needs of their patients, they knew they had to find a solution to provide these critical services to the city’s most vulnerable populations.

Rachel Waller, M’99

Rachel Waller, M’99

With over half of all patients receiving substandard or no mental health care, the clinics needed to provide thousands of behavioral care sessions to their patients. But where to find a group psychologists willing to contribute hundreds of hours of work at little or no cost?

Bruce Rybarczyk, Ph.D., a professor in VCU’s Department of Psychology, had the perfect answer: his doctoral trainees. As a result, since 2008 trainees have delivered over 8,500 pro bono sessions at the Ambulatory Care Center on the MCV Campus, the Daily Planet for the Homeless and the Fan Free Clinic.

The Safety Net Primary Care Psychology Collaborative has proved fruitful for everyone involved. The clinics are able to better cover the mental health needs of their patients, while the doctoral students get valuable experience working with a wide-range of patients. Most importantly, the medically underserved in the Richmond community get access to the care they need.

Rachel Waller, M’99, has seen the benefits of the collaborative firsthand through her work on the internal medicine service at the Ambulatory Care Center.

“Integrating mental and physical health care is important because you cannot have good control of physical health outcomes when mental health issues such as anxiety and depression go untreated. In our patient population, with limited care access and transportation issues, having psychology resources available during the primary care visit is vital.”

“The ‘warm handoff,’ in which a primary care provider introduces the clinical psychology services team to the patient can really improve willingness to seek care, particularly since there remains an unfortunate stigma for many in acknowledging that they are experiencing mental health issues.”

Integrating mental and physical health care services at the clinics has been an effective method for improving patient outcomes. Behavioral and physical health problems are often interconnected; treating one side of a patient’s problems but not the other often means more care, and more costs, down the road. Study findings show patients receiving this type of integrated healthcare had fewer hospitalizations and emergency room visits.

Psychology professor Bruce Rybarcyz and vice provost for community engagement Catherine Howard celebrated the success of the Safety Net Collaborative this spring’s Currents of Change Award Ceremony. Photo credit: Steven Casanova.

Psychology professor Bruce Rybarcyz and vice provost for community engagement Catherine Howard celebrated the success of the Safety Net Collaborative this spring’s Currents of Change Award Ceremony. Photo credit: Steven Casanova.

These results are evident on the MCV Campus. Waller, who works as an assistant professor in the Department of Internal Medicine, says the clinic has seen “decreased admission rates for medical illness for our patients who utilize clinical psychology students compared to controls.”

The success of the program has not gone unnoticed. This year the collaborative won VCU’s Currents of Change Award, which recognizes mutually beneficial partnerships between the university and the Richmond community.

This experience in collaborative, team-based care is invaluable for both medical and psychology trainees. Since the collaboration began, 65 doctoral students have worked at the clinics, six of whom have gone on to work in integrated care positions as a result of their experience at VCU.

Medical residents also benefit from the help offered by their colleagues in the psychology department, as many report greater work satisfaction and significant benefits for their patients since the collaboration started.

Waller says that outpatient care is moving from a model that emphasizes productivity to one that focuses on medical outcomes. Cohesive, interdisciplinary teams like the collaborative will be better equipped to meet the demands of the newly emerging outpatient medical system.


Swim, Study, Bike, Study, Run: Fourth-year student Samone Franzese balances medical school and triathlon


For fourth-year student Samone Franzese, unwinding means intense training sessions two times a day to prepare for her next triathlon.

Medical students face long days of clinical rotations, long nights of studying and intense pressure to succeed. As a result, students seek activities outside of school that help them relax and decompress. For many students this means spending time with their families, reading a good book or volunteering in the community.

For fourth-year student Samone Franzese, however, unwinding means intense training sessions two times a day to prepare for her next triathlon — not most people’s idea of relaxing after a long day at work.

On a typical day Franzese starts off by heading to the pool to swim for an hour, then comes to campus for eight to ten hours, and then heads out for another hour or two of training at the track or on her bike.

This routine changes depending on her school schedule — a surgery rotation that required 70- to 80-hour work weeks limited her training to key track and bike workouts, and required more time management. She intentionally scheduled her pediatrics rotation during the summer to try to avoid getting sick.

This intense regimen has paid off — after strong performances in amateur races this summer Franzese will race in the elite field for the first time this fall.


After strong performances in amateur races this summer, fourth-year student Samone Franzese will race in the elite field for the first time this fall

A long-time runner, she was introduced to triathlon while recovering from an injury during her first year of medical school. “I was talking to a trainer who was helping me get back to running, and she suggested I join the triathlon team because there would be more variety in my training and a group to work with. That sounded great to me, so I joined and just fell in love with triathlon. And I’ve been doing it ever since.”

For Franzese, however, staying physically fit is more than just a pastime — it’s part of her job. A second lieutenant in the Army, she is attending medical school through a military scholarship that has given her the opportunity to go on rotations at military bases during summers and will require her to complete service time after she graduates.

Even among her peers in the armed forces Franzese’s ability in the triathlon is remarkable. She was selected to join the United States Military Endurance Sports Elite Triathlon team in November 2014, and went on  to win the Armed Forces Championship this June. “Being selected for the team vindicated a lot of the hard work I put in,” says Franzese.

Learn More

To learn more about how Samone balances medical school and triathlon, visit her blog at samonefranzese.com

Despite her success, new challenges lie ahead as she begins to enter elite races. Triathletes qualify to enter elite races only after proving themselves in amateur races, and the large difference in competitors’ abilities means new elite racers like Franzese, who are used to dominating their competition, may find themselves at the back of the pack.

Throughout all of her training Franzese has been surprised by the amount of support she has gotten from the medical school. “My classmates are always interested to hear about my races, and I think most people understand that you need to have a life outside of campus. I love getting away from academics for at least an hour a day to just be and think about whatever I want. Triathlon has become my therapy during medical school.”

By Jack Carmichael


Student team gets new perspective in Ghana

A team of four medical students traveled to Ghana this past summer to do outreach work in rural clinics. They also visited schools where they did head-to-toe physicals on dozens of school children.

The Class of 2017’s Ashvin Sood feels fortunate he’s had the opportunity to visit many communities around the world. In particular, a Semester at Sea program allowed him to travel from country to country, including Ghana, while studying world history and health disparities.

“While I had a memorable experience,” said Sood, “I was saddened by seeing fellow human beings struggle with basic necessities like having access to healthcare professionals or not having the ability to travel to a hospital because the roads were too dangerous to drive on during the night.”

At first he wasn’t sure how he could make a difference. But in 2014 – the summer after his first year of medical school – a light bulb turned on. He saw that, even with just one year of medical school under his belt, his training could be put to use helping to serve the underserved.

That summer, he returned to Ghana with classmates on a medical relief trip. They visited several communities and saw illnesses from malaria to malignant hypertension. “It was fulfilling to give back to those who did not have the same opportunities that we do in the states,” said Sood, “but it was also difficult to reflect on the future health of the people we treated and when they would have the opportunity again to visit a clinic or see a doctor or nurse.”

That question inspired him to find a way to send medical students to one community in Ghana every year.  And Team Norvisi was born. Taking its name from the Ewe language that’s spoken in eastern Ghana, Norvisi means brotherhood and sisterhood.

“I love this word because it simply indicates that we are all family. That is what I hope Norvisi becomes – an organization that can bring two cultures together, provide an experience for students to learn, provide Ghanians medical assistance and help strengthen a community. ”

Team Norvisi

Board: The Class of 2017’s Sarah Berg, Kristina Fernandez, Qasim Kazmi, Ashvin Sood and Leah Towarnicky

2015 Travel Team: The Class of 2018’s Erica Chan, Allison Hinson, Kevin Liu, and Danushka Senevirante

Sood knew he wouldn’t go on a summer 2015 trip since he would be absorbed in third-year clinical rotations on the MCV Campus. Instead, he recruited fellow students with the same enthusiasm for rural clinic outreach in Ghana. A five-member board is made up of third-year medical students, and rising second-year students made up a four-member travel team.

For six months they planned the 2015 trip, first getting in contact with Blue-Med Africa. The in-country non-profit organization hosts students from around the world to help with rural clinic outreach as well as in two regional hospitals.

At the end of May, the four travelers took off for a three-week stay in eastern Ghana. Their home base was the town of Ho in the Volta region.

“For the most part, our work was in the rural villages where we saw patients and distributed medications,” said the Class of 2018’s Kevin Liu. “We also visited schools to do quick head-to-toe exams on the kids.”  They learned ringworm is a common fungal infection in the children and treated those affected with an anti-fungal lotion.

The team also was involved in dressing wounds and disinfecting wounds of post-infectious leprosy patients. Because of the stigma associated with the disease, the patients live together in an independent village. Though they’ve been treated and are no longer infectious, many of them were missing limbs or had ulcer-laden and deformed extremities.

“In our three weeks, through our interactions, I grew to admire the resilience of one lady who I took care of each time we visited,” said Liu. “She had multiple ulcers on her feet that lacked sensation, and the ulcers made balancing on her feet particularly difficult. Nevertheless, she walked from her home to the community center each time to receive care from me. I would clean her ulcer and as precisely as I could, wrap it up. She had such resilience, and because she embraced our services and noticed improvement through years of care, I have no doubts her wounds will heal in the long run.”

The summer experience also took the team into a regional hospital for an introduction to the different medical units as well as types of patients and diseases seen in Ghana. Liu and a fellow student also spent a couple hours in the operating room shadowing surgeons. “Witnessing an emergency C-section was certainly the highlight of my hospital experience,” said Liu.

“Our goal is to make a positive impact on the communities we serve, while gaining valuable insight into medical care in underserved settings,” said Liu. “I believe we achieved this during our trip, but as we improve, we are hopeful that we will have an even more impactful learning experience!”

A future trip is being planned for summer 2016 to the village of Tafi Atome with the organization Compassionate Journeys. “We are hoping to send medical students and physicians here on a yearly basis to work in their clinic and provide medical relief,” said Sood. The team is interested in recruiting a faculty advisor from the medical school as well as an American physician to join the trip.



Alumna, husband fund scholarship for medical students

Nader Silver, the inaugural recipient of the Dr. Rosemarie T. Greyson-Fleg and Dr. Jerome Fleg Fund Scholarship in the School of Medicine.

Rosemarie Greyson-Fleg, M’80, credits the VCU School of Medicine’s three-year program with jump-starting her career as a physician.

“It was great. I was an older student, and the possibility of doing a three-year program was very attractive to me,” said Greyson-Fleg, a diagnostic radiologist in Clarksville, Maryland. “Everything worked out really well. I was very grateful that I was given that chance at VCU.”

The three-year option is no longer offered, but the school’s accelerated degree program gave Greyson-Fleg the chance to rotate into internal medicine early, where she thrived. She ultimately made the decision to specialize in radiology, giving her more time with her family.

To express her gratitude, Greyson-Fleg and her husband, Jerry, established the Dr. Rosemarie T. Greyson-Fleg and Dr. Jerome Fleg Fund in 2013 through generous gifts of stock. The scholarship is part of the School of Medicine’s 1838 Campaign to help reduce medical student debt.

“My husband and I have supported scholarships at other institutions,” Greyson-Fleg said. “Now it’s my turn to give back to VCU.”

The scholarship – awarded for the first time in April to Nader Silver, a student at the VCU School of Medicine Inova Campus – supports a fourth-year student pursuing a career in the primary care fields of family medicine or pediatrics. Silver, who will start residency training in family medicine this summer, met Greyson-Fleg shortly after receiving the award.

“We had a nice time sharing thoughts about primary care,” Silver said. “Her son is a family medicine physician in New Mexico, and we had many similar interests. I hope to connect with him at some point. I look forward to keeping her posted over the years. I’m very thankful.”

Greyson-Fleg is thankful, too – not only for the education that she received at VCU but also for the university’s careful stewardship of her gifts.

“I know the money is in a good place. The gifts are well-directed,” she said. “The school has done so much for us alumni. We were all given chances to start our careers. Giving back is important to all of us.”

As parents of a primary care physician, Greyson-Fleg and her husband know all too well how important it is help keep student debt load to a minimum.

“Our son, Anthony, is the reason we created the scholarship for those with a love of primary care and pediatrics,” she said. “Those in primary care don’t earn the same kind of money as other specialists. This scholarship is one way we can help.”

Only half of the university’s medical students receive scholarships. The 1838 Campaign helps increase the number and size of scholarships to give the school a competitive edge for recruiting top students, rewarding student excellence and reducing the burden of debt.

“I am proud of our school’s longstanding investment in students who are headed into primary care careers, especially in light of projections that continue to warn of a future shortage of primary care physicians,” said Jerry Strauss III, M.D., Ph.D., dean of the School of Medicine. “I am grateful to Rosemarie and Jerry for establishing this scholarship that honors their son Anthony’s commitment to primary care. They understand the importance of providing financial aid to medical students, and their gift will help us attract students to this calling.”

This article by Nan Johnson first appeared in Volume 3 of Impact, the quarterly publication of VCU’s Office of Development and Alumni Relations.


Students organize Richmond’s first Camp Cardiac for high school students interested in medicine

Ameya Chumble watches Ryan Melchior demonstrate surgical knots

Camp organizer Ameya Chumble watches cardiology fellow Ryan Melchior, M.D., leads students through the surgical knots workshop.

When Ameya Chumble was in high school in Martinsville, Va., summertime educational opportunities were slim to none. Especially in specialized areas such as medicine.

Now he’s a rising second-year student at the VCU School of Medicine. During his first year on VCU’s MCV Campus, he learned about Camp Cardiac, a national day-camp for high school students interested in learning about medical careers. He jumped at the chance to establish a Richmond site of the program.

With the help of medical school faculty members – all volunteers – Chumble and a team of 14 medical students created an impressive schedule of presentations and activities. From obtaining CPR certification and learning suturing techniques, to hearing case studies and observing a live surgery, the high school students spent an action-packed week on campus.

Most of the 25 campers came from high schools in and around the Richmond metro area. One exception was a Seattle, Wash., student who attended the camp while her family visited the area during an extended vacation.

To apply, campers submitted a 300-word essay outlining their interest in attending, what they hoped to learn from the experience and why they were interested in the health care field. Scholarships were available to help cover the cost and meals were provided at no charge by the national Camp Cardiac organization.

“Since this was our inaugural year, we didn’t know what to expect of the campers,” Chumble says. “We ended up with a highly motivated and impressive group of individuals. Our students were flying through materials and tasks people usually don’t see until their first year of medical school. It was amazing.”

Camp Cardiac Staff acting as patients

Camp Cardiac Staff acted as patients so the campers could get a taste of what it’s like to take a patient’s medical history.

Established in Chicago in 2010 by cardiac surgeon Richard Lee, M.D., and three medical students, Camp Cardiac introduces high school students ages 15 and older to the real world of medicine. It focuses on both classroom teaching and hands-on experiences. It also serves as a springboard for students to develop self-awareness of a heart healthy lifestyle.

The importance of healthy living became all too clear during a presentation by Jordana Kron, M.D., associate professor of cardiology and program director of the Clinical Cardiac Electrophysiology Fellowship. Kron and her patient, Mel Shaffer, provided a living example to illustrate the students’ weeklong coursework.

“I remember hearing patient stories when I was in school,” Kron says. “To hear something from a patient’s point of view means so much more.”

Shaffer told his first-hand account of how chest pains at the gym turned into sudden cardiac death: a disruption of his heart’s electrical system resulted in a potentially deadly malfunction. The unexpected condition can sometimes be successfully treated with CPR or defibrillation as it was in Shaffer’s case. He was shocked 11 times after being brought to the emergency room.

Kron presented Shaffer’s electrocardiogram history to the students and asked them to interpret the readout. After hearing his story, they peppered him with questions about his pacemaker and stents as well as his lifestyle changes.

“The students were very attentive and asked a lot of great questions,” Shaffer says. “They were very responsive, which showed they were not only listening attentively, but were comprehending complicated concepts. They had an obvious interest in a career in medicine based on their response and participation.”

Amit Varma shows students artificial heart technology

Campers get an up-close look at the technology that powers artificial hearts with cardiology fellow Amit Varma, M’06, H’12.

Kron will definitely volunteer to be a part of next year’s Camp Cardiac.

“I hope I’m asked to do it again,” she says. “The week’s itinerary was outstanding and it was a great success.”

Chumble and his team started planning the camp nearly nine months in advance.

“Finding professors took time, but they were very gracious,” he says. “We couldn’t have done it without the Departments of Anatomy and Neurobiology, Cardiology and Cardiothoracic Surgery. Their interest and support was overwhelming.”

The 2015 Camp Cardiac was so successful, the MCV Campus now is eligible to host its sister camp, Camp Neuro.

Chumble hopes to serve in an advisory capacity for next year’s camps, but most of the program’s leadership and coordination will be passed onto interested students in the Class of 2019 so that Chumble and his teammates can concentrate on their studies. In early 2016, they’ll take Step 1 of the USMLE national boards and then will move into clinical rotations and the chance to work with more patients like Shaffer.

“This year’s event was a lot of fun. I couldn’t have thought of a better way to spend a week out of my summer.”

By Nan Johnson


Dozen with ties to medical school played roles at ACP’s Internal Medicine 2015 meeting

The American College of Physicians is the second-largest physician group in the United States. Its annual meeting, also its centennial celebration, was held April 30 – May 2, 2015, in Boston, Mass. From behind the scenes to center stage, a dozen with ties to the medical school played roles at the meeting.


John F. Fisher, M’69, H’77

John F. Fisher, M’69, H’77, received the Jane F. Desforges Distinguished Teacher Award at the American College of Physicians’ national meeting in Boston, Mass., on April 30, 2015.

A professor emeritus of Georgia Regents University, Fisher’s academic career spans 38 years. The ACP honor is that latest of nearly five dozen teaching awards, including the Clinical Teacher Award from the Infectious Diseases Society of America, the ACP Georgia Chapter’s J. Willis Hurst Teaching Award and two dozen Educator of the Year awards from Georgia Regents University.

During residency training at VCU, he was given the William Harrison Higgins Award. As an infectious disease fellow, he received the Best Fellow Award two years in succession. Following his training, Fisher joined the faculty of the Medical College of Georgia (now Georgia Regents University), where he was professor of medicine and program director for the Infectious Disease Fellowship. He also served as chief of the Division of Infectious Diseases at the VA Medical Center in Augusta, Ga.

Fisher has served on the education committees for both the IDSA and the National Foundation for Infectious Diseases. He has 101 publications including 57 articles in refereed journals and 44 book chapters. At the ACP annual meeting, he was advanced from Fellow of the American College of Physicians to Master of the American College of Physicians.


Richard “Dick” P. Wenzel, M.D.

Richard “Dick” P. Wenzel, M.D., was the Massachusetts Chapter Lecturer at the ACP meeting. An emeritus professor and former chairman of the Department of Internal Medicine, Wenzel has been long been involved with the ACP and has frequently presented at the annual meeting, keeping physicians up to date with the latest information on topics in internal medicine and infectious disease. His topic at Internal Medicine 2015 was evidence-based physical diagnosis.

In 1988, the Massachusetts Chapter Award Lectureship was established to honor a distinguished Massachusetts internist and to honor an outstanding member of the annual meeting faculty. Today, the recipient of the award is selected by the chair of the Internal Medicine Scientific Program Planning Committee.

Robert Centor

Robert M. Centor, M’75

Robert M. Centor, M’75, concluded his one-year term as chair of the ACP Board of Regents at the annual meeting. The Board of Regents is the main policy-making body of the College.

A member of ACP since 1978, Centor was named a Fellow of ACP in 1985 and became a Master of ACP on October 1, 2014. He has served on the Board of Regents since 2008 and also on many of ACP’s committees, including the Membership Committee, Finance Committee, Strategic Planning Committee and the Health and Public Policy Committee, which he chaired from 2009-2011. Centor was awarded the Laureate Award for outstanding service to medicine and ACP from the Alabama Chapter of ACP in 2009.

He is currently professor of medicine and regional dean of the University of Alabama at Birmingham, Huntsville Regional Medical Campus. He was on the internal medicine faculty on VCU’s Medical College of Virginia Campus until 1993.


Lisa L. Ellis, M’01, H’04

Lisa L. Ellis, M’01, H’04, chaired the Scientific Program Committee that created a mix of small group sessions, classic lectures and hands-on activities for the annual meeting. Faculty presented new findings in internal medicine and its subspecialties, presented new approaches in practice management and discussed issues related to health care policy as well as lead sessions to hone leadership and teaching skills.

“When I attend each year, I bring back new ideas for managing patients as well as techniques for enhancing my own leadership style,” says Ellis who as the ACP Governor for Virginia represents the state on the ACP’s national Board of Governors. In that role, she helps implement national projects and initiatives at the chapter level and represents member concerns at the national level. Ellis also is on the Board of Governors’ executive committee, which advises the Board of Regents.

Ellis currently is the chief medical officer for the Medical College of Virginia Physicians at VCU and has an appointment as an associate professor in internal medicine and OB-GYN.

A student and young alumnus have taken leadership roles in the organization:


Ali M. Khan, M’09

Ali M. Khan, M’09, is chair of the ACP’s National Council of Resident/Fellow Members that represents the interests of over 22,000 residents and fellows-in-training. He’s been on the 11-member council since his intern year at Yale and has helped lead ACP’s High Value Care initiative that educates and engages physicians as well as resident and fellow members in how to practice in a value-sensitive, thoughtful manner for resource stewardship and patient engagement.

At the ACP’s annual meeting, he co-hosted the council’s marquee event, a TED talk-style national forum for promising innovations and bright ideas for teaching high-value care. Moderated by author Sandeep Jauhar, M.D., and the New York Times’ Lisa Sanders, M.D., the event showcased winners from the second annual Teaching Value and Choosing Wisely Challenge sponsored by the ABIM Foundation and the national non-profit Costs of Care.

“We’ve read articles, attended lectures and held forums making the case for value-based care delivery,” Khan says. “Now, however, those words are being bolstered by action – on the ground, at institutions all across the country, led by talented health professionals with the creativity and drive to effect the collective change we seek. Award Winning Innovations isn’t about making the theoretical case for value – it’s about sharing the best work being done nationally to make that case a reality.”


MD-PhD student Chelsea Cockburn

MD-PhD student Chelsea Cockburn began her four-year term as a representative on the National Council of Student Members in April 2015. Council members organize programming for medical students at the national ACP conference every year, and Cockburn attended the annual meeting in Boston where she was looking forward to meeting the rest of the council members as well as internal medicine physicians.

As a member of the student council, Cockburn is assigned a region of medical schools in the U.S. and will help advise the internal medicine interest groups at those schools to strengthen activities at the chapter level. She’s also been selected to represent the council on the ACP Education and Publication Committee that provides scientific and professional information to physicians, trainees and patients.


ACP attendees with ties to the medical school reunited during the Internal Medicine 2015 meeting. Each year, the Department of Internal Medicine hosts a reception. This year it was held at Boston’s Atlantic Beer Garden overlooking the harbor.

A number of faculty from the Department of Internal Medicine presented at Internal Medicine 2015:

  • Stephanie A. Call, M.D., MSPH, professor in the Division of General Medicine and Primary Care.
  • Alan W. Dow III, M.D., associate professor in the Division of General Medicine and Primary Care.
  • Mary H. Hackney, M.D., associate professor in the Division of Hematology/Oncology.
  • Puneet Puri, M.D., assistant professor in the Division of Gastroenterology.
  • George W. Vetrovec, M.D., professor in the Division of Cardiology.

Others were honored at the meeting:

  • Wendy Klein, M.D., associate professor emerita, was awarded the designation of ACP master and was recognized as the Virginia ACP chapter’s 2015 Laureate winner. Klein was co-founder of the VCU Institute for Women’s Health and was the department’s first program director for an innovative residency in Women’s Health.
  • Curtis N. Sessler M.D., the Orhan Muren Distinguished Professor of Medicine, and professor in the Division of Pulmonary Disease, was named an ACP fellow.
  • John R. Strunk, M.D., assistant professor in the Division of General Medicine, was named an ACP fellow.
  • Darren Witte, M.D., in General Medicine and Pediatrics, was named an ACP fellow.