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A dozen fourth-years do clinical rotations in Italy and Spain

Katie Waybill, M’16, was awestruck by the pace of life in Messina, Italy.

“It was so much slower,” she said. “It really gave us a chance to feel the culture of the city, to live every moment.”

Waybill was one of six fourth-year medical students to travel to Italy in February as part of a four-week international exchange between the VCU School of Medicine and the University of Messina. Another six students just returned from Spain as part of an exchange with the University of Cordoba.

“It’s so much better when you are learning a language to be immersed in the environment,” said the Class of 2016’s Ellie Balakhanlou. “I feel like I left there more competent because I was forced to get out of my comfort zone a little bit and really converse in the language.” Pictured here: The students on the Cordoba rotation on a trip into the High Atlas Mountains, where they visited some Berber villages.

“This is a great way for our students to see how healthcare is performed in other parts of the world,” said Chris Woleben, M’97, H’01, associate dean for student affairs who helps coordinate the exchange. “This experience helps our students become well-rounded in dealing with patients who come from different backgrounds.”

The medical exchange between the three schools began 10 years ago. This year, about 30 students from the MCV Campus expressed interest, with 12 selected through a lottery process. When they applied, they selected the specialty that interested them the most and were matched with physicians to shadow.

“Medical students there don’t get as many hands-on experiences as we do here,” said student Sushmita Gordhandas, who traveled to Spain. “But I still learned a lot. It was interesting to see how different healthcare is in another country.”

Gordhandas, who will be moving to Seattle for her OB-GYN residency at the University of Washington, rotated in radiology while in Spain. She saw a variety of cases, from a brain tumor to broken bones.

“In the U.S., there’s more of a mindset that your life is your job,” she said. “In Spain, you do your job and go home to your family. You work hard, but family is the priority. That was one difference, but the biggest thing we encountered was the language barrier. That was a little challenging, but it all worked out. We had friends on our side.”

Many of their counterparts who already had rotated on the MCV Campus as part of the exchange were happy to lend a helping hand, and many of the assigned professors spoke English.

“Some of the residents had already been here and were familiar with MCV,” said Waybill, who will stay in Richmond to complete her internal medicine residency. “Their English was really good. They helped us so much.”

For Ellie Balakhanlou, the trip to Cordoba gave her the opportunity to flex her Spanish-speaking muscles.

“It’s so much better when you are learning a language to be immersed in the environment,” she said. “I feel like I left there more competent because I was forced to get out of my comfort zone a little bit and really converse in the language.”

“It was a clinical rotation for us, but we learned so much outside of that,” said Waybill, who rotated in radiology. She reviewed chest x-rays and saw everything from bowel cancer and congenital heart anomalies to pneumonia. She also had the opportunity to run CT scans on two Vatican mummies. “I am so appreciative for the chance to live in another culture.” Pictured here: The students on the Messina rotation on a day trip to Sicily.

Balakhanlou will stay at on the MCV Campus for her residency in physical medicine and rehabilitation. While in Spain, she was part of the physical rehabilitation rotation and worked with cardiac, pulmonary and pediatric patients.

“I got to do some exams and talk with the patients,” she said. “It was great. The doctors introduced us as Americans and all the patients were so welcoming. They joked with me that I got the chance to practice my Spanish with them while they got to practice their English with me. It was a fascinating experience.”

Each group made time for sightseeing. In Italy, for example, the students spent a weekend in Tuscany, visited the Leaning Tower of Pisa and saw Greek ruins in Agrigento.

“It was a clinical rotation for us, but we learned so much outside of that,” said Waybill, who rotated in radiology. She reviewed chest x-rays and saw everything from bowel cancer and congenital heart anomalies to pneumonia. She also had the opportunity to run CT scans on two Vatican mummies. “I am so appreciative for the chance to live in another culture.”

With a growing number of students applying for the exchange, the medical school hopes to expand the program to include more countries in the coming years.

“In an ever increasing globalized world, it’s important to have inter-cultural experiences,” said Michael Ryan, M.D., assistant dean for clinical medical education. “It makes our students more valuable and better equipped to understand our complex world.”

And become better physicians in the process.

“Health care is different no matter where you go,” Waybill said. “No one system is perfect. But if you can take the strengths from all, it will allow us to have a cohesive relationship with other nations and work toward a stronger healthcare system for everyone.”

By Janet Showalter


MacGyver medicine: Medical school team wins wilderness medicine event

Stabilizing a patient with spinal cord injury. Emergency tracheotomy. Intubation. It’s all in a day’s work.

Except now imagine doing these procedures while mountain biking, canoeing, running through the woods with map and compass, and carrying all your supplies on your back.

The Class of 2016’s Phil Griffith, Chris Woleben, M’97, H’01, and the Class of 2017’s Jenika Ferretti-Gallon prevailed in the Mid-Atlantic MedWAR that combines wilderness medicine and adventure racing.

Sounds almost impossible, but the medical school’s Lactated Ringers team prevailed at the Mid-Atlantic MedWAR (Medical Wilderness Adventure Race) competition on March 19.

MedWAR events pit three-person teams of wilderness medicine enthusiasts against each other for a day-long event that challenges their medical knowledge, orienteering skills and stamina. The competition, held in several locations throughout the U.S., was created in 2000 by two emergency medicine physicians with a passion for adventure racing. MedWAR events have no route markers, water stations or cheering spectators; instead they simulate backcountry rescue situations so participants can test and improve their skills.

The Class of 2016’s Phil Griffith heard about the event last year and decided it was the perfect venue for his love of the outdoors and career plans as an emergency physician. “Emergency medicine fits with wilderness medicine,” he noted. Except in the outdoors, “You’re practicing with fewer resources, higher evacuation times and the same principles of stabilize and improvise.”

He participated in the event for the first time last year with Chris Woleben, M’97, H’01, on a team dubbed the Lactated Ringers. This year, the Class of 2017’s Jenika Ferretti-Gallon joined them.

An associate professor in the Division of Pediatric Emergency Medicine, Woleben is also associate dean for student affairs in the medical school. Though he’s far more experienced in medicine, Woleben calls the students “the masterminds to our team’s success.”

The competition, held in Newport News, includes three loops (four for more advanced competitors) consisting of questions and hands-on scenarios. Each team must navigate to checkpoints where they will encounter physical challenges or wilderness medicine simulations, which they must successfully complete before moving forward.

The team takes its name from Ringer’s lactate solution that’s often used for fluid resuscitation after blood loss due to trauma, surgery or other injury.

During the race, which the Lactated Ringers completed in under seven hours by mountain bike, canoe and foot, they performed a cricothyrotomy on a pig trachea and removed a fish hook from someone’s skin (using a pig’s foot as a stand-in). One memorable scenario involved stabilizing a skydiver who had landed in a tree and sustained spinal cord injury.

The trio capitalized on the lessons learned from the experiences of the 2015 team.

“The reason for our success was that we planned in advance,” said Ferretti-Gallon. “We practiced orienteering the weekend before the race at a Boy Scout camp.”

The group also knew what to carry in their pack, smaller than last year’s but still a hefty 20 pounds of wilderness supplies. “The most important thing you can have is gloves,” said Griffith. “And a knife is always useful.” The group also hauled water purification equipment, shelter, epinephrine for anaphylactic shock, gauze and a CPR mask. A skin stapler came in handy, too, for making quick repairs on their simulated victims so the team could get back on the course.

With few penalties for wrong answers and some bonus points for their knot-tying skills, the team was named winner of the Intermediate division. In addition to bragging rights, the team won a copy of “Improvised Medicine,” a book Griffith dubs MacGyver medicine. “Actually, I’ve had my eye on that for a while,” he said.

It also gave them confidence. “MedWAR can change the way you think about practicing medicine,” Ferretti-Gallon said. “It gives you skills to apply in the field. It’s encouraging and it’s empowering.”

She’ll hold down the fort next year at MedWAR, as Griffith moves to Ohio for residency.

However, he remains prepared for anything he encounters. “I always try to keep my medical bag with me. And my keychain is just exploding now with a bag of gloves, a pocket knife and other supplies.”

By Lisa Crutchfield


“My country needs me” – Trio of Fulbright students working to improve medicine back home

Soon after realizing her dream of becoming an assistant professor at King Edward Medical University in Pakistan, Javeria Aijaz, MBBS, noticed a startling deficiency at the medical institution that’s renowned in her native country.

“Despite being a top-ranked university, there was hardly any research work being done,” she said. “There is such a great need.”

She knew earning a Ph.D. in human and molecular genetics would put her one step closer to helping her country research and fight disease. With limited educational opportunities in this field available in Pakistan, she turned to the United States.

Aijaz applied for a Fulbright scholarship, which enables graduate students, young professionals and artists from abroad to study and conduct research in the United States. When she received word last year that she was accepted into the program, she was overwhelmed.

“I’m so thankful every day that I’m in this position to help my country,” she said.

The Fulbright Foreign Student Program operates in more than 155 countries worldwide. Approximately 4,000 foreign students receive Fulbright scholarships each year. Once students are accepted, the merit-based program helps match them with universities that best meet their needs.

For Aijaz, that meant the School of Medicine at Virginia Commonwealth University. She arrived on the MCV Campus in the fall and will remain in Richmond for the next four to five years while completing her Ph.D.

“I’ll then return home,” she said. “My country needs me.”

Aijaz is not alone in her quest. Two other Fulbright scholars are also on campus. Gladys Langi, from Indonesia, and Viviana Rodriguez, from Colombia, also are on a mission to improve medicine in their home countries. All three are enrolled in degree programs within the School of Medicine.

“To have three Fulbright scholars at the same time is pretty exciting,” said Jan Chlebowski, Ph.D., associate dean for graduate education in the medical school. “It’s definitely a unique set of circumstances we have not seen before.”

A handful of Fulbrighters have been enrolled at the VCU School of Medicine in the past, but in Chlebowski’s 38 years on campus, he’s never seen three in the same year.

“We’ve had more exposure in the international arena,” he said. “As that footprint has grown, awareness and appreciation of VCU as a potential destination has grown. Remember that for these students, English is not their first language. Everything they do is even more of a challenge. They are managing it very well. These students are amazing.”

Meet these Fulbright students.

Javeria Aijaz
from Pakistan,
pursuing a PhD in
the Department of
Human and Molecular
Gladys Langi
from Indonesia,
pursuing a master’s
degree in the
Department of Human
and Molecular Genetics
Viviana Rodriguez
Viviana Rodriguez
from Colombia,
pursuing a PhD
degree in the
Department of

Javeria Aijaz

Growing up in Pakistan, Aijaz thought she would study engineering. But her father encouraged her to take the medical route. She earned her medical degree from Punjab University in 2002, then completed a fellowship in hematology at the College of Physicians and Surgeons.

She was named assistant professor at King Edward Medical University in 2009. She joined the GIZ Health Sector Support Program’s Safe Blood Transfusion Project two years later. Since its inception, SBTP has delivered a series of improvements that have significantly contributed to blood safety standards.

Javeria Aijaz, from Pakistan; pursuing a PhD in the Department of Human and Molecular Genetics

“I learned that in a resource-strained country like Pakistan, safe blood transfusions would not be possible without eliminating preventable, transfusion-dependent genetic diseases,” she said. “The experience strengthened my desire to promote research in genetics as a public health measure.”

With her three children growing older, Aijaz decided the time was right to apply for the Fulbright program and pursue her Ph.D. Her husband and children remain in Pakistan but are applying for visas so they can join her here.

“I knew now was the time to make the move, otherwise it would be too late,” said Aijaz, 36. “I miss my family terribly, but there is a lot of pressure here at school to take my mind off that.”

Some of the challenges facing Aijaz are sophisticated labs and technology.

“Javeria had all this clinical knowledge when she came, but had not worked in a lab,” said Joyce Lloyd, Ph.D., vice chair of education for the Department of Human and Molecular Genetics. “She was not fazed at all about that. She’s always craving more information and has really shined.”

Gladys Langi 

After earning her bachelor’s degree in microbiology from Bandung Institute of Technology in Indonesia, Langi dreamed of a career in human genetics.

“Then I thought, do I really want to do this?” she said. “I decided to work first before returning to school.”

Gladys Langi, from Indonesia; pursuing a master’s degree in the Department of Human and Molecular Genetics

She joined Mochtar Riady Institute for Nanotechnology as a research assistant in the Single Nucleotide Polymorphisms laboratory. For two years, she searched for genetic variants in transforming growth factor beta receptor genes and their association with liver disease progression. With her interest in genetics growing deeper, she knew more education was a necessity.

She’s on the MCV Campus pursuing her master’s in human and molecular genetics. She hopes to one day earn a Ph.D. in the same field.

“She has such a work ethic,” Lloyd said. “She’s a very high achiever academically. She has clear goals and is committed to them.”

Langi plans to return to Mochtar Riady as a principal investigator, focusing on complex diseases such as substance abuse and cancer.

“I want to be a scientist studying the genetic profile of Indonesian people,” Langi said. “We have limited knowledge of that.”

While Langi, 27, misses her family, Skype and social media has helped keep her in touch. She’s also making new friends here. She’s joined study groups, and the school’s international office matched her with a volunteer who is making the transition to a new culture a smoother one.

“I was worried at first because this is my first time living abroad away from my family,” she said. “I find Richmond is such a great place full of diversity and the people are very welcoming. I feel like I blend right in.”

Viviana Rodriguez

While working as a research assistant in a clinical trial, Rodriguez met a premature baby who changed her life.

The baby girl was struggling to survive, an image that has stayed with Rodriguez for years.

“I knew the thing that I was studying could help people like that little girl,” she said. “I knew I had to finish what I started.”

She earned a bachelor’s in statistics from Universidad Nacional de Colombia in Bogota in 2006, then a master’s in clinical epidemiology in 2012. She now has her sights set on a Ph.D. in biostatistics.

Viviana Rodriguez, from Colombia, pursuing a PhD in the Department of Biostatistics

“In spite of the image of biostatisticians as people handling exclusively computers and incomprehensible data, their work plays an essential role in the improvement of our health services,” said Rodriguez, 32. “I want to devote my life to health research.”

With her husband also in Richmond, Rodriguez is settling in nicely to a new routine.

“She is doing well in everything,” said Roy Sabo, Ph.D., program director for the Department of Biostatistics. “She is extremely motivated, very mature and incredibly strong. If all Fulbright students are like her, we need to start hunting them down.”

Before coming to Richmond, Rodriguez worked as an assistant professor in the Clinical Epidemiology and Biostatistics Department of the School of Medicine at Pontificia Universidad Javeriana in Bogota. After completing her Ph.D., she will return as a researcher and professor.

“I know I could make more money outside of healthcare, but here, I can really help people,” she said. “That is what I want to do.”

Most of the analysis used in health research in Colombia ignores the clinical conditions and variables of the environment, Rodriguez said.

“Through research, we can do a better analysis of which treatments are most beneficial,” she said. “Thanks to the Fulbright program, I will be able to help my country. It’s a dream come true.”

By Janet Showalter


Class of 67’s John Bagley recalls an unexpected connection to transplant pioneer H.M. Lee

As he flipped through a recent issue of VCU’s Impact, his eye fell on an article about transplant pioneer H. M. Lee, M.D., and the endowed lectureship that has been established in his name.

The sight reminded John Bagley, Jr., M’67, H’73, of one of his own favorite stories.

The Class of 67’s John Bagley, Jr. (on right), was drafted into the U.S. Army Medical Corps after completing his intern year. Sent 7,000 miles from his native Richmond to Korea, he had an unexpected encounter that reminded him of home.

After earning his medical degree in 1967, the Richmond native served his internship at Norfolk General Hospital. During that time, he was drafted into the U.S. Army Medical Corps.

“It was the height of the Vietnam War, but my orders were for Korea,” says Bagley. “I was stationed at Camp Red Cloud along with three or four other doctors.”

Camp Red Cloud was about an hour north of Seoul, just outside of the village of Uijeongbu.

“If you have ever seen photos of slums in places like Bangladesh, you can imagine what Uijeongbu looked like in those days. Mud streets with ramshackle buildings on either side.”

After he’d been there several months, a recommendation came down for the Army doctors to meet the local Korean doctor, whose responsibilities included the gynecological care of the thousands of prostitutes who lived in Uijeongbu.

“So off we go to town to meet the local doctor, an elderly fellow named Dr. Lee,” describes Bagley. “We are ushered into this dark, cramped office on the main street of town. It reminded me of Doc Adam’s office in Gunsmoke. There were anatomical charts on the wall in Korean and jars filled with Ginseng roots. So we’re sitting there waiting for the doctor and I notice this 8×10 photo on the desk of a young Korean boy in a cap and gown. I think to myself, ‘That guy looks familiar.’”

John Bagley, Jr., M’67, H’73

The Korean doctor spoke no English, and the Army doctors spoke no Korean. “We are chatting through an interpreter and during a lull in the conversation, I say, ‘Dr. Lee, I was noticing the photo on your desk. Who is that young man?’

“He replied, ‘That is my son.’”

“What does your son do?”

“He is a doctor in the United States.”

“Where in the United States?”

“In Virginia.”

“When I recovered from my shock, I smiled and said ‘Dr. Lee, your son was one of my professors in medical school.’

“Naturally, he was as shocked as I was. I travel 7,000 miles from home to meet one of my professors’ father. That’s what I call my favorite ‘it’s a small world’ story.”

After that encounter, Bagley and the elder Lee got together several times over the next year. Lee even took the Army doctors to some of his favorite restaurants in Seoul.

In 1969, having listened in on the radio to the first moon landing (they had no television at the Army camp), Bagley returned to the states. He went on to complete OB-GYN training on the MCV Campus and set up practice in Richmond. After a 39-year career and an estimated 3,000 labor and deliveries, he is now retired and living in Providence Forge, Va.


From medieval literature to medical school: Cambridge grad sets his sights on helping others

Gabrovsky,Alexander  Hiking in the Scottish Highlands

The Class of 2019’s Alexander Gabrovsky unusual path to medical school included publishing a 312-page book about the English poet Geoffrey Chaucer.

As an elementary school student living in the picturesque village of Murs, France, Alexander Gabrovsky’s fascination with the medieval world took hold.

“The family we rented our house from lived in a hilltop chateau from the 12th century,” he said. “I used to spend time there and was mesmerized by the architecture and the family’s stories of their medieval ancestors.”

So much so that he has spent much of his life studying that time period. The Class of 2019’s Gabrovsky not only holds a master’s degree and Ph.D. in medieval literature from the University of Cambridge in England, but he has written a book about Geoffrey Chaucer, who is widely considered the greatest English poet of the Middle Ages.

Published in September, “Chaucer the Alchemist: Physics, Mutability and the Medieval Imagination” investigates Chaucer’s fascination with the philosophical and scientific thinking surrounding change in the natural world. Gabrovsky argues an integrated knowledge of alchemy and physics is crucial to our understanding of the physical and psychological transformations that are central to Chaucer’s poetry. The 312-page tome expands on Gabrovsky’s Ph.D. dissertation.

“It was a lot of work, but I also had a lot of fun,” said Gabrovsky, who traveled to Italy to trace Chaucer’s footsteps and spent time in Scotland and Cambridge studying medieval manuscripts and deciphering cryptic verses on alchemy. “It’s surreal. It’s a strange feeling walking into the library here and seeing my book on the shelves.”

Some of Gabrovsky’s classmates who were on hand for his recent book signing on campus have the same reaction. But making the transition from medieval literature to medicine makes perfect sense, he said.

“I have a long list of reasons for going into medicine,” Gabrovsky said. “I enjoy the multi-disciplinary aspect of it and the problem solving. But it also comes down to helping the sick and vulnerable.”

Gabrovsky, 31, grew up Portland, Maine, then lived in southern France for a year while in elementary school. He graduated from high school in Los Angeles and earned a bachelor’s degree in English from UCLA in 2006. He took two semesters in Beijing, then completed a post- baccalaureate program at Johns Hopkins before completing his master’s and doctorate at Cambridge.

Now he’s pursing a degree that’s been a dream of his all along.

Gabrovsky,Alexander  Restoring a medieval skeleton in Pisa Italy

Alexander Gabrovsky restoring a medieval skeleton in Pisa, Italy.

“I must really like wearing a backpack,” joked Gabrovsky, who taught medieval literature at Cambridge for a semester. “I love learning. With medicine, you take classes in all different aspects of science – there’s a broad spectrum of learning, but you have to integrate that knowledge to understand the rich complexity of the entire human body.”

This past summer, Gabrovsky spent time in Italy, where he worked in a lab reconstructing the skeleton of a 14th century Tuscan peasant, who he thinks sustained a war injury to his femur. He analyzed bones from gravesites and studied ancient diseases.

Next summer, he will work alongside a pathologist from the MCV Campus as they analyze and study South American mummies from pre-Columbian civilizations, such as the Incan empire. He recently arranged a postdoctoral position in the UK, hoping to take a research year between his second and third year of medical school to examine the influence ancient and medieval parasites may have had on human evolution.

“Alexander may not be your typical medical student, but that’s what makes VCU so great,” said Susan DiGiovanni, M’84, H’89, interim senior associate dean for medical education and student affairs. “Students like him add interest and depth to any conversation. They add such diversity to the class.”

Gabrovsky, who is not only fluent in both French and Mandarin Chinese but also reads several medieval languages, is not yet sure of his specialty, but is confident it will take shape over the next few years.

“I am sure that VCU is the perfect place for that to happen,” he said. “We have a well-known paleopathology lab here, as well as a Paleopathology Club, which is really unique for a medical school. And VCU has such a great culture. Everyone is so warm and welcoming. I really get the feeling we are all here to learn and help each other become the best in our field.”

By Janet Showalter


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 10,000 pro bono sessions at the Ambulatory Care Center on the MCV Campus, the Daily Planet for the Homeless and the Fan Free Clinic. A fourth clinic, VCU’s Hayes E. Willis Health Center, was added in August.

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 Rybarczyk and vice provost for community engagement Catherine Howard celebrated the success of the Safety Net Collaborative this spring’s Currents of Change Award Ceremony. Also pictured are Kathy Yost Benham, director of Client Support and Mental Health Services at the Fan Free Clinic, and Paul Perrin, Ph.D., assistant professor in the Department of Psychology, who supervises the program at the Daily Planet. 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, 80 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.

The collaborative has been funded for three years by the HRSA Graduate Psychology Education program, and this past summer additional support was received from the Virginia Health Care Foundation and Richmond Memorial Health Foundation.

By Jack Carmichael