Radiology chair’s vision is ‘all about what’s possible’
November 16, 2022
Ann Fulcher, M’87, H’91, focuses her gaze on two very different worlds. Through one lens, she captures luminous flowers, midflight birds, vibrant streetscapes and still-wild territories, in her work as an award-winning photographer.
Through another lens she surveys the no less remarkable landscape of the human body, as an award-winning radiologist and chair of the VCU School of Medicine’s Department of Radiology.
And if these pursuits share a common theme beyond a way of seeing, Fulcher can name it without hesitation. It’s the word that has shaped her life, guided her leadership and defined her department’s mission: excellence.
“None of us can be perfect,” Fulcher says. “But we can sure strive to be excellent.”
As one of the School of Medicine’s longest serving department chairs—she has held the position since 2003—Fulcher says the biggest change she has seen over the course of her career has been the increasing importance that radiology plays in the care of the patient. Though always essential, “with each year we have become more and more integral in care to a larger number of patients.”
Advances in capabilities and quality, as well as the applications of imaging technology, have been central to that expanding role. PET, CT, MRI, ultrasound and even X-ray provide ever more detailed information. A CT scan that once might have produced 50 images now generates 1,000 in a fraction of the time.
Today, Fulcher oversees a department of 650, including physicians, nurses, technicians, engineers, technologists, and support and administrative staff. The field of interventional radiology has grown to the point where it is now a stand-alone residency on the MCV Campus. And the department has added a growing number of settings for its services (the new tower at the Children’s Hospital of Richmond at VCU will be next). Yet despite the department’s size, its strength, Fulcher says, is collaboration not only within the department but throughout the health system.
“To get a radiology department to work, everybody has to be on board as one team,” Fulcher says. “Over the years we have really broken down walls and built bridges, and the result has been the birth of this incredible team of individuals. We are a service to all the other departments in the institution and as a result to all of those patients.”
That teamwork received national recognition in 2022, when the American College of Radiology designated the department as a Diagnostic Imaging Center of Excellence—the only academic medical center in Virginia and one of only 16 nationwide to be awarded this recognition.
An ‘aha’ moment every day
Back when Ann Fulcher was a medical student, her professor Mary Ann Turner, M.D., H’75, wouldn't have been surprised to learn how the department would flourish under Fulcher’s leadership. “She has one of the most extraordinary sets of talents and skills of anyone I have ever come across,” Turner says. “All of us involved in her early training in radiology recognized she was something special.”
Fulcher originally imagined she would become an allergist, but an introduction to radiology during third-year rotations captivated her interest. Her residency proved “a daily confirmation that I had chosen the right path.” She happily arrived early and stayed late, “just because I loved radiology so much,” she says. “The ‘aha!’ moment came every day.”
She loved that radiology was like solving a puzzle. The collaborative nature of the work, interacting with colleagues and specialties throughout the health system to provide the best care for patients, makes it rewarding as well as constantly new and interesting, she says.
Following residency, Fulcher served four years with the U.S. Air Force at Andrews Air Force Base and taught at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. At age 32, and barely more than a year into her service, Fulcher found herself in a high-profile position, tapped to serve as chair of the department. “It was a great opportunity and one I didn’t expect.”
‘All about what is possible’
After completing her service, Fulcher returned to the MCV Campus in 1995 as an assistant professor and a specialist in abdominal radiology, but quickly moved up the ranks. She earned tenure as an associate professor in 2000, and was both named a full professor and became department chair in 2003.
When the role of chair was offered, she spent several months evaluating whether it was the right choice both for her and the department. “I never had it on my to-do list to be a chair,” Fulcher says.
When she agreed to take the position, she tapped Turner—her former professor and mentor, now colleague—to serve as vice chair. “When I first came back as faculty, she was one of the people who greeted me on the first day and said, ‘I am here to help you if you want my help,’” Fulcher says. “Dr. Turner was at a point in her career when she didn’t need to champion younger faculty, but she did. She has been 100% with me throughout this journey.”
Turner says that at 42, Fulcher was not only one of the youngest, but also the only woman among the 19 clinical department chairs. While no one doubted Fulcher’s talents or abilities, nevertheless some wondered if she was ready for the role. “You don’t know who you are dealing with here,” Turner recalls thinking at the time. “I told them, ‘You have an exceptional person with exceptional abilities. You all don’t know what you have yet, but you will.’”
Indeed, Turner says, Fulcher more than proved her abilities. “Her leadership has been just terrific and amazing,” Turner says. Fulcher is a responsive leader, someone who values teamwork and is quick to recognize and support the accomplishments of everyone within her department. Always detail-oriented but never a rigid perfectionist, Fulcher is “all about what is possible,” Turner says. “She is always looking for how we can be better, and if it can be done, she gets it done.” It’s a positive spirit that is infectious and attracts positive people to work with her.
Her excellence extends beyond her leadership, too. In 2021, Fulcher was one of only two radiologists nationwide to receive the prestigious lifetime achievement Gold Medal Award from the Society of Abdominal Radiology, which honors members who have made lasting contributions to the field.
The award recognized, among other work, pioneering research Fulcher conducted in the late 1990s in collaboration with Turner and gastroenterologist and emeritus professor of medicine Alvin Zfass, M’57. Fulcher, still junior faculty at the time, advocated for VCU to acquire advanced MRI software and then conducted research to demonstrate that a noninvasive MRI scan could more effectively image pancreatic and bile ducts than the then-standard-of-care: an invasive procedure known as ERCP involving contrast dye, a scope and some risk of complications.
“She was able to show that gastroenterologists no longer had to do ERCP for diagnosis, because MRCP was just as good. That was a huge statement,” Zfass says. “It lowered the cost of health care, it was not interventional, and it changed the face of how we look at pancreaticobiliary disease.”
One of the first to employ the technology, Fulcher adds, “we have literally done thousands since then. I get excited every time we do an MRCP because it carries so much benefit for the patient and for the referring physician. We are finding a lot of abnormalities that can be treated.”
A new way of seeing the world
As much as Fulcher loves her work, however, about a decade ago she had a self-reckoning. Her career had been her focus, and to the extent she ever traveled, it was for medical meetings or a quick beach trip. “I said, ‘Ann, there is a big world out there,’ and so I planned a trip to the Galapagos Islands.”
Deciding that such an adventure deserved more than some point-and-shoot snaps, she bought a digital camera and began teaching herself photography. She met professional photographer David Everette, who became her mentor in this new endeavor. Travel and photography became her new passions.
Since then, she has photographed polar bears in the Canadian arctic, wild horses in France, jaguars in Brazil, street food vendors in India and the Day of the Dead Celebration in Oaxaca, Mexico. She has traveled to Botswana and Namibia, Iceland and Italy, Panama, Costa Rica and more. She visited Omaha Beach in France, “to the exact place where my father landed on D-Day.” And when the pandemic struck just as she was about to depart for Borneo, she turned to photographing birds, wildlife and flowers at home in Virginia.
Photography “has become something very important to me and has allowed me to grow outside my profession,” Fulcher says. At the same time, she views her work as a radiologist and as a photographer as connected ways of seeing the world. “Radiologists look at and manage and analyze images all day, and so looking at a scene as a photographer—figuring out what the composition should be, what the light should be—is a natural fit,” she says. “I feel very alive when I am working as a radiologist and when I am shooting photography.”
And as always, excellence has remained her guiding principle.
“Doing something good is never good enough for Ann,” Turner says. “It has to be excellent.”