Blazing a New Path Forward: Syracuse Community Health Launches Family Medicine Residency Program

By Elizabeth Landry

First Year Family Medicine Residents (L-R): Shramika Pokharel, MD, Urva Barot, MD, Roselyn Akukalia, MD, Nozima Akbarova, MD

2025 has proven to be a milestone year for Syracuse Community Health – it was the inaugural year for its new Family Medicine Residency Program, which offers a unique approach to family medicine training rooted in out-patient settings, community based care, and serving the needs of the most vulnerable patient populations. At the center of the program are the four residents leading the way in SCH’s new endeavor, which is led by Program Director Cristian Andrade, MD. Having already completed four years of undergraduate college and four years of medical school, these residents are training to become family medicine physicians who will offer comprehensive, continuous healthcare for people of all ages—infants, children, adults, and the elderly.

Shramika Pokharel, MD, Urva Barot, MD, Nozima Akbarova, MD and Roselyn Akukalia, MD will each spend three years caring for diverse communities, rotating through SCH and Crouse Hospital in 

Syracuse, Rome Health in Rome, and Samaritan Medical Center in Watertown. At each location, they will learn from the physicians they train with as well as the patients they serve.

“Our new Family Medicine Residency Program is an exciting step forward for both medical education and community health,” said SCH CEO Ofrona Reid, MD. “By training residents in an underprivileged area, we are fostering innovative, compassionate care where it’s needed most. This program empowers future physicians to tackle health disparities head-on while strengthening the well-being of our entire community.”

While family medicine is one of the largest residency specialties in the United States, acceptance into family medicine residency programs is highly competitive. According to 2025 data from the National Resident Matching Program (NRMP), there are approximately 13,000 to 14,000 applicants per year for only about 5,500 to 5,800 available residency positions, resulting in an approximate match rate of 40-45%. By offering a new program that will actively train 12 family medicine residents over the next three years (and more anticipated in the years to come), SCH is creating more opportunities for residents while simultaneously helping to address the family medicine physician shortage in the Central New York community.

Dozienze Nwoke, MD, a family medicine physician from Long Island, came to SCH last year to help lead the program as the Assistant Program Director. “It’s very exciting, the fact that we’re able to produce highly trained physicians to go out into society and take care of our sick and needy,” he said. “The Syracuse population is a very underserved population, and it’s just a blessing to be part of a program that produces physicians that will go out there and help take care of the community.”

A Unique Blend of Innovation, Collaboration and Community

As the first ambulatory teaching health center in the region, SCH’s Family Medicine Residency Program offers a unique, innovative, community-based model for training Central New York’s next generation of family physicians. Dr. Nwoke explained how the outpatient clinic setting sets the program apart and allows residents to gain a more wellrounded, community focused training.

“Because it’s an outpatient program, the basis is strictly in the community,” said Dr. Nwoke. “So that makes it totally different from anything else. Because we’re in a community-based program, we’re not connected directly to a hospital. Our residents do go into rotations at different places where they are exposed to inpatient care, but the main focus is outpatient medicine. We’re dealing with chronic issues, and our goal is to basically provide preventative care to the community, to teach them and educate them about different ways they can prevent different illnesses.”

Along with the community partnerships collaborating with health centers in Rome and Watertown, residents gain a big-picture view of healthcare in diverse settings and communities – something the residents themselves highly value.

“One of the aspects I value most about this program is its intentional design in exposing residents to both urban and rural healthcare settings,” said Dr. Barot. “Syracuse offers an urban patient population with complex social and cultural dynamics, while Rome and Watertown provide opportunities to care for rural communities facing unique challenges such as limited access to specialty care and resources. This dual exposure ensures we are trained to become well-rounded physicians— adaptable, culturally competent, and prepared to serve diverse populations in any setting.”

Dr. Akukalia offered similar sentiments – emphasizing how the program’s strong foundation of community-based, outpatient care most aligned with her own medical philosophy.

“What truly resonated with me was the program’s deep commitment to community engagement. The opportunity to build lasting relationships with patients, understand their unique social contexts, and contribute meaningfully to the health of underserved populations is exactly the kind of impact I aspire to make as a physician,” said Dr. Akukalia.

Commitment to Healing the Underserved

Perhaps the strongest draw to the Family Medicine Residency Program at SCH as expressed by residents is the opportunity to serve diverse and vulnerable patient populations while undergoing their training.

“Throughout my education and community work, I have been called to care for those who often go unheard, advocating for patients with limited resources. I see this residency as more than training; it’s an opportunity to grow into a physician I’ve always aspired to be: one who serves with compassion, humility, and dedication,” shared Dr. Pokharel.

Although Dr. Akbarova hasn’t yet rotated through the Watertown location, she shared how she has already learned so much from working with the underserved populations in Syracuse and Rome, and how her experiences are already shaping the way she approaches every patient interaction.

“Working with such diverse populations has taught me to listen more deeply, to ask questions with respect, and to appreciate that every patient teaches me something new,” shared Dr. Akbarova. “No matter where they come from, my goal is always the same — to meet them where they are and help them feel seen, heard, and cared for… Every interaction, no matter how brief, is an opportunity to offer comfort and reassurance. Acting with responsibility, empathy, and respect helps patients feel supported through some of their most vulnerable moments.”

Whole-Person, Patient-Centered Care

Directly related to the outpatient setting in which residents learn to care for diverse, underserved populations is the program’s focus on forming physicians who care for the patient as a whole person and in every stage of life. Dr. Nwoke explained that, in accordance with SCH’s mission to provide high-quality care to every patient they serve, there are many questions residents learn to ask and consider when treating patients.

“It’s not just about medication, it’s about the home. How’re things going at home? Are you able to eat well? Are you on some type of food assistance? Do you have shelter? Are you safe at home? Do you feel safe in your environment? We assist if they don’t have transportation. We treat the whole person, including their environment,” Dr. Nwoke said.

For Dr. Akbarova, her passion for treating patients by aiming to understand who they are as people and developing strong relationships with each individual is what initially drew her to family medicine.

“From the very beginning of my medical journey, I was drawn to the philosophy of family medicine — the opportunity to care for patients across all ages and life stages, to build relationships that go beyond a single visit, and to truly understand the stories behind each person’s health. I practiced as a family physician in my home country for a short time before coming to the United States, and that experience solidified my passion for the field. I found great meaning in continuity of care, in seeing how trust and consistency can transform not only outcomes, but also lives,” said Dr. Akbarova.

Dr. Pokharel identified an important connection between serving in the community setting and treating each patient as a unique individual throughout every stage of life. She said that’s how she feels she can make the most meaningful difference in patients’ lives.

“Training in a community setting allows me to be closely connected to patients’ everyday lives – to care for them not only when they are sick but also to promote wellness and prevent illness before it begins,” said Dr. Pokharel. “This environment reflects the true spirit of family medicine: being there for families through every stage of life, addressing diverse needs, and making a lasting impact through preventive care and health education.”

Investing in the Future of Healthcare

Just as the four residents are training to learn how to make the most positive, lasting impact on the lives of patients they serve, the Family Medicine Residency Program at SCH is also aimed at making a strong, positive impact on the future of healthcare itself in the Central New York region. The residents each spoke about the sense of honor they feel in being a part of the inaugural year and class of the program.

“There is a strong sense of responsibility and collaboration among those of us starting this journey together,” said Dr. Barot. “It’s inspiring to know that the work we do now will lay the foundation for future classes, and I am proud to be a part of that legacy from the very beginning.”

Sharing how proud and grateful she is to be an SCH Family Medicine Resident, Dr. Akukalia said, “I see SCH as a beacon of hope for our community: a sanctuary where people find not only medical care, but also comfort, understanding and support for

 their social and psychological needs. It’s a place of healing and refuge, where solutions are found and lives are uplifted.”

Family Medicine Residency Program Coordinator Lori Chudyk shared her experience welcoming the residents into the program, and how she looks forward to the contributions they’ll go on to make as physicians in the future.

“It has been truly wonderful to watch our four new residents grow during this first year of the Family Medicine Residency Program. From the interview process to helping them settle into a new city and witnessing their ‘first day of school,’ every step has been meaningful. I am so proud of each of them. My greatest joy will come in June 2028, when they complete their residency and fully transition into independent practicing physicians. What a journey it is to watch their transformation,” said Chudyk. 

Perhaps Dr. Nwoke best summarized the overall goal of both SCH and the new Family Medicine Residency Program, as all involved continue to work to strengthen the safety net for the community for years to come: “I think it’s just about giving back to the community, to those that are less fortunate,” he said. “I think the best way we can help the community is by educating them and showing them we’re there. The best gift of life is to know you’ve helped someone – helped someone to live another day.” 

 

Strategic Issues: 2026

By: Kathryn Ruscitto,
Advisor

Planning strategy today requires holding steady while priorities continually shift. The answer to “What matters most?” often depends on where you sit within the health system. This brief overview blends both system- level and clinician perspectives.

In an age saturated with information, it is easy to be diverted by whatever emerges as the issue of the week. Clear strategic priorities help maintain discipline and focus, allowing leaders to pursue long-term goals while still reassessing risks and opportunities as they arise.

Key Strategic Issues Identified by Health Leaders

1. Improving Care Outcomes: Integrated Care and Social Determinants
Achieving better outcomes requires linking care across time, place, and discipline, while fully accounting for the impact of social determinants on health. Coordinated models and multisector partnerships remain essential. Best practices include using data and technology to improve access and processes, implementing safety practices and ensuring equity in care.

2. Climate Change and Health Impact
Environmental conditions increasingly shape individual and population health. Rising temperatures are contributing to tick-borne diseases, food system instability, and antimicrobial resistance. Climate readiness is now part of core health strategy. Best practices include: assessing facilities for weather impact, disaster and community support, planning and health surveillance for emerging disease.

3. Technology and Public Health
The current information landscape offers powerful tools. Data mining can accelerate diagnosis and treatment, and zip-code-level analysis can help identify pockets of chronic illness. Technology is rapidly reshaping population health capabilities. Best Practices: Modernize data infrastructure, ensure data security, use data to address  specific problems and evaluate solutions, leverage AI in systems improvement.

4. Workforce Sustainability and Culture
Aging, workload, violence, and cultural pressures have eroded the clinical workforce. Strategic focus must be placed on the elements that can be improved—work environment, support systems, safety, training, and retention. Best practices: Continuous learning at all levels, Employee health and well being programs, open communication models across workforce.

5. Investing in Data, AI, and Value-Based Skills
AI offers the potential to improve quality by making complex data more usable. Clinicians will continue to lead decision-making but will have deeper information available to them. Building skills for value-based care is part of this transition. Best Practices: Aligning workforce and future technology needs, simulation labs and classes for using data to improve quality and skills.

6. Developing Broader Leadership
Future leaders must have a grounded understanding of clinical realities. Strengthening leadership development opportunities for clinicians is essential for organizational resilience. Best Practices: Leadership Academies, mentoring for future roles, coaching opportunities, and organizational commitment to clinician development.

Aligning Community Needs and Organizational Demands
Community needs must fit within overarching strategic goals. AI tools can quickly assess communities at the zip code level and synthesize insights from health system and industry best practices. The organizational dedication to strategic goals helps leaders build a clearer picture of where to focus on a short and long term basis. Strategy in the age of information is even more crucial to ensure organizational readiness.

National Resources
• American Journal of Healthcare Strategy ajhcs.org
• The Advisory Board advisory.com
• Harvard Medical School hms.harvard.edu
• Professional Associations: AMA, CHA, AHHA, ANA, AHA

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

What Private Equity Really Means for Your Medical Practice

Brian Hurley, OneGroup, Senior Vice President Health Care & Business Specialist

Private equity (PE) investment in healthcare has grown quickly, reshaping how medical practices run day to day. For physicians and practice owners, selling to a PE firm is a complex decision. It can open doors for growth and support, but it also brings challenges. —offering strategic advantages and potential pitfalls. In New York State, strict regulatory constraints add another layer of complexity that need to be understood before moving forward.

The Three-to-Five-Year Plan

Most PE firms typically work on a three-to five-year investment plan and during that time they focus on raising the value of the practice thru steps such as: Consolidating smaller practices into larger networks
• Streamlining administrative functions via Management Services Organizations (MSOs)
• Improving billing and coding practices
• Introducing performance metrics and financial targets

While this model can drive short-term profitability, critics argue it may prioritize financial returns over long-term patient care and physician autonomy.

Advantages of PE Ownership

• CAPITAL INFUSION:
Immediate financial resources for technology upgrades, service expansion, or debt reduction.
• OPERATIONAL SUPPORT:
MSOs take time-consuming tasks off your plate providing centralized human resources, IT, andcompliance services, reducing administrative burdens and letting you focus more on patient care.
• NEGOTIATING POWER:
Larger networks often secure better rates with insurers and suppliers.
• EXIT STRATEGY:
Helpful for physicians planning retirement or a transition with financial upside.

Disadvantages and Risks
• LOSS OF AUTONOMY:
Physicians may have less say in clinical decisions and staffing.
• PRESSURE TO PERFORM:
Aggressive financial targets can lead to higher patient volumes and shorter visits.
• STAFFING CUTS:
Cost-cutting measures may impact morale and the patient experience.
• REGULATORY CHALLENGES:
In New York, corporate ownership restrictions require creative structuring through MSOs or joint ventures.


MSOs:
Navigating Compliance
MSOs handle non-clinical operations while physicians stay in charge of medical decisions. This model lets private equity groups support and influence the business side without violating state rules that limit non-physician ownership.

New York’s Landscape

The state’s corporate practice of medicine doctrine limits direct ownership by nonphysicians. This means PE firms often succeed by focusing on specialties like dermatology and ophthalmology, where economies of scale and centralized services offer clear advantages.

Final Thoughts
Private equity can provide growth, efficiency, and financial stability—but not without trade-offs. It can also change how physicians work and make decisions. The best approach is to balance the financial upside with the impact on autonomy and patient care. In regulated environments like New York, success depends on thoughtful structuring and a commitment to patient care.

Thinking about how private equity could impact your risk exposure or insurance needs?
OneGroup’s Risk Management and Insurance team can help you sort through your options and stay compliant as you plan for the future.

OneGroup is uniquely qualified to help physicians and medical practices with all of their business challenges. If you have any questions or would like additional information, please feel free to reach out to Brian Hurley at 315-708-3635, bhurley@ onegroup.com or Lynn Trentini 518-698- 9997, ltrentini@onegroup.com.

References

Commonwealth Fund. (2023a, November). Private equity’s role in health care. https://
www.commonwealthfund.org/publications/explainer/2023/nov/private-equity-role-health-care

Medical Economics. (2023). Navigating the pros and cons of selling your medical practice to private equity. https://www.medicaleconomics.com/view/navigating-the-pros-and-cons-ofselling-your-medical-practice-to-private-equity American Journal of Medicine. (2023). What happens when private equity firms sell medical practices. https://www.amjmed.com/article/
S0002-9343(23)00589-2/fulltext

Commonwealth Fund. (2025, May). How private equity deals are reshaping your health care [Podcast]. https://www.commonwealthfund.org/ publications/podcast/2025/may/how-privateequity-deals-are-reshaping-your-health-care Harvard Business School Library. (n.d.). What happens when private equity firms sell medical practices. https://www.library.hbs.edu/workingknowledge/what-happens-when-private-equityfirms-sell-medical-practices

When the Algorithm Acts Alone:The Risks of and Emerging Standards Regarding Agentic AI in Healthcare.

By: Scott Carroll, Kennedy Farr, and Jennifer Forward

Kennedy A. Farr

Jennifer Forward

Scott V. Carroll

Agentic artificial intelligence (“agentic AI”) refers to systems that can independently plan and execute multi-step tasks without continuous human direction. Today, these systems can analyze charts, labs, imaging, and medication lists, identify concerning trends, and even draft suggested care plans on their own.

This autonomy distinguishes agentic AI from traditional “generative AI,” such as ChatGPT, Microsoft Copilot, or Google Gemini. Generative AI cannot initiate tasks because it waits for human prompts and cannot interact with operational systems to schedule tasks. Once a conversation with a human ends, generative AI does not retain goals or continue working toward them. Agentic AI, by contrast, maintains objectives over time, continuously monitors new information, and adapts its actions to achieve its programmed goals.

While agentic AI promises potential relief from workforce shortages and could automate routine clinical tasks, it also comes with clinical, security, and ethical risks.

Clinically, agentic AI errors in diagnosis or treatment recommendations and orders could lead to patient harm. Agentic AI learns from human-provided data, and biased data can perpetuate health inequities. Further, since such systems by their nature operate autonomously, a single mistake can trigger a chain of incorrect actions that may harm a patient.

Security risks arise because agentic AI requires broad access to sensitive patient information. Weak security could expose data to breaches, and malicious actors could potentially hack an agentic system, allowing it to take harmful actions.

Accountability becomes unclear when an agentic AI system makes a mistake. Responsibility will likely fall on the clinician who used the tool, the facility that deployed it, and the developer who built it. Such a complicated and evolving legal and risk management landscape creates liability concerns. Indeed, MLMIC has issued several publications addressing risk management and the use of AI in clinical settings.

Practitioners should recognize that using agentic AI creates a professional obligation to understand the tools well enough to ensure satisfaction of the medical standard of care and to uphold the duty to do no harm. Errors made by agentic AI can breach these duties, especially when practitioners lack proper knowledge of how to use the system. Use of experimental or novel tools on patients also implicates concerns related to patient disclosure and consent and human subject safety considerations (and potential requirements for Institutional Review Board approvals). Finally, there is also the risk that increased reliance on automated systems could erode the human empathy central to patient care, as agentic AI cannot understand or express compassion.

Agentic AI is moving from pilots to clinical use, but guidance remains varying. Leading health coalitions, including the Coalition for Health AI and the Trustworthy and Responsible AI Network, have advanced methods to assess safety and performance. Additionally, there are some growing sets of guidelines to use when evaluating and validating this new technology. For example, on September 10, 2025, the Consumer Technology Association (CTA), North America’s largest technology trade association, released a new standard for validating AI tools that predict health outcomes. This fifth CTA AI standard offers a structured scheme for testing predictive algorithms in controlled and real-world settings. It emphasizes transparency about training data, encourages developers to ensure models can explain how they arrive at specific predictions, and calls for robust post deployment plans to monitor quality and recalibrate when performance drifts.

The sector has not united around one approach, leaving potential users to navigate a patchwork of frameworks. We expect over time that there will be a consolidated set of standards and guidelines for development and clinical use that developers, hospitals, systems, and clinicians can refer to when implementing AI and machine learning tools, including agentic AI.

Regarding regulation in New York State, there are not yet agentic-AI-specific rules for clinical care, but New York has established guidelines that will shape deployment in health settings. In 2023, the Governor issued an executive order establishing an AI policy and governance framework and directing ethical-use policies for state agencies, followed in 2024–2025 by guidance from the Office of Information Technology Services on responsible use of generative AI.

State medical boards retain their principal role of regulating the practice of medicine and have likewise begun articulating principals for the use of AI in medical practice, emphasizing that agentic systems cannot independently practice medicine, licensed clinicians remain ultimately responsible for diagnosis and treatment decisions assisted by AI, and development should be transparent, documented, and consistent with the standard of care, patient safety, and existing scope-of practice supervisions requirements. Indeed, over the last year, the New York State Board of Medicine has engaged in discussions with technical, legal, and regulatory representatives regarding this topic. However, no formal guidance or advisories have yet been issued by the Board. Additionally, professional specialty boards may develop their own specialty specific guidance for using agentic AI. Providers should closely monitor guidance from the Board of Medicine and their professional societies.

For hospitals and clinicians, professional standards operate alongside Department of Health requirements for the operation of hospitals and clinics, such as quality assurance, credentialing, and risk management, that apply when agentic AI influences diagnosis or treatment. Additionally, regulatory issues arise with agentic AI. Agentic AI systems may require FDA oversight, warranting premarket review and ongoing controls, because when, to a reasonable person, it provides medical treatment or clinical decision support that influences care, it could be considered a medical device warranting oversight. Users of AI and machine learning applications, including agentic AI, should understand the level of oversight by the FDA of their specific application and its current status.

The regulatory and industry guidance discussed in this article do not resolve the legal issues but provide early guidance to practitioners and the industry as agentic AI enters clinical practice. Physicians and medical groups considering any AI tool need to evaluate these tools as they would any new medical device or drug, ensuring they understand the technology, its intended use, and built-in safeguards, and take additional risk management steps that are appropriate based on the nature of the tool. If you have questions about the topics discussed in this article, please contact Lippes Mathias health law team members Scott V. Carroll (scarroll@lippes.com), Kennedy A. Farr (kfarr@lippes.com), or Jennifer Forward (jforward@lippes.com).

Auburn Community Hospital Appoints Migdalia Bonilla-Martir, MD as Chief of Obstetrics and Gynecology

Auburn Community Hospital (ACH) is pleased to announce the appointment of Migdalia Bonilla-Martir, MD, FACOG, as Chief of Obstetrics and Gynecology.

Dr. Bonilla-Martir brings extensive clinical and academic experience, a strong commitment to patient-centered care, and proven leadership in developing comprehensive women’s
 health services. She joins ACH from Vassar Brothers Medical Center in Poughkeepsie, N.Y., part of Nuvance Health, which recently joined Northwell Health. The system was recognized with a 2025 Women’s Choice Award for Best Hospital and is nationally regarded for excellence in women’s healthcare.

Throughout her career, Dr. Bonilla-Martir has provided comprehensive obstetric and gynecologic care, with a focus on improving outcomes for women at every stage of life. In her new role, she will oversee departmental clinical operations, support quality and patient safety initiatives, and lead the growth and enhancement of comprehensive women’s services at Auburn Community Hospital.

“We are thrilled to welcome a physician of Dr. Bonilla-Martir’s caliber to Auburn Community Hospital,” said Scott Berlucchi, President and CEO. “Her expertise, compassion, and vision for advancing comprehensive women’s healthcare in Central New York make her an outstanding addition to our medical leadership team. Dr. Bonilla-Martir will lead efforts to create and implement a full spectrum of women’s health services that address the evolving needs of women throughout their lifetimes.”

Dr. Bonilla-Martir expressed her enthusiasm for joining ACH, saying, “I am honored to take on this role and to serve a community that values high-quality, accessible care. I look
forward to working closely with hospital leadership, providers, staff, and patients to better understand and address the individual healthcare needs of women in Central New York.”

Auburn Community Hospital remains committed to expanding specialty services and strengthening its medical staff. The appointment of Dr. Bonilla-Martir reflects the hospital’s continued dedication to recruiting exceptional clinicians who are committed to serving the region.

To schedule an appointment with Dr. Bonilla-Martir, please contact Auburn OB/GYN at 315 252-5028.