Late nights and leaps of faith saved a family medicine residency program serving Delaware County

A notification with breaking news streaked across the phone.  

Gaby Borodyansky, DO, realized her life was about to take a turn as she walked the halls of a museum while on vacation this past spring. 

“I just looked around for a second and I was like, ‘what do you mean?!’” said Borodyansky, who was, at the time, a second-year resident in the well-regarded family medicine residency program at Crozer Health.  

The news rocketed around the health care industry and the Philadelphia region. The corporate owners of Crozer were declaring bankruptcy and shutting down the health system, based in Delaware County, PA. The implications for regional health care were massive; for Borodyansky it meant her training was at risk and, more importantly to her, the patients under her care might suddenly lose access to a doctor. 

Crozer’s Family Medicine department served a large population of low-income patients, mostly insured by Medicaid, in a part of Delaware County with few other choices for care. Collectively, Crozer’s family medicine physicians, and in particular the residents, were a primary care lifeline for nearly 25,000 patients a year who received their care at family health clinics in Upper Darby and Springfield.  

Crozer’s financial stress threatened to end the residents’ ability to work in these clinics and to continue their training together. If the residency program closed, the “orphaned” trainees would be left to scatter to whatever program would take them in.  

But today, it’s clear the turn in Borodyansky’s life led to an outcome worth celebrating. She and her fellow residents are still together treating the same patients after their training program found a new home at Penn Medicine Chester County Hospital at the beginning of June. Transitioning the active residency program—more than a year before a new program was slated to begin at the hospital—was a journey involving many late nights, unforeseen regulatory obstacles, and a lot of creative optimism. 

Residents without residence 

“There’s just no way all these people are going to go without needed care,” third-year resident Ansu Thomas, DO, recalled thinking this spring. 

At the time, Thomas and the other residents thought that some deal would materialize to keep Crozer Health in business.  

These residents had chosen family medicine out of a passion and concern for their patients, which they didn’t plan to give up. 

“Getting to see our patients appointment after appointment, having that long-term relationship,” Thomas explained, touching on an especially rewarding element of the field. “I liked being with doctors [on rounds] who said, ‘I know their family and I’ve seen them grow up.’” 

Second-year resident Rachelle Rodriguez, DO, also pointed to the crucial role of their health clinics for these patients.  

The communities in Delaware County served by this family medicine program are among the poorest in the state, which means many patients can’t afford reliable transportation options, and public transportation is limited. Simply driving to the next city or the next county to seek out medical care is not an option for many.  

Rodriguez said that many first-time patients arrived at the clinics with chronic conditions that hadn’t received medical treatment. “They probably have very busy lives where they work nine to nine jobs and have no time for themselves,” she said. 

As news about the future of Crozer became more fraught, these residents focused on what they could still control: their commitment to the welfare of their patients.  

“We all felt like we owed it to them to provide the best care that we could in that moment, no matter what, no matter the resources,” said Thomas. 

Meanwhile, each day brought more uncertainty about their own futures and their continued training as physicians. If the program didn’t find a new home, the residents would all need to apply to transfer to other programs.  

Borodyansky remembers sitting on an empty ICU bed during a virtual meeting with the director of the program when she asked if she should start applying to other programs. The next morning, Borodyansky was told she could start emailing other programs, but she didn’t even get the chance. 

“Literally that afternoon we got an email that said, ‘Congratulations! You’re all Penn residents now,’” said Borodyansky. 

The news was approached with caution by a group who had been through months of fits and starts. 

“When I got that email, I was like, I will not celebrate until a pen is to paper and I sign something, but another initial feeling I had was: thank God,” said Rodriguez. 

It was a moment of clarity and elation brought to life by an ensemble cast effort in the background, the details of which were invisible to most of the residents, until after the plan was cemented. 

One Friday this past summer, three family medicine residents stood behind computer carts at the nurse’s station on the third floor of Chester County Hospital. One by one they ran down the observations from patient rounds as Katherine McDonnell, MD, interjected with questions and guidance.

These former Crozer residents were bringing to life a scene of teaching that Chester County Hospital leaders had long envisioned, as they are now in the thick of the three years of rigorous training that goes into a family medicine residency. The in-hospital training takes these new doctors across specialties from the emergency department to the surgery floor, intensive care units, and—putting the “family” into family medicine—including obstetrics, newborn nursery, and pediatric units. These doctors also continue to see patients at the pair of outpatient clinics in Delaware County that were the base of the out-of-the-hospital clinic experience while the program was at Crozer. Family medicine doctors are Swiss Army knives and the residency is designed to sharpen as many tools as possible.

But this scene was happening at Chester County Hospital a full year sooner than expected. A new family medicine residency program was in development at the hospital, with a target of opening in July 2026.

“Timing is everything, and that’s not the way things evolved,” said John Sheffield, MD, program director for the new Penn Medicine Chester County Hospital family medicine residency program.

The longstanding plan for the residency program was focused on supporting the community’s health needs.

“There is strong research showing much of the value in health care comes with primary care, from the chronic disease management and prevention and really focusing on that from the ground level and investing in that,” said Sheffield. “In Chester County specifically there’s clearly a shortage of primary care family physicians.”

The plan was to begin with a class of six residents in 2026 and then build to a program with 18 residents over three years. Instead, as Crozer careened toward closure, there was furious maneuvering behind the scenes to see how Penn Medicine could step in and help. And that help would radically alter the trajectory of the plan for Chester County Hospital.

“They had a hospital without a program, we had a program without a hospital,” said Bill Warning, MD, the former director of the Crozer family medicine residency program and now the co-director of the program at Chester County Hospital.

To Warning, it was algebra. He was part of a small group of people who devoted late nights and weekends to solving the equation this spring while Crozer was moving toward closing.

Chester County Hospital was already in the process of trying to earn accreditation, but this situation presented a faster way to get the program up and running: a switch of the sponsoring institution of the existing program from Crozer to Penn Medicine. Meanwhile staff and leaders at Chester County Hospital demonstrated enormous flexibility to quickly install a program, including to make the residents feel physically at home. The hospital renovated a large resident suite with call rooms, workstations, and a lounge area.

“Heroic efforts [were] performed by Penn and CCH teams to get us onboarded,” Warning said. That included ensuring all the new residents received electronic medical records training on EPIC, credentialling of the new residents for insurance purposes, and getting badges issued for hospital access. Warning said more than 70 people from human relations to occupational health to information technology were working seven days a week for three weeks to make sure the transition from Crozer to Penn Medicine was seamless.

“It is one of the things I’m most proud about at Chester County. We can get behind a need … we’re scrappy, we’re nimble. Change is exciting to us,” said Chester County Hospital CEO Karen Pinsky, MD. “Our mantra is, start with yes.”

Abiding by the ‘start with yes’ mantra meant teaching doctors pegged for the rollout of the family medicine residency would have to step up immediately, a year ahead of expectations.

“There easily could have been pushback, there easily could have been resentment,” said Richard Wender, MD, Penn Medicine’s chair of Family Medicine and Community Health. “There was almost none of that.”

This solution also means that the primary care patients in Delaware County won’t be losing their doctors. All of the staff that are part of the family medicine program at the ChesPenn Center for Family Health at Upper Darby and the Springfield Center for Family Health are in their same roles, just under the Penn Medicine banner. The residents will continue their outpatient training at those clinics even as the inpatient training moves to Chester County.

“It’s a cliché to say bold leadership, but I think it did demand some bold leadership from the very top of the health system down to make this happen—and a high degree of trust,” said Wender. 

Put another way, trust plus leadership multiplied by raw effort equaled the solution to what appeared to be an impossible problem. 

“The practice of medicine and medical education are all team sports. This was the most striking example of teamwork I’ve ever been involved with,” said Sheffield. 

For the residents themselves, the experience of solidarity through crisis during a formative stretch of their training may very well echo long into their careers. And these residents formed a bond with each other forged in a cauldron of uncertainty and hope and disappointment and dedication. 

“My class has been flexing about this: We’re adaptable. We can do any EMR, we can work at any hospital, we can work at any clinic. You can put us in any situation, and we can handle it,” said Borodyansky. “It’s made us...definitely closer as a program.” 

It is an experience now baked into the DNA of the family medicine residency program at Chester County Hospital. 

“We came from somewhere, and we bring something, and we want that to continue on in the new program as our legacy,” said Rodriguez. 

“I feel like we have a lot of grit, and I think Penn can [help] us to be even better.”