HealthFocus Winter 2026

How graduate medical education is strengthening care, expanding training and shaping the future

TidalHealth is no longer only a place that community members come for medical care. It continues to grow as a teaching system and the benefits of that extend far beyond the hospital walls. 

As graduate medical education continues to grow, TidalHealth Peninsula Regional is also strengthening its tertiary and complex care capabilities, bringing more advanced specialty care closer to home for patients and referring practitioners. 

The first class of 10 internal medicine residents, who have now graduated, started their journey at TidalHealth in 2022. Currently, there are 90 residents and fellows who are part of graduate medical education programs at TidalHealth. 

TidalHealth has six residency and 11 fellowship programs accredited by the Accreditation Council for Graduate Medical Education, or ACGME. Some of TidalHealth’s programs will accept their first learners in 2026, and there’s additional growth planned.  

After graduating from medical school, new physicians first complete a residency program and then decide whether they would like to pursue a fellowship for more specialized training. At TidalHealth, they are learning not at just one location, but throughout the health system. 

‘A great place to learn’ 

Alex Daniels, MD, a PGY-2, or post-graduate year 2, resident in the TidalHealth Anesthesiology Residency, has loved her time at TidalHealth so far — the work, her colleagues and the population.  

“I really do enjoy coming to work each and every day,” she said.  

Being part of the first class of anesthesiology residents has also allowed Dr. Daniels and the other residents to provide feedback and help shape the program. The residency has given her an opportunity to gain hands-on experience and learn how to communicate medical information to patients in a way they can understand.  

“This is a great place to learn, to train, to really get that foundation,” she said.  

Jack Snitzer, DO, MHA, FACOI, FACE, was involved with TidalHealth Graduate Medical Education before the first residents set foot in the building. Dr. Snitzer is the associate program director for the TidalHealth Internal Medicine Residency and previously served as the program director and as a core faculty member. 

He had a role on planning committees about a year before the residency began. Dr. Snitzer and others involved in the program celebrate the learners’ success and want to follow their future careers.  

“This is our chance to make a mark on the future — and the community,” Snitzer said.  

Five of the first 10 TidalHealth Internal Medicine Residency graduates are still working for TidalHealth. Snitzer has also already had the chance to make an impact on a resident pursuing a future career in endocrinology — his specialty. 

Improved care 

When attending physicians, the fully licensed doctors who supervise residents and fellows, teach trainees, they are also keeping themselves up to date on the latest knowledge and refreshing their skills, which leads to providing better care, Dr. Snitzer said.  

This benefits everyone, from attending physicians to residents and fellows to patients. 

“Everybody teaches everybody else,” he said.  

Research shows that teaching hospitals improve outcomes, too. A 2017 study in the Journal of the American Medical Association found that major teaching hospitals were associated with lower mortality rates than nonteaching hospitals for several common conditions.  

In addition to sharing medical knowledge, attending physicians also teach residents how to talk to and interact with patients, said Nita Hensley, administrative director of medical education at TidalHealth. Hospital patients and their families can experience a wide range of emotions.  

By teaching others, attending physicians improve their own skills, too.  

“It overall becomes a better patient experience as well,” said Hensley, who has been with TidalHealth Graduate Medical Education since its start.  

Residents also practice in the TidalHealth Center for Medical Training and Simulation and then have an opportunity to review recordings with an attending physician to see what they did well and how they can improve, she said.  

Some real-life patients may see a whole team — an attending physician, a senior resident, an intern and a medical student, Hensley said. Four different people can share their perspectives.  

“One might see something that the other one doesn’t,” she said. 

Increasing doctors on Delmarva 

The TidalHealth Graduate Medical Education program exists to train physicians, with the hope that those who train at TidalHealth will stay here. With many practitioners getting close to retirement and a growing population in the community, Delmarva needs more doctors, Hensley said.  

“If we can replenish what we already have and help it grow, that’s the long-term goal,” she said.  

Being a teaching hospital also helps with recruiting attending physicians, Dr. Snitzer said. Many doctors want to teach at hospitals that have residency and fellowship programs.  

When Maninder Singh, MD, FACC, started working for TidalHealth about four years ago, he missed the opportunity to be part of a fellowship program. He was a core faculty member in a fellowship program at Guthrie Robert Packer Hospital in Pennsylvania, where he worked before coming to TidalHealth.  

Dr. Singh is now the program director of the TidalHealth Cardiovascular Disease Fellowship. The first fellows started in 2024 and since it was a new program, he and the others involved were able to make it the program they wanted it to be, rather than following what had been done in the past. He wanted to acknowledge the support of the team that has made this program possible, along with the core faculty and teaching faculty.  

Dr. Singh enjoys being able to teach and give back to future practitioners, and it’s satisfying for him to see the fellows grow in their professional careers.  

“It’s part of my job that I really love,” he said of the fellowship. 

More to come 

The TidalHealth Internal Medicine Residency will welcome its fifth class in 2026 and the program already has a strong reputation and is attracting candidates with stronger qualifications, Dr. Snitzer said.  

Prospective residents like that TidalHealth now offers fellowships, as well as the TidalHealth Richard A. Henson Research Institute, he said. Dr. Snitzer said there are so many strong applicants that the interviewers can really focus on whether the candidates are a good fit at TidalHealth.  

Hensley said she hopes residents who train at TidalHealth will stay here for their fellowships. While they go through the same interview process as anyone else would, they can also show what they have to offer daily, she said.  

The TidalHealth Cardiovascular Disease Fellowship is in year two, and the fellowships in endocrinology, diabetes and metabolism; gastroenterology; hematology and medical oncology; nephrology; pulmonary disease and critical care medicine and rheumatology all welcomed their first fellows in 2025.  

As the programs grow, fellows will also have more of a role in teaching residents.  

The graduate medical education program has been a positive addition to TidalHealth both for those teaching and those learning.  

“It’s been a dream to do this,” Dr. Snitzer said. 

As we begin a new year at TidalHealth, I am proud of the momentum our team has built across Delmarva. In the pages that follow, you will see a clear theme: we are expanding access, elevating quality and investing in the people, programs and spaces that will define the future of care in our region.

Our cover story, “The making of an academic health system,” highlights an exciting milestone in that journey. TidalHealth’s transformation into a teaching health system is more than a title change. It means more physicians training at the bedside, more opportunities for clinical research and stronger partnerships. Most importantly, it means patients benefit from a learning environment where evidence, innovation and teamwork come together every day. Our growing Graduate Medical Education programs are already paying off, with many physicians choosing to build their careers right here at home.

This issue also celebrates the measurable results of our focus on safety and excellence. You will read about national recognitions including CMS 5-star performance at TidalHealth Nanticoke, Healthgrades distinctions, and Leapfrog “A” ratings earned at two of our hospitals, with ongoing work across our system to advance safety and quality. Together, these achievements and the progress underway reflect the commitment of our team members and medical staff to deliver the right care, at the right time, in the right setting.

You will also see how we are transforming access through new technologies and expanded services, from aquablation and robotic bronchoscopy to expanded GI access, geriatrics, women’s health, pediatric neurology and mobile mammography that brings screening closer to where people live and work. Our continued Epic integration supports a more connected experience for patients and care teams.

Finally, we are growing to meet community needs through new clinics, groundbreakings and facility expansions, and through philanthropic support that fuels progress across our system. I hope you will also take pride in workforce milestones, including Atlantic General Hospital’s CNA training program, and the many graduates now serving patients throughout our organization.

Thank you for trusting TidalHealth. We are grateful to serve you, and we are ready for all we will accomplish together in the year ahead.

TidalHealth earns multiple Healthgrades awards

TidalHealth received numerous accolades for clinical excellence from Healthgrades’ 2026 Star Report, the No. 1 site Americans use when searching for a doctor or hospital.

• TidalHealth Peninsula Regional in Salisbury received the following awards:
• America’s 50 Best Hospitals for Vascular Surgery (2015-2026)
• Vascular Surgery Excellence Award (2015-2026)
• America’s 100 Best Hospitals for Spine Surgery (2024-2026)
• Spine Surgery Excellence Award
• Coronary Intervention Excellence Award
• Outpatient Joint Replacement Excellence Award
• 5-Star ratings for back surgery and outpatient total knee replacement

TidalHealth Nanticoke in Seaford was recognized with 5-Star ratings for the Treatment of Sepsis (2023-2026) and Treatment of Respiratory Failure (2024-2025).

A total of 11 services at TidalHealth earned a Healthgrades 5-Star rating, which indicates they are performing statistically significantly better than their peer services at other U.S. hospitals. Among those, Treatment of Carotid Procedures was 5-Star rated for a 15th consecutive year (2011-2025), the Treatment of Hip Fracture for a 10th consecutive year (2016-2025), and the Repair of Abdominal Aorta for a ninth straight year (2017-2025).

TidalHealth Nanticoke named Delaware’s only 5-star hospital by CMS two years in a row

For a second consecutive year, TidalHealth Nanticoke has received a prestigious 5-star rating from the Centers for Medicare and Medicaid Services (CMS) in its recently released 2025 Hospital Quality Star Ratings.

The Seaford hospital is the only hospital in Delaware to earn this top rating in 2025, as it also was in 2024, highlighting its role as a leader in healthcare excellence within the state. This distinguished recognition, the highest awarded by CMS, underscores the Seaford hospital’s commitment to providing exceptional care and achieving outstanding patient outcomes.

Setting the safety standard on Delmarva

TidalHealth was again nationally spotlighted in the Fall 2025 Leapfrog Hospital Safety Grade report and remains the highest rated health system in patient care and patient safety in the region.

Both TidalHealth Peninsula Regional in Salisbury and Atlantic General Hospital (AGH) in Berlin were awarded an “A” grade, Leapfrog’s highest honor. The designation recognizes both hospitals for their efforts in protecting patients from preventable harm and errors and providing safer healthcare. This is the sixth consecutive ratings period with an “A” grade for TidalHealth Peninsula Regional and the second for AGH.

This fall, TidalHealth Peninsula Regional and Atlantic General Hospital are just two of just 13 hospitals in Maryland to achieve an “A” and the lone representatives on the Eastern Shore. In Delaware, TidalHealth Nanticoke is rated a “B,” which is the highest grade given to any hospital in Southern Delaware.

Blue Cross Blue Shield distinctions for hip and knee replacement surgery 

TidalHealth Nanticoke and TidalHealth Peninsula Regional were both designated a Blue Cross Blue Shield (BCBS) Blue Distinction Center + (BDC+) for Total Hip and Knee Replacement Surgery for its dedication to treating individuals living with joint pain.

Both hospitals have implemented a systematic approach to improving quality of life, which makes available to patients the very best surgical options and outcomes at an affordable rate.

The award evaluates how organizations like TidalHealth use clinical outcomes and performance measures to identify opportunities to improve care, case volume, demographics and affordability.

TidalHealth Nanticoke earns Aetna bariatric quality designation

TidalHealth Nanticoke was designated an Aetna Institute of Quality® Bariatric Surgery Facility for treating individuals living with morbid, or extreme, obesity.

The Seaford hospital has implemented a systematic approach to improving quality of life, which continues making available to patients the best surgical options and outcomes, nutritional lifestyle changes and exercise, all of which are essential to success.

TidalHealth’s commitment to quality bariatric care includes a team of appropriately trained staff, leadership and surgeons who participate in meetings regularly throughout the year to review surgical outcomes. They seek continuous improvement to enhance structure, process and outcomes.

Ribbon cut on new mobile mammography unit

In a rural area like Delmarva, many residents are miles from essential healthcare services. In late October, the ribbon was cut on TidalHealth’s new mobile mammography unit, which will break down barriers to healthcare by bringing mammography screenings to communities.

The unit made its public debut at the Crisfield Library for a ribbon cutting after The Drive for Mobile Mammography met its $1 million fundraising campaign. The TidalHealth Foundation raised funds from community donations, and every donor who made a gift in honor of or in memory of a loved one is recognized on the back of the van.

The 38-foot motor coach will offer comprehensive 3D breast cancer screenings, performed by a certified mammographer. A dedicated multidisciplinary team will accompany the unit to address the social, environmental, behavioral and medical needs of each patient.

The unit is expected to be on the road in spring 2026. Stay tuned to tidalhealth.org/mobilemammography to see the schedule once it becomes available.

Atlantic General Hospital to adopt Epic in March

In March, patients in Berlin will notice a streamlined, patient-friendly healthcare experience as Atlantic General Hospital (AGH) and its medical offices launch the Epic electronic medical record (EMR) system.

Epic is one of the nation’s leading EMR platforms, trusted by hospitals and health systems for its secure, integrated and highly efficient approach to managing patient health information. This change will bring impactful benefits to patients and clinical teams in Berlin, including improved care coordination, streamlined workflows, and enhanced access to personal health information through the MyChart patient portal.

AGH is excited to take this important step forward. Teams throughout the TidalHealth system have been working diligently to prepare for a smooth transition that brings long-term value to the communities we serve.

Aquablation now offered at TidalHealth Nanticoke

Elizabeth Kornfield Chadwell, MD, and David Cohen, MD, of TidalHealth Urology, completed the first Aquablation® therapy procedures at TidalHealth Nanticoke in August.

Aquablation is an ultrasound-guided, robotic-assisted, minimally invasive approach to treating benign prostatic hyperplasia, which is an enlarged prostate. 

Instead of the electric knife that is used in the older transurethral resection of the prostate (TURP), Aquablation uses water pressure instead. Aquablation is precise, and there is a significantly lower risk of retrograde ejaculation than with TURP.

A variety of problems relating to urination, from a slow stream to having to urinate frequently, can be signs of benign prostatic hyperplasia in men.

Dr. Kornfield Chadwell and Dr. Cohen care for patients at TidalHealth Urology, located on the TidalHealth Mears Campus at 100 Rawlins Drive in Seaford. To schedule an appointment, call 302-990-3300 or visit the TidalHealth Urology scheduling page.

Robotic bronchoscopy enhances lung cancer detection and treatment 

Launched in late 2024, robotic bronchoscopy at TidalHealth Nanticoke in Seaford offers a minimally invasive way to collect lung tissue samples with exceptional precision. As part of our thoracic oncology and lung cancer screening program, the technology uses advanced robotics and real-time imaging to help physicians navigate intricate bronchial passages to diagnose suspicious nodules and identify early-stage lung cancer. 

TidalHealth Nanticoke has the busiest thoracic oncological program in the state of Delaware, and the team — led by cardiothoracic surgeon Kurt Wehberg, MD, and pulmonologist Ammar Alhaddad, MD — leverages both the Ion robotic bronchoscopy platform for diagnosis and the da Vinci robotic system for surgical treatment. These tools work together to support accurate biopsies and minimally invasive resection of lung cancer tumors and pulmonary nodules. The program’s rapid response time is another key advantage; most patients are evaluated and, when needed, biopsied within three to four days. 

For more information about robotic bronchoscopy at TidalHealth Nanticoke, patients can speak with their provider or contact Holly Schreiber, CRNP, Multidisciplinary Thoracic & Pulmonary Nodule Coordinator, at 302-297-2598. 

Enhanced GI access in Ocean Pines

TidalHealth Gastroenterology has added two nationally recognized physicians at its Ocean Pines location, expanding access to specialized gastrointestinal care on the Eastern Shore.

Dr. Andrew Canakis, DO brings expertise in advanced endoscopic procedures including endoscopic ultrasound and endoscopic retrograde cholangiopancreatography. Dr. Mehak Bassi, MD specializes in inflammatory bowel disease, including Crohn disease and ulcerative colitis. Together, they strengthen a growing gastroenterology program that offers advanced subspecialty services and a full spectrum of general GI care.

Dr. Bassi is board-certified in gastroenterology and treats a wide range of digestive conditions, including celiac disease and obesity-related disorders. She performs colonoscopy, upper endoscopy, enteroscopy, and small bowel capsule studies, and supports medical education, community outreach and colorectal cancer prevention efforts. She has been recognized through the ACG Leadership YOU program and contributes to peer-reviewed publications and national conferences.

An Eastern Shore native, Dr. Canakis returns home as a specialist in advanced therapeutic endoscopy, supporting diagnosis and treatment of pancreaticobiliary disease and early GI cancers. He has authored more than 140 scientific papers, is board-certified in internal medicine and gastroenterology, and serves as associate program director for the TidalHealth Gastroenterology Fellowship.

To learn more or schedule an appointment, visit Gastroenterology Care on Delmarva.

Care designed for Delmarva’s aging community

Rural communities on the Lower Eastern Shore are home to a higher-than-average proportion of older adults, a reality that can complicate access to care, chronic disease management, and the ability to age safely at home. To help meet those needs, TidalHealth offers specialized services through TidalHealth Geriatrics, led by Anna-Maria Izquierdo-Porrera, MD, PhD. The program provides evidence-based, personalized care focused on safety, function, and each patient’s goals.

Geriatric medicine requires specialized expertise in chronic disease management, age-related physiological changes, and the social factors that shape day-to-day health for older adults. Dr. Izquierdo-Porrera supports patients facing mobility concerns, cognitive changes, and mental health needs through a coordinated, patient-centered approach. Because caregivers and family members often play a key role in decision-making and follow-through, she also collaborates closely with them and with other specialists involved in a patient’s care to ensure treatment plans are clear, practical, and aligned.

Through TidalHealth Geriatrics, Dr. Izquierdo-Porrera and her team offer a structured model designed around the realities of aging on Delmarva. Services include outpatient geriatric care, home-based primary care, and pop-up community clinics that follow age-friendly principles and streamlined referral pathways. Together, these services help older adults access the right care in the right setting, supporting healthy aging, independence, and quality of life.

To learn more, visit Schedule with Anna Maria Izquierdo-Porrera, MD, PhD, Geriatrics.

New women’s health hub opening in Berlin in March

Women will soon be able to access numerous healthcare practitioners under one roof at the Gudelsky Family Medical Center in Berlin.

This office is expected to open March 2, and practitioners will include Christine Neto, MD, Margo Gill, MD, Melissa Braniff, CRNP, Kerri Ellinger, PA-C, and Michelle Farlow, DNP. Catherine Casto, MD and Peter G. O'Hare, III, MD will also see patients from this location in the future.

The Gudelsky Family Medical Center also offers women’s health imaging services, including mammography, ultrasound, x-ray and bone density tests, as well as lab services.

The practice is located at 10614 Racetrack Road, Suite 5, in Berlin, and is accepting new patients. To make an appointment, call 443-728-1050.

Pediatric neurology now available at TidalHealth with Stephen Falchek, MD

TidalHealth Neurology in Salisbury, Md., now offers specialized pediatric neurology services with Stephen Falchek, MD, a nationally recognized expert with more than 25 years of experience.

Dr. Falchek provides care for a wide range of neurological conditions in children, including epilepsy, movement disorders and developmental delays. He brings advanced training in clinical neurophysiology and a deep commitment to comprehensive, family-centered care.

A key focus of Dr. Falchek’s practice is supporting pediatric patients as they transition from pediatric to adult neurology, ensuring continuity of care and guidance during this critical stage. His approach emphasizes collaboration with families, primary care providers, and adult neurologists to provide a seamless care experience.

Dr. Falchek is now accepting new patients. To schedule an appointment, call 410-912-6114.

TidalHealth physicians now offer Inspire for sleep apnea

The CPAP, or continuous positive airway pressure, machine can be great for some people with sleep apnea. But if CPAP isn’t a good fit, and a patient has moderate to severe obstructive sleep apnea, Delmarva residents can now explore another treatment option — Inspire.

In August at Atlantic General Hospital in Berlin, Nathan Deckard, MD, implanted the Inspire V device in a patient suffering from sleep apnea — a first on Maryland’s Eastern Shore. Now, Kunal Agarwal, MD, FAAFP, FAASM, DipABOM, and Julie Berry, MD, are working together to offer this procedure and before-and-after care through TidalHealth.

Prospective patients can start by scheduling an appointment with Dr. Agarwal, who practices at TidalHealth Primary Care and TidalHealth Sleep Medicine in Lewes. He will confirm that each patient is a good candidate for the procedure. The approved candidates will then see Dr. Berry at TidalHealth Ear, Nose & Throat Surgery in Millsboro. She will do a surgical evaluation of the patient and then perform the surgery to implant the device at TidalHealth Nanticoke.

After surgery, the patient will return to Dr. Agarwal for follow-up appointments, which include device activation, fine-tuning of the device’s settings and a post-activation sleep study.

Inspire has been FDA-approved for more than 10 years, with more than 100,000 implants completed in the U.S. It has consistently high patient satisfaction and excellent long-term outcomes for people who are unable to tolerate CPAP. Dr. Agarwal currently manages more than 300 Inspire patients, with positive results.

To schedule an appointment with Dr. Agarwal, visit Kunal Agarwal, MD or call 302-297-2431. His office is located at 1526 Savannah Road in Lewes.