Boston University-Armenia Medical Partnership
The Boston University-Armenia Medical Partnership (BU-AMP) is a multi-disciplinary program to coordinate collaborations and student and faculty exchanges between the Aram V. Chobanian & Edward Avedisian School of Medicine and health policy and care entities in Armenia.
In June 1991, the School, then led by Dean Aram Chobanian, MD, signed affiliation agreements with the Yerevan State Medical Institute, the Postgraduate Medical Institute of Armenia and the Armenian Ministry of Health. Although affiliations have changed over time as Armenian political and health policies have evolved, the partnership remains committed to support health education and care exchanges and collaboration with colleagues in Armenia.
Current BU-Armenia Medical Partnership initiatives include five short- and long-term projects at different stages of development:
- Fourth-year medical student elective in Armenia
- Faculty Exchange Program
- Emergency Medicine (EM) Fellowship
- Primary Healthcare Reform Initiative
- Health Professions Education Development
Medical Student Electives in Armenia: While medical student electives do not directly affect Armenian healthcare, the BU-AMP has offered the elective since the 1990s. Medical students who are interested in improving healthcare in Armenia are given the opportunity to gain an understanding of the Armenian healthcare system to more effectively contribute in the future.
With the aim of re-establishing the elective post-COVID, Dr. Kaligian, the current Director of the BU-Armenia Medical Partnership, met during their visit in July 2023 with the Armenian National Institute of Health (ANIH) leadership team. The BU-AMP will offer rotations in internal medicine, pediatrics, ob-gyn, cardiology, and neurology at various hospitals in Yerevan. BU faculty also met with faculty at Erebouni Medical Center, Wigmore Women’s and Children’s Hospital, and Surb Grigor Lousavorich Medical Center.
BU-AMP is working with BU Global Health to meet the requirements to restart the medical school elective in Armenia. US medical students will be part of Armenian resident teams affiliated with ANIH, and attending preceptors are being identified in Armenia who will be ultimately responsible for the medical students’ education and evaluation.
Faculty Exchange Program: BU-AMP previously facilitated and funded faculty exchanges between Armenia and BU. Most of these exchanges were month-long rotations for Armenian faculty at Boston Medical Center to observe various specialties in practice.
BU-AMP has not yet determined which medical specialties would be most beneficial to the Armenian healthcare system, or from which Armenian regions or hospitals. We will work to determine where the need and impact would be greatest by further consulting Armenian institutions.
Dr. Viken Babikian has been working for some time with Erebouni Medical Center and the ANIH to establish a Stroke Center. Neurology observerships in Boston in the winter of 2023 could serve as a basis for future exchanges in other specialties.
Primary Healthcare Reform Initiative: Several recent reports from the WHO, World Bank, and others, have recognized primary healthcare reform as a cost-effective method to advance population health in low- and middle-income countries. Also, reports on the state of Armenian healthcare by the WHO, the World Bank, the Primary Healthcare Practice Initiative (PHCPI) note the lack of a functioning primary care system and recommend creating such a system. Like many former Soviet Union countries and countries with similarly centralized governments, investments in healthcare were targeted at hospitals and specialists, and primary care was neglected or ignored.
The Ministry of Health (MoH) has developed a Primary Healthcare Reform (PHCR) Taskforce to analyze the primary care system in Armenia and how to enact fundamental change. This pillar of the MoH’s reform initiatives comprised the greatest portion of the Minister’s addresses at the 2023 International Medical Conference in Armenia.
Health Network for Armenia (HENAR) has also adopted primary care reform as one of its highest priorities. The Chobanian & Avedisian School of Medicine is uniquely positioned to help with this initiative, since BU’s Department of Family Medicine Global Health Collaborative (DFM GHC ) has enacted fundamental primary care reform in southeast Asia, most notably in Vietnam, but also in Cambodia, Laos, and Myanmar. The DFM GHC has also helped established a functional medical system in Lesotho in Africa.
The Armenia Partnership is currently coordinating with BU’s DFM GHC, HENAR, Armenia’s MoH, and American University of Armenia (AUA), to identify short-, medium-, and long-term initiatives that will guide the development of a fully functional primary care system in Armenia over the next 10-15 years.
Emergency Medicine (EM) Fellowship: No EM residency training currently exists in Armenia. Emergency departments (ED) are staffed by intensivists, cardiologists, pulmonologists, and other specialists.
Faculty at Yale and Brown have developed an 18-month short-format EM fellowship program to re-train existing ED staff physicians as EM specialists, using virtual lectures, rotations in the US for training in simulation procedures and observership in US EDs. US faculty plan to visit Armenia to provide hands-on training in Armenian EDs. BU-AMP hopes to facilitate participation of BU Emergency Medicine faculty and residents in the training of Armenian ED physicians.
Health Professions Education Program: Critical to the development of an efficient and cost-effective healthcare system in Armenia is the development of systems-based medical training programs. At present, no consistent competency-based curriculum development exists in Armenia. We will leverage the Chobanian & Avedisian School of Medicine Masters Degree in Health Sciences Education program to offer training in curriculum development to help systematize and develop competency-based training across the Armenian healthcare system.