International Conference Brings Medical Training to Armenian Physicians, Pays Tribute to Late Raffy Hovanessian

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BOSTON — More than 1,000 medical professionals from 35 countries participated in a virtual conference September 11-12 which provided free continuing education credits to doctors in Armenia and Artsakh while honoring the memory of a physician who had dedicated much of his life professionally to medicine and personally to Armenia.

The first “Dr. Raffy Hovanessian International Digestive Disease Virtual Conference” was organized by the International Center for Professional Development

(ICPD) and sponsored by the Fund for Armenian Relief (FAR), including its Dr. Raffy Hovanessian Education Fund and Dr. Edgar Housepian Medical Education Fund as platinum sponsors, and Izmirlian Medical Center as Gold level sponsor. The partners of the conference were the Ministry of Health in Armenia, and Arabkir Medical Center. The Skill Event Management Company was also a partner and took the lead in the logistical and technical aspects of the conference.

ICPD.am was founded by Doctors Rafi Avitsian, Ara Babloyan, and Gevorg Yaghjyan, with the mission of expanding medical education in Armenia.  Together, the trio and  Dr. Ara Nazarian form the ICPD board of directors. The organization has put together several conferences on topics such as COVID, pain management and post-conflict rehabilitation.

Chairing the conference was world-renowned gastroenterologist Dr. Asadur Jorge Tchekmedyian, of Uruguay. Keynote speaker Dr. John Bilezikian (Columbia University, US) led a roster of 54 speakers representing 23 countries.

For Rafi Avitsian, this seminar is another step toward bringing the latest in discoveries and methods in medicine to the professionals in Armenia or Artsakh who may not have other ways of easily continue learning.

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As for why the inaugural Hovanessian program would be dedicated to digestive health, Avitsian said, “During conversations with medical practitioners and specialists in Armenia as well as diaspora, ICPD recognized an important educational gap in this specialty. Most importantly, GI and specifically colorectal cancer screening is in dire need of attention with focus on endoscopy. Since Dr. Raffy Hovanessian was a specialist in gastroenterology, this was the best opportunity to plan an international world class meeting which not only addressed the educational need, but also created networking between specialists in Armenia, Artsakh and worldwide to learn from each other’s experiences.”

Avitsian added, “The purpose of the conference was to bring together world class educators in digestive diseases to provide key instructions in such high quality, that would be useful for continuing medical education, not only for physicians in Armenia and Artsakh, but also all physicians worldwide; honor the memory of the late Dr. Raffy Hovanessian, who dedicated a good portion of his professional life to bring advanced healthcare education to providers in Armenia; provide an opportunity for physicians in Armenia to access and collect continuous medical education credits required by the Ministry of Health in Armenia, these credits can also be used in European Union countries and even be converted to the credits used by physicians in United States of America, hence the world class quality of the conference and finally demonstrate the capability of an Armenia-based educational establishment at a global stage to attract professionals worldwide in receiving their required continuing medical education.”

Dr. Rafi Avitsian

Avitsian is a professor of anesthesiology in the department of General Anesthesiology at the Cleveland Clinic. He also serves as the Secretary of Medical Staff Office of Cleveland Clinic. He is the program director of Neuroanestheisology Fellowship and is one of the founders of International Council for Perioperative Neuroscience Training (ICPNT). He is an American Board of Anesthesiologists’ Applied Senior Examiner, and the past president of Society for Neuroscience in Anesthesiology and Critical Care (SNACC), as well as a member of the Association of University Anesthesiologists and recipient of ASA-SEA Distinguished Education Award. He has more than 45 published, peer-reviewed manuscripts, among other written works, and is on the editorial board of Journal of Neurosurgical Anesthesiology and an ad hoc reviewer for Anesthesiology, Anesthesia Analgesia, World Neurosurgery Journal.

Tchekmedyian added that the goal was “To bring the best GI educational activity with top international speakers, leaders in their respects fields. Through this educational summit we create a wide network of specialties with similar aims to pursue the best care for our patients both in Armenia and worldwide.”

Many of the doctors participating come with extensive and impressive resumes and are renowned globally.

Tchekmedyian concurred, “This conference brought together than 70 participants with more than 1,000 attendees. These outstanding professionals are among the best gastroenterologists and endoscopists worldwide and in addition are key leaders in their topics of reference.”

“While interacting with the Armenian healthcare professionals, this amazing group of experts felt that they could contribute to a better, healthier future for Armenia’s people. Also, everyone feels proud to develop this kind of cooperation for a part of the world that is struggling with difficulties and is being kept in isolation by acts of foreign aggression,” Tchekmedyian noted.

Dr. Asadur Jorge Tchemedyian

He continued, “Our biggest aim is to help bring down the barriers that Armenia is facing while dealing with digestive diseases. We wish we could contribute to bring down these barriers and help build a network of professionals aimed to build a stronger healthcare system in the GI field. The accessibility of the specialties to free international educational activities is scarce and is a problem for several countries. If also you need to face a pandemic and an unfair foreign aggression then is not only a matter of cooperation if not a debt and a responsibility as Armenians wherever we are. On the other hand, I am proud to talk about our roots with my colleagues and I feel enthusiastic when they become familiar with our ancestries and culture.”

He continued, “From the beginning I was convinced that this was the only way to make a real impact. I am thankful to the leadership of ICPD, to our generous contributors and the time and dedication of an amazing team that worked tirelessly and with devotion to achieve this.”

Physicians in Armenia are mandated by the state to receive continuous training. Achieving this can be expensive, even prohibitive, and time-consuming. This way, they were able to bypass costs and learn from the best.

Dr. Gevorg Yaghjyan said the Ministry of Health (MOH) in Armenia “has realized the importance of continuing Medical Education (CME) for health care professionals in Armenia. Accruing CME points is mandatory for all physicians practicing in Armenia after year 2021. Thus, quite important steps have already been taken in the Republic of Armenia. In this respect, the vision of the future is related to maximizing the CME system in Armenia to international standards, conclude CME credits with developed countries, ensure access to continuing education through the use of modern technologies, and digitalize the CME process.

“Hence, the objective is to lay a solid foundation for continued professional development. These steps are related to the creation, improvement or development of legal, financial, practical and technical means by the state. Having modern CME/CPD systems in place, makes it easier to have this recognized in the perspective of pan-European CME harmonization. Considering the fact that continuous professional development of health care providers is a key component of improving health care and that Armenia is the first country in the region to introduce the CME system as a mandatory requirement for a health care provider’s professional activity, international recognition of CME national credits will also promote the recruitment of highly qualified medical professionals to pursue their continuing education in the Republic of Armenia and receive internationally recognized credits,” he added.

Noted Avitsian, “We were planning to have this conference in an affordable manner with a nominal fee, but thanks to our sponsors we were able to make it free for registrants. We were planning to create networking between specialists, but we found out that there are internationally, even non-Armenian, famous specialists who are ready to come to Armenia and provide live sessions of training. We were planning to convince speakers and moderators to participate with minimal honoraria, but we discovered they ALL accepted to participate, out of their comfort zone dedicating their time and effort freely, some participating at their very inconvenient local time to make it easier for participants in Armenia. Thus, we could say we not only reached but exceeded all our expectations.”

“There will come a time, hopefully with normalization of the economic situation, when the participants will be able to participate with minimal registration fees, however as mentioned the goal of ICPD is to always make it affordable, with less expenses for registrants in Armenia and Artsakh,” concluded Avitsian.

Tchekmedyian said that for him, the GI field is not just his specialty but a calling. “GI is a mix between physical disease and the impact of feelings on the GI tract. Endoscopy is an instrument to approach (in other ways) unapproachably or extremely difficult to access diseases and immediately resolve them in a minimally invasive way. This allows us to solve the situation quickly and reliably and in harmony with the needs of our patients. Obviously it is an invasive procedure and we need to practice it with the highest skills to minimize the risks. Digestive diseases and endoscopy are my passion and my job.”

And to share his field with Armenian colleagues was a “dream,” he said. He explained that those who guided him in his current profession made such an impact on his life that he would like to pay it forward.

Dr. Raffy Hovanessian

Tchekmedyian is the chief of endoscopy at Asociación Española, Montevideo-Uruguay and president of the Interamerican Society for Digestive Endoscopy. He has been involved in GI education and endoscopy activities as Assistant Professor of Gastroenterology at the state university in Uruguay for many years. He was the President for the 24th Panamerican Congress of Digestive Endoscopy (March 2020) and co-chair of the LoC for the second World Congress of Endoscopy – ENDO 2020. Now he sits on the steering committee for the third world congress of endoscopy to be held in Japan next year. He has worked with the World Health Organization and the International Atomic Energy Agency regarding  radioprotection for patients and staff for many years. He is also an Aurora Forum Goodwill Ambassador.

He got his medical degree in Uruguay at the University of La República in Uruguay and completed his training in Spain and Chile. Before entering medical school, he studied Armenian history at the University of La Verne in the US, something he calls “an amazing experience academically if not an incredible experience, sharing education and living with students from all over the world.”

Tchekmedyian singled out the Armenian Association of Gastroenterology and the Armenian Association of Endoscopic Surgeons and GI, endoscopists, surgeons, pathologists among several professionals involved. “During more than 20 years of practice, I have learned from several of these international faculties, and they were my source of inspiration. Having this roster all together, supporting the education in Armenia is a dream come true. I can only thank all who get involved. May God bless each and all of them,” he added.

Avitsian praised Tchekmedyian for being able to gather such a roster of speakers, all for free. The speakers had prerecorded their talks but were present for questions. “A highlight of the conference was the keynote speech by Dr. John Bilezikian, who through his talk shared some memories he had from Dr. Hovanessian, as well as the important topic of COVID-19,” he added.

Yaghjyan offered some grim statistics about medical care providers in Armenia. According to 2017 data in Armenia, the latest available, the absolute number of workforce (doctors and nurses) employed at public, private, academic, research, higher and secondary vocational educational institutions was 29,760 and the absolute number of doctors including all specialties (including dentists) was 12,964 (43.51 per 10,000 population), which compared with 2011 is less by 526 – i.e. 13 490, (41 per 10,000 population), and for nurses by 1688, accounting 16 796 in 2017 (56.5 per 10,000 population). The overall concentration of active physicians for Armenia differs greatly across the capital city and peripheries. In 2017 the number was 57.8 per 10 000 population in Yerevan and only 21.4 in provinces (marzes in Armenian) (Lori). The lowest rates are seen in Gegharkunik (12.7 per 10,000 population) and Armavir (13.6).

Yaghjyan is a specialist in plastic and reconstructive surgery. In addition to his own full time surgical practice, he offers his expertise as a consulting surgeon to the leading general and sub-specialty surgeons in Armenia and Karabakh. He is the former vice rector of the Postgraduate and Continuing Medical Education at Yerevan State Medical University from 2007-20011, he is Associate Professor at the university Hospital’s at Division of Plastic and Reconstructive Surgery. In 2010 he was awarded the Gold Medal for Excellence in Teaching from Yerevan State Medical University (devoted to 90 anniversaries).  In 2011 he was honored with the Drastamat Kanaian Gold Medal from the Ministry of Defense of the Republic of Armenia.

Dr. Gevorg Yaghjyan

Over the past 10 years, Yaghjyan has taken part in educational and professional training programs at renowned medical centers and universities around the world— University of Pennsylvania, Yale University, Cornell University, University of Salzburg, among them. In 2008, he was awarded a Fulbright Scholarship to Yale University, which he has had to postpone due to the extraordinary demands of his thriving surgical practice and teaching commitments. In 2013 he was again awarded a Fulbright Scholarship in Boston University Medical School.

He served as Director of Medical Programs at the National Competitiveness Foundation of Armenia and as Acting Director of the Isotope Production Center in Armenia from start to completion from 2011-2015.

Dr. Raffy Hovanessian’s widow, Vicki Shoghag, expressed her delight with and pride in the program.

“The first Dr. Raffy Hovanessian International Digestive Disease Virtual Conference was a tremendous success having speakers from five different continents, 1000 attendees as well as 64 physician speakers.  Heartfelt thanks to the visionary organizers Dr. Ara Babloyan, Dr. Rafi Avitsian, and Dr. Gevorg Yaghjyan, Dr. Asadur Tchekmedyian and Dr. John Bilezikian.  The mission of the Symposium was that education is a pathway  for credentialing the healthcare professionals of Armenia and Artsakh. Thank you for making Dr. Hovanessian’s vision of Continuing Medical Education a reality through this stellar Symposium,” she said.

FAR Executive Director Garnik Nanagulian similarly expressed his satisfaction with the program. “FAR’s sponsorship of this particular ICPD conference has a special meaning to us, because of our connection to a longtime hero of the Fund for Armenian Relief,  Dr. Raffy Hovanessian. He was a great figure in FAR’s history, a champion of many initiatives FAR launched in Armenia and Artsakh, a caring and dedicated mentor.”

ICPD, Avitsian Paid Tribute to FAR And Hovanessian

“ICPD is cognizant of its duty towards honoring all those who spent a significant portion of their career in helping to improve the healthcare and physician education in Armenia and Artsakh. Dedicating a conference series to such individuals is just a natural response for such an organization as ICPD. Dr. Raffy Hovanessian was a shining beacon and a perfect symbol of how Armenian physicians and scientists living in diaspora, should not forget their ancestry and hear the calling to assist in expanding access to high standard health care in Armenia. FAR has also been a leader in transforming healthcare professionals into medical ambassadors in their communities. We are happy that FAR has seen the value of collaboration with ICPD, the result of which will be better preparation of physicians in Armenia,” Avitsian said.

According to Avitsian, the ICPD “relies on live conferences, online modules, workshops and simulations to offer the latest advances in healthcare to specialists, not only in Armenia and Artsakh, but also regional countries and beyond. ICPD is growing and continuously increasing the number of educational resources and quality conferences to physicians, nurses and other healthcare providers.”

COVID is never far from the picture, unfortunately. Avitsian added, “The ICPD is continuously in contact with the Ministry of Health in Armenia to identify educational needs in healthcare and plan its activities accordingly. Regarding COVID, the first international virtual conference addressed the COVID pandemic in July 2020 in which more than 1000 participants benefited from the COVID Pandemic- Lessons Learnt conference. Since COVID is a disease affecting many organs, each specialty conference naturally includes relevant COVID issues specific to that specialty. In the recent conference, Dr. John Bilezikian, who presented the keynote speech, addressed COVID in gastroenterology topic.”

Avitsian said that in addition to the seminar in 2020, COVID issues and continuous educational programs are “continuously being added to the website for members to review.”

Another medical issue facing the medical community in Armenia and Artsakh is war-related injuries. “Regarding the war injuries, this is also on top of the priority list. There were two important educational conferences in this regard, the ‘Essentials of Pain Management After Trauma’ presented in March of this year addressed specifically acute and chronic pain after trauma during war, and the two-day virtual ‘Post-Conflict Rehabilitation’ conference organized in collaboration with Therapists for Armenia and Armenian American Sports Medicine Coalition. These two conferences were very well received by participants and was useful to help those injured in the recent conflict in Armenia and Artsakh.”

Tchekmedyian noted that he hopes to help Armenia deal with COVID too, based on his native Uruguay’s efforts. “Uruguay did well dealing with the pandemic because of years of building a solid and accessible health system. In this way we are trying to cooperate via the Minister of Health of Uruguay and with the vice minister that is also of Armenian origin, Jose Luis Satjian. In fact, via the Uruguayan consul in Armenia, Eduardo Rosenbrock, there are some ongoing projects to see the possibility of cooperation.”

Dr. Hambardzum Simonyan, Deputy Country Director and Health Programs Director for FAR in Armenia, noted, “since its inception in 1988 the continuing medical education was on the top of FAR’s healthcare programs agenda. FAR has been one of the pioneers in implementation of various CPDs’ in Armenia and. The recent initiative by ICPD was one of the examples. Great conference, with the most actual topics relating to the gastrointestinal diseases (one of the most common and problematics in Armenia), which were delivered by world famous specialists. These kinds of conferences have at least two tangible outcomes — knowledge improvement and network development.”

Concluded Nanagulian, “ICPD is becoming a major forum not only for doctors in Armenia, Artsakh, but for every medical doctor everywhere in the World. I see it becoming very soon one of the most wanted conferences in hot topic items of the modern medicine — for the international medical community.”

To learn more about ICPD, visit ICPD.am.

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