Armenian Emergency Medicine Physicians Visit Yale By Cat Urbain, MALS

In February, the Yale Department of Emergency Medicine welcomed two visiting physicians from Armenia, Lilit Serobyan, MD, and Vache Buniatyan, MD. The doctors, who are among the first graduates of the Yale Armenian Unified Emergency Medicine Residency Program (YUAEMRP), share their reflections on the program and their visit to New Haven, Conn.

The program was launched in 2023 by Sharon Chekijian, MD, MPH, associate professor of emergency medicine at Yale School of Medicine. In 2025, Chekijian was named the inaugural chair of the Department of Emergency Medicine and Disaster Medicine at the National Institute of Armenia.

Tell us about yourselves and why you joined the Armenian Unified Emergency Medicine Residency Program.

We are among the first graduates of this 18-month program. Before entering emergency medicine, we each trained as cardiologists. At that time, there was no national emergency medicine specialty in Armenia.

We joined the program because we wanted formal, structured training in emergency care. Previously, it was difficult to pursue this type of training abroad, and emergency care in Armenia was largely provided by general practitioners or others trained in various subspecialties who were attracted to and already working in emergency medicine settings.

The program has allowed us to expand our clinical roles significantly. Before, we often had to send patients to different departments for evaluation and treatment. Now, we are trained to confidently manage many types of emergencies ourselves within our department, including trauma assessment and point-of-care ultrasound imaging.

How has the establishment of an emergency medicine residency changed clinical practice in Armenia?

The impact has been transformative. Before the residency program, emergency medicine wasn’t recognized as a distinct specialty in Armenia, and we worked within a much different model of care. Physicians functioned more like generalists and were limited in performing procedures such as trauma interventions.

Now, emergency departments are evolving into comprehensive care centers. We are trained to manage complex cases directly, improving both efficiency and patient outcomes.

The program has also led to structural changes, including the development of triage systems and the formation of an emergency medicine association in Armenia. Our class had twelve physicians, and the new residency class now includes approximately 40 physicians. Graduates are working across hospitals nationwide. The program is centered around weekly online didactic teaching, in-person workshops with hands-on teaching, and in-person precepting by visiting faculty.

What challenges still remain?

There are still limitations in resources and staffing. In many Armenian hospitals, there may be only one resident per shift, compared with the larger, team-based structure we saw at Yale. Because the workforce is still growing, we still have 24-hour shifts.

We also recognize the need to expand training beyond physicians. Educating nurses, particularly in triage, is a key next step. In addition, public awareness is important; many patients are not yet familiar with the concept of a modern emergency department, so outreach and education will be essential.

As emergency medicine continues to grow in Armenia, securing sustainable funding and clearly defining our role within the healthcare system will be important next steps. Maintaining strong collaborative relationships with other specialties will help ensure its continued development and success.

What impacted you most from your visit to Yale New Haven Hospital and Yale School of Medicine

Visiting Yale and New Haven was eye-opening and inspiring! It allowed us to see a highly developed emergency care system firsthand. We were especially impressed by the simulation center, the team-based structure, the integration of ultrasound into routine emergency care, and the Chest Pain Center.

Although the emergency department was often very busy during our visits, we were struck by how seamlessly everything flowed. The triage nurses, residents, and specialists each fulfill a defined role, working together as a cohesive unit to minimize delays and reduce uncertainty during critical moments.

The simulation center was remarkable. Simulation-based education could play a transformative role in Armenia by strengthening not only technical skills but also communication, leadership, and clinical decision-making.

As cardiologists, we were especially excited about the Chest Pain Center and its integration in the ED. Patients in the Chest Pain Center are managed through structured, evidence-based diagnostic pathways that include continuous cardiac monitoring, serial ECGs, and cardiac biomarker testing. The presence of such technology, combined with standardized protocols, would represent an important step forward in the development of emergency and cardiac care systems in Armenia. We hope we can establish a similar center soon!

Although we incorporate ultrasound training in our residency program, seeing it embedded so seamlessly into routine emergency care at Yale reinforced its value as an essential clinical tool. Its integration into routine emergency care clearly demonstrated its value in accelerating clinical decision-making and guiding immediate management.

What did this experience mean to you?

This visit was incredibly meaningful. We are deeply grateful to Sharon Chekijian, MD, MPH, for her vision and dedication in creating this program and for providing us with the opportunity to train and visit Yale. Beyond the clinical experience, we were inspired by both the academic environment at Yale and the city of New Haven itself. Walking into the Cushing/Whitney Medical Library and the Cushing Center, dedicated to neurosurgical pioneer Dr. Harvey Cushing, whose work we had studied for years, was a profound moment.

Most importantly, this experience strengthened our commitment to advancing emergency medicine in Armenia. We are fortunate to have had several Yale faculty members and fellows—including Drs. Rachel Liu, Cristiana Baloescu, Tushara Surapaneni, and Sarah Aly— have traveled to Armenia to teach and mentor. We look forward to continuing these collaborations and learning from one another. The partnerships we have built through this program have already helped shape emergency medicine in Armenia, and we are excited to see what comes next.

The Armenian Unified Emergency Medicine Residency Program is a collaboration between the National Institute of Health of Armenia and the Department of Emergency Medicine at Yale School of Medicine. It is the first formal emergency medicine (EM) residency program in Armenia.

This accelerated 18-month program was designed to train an inaugural cohort of emergency physicians who had already completed residency training in another specialty and were actively practicing in emergency departments or ambulance services. The curriculum follows the European Society of Emergency Medicine (EUSEM) standards and incorporates instruction from international faculty.

The program was founded and is led by Sharon Chekijian, MD, MPH. Dr. Chekijian works closely with Dr. Oriane Longerstaey, assistant professor at the Brown Department of Emergency Medicine, who is the associate program director for YUAEMRP. Collaborators include Yale faculty, Diasporan and Armenian national lecturers, and other colleagues from around the country who make weekly didactic lectures possible. Dr. Tigran Aghabekyan, future chief resident at SUNY Downstate, has served as the program coordinator since 2023.

We would like to acknowledge the contributions of the Fulbright Fellowship, the Armenian American Medical Association of Massachusetts, and the Fund for Armenian Relief.