Residents Champion Wellness
The Texas Tech Physicians of El Paso at Transmountain family medicine residents organized fun group wellness activities, including a trip to White Sands National Park, and hands-on pottery and painting classes. They documented the activities in their Wellness Passports.
TTP El Paso at Transmountain Residents Launch Wellness Program to Reduce Physician Burnout
Intealth grant expands resident-led wellness effort for international medical graduates training in the Borderplex
A wellness program designed by Texas Tech Physicians of El Paso at Transmountain’s Family Medicine Residency Program beat out 65 other proposals to become one of only three funded nationwide. The people who chose it say El Paso's border identity is exactly why it rose to the top.
Intealth, a national consortium that addresses the nation's physician shortage, awarded a $5,000 wellness grant to expand the Wellness Passport, an initiative for resident physicians who came to the United States from another country for their graduate medical education.
The program aims to boost the mental and physical wellness of these international medical graduates, known as IMGs. Designed by residents, the multilingual passport helps address burnout, isolation and the emotional strain that can accompany practicing medicine far from home.
“The Transmountain program had almost 90% international medical graduates in a border city where they interact with a lot of immigrants,” said Catherine Apaloo, M.D., senior vice president and chief IMG experience officer at Intealth. “It went very well with our vision of ensuring well-being for not only the physicians, but also a reflection on the population that they take care of.”
For many international medical graduates, residency also means separation from loved ones and unfamiliar systems and restrictions that can make traveling home difficult or impossible.
Arushee Bhatnagar, M.D., chief of the program’s Wellness Committee and lead on the project, discussed the challenges of adapting to a new environment. “There is a lot of social stress,” said Dr. Bhatnagar, a third-year resident in the family medicine program at Transmountain. “You are away from your family, you are in a new country, you do not know how things function here. That can be very isolating.”
Dr. Apaloo said 66 proposals were submitted before her team narrowed the pool to 12 finalists and conducted a thorough review of each. The Wellness Passport stood out, she said, because it was designed with millennial and Generation Z residents in mind, using gamification to track participation without adding to the already heavy demands of residency.
“The creativity and the fact that it could be reproduced by other places made it really come out on top,” Dr. Apaloo said.
From left, Texas Tech Physicians of El Paso at Transmountain family medicine residents Dr. Fedora Farrao, Dr. Arushee Bhatnagar, Dr. Shayne Paff, and Dr. Hellen Mutumba pose with their Wellness Passports.
Tracking wellness milestones with the passport
Dr. Bhatnagar and her fellow residents created the Wellness Passport as a practical and symbolic response to those pressures. Modeled after the passport many international physicians with J-1 visas carry, the booklet is printed in several languages and tracks wellness milestones throughout the academic year.
Residents earn stickers for activities tied to hydration, sleep, movement, mindfulness and time spent together outside clinical duties.
These include activities such as yoga, meditation, painting, pottery and group outings to White Sands National Park.
The program measures burnout before and after the intervention. According to Dr. Bhatnagar, the initial scores were sobering, and the follow-up results showed measurable improvement.
“When we had the baseline burnout scores, it was quite overwhelming,” Dr. Bhatnagar said. “Sometimes we do not speak up when we are suffering, and we do not even realize what the signs of burnout are.” She said the project helped residents feel more connected and gave them protected time to step away from the pace of training and focus on each other.
A welcoming community
Kristina Sinnott, M.D., program director for the family medicine residency program at Transmountain, said that support is especially meaningful for international medical graduates whose loved ones may be thousands of miles away. Some residents, she said, have gone years without seeing family members due to visa constraints and shifting travel circumstances.
“On top of doing all of medicine, which is hard enough as it is, your emotional outlets as an international resident are sometimes blocked,” said Dr. Sinnott. “El Paso is a very welcoming community. We are a perfect location to provide a wonderful experience for residents and to provide emotional support to our residents.”
Intealth, the parent organization of the Educational Commission for Foreign Medical Graduates, helps international medical graduates enter U.S. residency training. Through ECFMG, it verifies credentials and sponsors J-1 visas for physicians entering residency and fellowship programs. That support enables doctors trained abroad to continue their education and helps programs such as TTP of El Paso at Transmountain sustain physician recruitment for El Paso and the Borderplex.
The adjustment challenges facing J-1 physicians run deeper than geography. Dr. Apaloo, herself an international medical graduate and resident, described the cultural and systemic differences that international medical graduates confront upon arrival, from learning to navigate electronic health records to participating in a model of care that looks nothing like what they trained for abroad.
The wellness grant supports Intealth’s mission to advance inclusion and mental health for J-1 physicians facing family separation, unfamiliar systems, and immigration-related uncertainty during residency. Meanwhile, the Wellness Passport will continue with the next resident class in July.
“We do not always know what a resident is going through in their personal life or what struggles they are carrying,” said Dr. Bhatnagar. “This project gave light to journeys we were not aware of.”
About Texas Tech Health El Paso
Texas Tech Health El Paso serves 108 counties in West Texas and is dedicated to preparing the next generation of healthcare professionals. Established as an independent university in 2013, Texas Tech Health El Paso is a uniquely innovative destination for medical, nursing, biomedical sciences and dental education.
Focusing on excellence in healthcare education, research, and clinical service, Texas Tech Health El Paso has graduated over 2,600 professionals over the past decade. For more information, visit ttuhscepimpact.org.