California physician in training reveals how she copes with burnout, is researching solutions

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Yasmin Bains got her first taste of physician burnout after completing the Pre-Professional Health Academic Program at California State University, East Bay.

“It was go, go, go. I really did not take the breaks that were needed,” Bains said, noting the program was manageable but the stress level was higher than she’d anticipated. “I think emotionally and mentally, that’s where things got challenging. I had those classic signs of burnout after completing (the program). I was feeling disengaged, lonely, and started isolating myself from friends and family.”

And it wasn’t like Bains had never experienced a stressful environment.

Bains is a career-changer. Now a fourth-year medical student and primary care academic fellow at Touro University College of Osteopathic Medicine in Vallejo, she entered the medical field after many years working in the business world of Silicon Valley. She holds a bachelor’s degree in economics, which she earned in 2005 from Santa Clara University Leavey School of Business.

In 2011, Bains decided to shift gears.

“Family circumstances led me to looking into medicine as far as what I wanted to do next,” Bains said. “I always wanted to work with the community, but didn’t know my options until I met a physician who mentored me.”

Graduated from the CSU East Bay program in 2013, she began to wonder if she’d made a mistake, so she decided to hold off on applying for medical school, opting instead to take a year off to evaluate her priorities.

During that year away from her studies, Bains went to work full time with geriatric patients in Palo Alto. It turned out to be an experience she described as “important” because it reminded her why she felt medicine was the right decision.

“I had almost turned away from it because I was burned out, and that was a scary thought,” Bains said. “The truth is, my story is not unique. Burnout happens to a lot of us.”

Bains stepped back into her new world in 2015. She decided to build on the foundation of medicine by earning her master’s degree in medical health science, also from Touro University.

“That was a challenge but I had learned from my previous experiences and was trying to balance the school and the personal experience a bit more,” Bains said. “When I started medical school (in 2016), I knew I really wanted to address physician burnout.”

Through her research, Bains learned that physician burnout is widespread among medical students, and the trend continues into residency, when stress levels can escalate even more because of the greater degree of responsibility, authority and long hours.

“I really wanted to help sort of create this culture change here on campus, so one of the things I’ve been involved in since my first day of medical school is the WARM program (Wellness, Academics, Resilience and Mindfulness),” she said.

The goal of WARM is to help integrate students’ well-being into Touro’s medical school curriculum, a change from what Bains said was a “one-size-fits-all model” that consisted of one or two activities for students in a dedicated time slot, not accounting for their individual support needs.

“We decided this past year to move away from that model to a completely student-driven model of well-being. That means we create time within our own curriculum for students to take charge of their own well-being and lead their peers,” Bains said. “We went from offering one or two sessions of curriculum hours, to a 5-to-10-fold increase.”

WARM is an all-inclusive program that has grown to include staff and faculty. They tackle topics such as Imposter Syndrome, where people don’t believe they deserve, or have truly earned, their success, which can lead to increased anxiety. They also address the loneliness aspect of burnout and help strengthen students’ sense of community on campus, she said.

“Not every student will want to participate, but we want to give them this time and space to do what they want to do,” she said. “Some may just want to go to bed and get two hours of sleep.”

Bains’ advocacy work extends beyond medical school. She recently joined the Sonoma County Medical Association, and is involved with the California Academy of Family Physicians Solano-Napa chapter. She recently attended the CAFP’s annual meeting in Sacramento, where she presented a resolution on addressing burnout in residency training.

Dr. Tami Hendriksz, medical director of the Vallejo Unified School-Based Clinics, Touro University California College of Osteopathic Medicine, said Bains is a standout student.

“Being a medical student is tough enough, just getting by and through medical school,” Hendriksz said. “She involved herself in these other projects, and all have turned out amazing.”

Hendriksz also has her own thoughts on physician burnout.

“My personal take on physician burnout, and certainly on physician-trainee burnout, is that I find the term ‘burnout’ to be victim-blaming. Saying that someone is burned out makes it seem as though they have personally failed. It does not take into account the inherent challenges that exist in our health care and medical education systems,” Hendriksz said. “I see these more as abusive systems. Physicians are forced to do excessive amounts of paperwork, under strict time constraints, and have resultant time allotted for patient care, which is a set up for failure. Same with medical students and residents.”

Hendriksz, who also serves as associate dean of Clinical Education and associate professor of Medicine at the university, added that the current way medical students are taught and trained needs to be improved.

“Touro is doing a wonderful job implementing programs to benefit our students’ wellness, as well as looking into different ways in which we can deliver our curriculum,” she said. “Some programs say do more yoga and mediate more, but that’s not going to fix the underlying problem. More time spent meditating will not decrease the hours of medical paperwork you have to do.”

For Bains’ part, she’s not feeling burned out these days.

“The biggest thing is making sure I’m staying ahead of these feelings before they escalate,” Bains said. She said she’s learned to be aware of how she’s feeling and stays close to her support system, which includes mentors, counseling services, friends and family.

It’s been a year since she last felt burned out, triggered by the stress of taking her board exams. She worked through it and also made sure she was eating healthy, working out and doing things she enjoys, like taking a hike with her dog.

“Really simplifying your life helps. … Sometimes we have to compartmentalize our stressors so we can deal with them,” Bains said. “I also decided to continue volunteering once a week because that’s a reminder as to why I’m doing this. It may not work for everyone, but it was helpful for me.”

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