When Dr. Arushee Bhatnagar arrived in El Paso for her family medicine residency, she understood how isolating it could feel to begin a demanding new chapter far from home.
“You are away from your family, you are in a new country, and you do not know how things function here,” Bhatnagar said. “That can be very isolating.”
That shared experience inspired Bhatnagar and her fellow resident physicians at Texas Tech Physicians of El Paso at Transmountain to create the Wellness Passport, a program that encourages international medical graduates to explore the region, build friendships and care for their mental and physical well-being.
Now, the El Paso-grown initiative is gaining national attention. Intealth, a national organization that supports internationally educated healthcare professionals, awarded the program a $5,000 grant to expand its activities and explore its potential as a model for other residency programs. The Wellness Passport was one of only three projects selected from 66 proposals nationwide.
Nearly 90% of the Transmountain Family Medicine Residency Program’s physicians are international medical graduates, or IMGs. Many are adapting simultaneously to a new country, culture and healthcare system while managing the rigorous demands of residency. Visa processes and other travel circumstances can also make returning home to see loved ones difficult.
“There is a lot of social stress,” said Bhatnagar, a third-year resident who chaired the program’s Wellness Committee. “Sometimes we do not speak up when we are suffering, and we do not even realize what the signs of burnout are.”
Tracking wellness milestones
The multilingual Wellness Passport offers a practical and symbolic response to those challenges. Modeled after the passports carried by many international physicians with J-1 visas, the booklet tracks wellness milestones throughout the academic year.
Residents earn stickers by participating in activities related to hydration, sleep, movement, mindfulness and time spent together outside their clinical responsibilities. Activities have included yoga, meditation, painting, pottery and group outings to regional destinations such as White Sands National Park.
Each experience gives residents an opportunity to step away from the pressures of training, discover the El Paso region and strengthen the relationships that can help a new city feel more like home.
The program also measures burnout before and after residents participate. Bhatnagar said the initial scores revealed the depth of the need, while follow-up assessments showed measurable improvement.
“When we had the baseline burnout scores, it was quite overwhelming,” she said. “This project gave residents protected time to step away from the pace of training and focus on each other.”
From El Paso to a national audience
Dr. Catherine Apaloo, senior vice president and chief IMG experience officer at Intealth, said the Wellness Passport stood out because it reflects both the experiences of international physicians and the border community they serve.
“The Transmountain program had almost 90% international medical graduates in a border city where they interact with a lot of immigrants,” Apaloo said. “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.”
Apaloo said the program’s creativity, engaging format and potential to be replicated elsewhere helped set it apart.
“The creativity and the fact that it could be reproduced by other places made it really come out on top,” she said.
Dr. Kristina Sinnott, program director for the Family Medicine Residency Program at Transmountain, said El Paso is especially well suited to support physicians building new lives far from their families.
“On top of doing all of medicine, which is hard enough as it is, your emotional outlets as an international resident are sometimes blocked,” Sinnott said. “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.”
With support from the Intealth grant, the Transmountain residents will further develop the Wellness Passport and continue it with the next resident class. What began as a way for physicians to support one another in El Paso could ultimately help international medical graduates at residency programs across the country.
“We do not always know what a resident is going through in their personal life or what struggles they are carrying,” Bhatnagar said. “This project gave light to journeys we were not aware of.”
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