"Doctors' health matters. We are also human" - Dr Yakheka Dyasi

"In South Africa, burnout syndrome in anaesthetic registrars was reported to be about 27% in 2013," she explains. "In 2020, it was at 36%. That's an almost 10% increase!"

The 33-year-old received a 2021 Discovery Foundation Rural Individual Award for her study on the prevalence and risk factors of burnout syndrome in anaesthetic registrars in eight medical schools in South Africa.

Why did she apply to Discovery? "I work in a disadvantaged province, the Eastern Cape, where burnout in anaesthetic registrars is a big problem. Mental health for doctors is a serious issue that does not get enough attention. Like COVID-19, it is close to being a pandemic. I needed help to expand this study so the message can reach the relevant bodies to make a real change in this group of scarce, critically needed specialists in South Africa," she says.

Dr Dyasi adds that although burnout in doctors is a popular topic in literature worldwide, the prevalence, risk factors and impact is not well studied.

"And it is worse for us in a resource-limited setting like South Africa," she exclaims. "In the past eight months, two anaesthetic registrars have committed suicide. We don't know why they did it, but I believe burnout syndrome is definitely one of the contributing factors."

Why do anaesthetists suffer from burnout?

"In our country, especially in the public sector, the shortage of doctors and limited resources play a big role in burning out the few doctors we have," she says. Why does it affect anaesthetic registrars, in particular? Dr Dyasi explains: "The main stress with anaesthesia is that the life of the patient is literally in your hands. The type of work we do requires extreme concentration, because even a small mistake could cost the patient their life or impact their quality of life.

"On top of that, you're going through the many requirements to be a specialist. There's unfortunately limited psychological support when you're a registrar; you're expected to just handle it all. When you admit to burnout, people think you're weak. Then there's also a culture of professional bullying of registrars by seniors.

"Finally, it's important to highlight that registrars from different medical schools may have different reasons for experiencing burnout. So, our approach should be different in how we address it."

Finding solutions together

With her mixed-research study, Dr Dyasi aims to understand the risk factors of burnout in anaesthetic registrars in different provinces and universities, and with different historical background. She plans to extract themes from interviewing registrars on what they think should be done to mitigate the problem.

"The ultimate aim is to draft evidence-based recommendations to present to all the medical schools and anaesthetic heads of department, the Colleges of Medicine of South Africa, the South African Society of Anaesthesiologists and Health Professions Council of South Africa on how to deal with this problem we are facing," she explains.

Why is this such a timeous and relevant project? "South Africa has an overburdened heath system, with shortage of anaesthetists. We need more specialists, that is registrars. We are sadly running a risk of losing more of these doctors yearly. The mental health of a doctor has an enormous impact on our public health system," she says. "This problem is so much bigger than I thought at first. Registrars are suffering so much that most even regret getting into the programme."

Discovery Foundation alumna guides the way

Dr Dyasi's research supervisor is none other than Professor Busisiwe Mrara, a former recipient of a Discovery Foundation Academic Fellowship Award who in 2020 made history as the first ever super-specialist at Nelson Mandela Academic Hospital. As president of the College of Anaesthetists, Prof Mrara became the first black woman to hold the position in the Colleges of Medicine of South Africa.

"She is dynamite," says Dr Dyasi. "She's so academically driven and always aiming to improve and empower those around her. I had no interest in research before working with her, but she really showed me the importance of evidence-based medicine when you want to impact change."

Prof Mrara is not the first woman to motivate Dr Dyasi. Born in the Eastern Cape as an only child, and raised by her grandmother along with four of her cousins, she knew she wanted to be a doctor from an early age. "I was inspired as a young girl by a woman called Dr Mbambisa. This lady is a humble, stylish woman, but still a doctor, and in those days it was inspiring and beautiful to see that. I wanted to be just like her."