Cynthia Frary McNamara, MD, FACP

1) Medical Education; Rural healthcare, health disparity.

Department of Medicine Education Research Grant

Agency: Yale School of Medicine Department of Medicine

Title: Needs Assessment for Rural Medicine Curriculum in United States Medical Schools

P.I.: Cynthia Frary McNamara

Project Period: 9/2023 - 9/2025

Rural healthcare access is inadequate, and the lack of physicians practicing rurally contributes to health inequity. The medical training process must produce more future rural physicians to meet the population's needs. To understand the need for rural health education in medical schools and internal medicine residency training programs, we performed a multi-institutional survey of students and internal medicine (IM) residents on attitudes, interests, and comfort with competencies important in rural settings. Initial data have been submitted as an abstract to the 2024 SGIM National Meeting; this project was also submitted as a Thesis to the Yale School of Medicine by MS4, Kailey Carlson, for whom I serve as the Academic Advisor.

2) Medical education; Reproductive health, medication abortion, abortion regulations, health disparity, and patient care.

These topics were presented in the Women's Health and Gender Affirming Medicine Curriculum. My work with our team was included in the publication as follows: Henrich JB, Richman I, Rabin TL, Gielissen KA, Dhond M, Canarie JX, Hirschman AL, Windham MR, Maya S, McNamara C, Pathy S, Bernstein P, Smith R, Vasquez L. It Takes a Village: An Interdisciplinary Approach to Preparing Internal Medicine Residents to Care for Patients at the Intersection of Women's Health, Gender-Affirming Care, and Health Disparities. J Womens Health (Larchmt). 2024 Jan 8. doi: 10.1089/jwh.2023.0217. Epub ahead of print. PMID: 38190490. We further implemented a proof-of-concept pilot of a curriculum module for IM residents that addressed current controversial reproductive and gender-affirming healthcare topics. This work, entitled Teaching Politically Charged, Controversial Topics, has been submitted to the Journal of Graduate Medical Education and is currently in the revision process. An abstract, Preparing IM Residents for Patient Care in a Dynamic post-Dobbs Legal Landscape, has been submitted for presentation to the 2024 SGIM National Meeting.

3) Medical education; Addiction medicine

We developed an outpatient-based elective for IM residents. This work, Development and integration of ambulatory addiction medicine (AM) curricula for internal medicine (IM) residencies at two Veterans Affairs (VA) facilities, was disseminated as an oral presentation at the Association for Multidisciplinary Education and Research in Substance Use and Addiction national meeting, and as a poster at the SGIM regional meeting in 2023.

4) Socioeconomic determinants of health (SDOH) in the Yale Office-based medicine (YOBM) curriculum. Developed a scorecard for assessment of the presence of SDOH in curricula. We used it in the Yale Office-based Medicine Curriculum assessment for elements of identity-based and social determinants of health; it was presented as a poster at Yale Medical Education Day 2022.

5) Cessation of group battlefield acupuncture visits due to COVID-19: a pilot study. This study assessed the effect of cessation of this group visit model used to treat chronic pain on patients' pain control, medication utilization, and daily function. The work was published in Acupuncture in Medicine in 2022.

6) Agency: VA CSR&D $899,998

I.D.#: CX-21-001

Title: SARS-CoV-2 Vaccine and You

P.I.: Shaili Gupta

My Role: Sub-I

Project period: 12/2020-12/2024

The goals of this project are to evaluate the immune response to various vaccines against SARS-CoV-2 administered to VACHS staff and Veterans. This will provide critical data on the variation in immune response (T cell and B cell) and clinical correlates of immune response to mRNA SARS-CoV-2 vaccines among a large, diverse population (age, race, gender, medical comorbidities) of veterans to help inform the field and guiding bodies on vaccine plans for the upcoming years. My role in this project is as chief operations manager, where I work closely with the PI and direct the research staff in the day-to-day operations of scheduling subjects for bloodwork, assigning roles to other sub-investigators on data collection, subject phone visits, and coordinating between phlebotomy and research team.

My academic interests include medical education, particularly topics related to social and identity-based determinants of health and global and rural health that contribute to health disparity. I am part of the core faculty for the Women's and Gender Health Education Program. I have traveled extensively and delivered and taught outpatient primary care and inpatient internal medicine in low-resource countries.

My interest in medical education was developed and expanded through the Faculty Development Program at Johns Hopkins, where I formalized my experience in educating students and residents. I have taught medical trainees and colleagues in many capacities, including outpatient and inpatient medicine individually and in small groups. I have given formal lectures to large groups of medical personnel and to community-based lay personnel. I am interested in expanding medical education to IM residents to include elements of healthcare in which disparity is based on access and/or social and identity-based determinants of health.