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Cheryl Seymour, M.D., '01: Family, farm

By Andrew Clark

The past and present of the Rural Health Scholars: Cheryl Seymour (kneeling, right) poses with members of the Maine Migrant Health Program staff and three current Geisel students, Karl Dietrich (back row, second from left), Meaghan Kennedy (back row, third from left), and Holly Schroeder (back row, fourth from left).

Cheryl Seymour grew up on a 100-acre farm in Howard County, Md., a distant hour away from Washington, D.C., and Baltimore, so perhaps it's not surprising that even as a physician she hasn't left farm life behind.

Over the course of her career, Seymour has blended her background in farming with an interest in providing care to those who might not otherwise receive it by working with one of the country's least visible populations: migrant farm workers. "There's this great scarcity of resources out there," she says. "So there is this great need to provide help."

As medical director of the Maine Migrant Health Program (MMHP), Seymour spends much of her time bringing health care to the state's migrant farm workers. But that's just one of the roles Seymour fills. She also practices and teaches at the Maine-Dartmouth Family Medicine Residency Program in Augusta, Maine.

The trip from a farm in Maryland to caring for farm workers in Maine didn't happen overnight, but Seymour has long had an interest in providing care in rural areas. As an undergraduate at Duke, she became fascinated with the field of telemedicine—the use of technology to provide medical care at a distance. Seymour came across telemedicine in the context of its use by the military, but she saw the possibility of applying it to care for rural populations as well.

In 1998, during her first year of medical school, a chance encounter helped move her in the right direction. "I went to see Dr. Jim Yong Kim speak," Seymour recalls. At the time, Kim was deeply involved in the international health organization Partners in Health. He later served as president of Dartmouth College before leaving to become president of the World Bank. "After he gave his lecture, I went up to him and asked him for career advice," Seymour says. "He told me to learn Spanish. I had filed that advice away. But when it came time to pick a residency, I chose one in Lawrence, Mass., where Spanish would be necessary."

During her time at Dartmouth, Seymour studied abroad at the Probigua Language School in Antigua, Guatemala, and spent time working at a community health clinic in El Rosario, Honduras.

But it was another formative opportunity that helped lead to Seymour's current role with MMHP. While at Dartmouth, Seymour was one of the founding members of the Rural Health Scholars Program.

This program, which continues today, selects several students each year who are interested in providing medical care to rural populations. Seymour says the program was instrumental in developing her ability to work with migrant workers. The program provided a number of opportunities, including lectures from guest speakers and trips, such as her visit to Guatemala and Honduras.

"Being part of the program really opened up a number of possibilities," Seymour says.

One of the most important parts of the program was simply the community it fostered. "The Rural Health Scholars provided me with great support throughout medical school," she says. "It was really nice to have a home base and to be around people who were always supportive. The individuals in the program were really into working in an underserved community."

Cathleen Morrow, M.D., an associate professor of community and family medicine who was the director of the Rural Health Scholars Program from 2008 to 2012, has been elated to see what Seymour has achieved since medical school. In her eyes, Seymour's efforts represent everything the program was intended to accomplish.

"Cheryl's work with the Maine Migrant Program is great, and it's exactly what we hope to see," says Morrow. "The work she's doing is as rich and rewarding as you can find. There's a lot of hard work that goes into it. But the goal of the program is to help and inspire people to ultimately work in the field."

Being part of the program really opened up a number of possibilities.

After graduating from medical school, Seymour began her residency at the Greater Lawrence Family Health Center in Lawrence, Mass., a city in the northern part of the state with a large Latino population. Practicing in Lawrence was an important part of her development as a physician, Seymour says, in part because she had the opportunity to sharpen her Spanish skills.

In 2004, Seymour joined the Maine-Dartmouth Family Medicine Residency in Augusta on a one-year fellowship in geriatrics. At about the same time, she sought out an opportunity to get involved with helping provide care to migrant farm workers. She began volunteering for MMHP in 2004. Five years later she was named medical director for the program, which is the only organization in the state dedicated to providing care to farm workers. Each year more than 1,000 patients receive care from MMHP, which has turned vans into mobile health clinics in order to bring care directly to farm workers at their work sites.

Seymour says there is something special about being able to help people who might not otherwise have access to basic health care. "It's very rewarding," she says. "I get to be an advocate for the underserved. I can go to these rural areas in a van and provide a modicum of care. It's really enriching and this position involves a lot of interpersonal relationships. And it's a position that poses many intellectual and professional challenges."

Working in a state with 1.3 million acres of farmland, Seymour and her MMHP colleagues have a lot of ground to cover. And from blueberry picking to Christmas tree harvests, Maine's diverse agriculture creates a great need for health care for the migrant farming population. The nature of the work adds to the challenges faced by Seymour and other health-care providers.

"Farm work is very seasonal," Seymour points out. "And it's much different than the typical office practice, where people will come to me during my office hours." For one thing, she says, many of the workers do not speak English. And they may be wary of making contact with doctors. "They don't talk to people sometimes because they're afraid about their immigration status," she says. "So that will lead to them being afraid to access services."

According to Seymour, who both coordinates clinical initiatives and provides direct care to patients, these challenges make providing health care to migrant farmers quite the change of pace from her day jobs as a family practitioner and member of the faculty of the Maine-Dartmouth Family Medicine Residency Program. "I really enjoy the breadth of the family medicine field," she says. "There's a lot that's involved, but it's really fun. It's always been what I wanted to specialize in. I love the challenge of having to deal with so many different disciplines. And I love the familial aspect, which makes it very special. You are constantly involved with a family, whether it's the birth of a child [or] dealing with the illness of a grandmother."

When Seymour isn't working, her time is devoted to her own family: her partner and two daughters, a five-year-old and a two-year-old. So whether she's at home, in her office, or traveling the state with MMHP, Seymour's life revolves around farm and family.

Putting rural health training within reach

By Jennifer Durgin

As one of the few rural medical schools in the country, the Geisel School of Medicine has long attracted and provided opportunities for people like Cheryl Seymour who want to care for patients living far from major cities. Today, Geisel students can choose from clerkships in multiple rural locales—from Tuba City, Ariz., to Alaskan villages to small towns in Maine—and take advantage of an array of experiences offered through the Rural Health Scholars (RHS) program.

Founded in 1997, RHS prepares medical students to be leaders in providing health care to rural and underserved populations.

The Mellam Foundation's support has been critical in maintaining the work of Rural Health Scholars.

"The goal of the program is to intrigue and inspire students to one day make a difference in rural health care, where the needs are so great," says Cathleen Morrow, M.D., an associate professor of community and family medicine and director of the program from 2008 to 2012.

In recent years, the Mellam Family Foundation has played a vital role in sustaining and expanding the program. Founded in memory of Leo L. Mellam, who is credited with developing modern containerized freight transportation, the Foundation has been supporting rural health opportunities for Dartmouth medical students for several years. It first sponsored rural clerkships and then provided grants to RHS. The Foundation also gives to Dartmouth College to help fund undergraduate leave-term scientific research, and it supports many other programs nationwide in the areas of rural medicine, science, education, the environment, and social services.

"The Mellam Foundation's support has been critical in maintaining the work of Rural Health Scholars, providing mini-grants for students' outreach projects, helping with transportation costs to very remote sites, and assisting with the purchase of medical equipment for community health screenings," says Morrow.

Whether volunteering on a Native American reservation, participating in rural health seminars, or shadowing a physician in rural New England, Rural Health Scholars learn about and prepare for the challenges they will one day face practicing in underserved communities, far from the closest city.

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