On the morning of March 19, when the region was anticipating heavy snowfall, two different student groups were focusing on the same field: healthcare. One group, graduate students from the University of New England (UNE), were on day two of a week‑long stay in Eastport as part of a class that develops inter‑professional skills and cultural competency. The other group, the seventh and eighth graders of the Perry Elementary School, had a slightly less complicated but no less important learning experience with Dr. James Whalen. The orthopedic surgeon brought skeletons and other mammalian bones to explain his interest in the field, the importance of bone health and the intricacies of the human body. The two groups had planned to meet together later in the day at the Rowland B. French Medical Center, but because of the pending storm the group meeting was rescheduled for later in the week.
     Eastport Health Care (EHC) Chief Executive Officer Holly Gartmayer‑DeYoung explains that both efforts are a part of her organization's goal to raise awareness and appreciation for the importance of rural healthcare and raise aspirations in young students. The goal of the two groups meeting, she says, "is to spark interest, focus and/or hope for the elementary school students to consider a career in healthcare." She hopes that having the two interact "brings to light how exciting it can be to plan a career and to be able to remain a friend with a UNE graduate student who will be able to also encourage them."
     Healthcare workers in primary and family practice care -- physicians, nurses, dentists, social workers and more -- play a central role in community health. They work with community members over their lifetimes to ensure good health, treatment and continuing care of chronic health issues and are often the first place where a significant health issue is identified. But national shortages of primary care providers contribute to challenges of recruitment and retention in rural areas. Washington County is not alone in identifying and facing this shortage.      While not all students will have an interest in the field, Gartmayer‑DeYoung and others hope that, by exposing students early on, those who are interested will receive the support they need to follow the career path.
     Back at the elementary school, Whalen compared taking care of a patient to "just like taking care of a car." However, he told them, "When you operate, the engine is running. In the human body you can't turn somebody off for a while." Bones are like a giant puzzle, he said. Anyone who likes auto‑body and fender work should "come to this job," he said, meaning orthopedics. "Anyone who likes pumps and valves, go into heart work." For those students who like to draw, Whalen pointed at the complex renderings of human anatomy going around the room and suggested they take note.
     Some students were as fascinated, leaning forward to listen more closely. Others had half an ear cocked as the lunch hour neared. Despite the noise of other classrooms trooping to the lunch room, by the end of Whalen's discussion students were still raising hands and launching their answers when school staff member and EHC board member Roland Botelho noted that it was time to wrap‑up the class.
     As an EHC board member, Botelho has been involved in promoting the organization's scholarship program as well as working on bringing educational and aspirational opportunities to young students. Gartmayer‑DeYoung notes that the health center started the EHC scholarship program in 2008 but that the health center has a long history of inviting elementary school children to visit. While the program had "fallen by the wayside," she explains that there's renewed interest in holding an annual event. Since 2008 the scholarship program has awarded $38,000 to 21 students. The scholarships follow the students through their undergraduate degree programs as long as they stay in a healthcare career major and maintain a grade point average of 3.0. Students have ranged from Columbia Falls to Calais, with many from communities in between. They have gone on to study at Husson University, UNE, University of Maine and elsewhere.

Graduate students experience community
     The University of New England graduate students are participating in a new class, Cultural Competency in Healthcare. The course develops increased awareness and understanding in the student of the unique cultural needs of specific communities so that patients receive the best care possible. Combining students of different healthcare fields in an inter‑professional environment is not routine, says Anne Zill, director of the UNE Gallery of Art and Center for Ethics in Action. Physician assistant student Abigail Raymond says, "When we talk about inter‑professionalism, it includes peers, the patient, the patient's family and the community." Pharmacy program student Yelena Agakhanova says, "We're dedicated to our own separate programs, but this is a chance to work together." Another student explains that so much of what they learn in classrooms is hard facts. "But so much of what we do is trust." She adds, "Getting to the bottom of healing. It's wonderful that UNE has one course like this. But it's sad that it's the only one."
     The class that was visiting Eastport was the first of its kind for the campus and part of an effort that has taken a number of years to coordinate. UNE staff member and former part‑time resident of Eastport Joe Wolfberg approached Gartmayer‑DeYoung as soon as she came on board at EHC. He had been working on UNE physician assistant rotation sites within Washington County. As the program developed, the original vision changed to include a method of community building within the student body that then developed into the new course.
     What the students have found so far during their visit is that Washington County is not so different from southern Maine. Both have a wealth of resources and pockets of poverty. Bretton Neider, a clinical social work student, notes, "We're just scratching the surface. It would be presumptuous to know Washington County or the Passamaquoddy after just one week." She adds, "Just because there are a lack of resources doesn't mean a lack of care."
     Professor Karen Houseknecht, Ph.D., a pharmacology and drug metabolism expert in the Department of Pharmaceutical Sciences at the UNE College of Pharmacy, says, "Students need to think about engaging in different cultures." Many cultures exist, she explains. On the Eastport trip, "We're learners and not providers on this trip. We're trying to experience the community."
     Students had a busy schedule that included visits with: Pleasant Point residents and leaders; Eastporters including Sally Erickson of South Street Greenhouse, Hugh French of the Tides Institute & Museum of Art, scallop fisherman and former city councillor Earl Small and Lighthouse Lobster Manager Jeremy Brown, and the women of The Commons; Perry resident and businesswoman Georgie Kendall, and of course the Perry Elementary School students. They also met with Gartmayer‑DeYoung and senior leadership staff at the health center. They all stayed at the Milliken House Bed and Breakfast and had time to visit the city's downtown, despite the snow.
     Gartmayer‑DeYoung says of the program, "Although the health center is part of and is often moving at a pace to keep up with the expectations of the industry, we also embody a culture of relationship, of collaboration. We must remember to honor those we serve, but also ourselves. I truly hope this cultural immersion program demonstrates the caring in healthcare. When we know our community and honor the many gifts represented by the people in our community, we manifest caring. It is the ultimate responsibility as well as the gift."