Department Spotlight: Dr. Amanda Pendergast, MClSc'19

Tell me a little about you.
I am an academic family physician and Assistant Professor at Memorial University.  I live in St. John’s, NL with my husband Shawn and three children: Christopher, Darby and Adia.  We also have a Brittany Spaniel called Bergie Bits (named after small fragments that fall off icebergs).
Where were you born and raised?
I was born in St John's, Newfoundland and grew up in Gander, Newfoundland.
What degree(s) do you have, and from what universities?
BSc (Hons) in Biochemistry (Magna Cum Laude)  from the University of Ottawa
MD from the University of Ottawa
Completed Family Medicine Residency at UBC
Where do you practice medicine and in what scope? What are your research interests?
I practice full-service Family Medicine at the Shea Heights Medical Clinic in St John's, Newfoundland and Labrador.  In my practice, I see a wide variety of patients from newborns to the elderly.  Besides clinic visits, I also provide home visits and office procedures.  I work in an academic clinic, so I am fortunate to work with medical students and family medicine residents.  The one part of my practice that I miss is family medicine obstetrics.  I practiced with a fabulous group until 2017 when I had to cut back due to illness.  My research interests include breastfeeding, medical education and adolescent mental health and substance abuse.
What special interests or hobbies do you have?
I enjoy watching my children’s sporting events, especially their hockey games, practicing yoga and hiking.
Why did you choose to pursue a MCISc/PhD in the Department of Family Medicine at Schulich Medicine & Dentistry?
My practice was strictly clinically focussed while my children were young.  As they grew up, I realized I was looking for a change in my practice.  I took a leave of absence from my position and replaced an academic physician on sabbatical.  I thoroughly enjoyed the experience and decided this was the career change I sought.  During that year, I connected with two physicians (Cheri Bethune and Cathy MacLean) that had completed the MClSc program at Western.  They highly encouraged me to consider the Western program to complement my budding interest in academic medicine.   I recall Cheri telling me the program opened her mind, and I completely understood what she meant after I returned from the first onsite portion.  It was an incredible experience to be surrounded by so many like-minded individuals.  I went on to work in the same clinic as Cheri, and Cathy became our Chair of Family Medicine at Memorial.
Is there an experience of your time in the program that stands out for you, an “ah hah” moment?
I think my ah hah moment occurred just after the onsite portion of the Teaching and Learning in Family Medicine course.  We had a learner in difficulty at my site whom I was supervising.  I felt a little out of my league as this was more challenging than giving feedback to a resident who was progressing as expected.  A previous grad of the MClSc program, Cheri Bethune, guided me through this process, as did my colleagues taking the online portion of the course.  It seemed every week I would learn something from my online group and from my readings that would be displayed in real life with this resident.  In particular, I remember learning about ‘illness scripts’, and a few days later, Cheri discussed this with the resident as a way to enhance their learning.  I felt like I had my own personal T and L mentor.   
How do the writings and the person of Dr. Ian McWhinney influence your work in your career overall?
Dr. McWhinney has helped me understand my patients for who they are, not from an illness that may try to define them.  I am often surprised at how the same disease will present differently in different patients.  The context of their families, employment and social supports play an incredibly important role in how patients experience and perceive illness.  I am privileged in my practice to care for multiple generations of families which also allows me to experience insight into my patients’ proximal contexts.  Dr. McWhinney has also allowed me to be patient.   I am not pressured to understand everything at every visit.  I can prioritize the important topics to cover for me and for my patient.  Sometimes a patient might not want to discuss coping or suffering.  I may leave a visit feeling I am missing an important clue, but respecting their boundaries often allows their feelings to be revealed when they are ready to disclose. 
What has been your greatest experience to date in your teaching / research career?
Definitely completing my thesis.  I do not think I understood the amount of time it would take, and I have an incredible respect for anyone who has completed one.
What are your beliefs about Department of Family Medicine’s patient-centred care approach or education in healthcare through clinical excellence in general?
I am definitely an advocate for patient centered medicine.  My primary academic position is Phase 1 Lead for medical school.  I work with a team to oversee the curriculum and to provide assessment and evaluation.  We introduce patient centered medicine within the first two weeks of the program.  It is consistently reinforced during the clinical skills course.  This course is usually the most highly rated by the medical students.  We also have integrated learning sessions as part of the curriculum, where we link medical expert and non-medical expert CanMEDS roles using a patient narrative.  This course has underperformed historically, but my team revamped the sessions using feedback from Faculty and students.  We increased the evaluation rating dramatically.
What MClSc / PhD learning have you incorporated into your family medicine practice as a result of the program?
I reflect a lot on the Advanced Patient Centered Medicine course.  Not all patients want the advice I provide.  Some patients want me to recommend a treatment or an investigation that I know is not helpful, and perhaps harmful.  To me, this is a struggle in family medicine, to do the best for your patients and your community with the resources available, while being respectful of the patients’ wishes, even if they differ from your own.  Since completing the APCM course and reflecting on my experiences and those of my colleagues, I find I am less rigid.  I listen more to my patients and I try to find common ground during the more challenging interactions.  If I see a patient who is not interested in my advice, instead of getting frustrated, I simply ask them what they feel would help, or why my advice will not work for them.  I try to seize a portion of the patient’s expectations and combine this with my own recommendations to reach common ground.
Has your teaching / research changed as a result of the MClSc / PhD program?
Teaching brings me joy so I find I am very active with teaching in the medical school and residency program.  I present lectures and large group sessions with medical students and family medicine residents.  I facilitate small group sessions for medical students and residents.  I also organize conferences and workshops for Faculty. 

My teaching style and presentations have improved a lot since completing the Teaching and Learning in Family Medicine course as part of the MClSc.  I incorporate more visuals and videos, and change my teaching technique regularly.  I do my best to interact with the audience.  The MClSc program has helped me move beyond my comfort zone with teaching.  I am now completely comfortable getting up in front of a large group to teach or facilitate, even if it is off the cuff session. 
What would you consider the single most important benefit of the MClSc / PhD program?
One of the most important benefits for me was the opportunity to meet and work with educators and family physicians from around the world.   I met so many interesting and influential colleagues during this journey.  Several in my cohort have done amazing things to promote family medicine in their regions, such as Peru, Brazil and Singapore.  When I read medical education or family medicine journals, I recognize many names of previous MClSc graduates.  I also think it was a testament to the success of the program the number of graduates and current students who attended the 40th anniversary of MClSc program.  I am very proud to be a graduate of the MClSc program.   
I would be happy to chat with anyone who has questions about the program.