title: Investigating the barriers to teaching family physicians' and specialists' collaboration in the training environment: a qualitative study.
abstract: BACKGROUND
  Collaboration between physicians in different specialties is often taken for granted. However, poor interactions between family physicians and specialists contribute significantly to the observed discontinuity between primary and specialty care. The objective of this study was to explore how collaboration between family physicians and specialists was conceptualised as a competency and experienced in residency training curricula of four faculties of medicine in Canada.
  
  
  METHODS
  This is a multiple-case study based on Abbott's theory of professions. Programs targeted were family medicine, general psychiatry, radiology, and internal medicine. The content of the programs' objectives was analyzed. Associate deans of postgraduate studies, program directors, educators, and residents were interviewed individually or in focus groups (47 residents and 45 faculty members).
  
  
  RESULTS
  The training objectives related to family physicians-specialists collaboration were phrased in very general terms and lacked specificity. Obstacles to effective collaboration were aggregated under themes of professional responsibility and questioned expertise. Both trainees and trainers reported increasing distances between specialty and general medicine in three key fields of the professional system: the workplace arena, the training setting, and the production of academic knowledge.
  
  
  CONCLUSIONS
  The challenges of developing collaborating skills between generalists and specialist physicians are comparable in many ways to those encountered in inter-professional collaboration and should be given more consideration than they currently receive if we want to improve coordination between primary and specialty care.
authors.affiliation: Doctor Sadok Besrour Chair in Family Medicine, Department of Family Medicine, Universite de Montreal, Montreal, Canada. marie-dominique.beaulieu@umontreal.ca
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Beaulieu
authors.forename: Louise
authors.initials: L
authors.lastname: Samson
authors.forename: Guy
authors.initials: G
authors.lastname: Rocher
authors.forename: Marc
authors.initials: M
authors.lastname: Rioux
authors.forename: Laurier
authors.initials: L
authors.lastname: Boucher
authors.forename: Claudio
authors.initials: C
authors.lastname: Del Grande
mesh_terms: D000328:Adult; D002170:Canada; D003299:Cooperative Behavior; D003479:Curriculum; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010821:Physicians, Family / Q000193:education*; D012577:Schools, Medical; D013038:Specialization