Challenges Associated with the Education of Family Physicians in Iran: A Systematic Review

Context: Nearly 20 years ago, the family physician program (FPP) was established in Iran in rural areas and was expanded to some cities about 10 years ago. Different studies reported different challenges associated with the efficacy of human resources and their training or educational program. Objectives: This systematic review of the literature was conducted to comprehensively identify and collate the challenges associated with the education of family physicians in Iran. Evidence Acquisition: All published articles related to FPP in Iran were the subject of this study. The eligibility criteria included original articles, case studies, and reports published in English or Persian during 2011 - 2021 related to the challenges in the training and educational system of FPP in Iran. Data were extracted based on the SPIDER (sample, phenomenon of interest, design, evaluation, research type) technique and were reported based on the structure of PRISMA (preferred reporting items for systematic reviews and meta-analyses). International credible scholarly databases were searched. The search strategy was defined based on the search syntax and keywords. Results: The search strategy yielded 5570 potentially relevant articles and reports, of which 70 studies met the inclusion criteria. Following the full-text review, 58 studies were excluded, and, finally, 11 empirical studies and 1 report were included in the review. The study attempted to identify challenges associated with the educational system; knowledge and awareness of the FPs of the nature, activities, policies, and protocols of the FPP; and also challenges associated with the competencies of the FPs in areas like social conditions, clinical competencies, public health, and managerial skills. Conclusions: The current study identified consistent themes associated with the educational system and challenges encountered in preparing physicians for FPP upon graduation. These difficulties are not insurmountable.