Background: The escalating cancer burden and the pivotal role of primary-care physicians in prevention, early diagnosis, and timely referral highlight the urgent need to reform undergraduate oncology education. This study evaluated undergraduate oncology training in Iran, compared it with international benchmarks, and proposed context-sensitive recommendations for curriculum reform.
Materials and Methods: A structured critical narrative review was conducted per the SANRA guidelines. English- and Persian-language sources up to March 31, 2026, were searched across PubMed/MEDLINE, Scopus, Web of Science, ERIC, Google Scholar, SID, CIVILICA, and ISC, as well as relevant organizational websites. Two reviewers independently screened studies. Data were synthesized thematically across curricular structure, teaching and assessment strategies, international competency benchmarks (ASCO/ESMO, CanMEDS/EPAs), and sociocultural adaptation.
Results: Undergraduate oncology education in Iran is fragmented, compartmentalized across inpatient and subspecialty disciplines, and lacks a longitudinal curriculum map. Major gaps were identified in core general-practice competencies: primary prevention, screening, early detection, oncologic emergencies, cancer survivorship, and structured palliative care. Teaching relies heavily on passive lectures with minimal ambulatory, primary-care, simulation-based, or interprofessional training, and culturally sensitive communication (e.g., breaking bad news using SPIKES amid protective family collusion) is inadequately taught. Assessment remains predominantly knowledge-based, with limited workplace-based tools (OSCE, Mini-CEX, DOPS). International comparisons supported longitudinal cancer education, community-based ambulatory rotations, and competency-driven EPAs.
Conclusion: Reforming undergraduate oncology education in Iran requires a longitudinal, competency-based, integrated curriculum aligned with primary healthcare needs. Strategic priorities include formulating national core oncology EPAs, expanding ambulatory and community-based exposure, embedding palliative and supportive care, integrating simulation for complex communication, and deploying programmatic, workplace-based assessments.