Introduction: The growing cancer burden and the essential role of general practitioners in prevention, early diagnosis, and timely referral highlight the need to reform undergraduate oncology education. This study evaluated oncology education in Iran, compared it with selected international standards and experiences, and proposed practical recommendations for integrating and contextualizing oncology and palliative-care education.

Methods: A structured critical narrative review was conducted using the SANRA framework. English- and Persian-language sources available through March 31, 2026, were searched in PubMed/MEDLINE, Scopus, Web of Science Core Collection, ERIC, Google Scholar, SID, CIVILICA, and ISC, as well as relevant organizational websites. Two reviewers independently screened eligible sources. Data were extracted using a researcher-developed form and synthesized narratively and thematically across Iranian oncology education, international competency frameworks, and contextual adaptation recommendations.

Results: Undergraduate oncology education in Iran was fragmented, compartmentalized, and predominantly focused on inpatient settings and specialist treatment. Major gaps were identified in essential general-practice competencies, including cancer prevention, screening, early diagnosis, timely referral, symptom control, supportive and palliative care, and communication with patients and families. Teaching relied mainly on passive lectures, with limited use of ambulatory and primary-care settings, simulation, standardized patients, interprofessional education, and digital learning. Assessment was primarily knowledge-based, with limited use of OSCEs, Mini-CEX, direct observation, and other workplace-based methods. International comparisons supported integrating prevention, diagnosis, referral, palliative care, communication, teamwork, and continuity of care into the undergraduate curriculum.

Conclusion: Improving cancer care requires a longitudinal, integrated, competency-based curriculum adapted to Iran’s healthcare and sociocultural context. Priorities include defining national competencies, expanding primary-care training, integrating oncology and palliative care, adopting simulation-based methods, and implementing workplace-based assessment.