Background: Rising cancer burden and increasingly complex patient needs highlight the importance of oncology and palliative care education. This review examined the need for, and proposed context-sensitive strategies to achieve, early, longitudinal, and competency-based integration of these fields into Iranian undergraduate medical education.

Methods: An integrative review was conducted using Whittemore and Knafl’s five-stage framework, with the research question structured according to the Population–Concept–Context model. PubMed/MEDLINE, Scopus, Web of Science, Embase, ERIC, Google Scholar, Magiran, and SID were searched, alongside relevant grey literature and policy documents, from inception through July 2025. Eligible Persian- and English-language studies addressed undergraduate medical education, oncology or palliative care education, curriculum evaluation, educational needs, or curriculum integration. Two reviewers independently screened and extracted data. Quality was assessed using MMAT and AGREE II, and findings were thematically synthesized.

Results: Three major findings emerged. First, Iranian undergraduate medical education remains predominantly biomedical and fragmented, with heavy reliance on written assessments and insufficient structured instruction in communication, ethical decision-making, symptom management, and interprofessional collaboration. Second, these educational gaps may be associated with opioid hesitancy, inadequate pain and symptom management, difficulty delivering bad news, suboptimal end-of-life decision-making, limited teamwork, and emotional exhaustion among learners. Third, the evidence supports a longitudinal spiral curriculum that introduces cancer biology, pain, and the human dimensions of illness during the basic sciences and progressively develops clinical competencies through simulation, role-play, bedside teaching, OSCEs, Mini-CEX, DOPS, and portfolios.

Conclusion: Isolated lectures or elective courses are insufficient. Iranian undergraduate medical education should adopt a longitudinal, spiral, competency-based, and interprofessional model supported by national competencies, faculty development, performance-based assessment, and strengthened palliative care infrastructure.