Background: The rising cancer burden and increasingly complex patient needs highlight the importance of strengthening oncology and palliative care education. This review examined the need for and identified context-sensitive strategies to support early, longitudinal, and competency-based integration of these fields into Iranian undergraduate medical education.
Materials and Methods: An integrative review followed Whittemore and Knafl’s five-stage framework and the Population–Concept–Context model. PubMed/MEDLINE, Scopus, Web of Science, ERIC, CIVILICA, SID, and Google Scholar were searched from inception through March 2026, alongside grey literature, guidelines, policy documents, and curricula. Persian- and English-language studies on undergraduate oncology or palliative care education, curriculum evaluation, educational needs, or competency development were eligible. Two reviewers independently screened and extracted data. Quality and risk of bias were assessed using MMAT 2018 and AGREE II, followed by thematic synthesis.
Results: The synthesis identified three major findings. First, Iranian undergraduate medical education remains predominantly biomedical and fragmented, with limited longitudinal integration of palliative care and insufficient structured training in communication, ethical decision-making, symptom management, and interprofessional collaboration. Second, these gaps may contribute to opioid hesitancy, inadequate pain and symptom management, difficulty communicating bad news, uncertainty in end-of-life decision-making, limited teamwork, and emotional distress among learners. Third, the evidence supports a longitudinal spiral curriculum introducing cancer biology, pain, suffering, and the human dimensions of illness during the basic sciences, followed by the development of progressively complex clinical competencies through simulation, role-play, bedside teaching, OSCEs, Mini-CEX, DOPS, and portfolio-based assessment.
Conclusion: Iranian undergraduate medical education should replace isolated lectures with longitudinal, spiral, competency-based, and interprofessional training supported by national competencies, faculty development, performance-based assessment, context-sensitive implementation, and strengthened palliative care infrastructure.