Integration of medical education into the Iranian health system from the perspective of experts: A qualitative analysis.

Abstract

Background: In Iran, efforts have been made to integrate medical education and the health system with the aim of promoting social responsiveness. Despite these efforts, there is still room for improvement in this process. To gain a better understanding of this topic, a study was carried out to gather insights from experts on the integration of medical education in the Iranian health system.

Materials and methods: This qualitative study utilized Norman Fairclough's discourse analysis. Data collection involved interviews and video reports. The data collection took place in Tehran between November 2022 and February 2023. The participants included 10 policymakers and key informants who possessed in-depth knowledge about the integration of medical education into the health system. Additionally, six related speeches from media were subjected to qualitative inductive content analysis.

Results: Through discourse analysis, 96 codes, 17 categories, and 8 themes were extracted. The themes include the philosophy and objectives of integration, the concept of integration, the experience of the integration process, achievements of integration, future horizon of integration, indicators of integration, strategies for enhancing integration, and challenges and consequences of abstracting medical education from the healthcare system.

Conclusion: Despite facing challenges and limitations, integration has managed to achieve some of its original objectives. However, these achievements have been hindered by inadequate implementation, managerial shortcomings, and pre-existing cultural and economic issues within both the educational and service systems. Therefore, it is essential for the country's educational and service systems to take charge of integration, complete the process, and strive for functional integration. This requires health policy to prioritize integration efforts, address systemic barriers, engage stakeholders, and ensure that integration initiatives are guided by expert opinions and best practices. By doing so, policymakers can create a healthcare system that is more responsive to the needs of patients, more efficient in delivering care, and more effective in educating the next generation of healthcare professionals.