The Consequences of Integration of the Medical Education and the Health Services System of Iran: A Systematic Review and Meta-Synthesis of Literature

In 1995, a huge revolution occurred in Iran’s health system when the entire medical-related educa-tion program was integrated into the Ministry of Health. This paper was conducted to provide a review of all studies investigating this integration and to synthesize their results. This study was a systematic review and qualitative meta-synthesis of the papers on integration using the Walsh and Downe process. An extensive search of the databases of ScienceDirect, PubMed, EMBASE, ISI, Google Scholar, Scopus, SID, Magiran, and Irandoc revealed 187 articles of which 25 were selected. The content of the studies was analyzed and combined using the Walsh and Downe technique. The results showed 5 main concepts, including the goals and reasons of the medical education integration, integration achievements, challenges, and barriers to achieving the goals of integration, and the future of integration. The greatest success of the integration program was related to health services, while the least positive effects were related to medical education and research. A review of available documents shows that not all dimensions of integration have been well analyzed and their economic, social, developmental and scientific effects have not been studied. The majority of the limited studies in this regard were surveys and overview studies and few studies used economic analysis and modeling. Therefore, the effects of the integration cannot be evaluated using the available studies.