A scoping review published in Family Medicine and Community Health identified eight interrelated competency domains essential for family physicians practicing in primary health care, offering an updated framework to inform curriculum design, professional evaluation, and health system development.
Researchers at Universidad de La Sabana in Colombia conducted the review using PubMed, LILACS, and Scopus to identify literature published from 2010 to 2025. The search incorporated keywords and Medical Subject Headings (MeSH) terms, including “family physicians,” “clinical competence,” and “primary health care,” and was expanded using snowball sampling and official documents from the Pan American Health Organization. Of 1,754 studies identified, 34 met inclusion criteria and were analyzed.
The final sample included 10 reviews, 9 descriptive studies, 5 expert consensus reports, 5 qualitative studies, 2 interventions, 1 editorial, 1 clinical trial, and 1 book. Most studies were conducted in Canada (six publications), followed by the US and Mexico (five each), and Brazil, Colombia, and Spain (three each), with additional studies from South Africa, Latin America, Europe, Argentina, Chile, Ecuador, Japan, and Oman.
The eight competency categories identified were communication, knowledge management, health promotion, information and communications technology, clinical and administrative management, community- and public health–oriented care, teaching and research, and a domain focused on primary health care.
Knowledge management was the most frequently addressed domain, appearing in 28 studies (82%). Communication was reported in 20 studies (59%). Clinical and administrative management and the primary health care–focused domain each appeared in 12 studies (35%). Community- and public health–oriented care was identified in 11 studies (32%), while teaching and research and health promotion were each reported in 7 studies (21%). Information and communications technology competence was the least represented, appearing in 5 studies (15%).
Within these domains, the review outlined key competencies. Communication included empathy, delivery of difficult news, clear language, shared decision-making, clinical data gathering, and conflict resolution within multidisciplinary teams. Knowledge management encompassed evidence-based clinical reasoning, diagnostic and treatment skills, and interdisciplinary care for mental, organic, and end-of-life conditions.
Community- and public health–oriented care emphasized understanding social determinants of health, ensuring cultural and economic accessibility, engaging with community needs, and conducting epidemiological monitoring. Health promotion focused on patient education and support for healthy lifestyle behaviors.
Competence in information and communications technology included use of electronic health records, telemedicine, and digital tools to support care delivery and education, with the review noting their role in improving access in underserved or remote settings. Clinical and administrative management involved resource stewardship, leadership of multidisciplinary teams, risk management, and patient safety. Teaching and research competencies included critical appraisal, educational skills, and integration of evidence into clinical practice.
The domain focused on primary health care reflected the role of family physicians as first-contact providers delivering continuous, person- and family-centered care across settings and throughout the life course.
The researchers noted that family medicine differs from hospital-based specialties in its emphasis on prevention, continuity of care, and the integration of psychosocial factors into clinical decision-making, requiring a broad and adaptable competency profile.
Several limitations were acknowledged. The review excluded studies not published in English, Spanish, or Portuguese, and three eligible articles were not included due to lack of full-text access. Variability across national health systems limited comparability, and no formal assessment of study quality was conducted. The researchers also noted the potential for publication bias.
“The identification of eight categories … makes it possible to organise and conceptualise more clearly the fundamental dimensions of the family physician’s professional work,” the researchers wrote, adding that the competencies reflect the versatility required to deliver comprehensive care across clinical and community settings.
The study was funded by Universidad de La Sabana (MED-342-2023 project). The researchers reported no competing interests.
