Abstract
BACKGROUND: Medical leadership and management (MLM) competencies are increasingly recognized as essential for preparing physicians to navigate complex healthcare systems. Undergraduate medical education (UME) provides an optimal stage to introduce these skills; however, curricular approaches vary widely, and a comprehensive global synthesis is still lacking. This scoping review systematically mapped the international literature on MLM in UME, focusing on core competency frameworks, pedagogical approaches, and strategies for assessment and program evaluation. METHODS: A systematic search of PubMed, Embase, and ERIC databases was conducted up to February 2025, complemented by a gray literature search. Following the PRISMA-ScR guidelines, two independent reviewers screened 1,547 sources and selected full-text English-language publications related to MLM in UME. Data on competency domains, teaching methods, student assessment, and program evaluation were extracted and synthesized. Competencies were coded into predefined intrapersonal, interpersonal, and organizational categories. RESULTS: Sixteen publications met the inclusion criteria. Competencies were analyzed using a three-level analytical framework. Curricula predominantly featured interactive and experiential teaching methods such as simulation and project-based learning. Assessment commonly relied on reflective practice and multi-source feedback. Despite increased curricular activity, gaps remained in the integration of organizational competencies (e.g., systems thinking, strategic planning) and in the use of systematic, long-term evaluation strategies. CONCLUSION: This review highlights growing international momentum toward comprehensive MLM education in UME. While intrapersonal and interpersonal competencies are commonly addressed, organizational leadership remains underdeveloped. Strengthening the organizational-level domain, along with implementing longitudinal program evaluation, is essential for aligning MLM training with the evolving leadership demands of contemporary healthcare systems. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-025-08489-6.