Mapping competencies of family physicians in primary healthcare: a scoping review

Abstract

Objective

To map the available evidence on the competencies of family physicians in primary healthcare (PHC).

Design

A scoping review was conducted following the methodology of the Joanna Briggs Institute. The results were grouped into thematic categories and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Eligibility criteria

Include documents published from 2010 to 2025 in English, Spanish and Portuguese that were available in full text and responded to the research question.

Information sources

Using PubMed, LILACS and Scopus databases. The snowball methodology was employed to expand the search.

Results

A total of 1754 studies were identified, and several competencies were grouped into eight categories: communication, knowledge management, health promotion, information and communications technology, clinical and administrative management, community-oriented and public health-oriented care, teaching and research, focused on PHC. A set of interrelated components enriches each category.

Conclusions

Although the competency-based approach is not new, this review provides an updated and integrated framework that highlights eight interrelated competency domains essential for family physicians in PHC. The findings support its use in curriculum development, professional evaluation and future research aimed at strengthening primary care systems through a more strategic and people-centred workforce.

WHAT IS ALREADY KNOWN ON THIS TOPIC

• This research aimed to map and systematise the available evidence on the competencies of family doctors in primary healthcare (PHC), given the lack of an updated consensus that comprehensively integrates the skills, knowledge and attitudes required for professional practice at this level of care.

WHAT THIS STUDY ADDS

• Through a rigorous scoping review, based on the Joanna Briggs Institute methodology and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, 34 studies from multiple regions of the world were analysed, identifying eight interrelated categories of competencies: communication, knowledge management, clinical and administrative management, health promotion, information and communication technologies, community orientation and public health, teaching and research, and a cross-cutting competency focused on PHC.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

• The findings highlight the need to update, highlight and integrate these competencies, proposing a comprehensive model that positions the family doctor as a strategic leader in primary care, with the ability to coordinate teams, manage resources, solve clinical problems and offer care focused on individuals, their families and communities. This proposal represents a valuable contribution to both curriculum design and professional evaluation and seeks to strengthen the quality of care and move towards more equitable, accessible health systems that are centred on the real needs of the population. Although no follow-up studies derived from this work are reported, its practical and educational applicability paves the way for future research aimed at its implementation and evaluation in different contexts.

Introduction

Primary healthcare (PHC) was defined in 1978 during the Alma-Ata conference as ‘essential healthcare based on practical, scientifically sound and socially acceptable methods and technologies, accessible to individuals and families in the community through their full participation, and at a cost that the community and country can afford to maintain’.¹ Since then, it has become the cornerstone of efficient, equitable and sustainable health systems, playing a fundamental role in delivering comprehensive care centred on individuals, families and communities. This approach encompasses health promotion, disease prevention and the assuring of continuous access to care.²

Within this context, family medicine stands out as an essential component of PHC, providing continuous and comprehensive care at both the individual and family levels, which facilitates the implementation of preventive and educational health actions.³

This speciality emerged in the 1960s in response to the fragmentation and depersonalisation of medical care and has since been established in many countries as the basis of their health systems, contributing to better health outcomes, greater equity and more efficient use of resources, even in highly complex contexts.^{2 4} To effectively fulfil this role, family physicians must have solid knowledge and develop specific skills.⁵,⁸

Entities such as the Pan American Health Organization (PAHO) and the World Organization of National Colleges (WONCA), among others, have proposed multiple competencies for family physicians, grouping them into different categories over time.^{9 10} However, there is still no updated consensus that comprehensively encompasses all the skills, knowledge and attitudes necessary for these professionals to fully exercise their role as leaders in PHC. This lack of consensus limits the ability to clearly define their professional profile and to structure educational strategies that respond to the current demands of health systems, including promotion, prevention, diagnosis, treatment and rehabilitation, all of which are fundamental pillars of PHC.¹¹

Therefore, research was conducted to map the available evidence on competencies of family physicians in PHC.

Methods

A scoping review was carried out based on the guideline established in the Joanna Briggs Institute (JBI) Evidence Synthesis Manual¹² to answer the following research question: What are the competencies of family physicians in primary healthcare?

To this end, a literature review was conducted for the period between July 2024 and April 2025 in the PubMed, LILACS and Scopus databases, and the snowball methodology was used to expand the search by linking citations from the initially selected articles to identify documents that would be relevant to the research,¹³ as well as official documents published by the PAHO. The search was conducted via keywords and Medical Subject Headings (MeSH) terms, including ‘Family physicians,’ ‘Clinical Competence,’ ‘Competence,’ ‘Primary Health Care,’ ‘Professional Competence’ and the Boolean operators “AND” and ‘OR’. The complete search strategies are presented in table 1.

Table 1. Complete search strategies.

Databases	Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) terms used	Records retrieved
PubMed	((((Family Physician(Title/Abstract)) OR (Family physicians(Title/Abstract))) AND (Clinical Competence(Title/Abstract))) OR (Professional Competence(Title/Abstract))) AND (Primary Health Care(Title/Abstract)).	24
LILACS	(Médicos de Familia) OR (Médicos de Família) AND (Competencia Clínica) OR (Competencia) AND (Atención Primaria de Salud) OR (Atención Primaria de Salud)	1126
Scopus	(TITLE-ABS-KEY (médicos AND de AND familia) OR TITLE-ABS-KEY (médicos AND de AND família) OR TITLE-ABS-KEY (family AND physicians) OR TITLE-ABS-KEY (family AND physician) AND TITLE-ABS-KEY (competencia AND clínica) OR TITLE-ABS-KEY (competencia) OR TITLE-ABS-KEY (clinical AND competence) OR TITLE-ABS-KEY (professional AND competence) AND TITLE-ABS-KEY (atención AND primaria AND de AND salud) OR TITLE-ABS-KEY (atención AND primaria AND de AND salud) OR TITLE-ABS-KEY (primary AND health AND care)) AND PUBYEAR>2009 AND PUBYEAR<2025	589

Source: Authors’ own elaboration.

We included articles published between 2010 and 2025 in English, Spanish and Portuguese, with full-text availability. In addition, official documents and grey literature identified through the snowball technique were incorporated. We excluded duplicate or incomplete records, publications in other languages, or those focused on specialties other than family medicine. These criteria are summarised in table 2.

Table 2. Search strategies for each of the selected databases and eligibility criteria.

Inclusion criteria	Exclusion criteria
Referring to the competencies of the family physician in primary healthcare. Articles published in English, Spanish and Portuguese. Publications were published between 2010 and 2025. Full text available. Official documents related to the subject of interest.	Will not address the research question. Publications without access to full text. Published in another language. Articles focused on general practitioners or other medical specialties, or which do not specify the specialty of family medicine.

Source: Authors’ own elaboration.

A database was subsequently created in Microsoft Excel, where the articles were recorded and where a selection of documents was made by title and abstract independently by two researchers. Discrepancies were resolved by consensus. The resulting articles were read in full to determine their relevance for inclusion in the review. Those approved were analysed and grouped into categories determined by the authors and based on those defined in the PAHO and WONCA documents. Some of the articles covered more than one category and were categorised accordingly.

The document search and selection process was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology. Figure 1 presents the process in detail. After a full-text review of the selected articles, the authors proposed a categorisation of competencies based on existing frameworks. A series of components was recorded for each category, according to the information available.

Figure 1. PRISMA-ScR flow chart for the inclusion of studies. Source: Authors’ elaboration. PRISMA-ScR, Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Patient and public involvement

No patients or members of the public were involved in the design, conduct, reporting or dissemination plans of this scoping review.

Results

A total of 1754 studies were identified in the first phase: 1753, from database searches and 1 from grey literature. Of these, 18 records were eliminated as duplicates, leaving 1736 for title and abstract screening. Subsequently, 1697 documents were excluded for not meeting the inclusion criteria. 39 documents were considered full-text retrieval; however, three were not available in full text, one was written in a not-included language (Italian), and one was excluded for focusing on general practitioners rather than family physicians. Ultimately, 34 articles were selected for the final analysis, as presented in table 3.

Table 3. Overview of evidence included.

Author	Year	Type of study	Country
McKenna et al37	2024	Cross-sectional descriptive	USA
González-Limón et al20	2022	Cross-sectional descriptive	Mexico
Gryschek et al23	2020	Narrative review	Brazil
Jantsch2	2020	Review	Brazil
Pather and Mash29	2019	Qualitative	South Africa
Casson et al31	2019	Intervention	USA
Mitsuyama et al28	2018	Qualitative exploratory	Japan
Garcia-Rodriguez et al34	2018	Cross-sectional descriptive	Canada
Rodgers et al16	2017	Review	USA
Magee et al17	2017	Review	USA
Swofford et al32	2016	Cross-sectional descriptive	USA
Schultz and Griffiths42	2016	Intervention	Canada
de Villiers et al43	2014	Qualitative	South Africa
Esquerrà et al35	2012	Clinical trial	Spain
Warmenhoven et al38	2012	Qualitative	Canada
Laughlin et al21	2012	Qualitative, descriptive and participatory	Canada
Allen et al48	2011	Expert consensus	Canada
Henríquez and Hierro39	2011	Review	Ecuador
Hummers-Pradier et al30	2010	Expert consensus	Europe
Al-Kindi et al49	2019	Cross-sectional descriptive	Oman
Dois A, et al11	2018	Expert consensus	Chile
Pérez-Raffo et al18	2019	Expert consensus	Argentina
Gómez-Clavelina et al36	2014	Review	Mexico
Tenório et al22	2024	Cross-sectional descriptive	Brazil
Lawrence et al14	2011	Expert consensus	Canada
Armijos et al46	2016	Review	Latin America
Gómez-Clavelina et al41	2015	Descriptive and occupational analysis	Mexico
Castañeda Sánchez and Martínez Anota47	2016	Editorial	Mexico
Rojas Carrillo et al33	2024	Cross-sectional descriptive	Mexico
Saura et al44	2024	Narrative review	Spain
Hernández et al5	2019	Review	Colombia
Beltrán1	2012	Review	Colombia
Tuesca and Hernandez9	2022	Book	Colombia
Ros Martrat50	2004	Cross-sectional descriptive	Spain

Source: Authors’ own elaboration.

Figure 1 shows the flow diagram of the elements for systematic review and meta-analysis reports (PRISMA-ScR) for the phases of the process: identification, selection and inclusion of articles. 10 reviews, nine descriptive studies, five expert consensus reports, five qualitative studies (one exploratory and one participatory descriptive), two interventions, one editorial, one clinical trial and one book were identified. The literature was sourced from different regions worldwide; however, the majority of studies were conducted in Canada (six publications), followed by the USA and Mexico (five each), and Brazil, Colombia and Spain (three). Additionally, two studies originated from South Africa, one from Latin America; one from Europe; and one each from Argentina, Chile, Ecuador, Japan and Oman. These details are summarised in (table 3).

A wide range of competencies that characterise family physician was identified and grouped into eight categories. 28 articles (82.35%) addressed knowledge management competency; 20 (58.82%) focused on communication; 12 (35.29%) referred to clinical and administrative management; another 12 (35.29%) focused on PHC; 11 (32.35%) discussed community-oriented and public health competence; 7 (20.58%) highlighted teaching and research; another 7 (20.58%) referred to health promotion and 5 (14.70%) focused on information and communications technology competence (table 3). It should be noted that some studies addressed more than one competency.

Additionally, a diverse set of interrelated components enriches each of these core competencies that make up the profile. Table 4 presents this classification in detail, outlining the different skills, attitudes and specific knowledge that enable family physicians to effectively address the needs of both patients and the broader community.

Table 4. Core competencies of the family physician: categories and components.

Category	Components
Communication Ability to extract clinical data, to provide clear information and to be an articulating agent for health teams.	Being empathetic to patients’ needs Reporting bad news914 16 20,23 30 31 39 41 46 48 Maintaining clear language3 9 16 20 21 23 30 31 39 48 50 Empowering the patient for shared decision-making and active participation in their health-illness process1120 23 31 41 48,50 Obtaining clinical data511 20,22 36 39 46 Conflict resolution to improve the doctor-patient relationship and for an adequate relationship with the multidisciplinary team5 14 16 20 21 30 32 39 44
Knowledge management Facilitates the application of scientific evidence to the patient’s context, integrating with clinical reasoning, a dynamic process that combines knowledge, experience and professional judgement.	Use of evidence for clinical decision-making12 5 9 11 14 16,18 21 28 Clinical reasoning12 5 9 11 14 16,18 21 28 Practical skills of correct diagnosis and treatment12 5 9 11 14 16,18 20 28 Interdisciplinary approach to mental, organic and end-of-life pathologies12 5 9 11 16,18 21 28
Health promotion Ability to integrate the patient and make him/her an active participant in the process of disease prevention and health maintenance.	Patient education on their pathology and promoting the knowledge and applicability of healthy lifestyle habits1 5 9 16 17 30 39 41 46 48 50
Information and communications technology Ability to make use of different digital tools, which favours and optimises clinical care and management.	Use of digital tools and information systems for telemedicine9 28 43 44 Information and communications technology28 41 44
Clinical and administrative management Ability to make rational use of human, economic and material resources to enable processes to be executed cost-effectively.	Risk, time and interdisciplinary teams to promote the proper functioning of health teams1 5 9 11 28 32 38 39 41 44 Management and administration1 5 9 32 38 39 44 46 50 Patient safety44
Community and public health oriented The ability to provide comprehensive, continuous and quality care centred on the person, in the context of their family and the community to which they belong.	Knowledge and applicability of health determinants16 28 31 39 41 48 Geographical, cultural and economic accessibility16 28 31 39 41 48 Active listening to community needs9 28 39 41 48 Epidemiological surveillance and monitoring to establish anticipatory and containment strategies5 9 16
Teaching and research It is part of patient education, and the training of general practitioners and specialists.	Ability to read critically29 33 42 43 Teaching training with patients or members of the healthcare team34 41 43 47
Focused on primary healthcare It orients professional practice towards comprehensive, continuous, accessible, resolutive care centred on the person, their family and their community.	Functions as a resource manager1 11 17 28 50 First contact with the patient1 5 16 28 44 Life course and patient-centred and family-centred quality of care1 5 17 28 39 44 Performance in different care settings and in different types of prevention1 9 16 17 39 41 44

Source: Authors’ own elaboration.

Discussion

Competencies are defined as the ability to apply cognitive, attitudinal, instrumental and procedural knowledge to perform professional activities.¹⁴ For family physicians, these competencies are directed towards patients and the community and are aligned with PHC.^{14 15} Existing documents, such as the framework developed by the Swiss Medical Association in collaboration with the World Organization of National Medical Associations, Academies and WONCA, outline the competencies and characteristics of family physicians.¹⁰ However, the literature reveals no recent updates that consolidate these competencies beyond those earlier publications.

In this context, unlike the 2005 framework, the present scoping review synthesises the available information and identifies and characterises the essential competencies of family physician within the framework of PHC.¹⁶,¹⁸ The competencies proposed in this study are presented in table 4.

Although other medical specialties share some characteristics with family medicine, the competencies that define professionals in each field differ. Most specialties are primarily hospital-centred, whereas family medicine operates across a broader range of settings, enabling a more comprehensive approach to care. Furthermore, while many specialties focus mainly on treating established pathologies, family medicine emphasises treatment as well as disease prevention, continuity of care and follow-up. Importantly, family medicine extends beyond the individual patient and their pathology, incorporating psychosocial factors into clinical decision-making.¹⁹ This underscores the importance of defining the competencies of family physicians and distinguishing them from other specialists.

Communication

Effective communication skills are fundamental to establishing and maintaining a strong doctor–patient relationship. They enable the physician to obtain relevant clinical data, explain health problems in clear language and support patient understanding, participation in decision-making and engagement in care.²⁰,²² Communication is also critical when delivering bad news, allowing physicians to approach these situations with sensitivity, empathy and clarity.^{15 23}

Beyond doctor–patient interactions, communication competence is essential within multidisciplinary teams. They facilitate coordination, joint decision-making, a collaborative and respectful environment, and assertive conflict resolution.^{5 9} Several studies consistently associate empathetic, person-centred communication with improved adherence, better clinical outcomes and reduced medical litigation.^{24 25} This involves active listening, validating emotions and adapting communication styles to sociocultural characteristics.^{26 27} For example, surveys of family physicians and general practitioners in Japan highlight the importance of these skills in both rural and urban settings, showing that professionals with stronger communication abilities are perceived as more effective and achieve higher patient satisfaction.²⁸ Similar findings from other countries and regions, such as Canada and Europe, reinforce communication as a fundamental pillar of comprehensive and effective medical care.^{29 30}

Knowledge management

This competency enables the application of evidence from the literature to the patient’s environment and context. It works in tandem with clinical reasoning, a dynamic process that integrates knowledge, experience and professional judgement to provide an appropriate diagnosis and treatment for both organic and mental illnesses.^{215 31},³³

While the literature describes the ability to perform basic procedures—from anterior nasal packing to thoracentesis—it is noteworthy that many advanced surgical procedures reported are specific to contexts such as the United States, where the scope of family physicians differs from that in other countries.³⁴,³⁶

Moreover, the literature increasingly highlights the role of family physicians as key specialists in end-of-life care. In this context, the integration of clinical knowledge, ethical judgement and communication skills is essential, demonstrating that competencies do not act in isolation but rather form a cross-cutting axis that supports effective clinical practice in primary care.^{21 37 38}

Community-oriented and public health-oriented care

This competence is based on the ability to provide comprehensive, continuous and high-quality care centred on the individual, within the context of their family and the community.³¹ It requires a deep understanding of the social determinants of health and the application of a primary care approach aimed at promoting, maintaining and enhancing well-being throughout the individual’s and family’s life cycle.^{39 40}

The family physician is therefore responsible for serving as the gateway to the health system and must ensure cultural accessibility, by respecting each patient’s beliefs and preferences. Likewise, in collaboration with government entities, family physicians work to guarantee geographical and economic accessibility. However, addressing economic problems or inequalities is not the specialist responsibility; rather, these factors should be recognised as determinants of health within their scope.^{16 17}

All clinical decisions must also consider the prevalence and incidence of diseases, which requires working together with public health teams to conduct proper epidemiological surveillance and social and cultural context analysis, promoting an inclusive vision that considers the health needs of migrants and other vulnerable populations.²⁸

In this regard, family medicine training programmes targeted at underserved communities have been implemented in various countries with significant results. For example, in the United States, over 40 rural training programmes have been established in the last 25 years, including innovative models such as the rural training track, which combines urban and rural training. These programmes have proven effective in increasing the availability of physicians in rural and underserved areas.¹⁶

Health promotion

Health promotion focuses on empowering patients and making them active participants in the process of disease prevention and health maintenance. To achieve this, family medicine specialists must be capable of delivering prevention-oriented care, with a strong emphasis on promoting healthy lifestyles and providing health education aimed at patients their families and their communities.^{28 41}

Within this framework, family medicine specialists require solid training in health promotion, as their role extends beyond treating diseases to addressing the broader determinants of health at the community level. For this reason, countries such as Ecuador have emphasised in the family physician profile’s the ability to adapt care to the social and environmental context of the population, the efficient use of available resources and cooperation with community organisations to improve the health of the populations they serve. The promotion of healthy lifestyles is recognised as a key strategy to reduce costs for the system and prevent fatal outcomes in patients.³⁹

Thus, health promotion and disease prevention are not isolated actions but rather fundamental, interrelated and cross-cutting components that underpin effective clinical practice.¹

Information and communication technologies

This competency refers to training in the use of information and communication technologies (ICTs) which enable the use of different digital tools to facilitate and optimise clinical care and management. ICT helps to overcome the barriers to accessibility by supporting the responsible and efficient use of information systems, such as electronic health records, and by promoting the critical use of the internet to extract evidence that supports informed and conscious decision-making.^{28 42}

In addition, proficiency in technological skills, such as creating digital presentations and communicating in virtual environments, not only enhances patient education but also strengthens the teaching role of family physicians. In today’s digital era, these tools also serve as means to reach isolated communities, breaking down geographical barriers and extending access to healthcare and health education. The use of ICTs expands the scope of medical care, strengthening both clinical and training practices while maintaining the essence of close, continuous and person-centred care.⁴¹,⁴³

For example, in South Africa, graduates of a family medicine programme reported that strengthening this skill through a module had an impact on their knowledge and skills, not only individually but also in the training of their students and the patients in their care. This competency is similarly recognised in other countries, such as Mexico, where it is also considered fundamental to delivering high-quality patient care.^{29 43}

Clinical and administrative management

This competency refers to the ability to make rational use of human, economic and material resources to carry out processes in a cost-effective manner while maintaining high quality standards. It involves providing inclusive care that meets the needs of both patients and the community, as well as ensuring risk management and patient safety throughout the care process.^{32 44 45}

To fulfil this role, family physicians developed leadership and management skills in health programmes and services, integrating both communication and management skills, and demonstrating a strong commitment to achieving the objectives of the health system.^{39 44 46}

This competency is highlighted in a study conducted in Japan, in which interviews with 10 general practitioners and family physicians, experienced in both urban and rural areas, underscored the importance of the family physician’s role in coordinating multidisciplinary teams. Participants emphasised how the involvement of family physicians helped transform previously fragmented care into more integrated and collaborative models.²⁸

Teaching and research

Teacher training is one of the fundamental pillars and includes both patient education and the training of general practitioners and specialists.^{41 47} This role requires continuous updating in a field where rapid scientific, technological and social advances demand professionals capable of constructing knowledge in a critical, reflective and contextualised relevant manner.²⁹ To fulfil this responsibility, family physicians must develop communication skills, pedagogical leadership, critical thinking and the ability to assess learners continuously and within their social context.^{42 46 47}

Assuming this teaching role requires a high level of self-criticism and commitment to continuous improvement, understanding that teaching processes involve ongoing learning, reinterpretation and adaptation to new realities to meet emerging health and educational needs.⁴⁵ In addition, family physicians engage in research activities, contributing to the generation of new knowledge, evaluating clinical practices and integrating evidence-based findings into both teaching and patient care, thus ensuring that educational and healthcare processes remain current and effective.^{41 47}

Focus on PHC

PHC represents the core of the professional practice of family physicians. Many of the components mentioned here are aligned with PCH principles, guiding professional practice toward comprehensive, continuous, accessible, decisive care focused on the individual, their family and their community.²⁸

This orientation enables family physicians to serve as the first point of contact in the health system, promoting equity and efficiency in the use of available resources.^{14 16} It also strengthens their capacity to address the clinical and psychosocial needs of the community, across different age groups and population groups within epidemiological, cultural and social contexts, in which they find themselves, and independently of the practice setting in which the care process takes place, such as outpatient consultations, hospitalisation, emergencies or the patient’s home.^{1 9 17}

Therefore, developing strong competence in PHC not only improves the quality of care but also reinforces the family physician’s role as a key agent in the transformation and strengthening of the health system.

Limitations

This study has several limitations that should be considered when interpreting its findings. First, the potential exclusion of relevant literature due to language barriers, restricted access to full texts, the selection of databases, the temporal range of the search and the indexing criteria may have limited the comprehensiveness of the analysis. In addition, the diversity of national contexts and healthcare models introduces significant variability that hinders direct comparison across studies and may affect the generalisability of the results. Moreover, potential publication bias should be acknowledged, as studies with negative or neutral results are less likely to be accessible in indexed literature. Language bias is also relevant, since only articles published in English, Spanish and Portuguese were included. Finally, the heterogeneity in the methodological quality of the included studies constitutes another limitation, as no critical appraisal of internal or external validity was conducted, which may influence the strength of the conclusions.

Conclusions

The competency-based approach to the professional profile of family physicians is not new; this review demonstrated the need to update, integrate and make these competencies more visible. The identification of eight categories—communication, knowledge management, community-oriented and public health-oriented care, health promotion, information and communications technology, clinical and administrative management, teaching and research, focused on PHC—makes it possible to organise and conceptualise more clearly the fundamental dimensions of the family physician’s professional work.

These categories should not be considered as isolated compartments but rather interrelated elements that make up a comprehensive professional profile. The cross-cutting nature of these competencies reflects the versatility of the family physician to perform across multiple settings, from prevention and health promotion to comprehensive clinical management, contrasting with models focused exclusively on hospitals or specialised care.

Furthermore, this categorisation reinforces the recognition of the family physician as a strategic actor and natural leader within the first level of care. Their ability to coordinate interdisciplinary teams, manage resources efficiently and provide care centred on people and their contexts positions them as key agents in transforming health systems towards more equitable, accessible and sustainable models.

Finally, this proposal aims not only to serve as a tool for the training and evaluation of health professionals but also as a practical guide to strengthen PHC. By systematising and making these competencies visible, the goal is to improve the quality of care, promote contextualised clinical decision-making, and advance a model of care that is people-centred, has high-resolution capacity and is oriented towards the real needs of communities.

Data availability statement

All data relevant to the study are included in the article.