Mapping multimorbidity in undergraduate medical education: a scoping review

Multimorbidity is an increasingly common clinical and public health challenge, yet undergraduate medical education (UME) frequently emphasizes single-disease models. Using Cultural Historical Activity Theory (CHAT), this review maps how multimorbidity is conceptualized within UME to inform more deliberate teaching and curriculum design.

The authors conducted a scoping review to map the existing medical education literature on multimorbidity in the undergraduate setting. Search terms were developed using a Cochrane Multimorbidity Review as a foundation. Five databases were searched from inception to March 31, 2026: EMBASE, MEDLINE, CINAHL, ERIC and Web of Science. Data extraction was informed by CHAT, and findings were organized on whether articles positioned multimorbidity as a central or peripheral phenomenon of interest.

A total of 3636 articles were identified; 348 underwent full-text review, and 30 met inclusion criteria. Included publications comprised original research (17 [56.7%]), conference abstracts (5 [16.7%]), innovation reports (3 [10%]), opinion pieces (3 [10%]), one short communication, and one letter. Sixteen articles (53.3%) discussed multimorbidity as a central phenomenon of interest, while 14 (46.7%) addressed it as a peripheral phenomenon. When discussed as a central phenomenon, multimorbidity was consistently conceptualized, primarily addressed in formal classroom settings, frequently linked to clinical reasoning, and described as a curricular challenge. When addressed as a peripheral phenomenon of interest, conceptualizations were variable. Multimorbidity appeared within clinical teaching environments, was connected to diverse skills and topics, but educational initiatives were developed with minimal patient involvement.

This review reveals a core tension: although multimorbidity is common in clinical practice, its presence in UME remains limited and fragmented. It is inconsistently conceptualized and often disconnected from clinical contexts. Strengthening multimorbidity education through stronger conceptual foundations and better integration across curricula and authentic clinical environments is essential to preparing learners to deliver effective care to people living with multimorbidity.