Preparing residents and fellows for armed conflict and war settings: a scoping review protocol of educational programmes
Reine Obeid, Ali Bou Melhem, Ola El Zein, Joseph Abourjeili, Carmen Assi, Nizar El Bcherawi, Marianne El Khoury, Patrick Maroun, Fatima Msheik-El KhouryIntroduction
Armed conflict and war increasingly strain healthcare systems worldwide, particularly in regions affected by protracted violence and instability. Physicians practising in war settings must deliver care under conditions of insecurity, resource scarcity and health system disruption, yet graduate medical education (GME) largely prepares trainees for stable, high-resource environments. Residents and fellows are often underprepared for the clinical, ethical and operational challenges of armed conflict. This scoping review aims to map and synthesise the existing literature on educational programmes designed to prepare residents and fellows for clinical practice in armed conflict and war settings.
Methods and analysis
The review protocol follows the methodological framework proposed by Arksey and O’Malley, with refinements by Levac et al and the final review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews guidelines (PRISMA-ScR). Guided by the Population-Concept-Context (PCC) framework, this scoping review will include articles that describe educational and training programmes (Concept) involving medical residents and fellows (Population), and which are intended to prepare these physicians-in-training for armed conflict and war-related clinical practice environments (Context). We developed the search strategy with the support of an experienced librarian and will execute the database searches on 3 August 2026, across the following databases: MEDLINE (Ovid), Embase (Elsevier) and ERIC (EBSCOhost), with no start-date restriction. No language restriction will be applied; with translation support to be used where required for screening and data extraction. Additional grey literature searches, citation tracking and search updates will be conducted between July and August 2026 and will be repeated before the review is completed. Two reviewers will independently screen eligible studies for inclusion and extract data using a piloted data charting form. Findings will be synthesised through descriptive mapping and narrative analysis to examine programme characteristics, curriculum content, teaching strategies, assessment approaches and reported barriers and facilitators.
Ethics and dissemination
Ethics approval is not required for this scoping review. The professional stakeholder consultation component will be conducted in accordance with institutional guidance and, if required, will be submitted for ethics review or exemption determination. Findings will be disseminated through peer-reviewed publications and conference presentations, with the aim of informing GME curricula and strengthening physician preparedness for armed conflict and war settings.