Document Type : Original Article


1 Department of Management and Educational Planning, Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran

2 Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Family Health, Social Determinants of Health Research Center (SDHRC), Ardabil University of Medical Sciences, Ardabil, Iran Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran


BACKGROUND: Despite the great comparative advantage of Iran in terms of infrastructure,
technology, and human resources as well as the significance of medical tourism in the tourist industry,
in practice, the quality of human resources has received less attention. Consequently, this study was
conducted to design a model of competency‑based training for Iranian medical tourism.
MATERIALS AND METHODS: This study was an exploratory mix, and the Delphi method and
semi‑structured interviews were used for the qualitative part of this study. In the second part, the
analytical method was utilized for the quantitative part of this study.
RESULTS: The results indicated the main components of medical tourism to be public interactions
and private interactions and seven subcomponents. Medical Tourism’s Competency includes three
main components and seven subcomponents.
CONCLUSION: Although some training separated and scattered is present in Iran’s medical tourism.
However, Iran requires a comprehensive training model of which its design was explained in this paper.


1. Rerkrujipimol J, Assenov I. Marketing strategies for promoting
medical tourism in Thailand. J Tour Hosp Culinary Arts
2. Lee M, Han H, Lockyer T. Medical tourism – Attracting Japanese
tourists for medical tourism experience. J Travel Tour Mark
3. Smith R, Álvarez MM, Chanda R. Medical tourism: A review of
the literature and analysis of a role for bi‑lateral trade. Health
policy. 2011 Dec 1;103(2‑3):276‑82.
4. Smith M, Puczkó L. Health and Wellness Tourism. New York.
USA: Routledge; 2008.
5. Abadi F, Sahebi I, Arab A, Alavi A, Karachi H. Application of
best‑worst method in evaluation of medical tourism development
strategy. Decis Sci Lett 2018;7:77‑86.
6. Alfandi AM. Training impact on the performance of employees:
A case of Jordanian travel and tourism institutions. Int Bus
Manage 2016;10:377‑84.
7. Le C, Wolfe RE, Steinberg A. The past and the promise: Today’s
competency education movement. In: Students at the Center:
Competency Education Research Series. Massachusetts Jobs For
the Future; 2014.
8. Reed CM Reed Christie M. Medical tourism. Medical Clinics of
North America 2008;92(6):1433‑46.
9. Gholami M, Keshtvarz Hesam Abadi AM, Miladi S, Gholami M.
A systematic review of the factors affecting the growth of medical
tourism in Iran. Int J Travel Med Glob Health 2020;8:1‑12.
10. Jabbari A, Gholami M, Kavosi Z, Chamanpara P, Gholami M.
Potential factors affecting medical tourists’ viewpoint about
healthcare services quality in Shiraz, Iran. Int J Hosp Res
11. Cohen MM, Elliott F, Oates L, Schembri A, Mantri N. Do wellness
tourists get well? An observational study of multiple dimensions
of health and well‑being after a week‑long retreat. The Journal of
Alternative and Complementary Medicine. 2017 Feb 1;23(2):140‑8.
12. Carrera P, Lunt N. A European perspective on medical tourism:
The need for a knowledge base. International Journal of Health
Services. 2010 Jul;40(3):469‑84.
13. Gyu Ko T. Medical tourism system model. Int J Tour Sci
14. Connell J. Contemporary medical tourism: Conceptualisation,
culture and commodification. Tour Manage 2013;34:1‑13.
15. Savasan A, Uzunboylu H, Tuncel E. Training in medical tourism,
a necessity or a perspective? A needs analysis of stakeholders on
training issues in medical tourism. Int J Educ Sci 2016;15:225‑33.
16. Tan J. Adaptive Health Management Information Systems.
Burlington, Massachusetts: Jones & Bartlett Learning; 2019.
17. Aydin G, Karamehmet B. Factors affecting health tourism and
international health‑care facility choice. Int J Pharm Healthc Mark
2017, Vol. 11 No. 1, pp. 16‑36.
18. Wang YH. Expectation, service quality, satisfaction, and
behavioral intention‑evidence from Taiwan’s medical tourism
industry. Adv Manage Appl Econ 2017;7:1.
19. Gan LL, Frederick JR. Medical tourism facilitators: Patterns of
service differentiation. J Vacation Mark 2011;17:165‑83.
20. Lunt N, Jin KN. Developments in medical tourism. China Health
Rev 2013;4:12‑9.
21. Mahmoudifar Y, Tabibi SJ, Nasiripour AA, Riahi L. Factors
affecting development of medical tourism industry in West
Azerbaijan Province of Iran. Int J Health Stud 2017;2(4): 25‑31.
22. Ganguli S, Ebrahim AH. A qualitative analysis of Singapore’s
medical tourism competitiveness. Tour Manage Perspect
23. Khan MJ, Chelliah S, Haron MS, Ahmed S. Role of travel
motivations, perceived risks and travel constraints on destination
image and visit intention in medical tourism: Theoretical model.
Sultan Qaboos University Medical Journal. 2017 Feb; 17(1):7‑11.
24. Verulava T, Jorbenadze R. Medical tourism in Georgia: Current
barriers and recommendations. Malays J Public Health Med
25. Khodayari ZR, Tourani S, Qaderi A, Salehi M, Jafari H. Readiness
of teaching hospitals in attracting medical tourists based on joint
commission international standards. J Qazvin Univ Med Sci
26. NasiripourAA, SalmaniL. The role of Tehran’s hospitals capability
in development of medical tourism. Hospital 2011;9:57‑68.
27. Morovati AN, Forotan MR, Abolghasemi M. Infrastructure
Marketing Mix Methods for the Development of Medical Tourism
Marketing. Paper Presented at the First National Marketing
Conference: Opportunities and Challenges, Mashhad; 2013.
28. Maboodi MT, Hakimi H. Determinant factors on medical
tourism (Case study: Iran). J Tour Plann Dev 2016;15:80‑106.
29. Hadizadeh Moghadam AZ, Ghanbarzadeh R, Fakharmanesh S.
Pattern of effective factors on the motivation of medical tourists
to enter Iran. J Bus Manage Perspect 2013;12:59‑79.
30. Nguyen T. Medical Tourism: Studying the Impact of Motivational
Factors, Destination Image on Perceived Quality and Overall Satisfaction Using SEM Analysis. Pomona: California State
Polytechnic University; 2016.
31. Mogaka J, Mashamba‑Thompson T, Tsoka‑Gwegweni J,
Mupara L. Effects of medical tourism on health systems in Africa.
Afr J Hosp Tour Leisure 2017;6:1‑25.
32. Crooks VA, Turner L, Snyder J, Johnston R, Kingsbury P.
Promoting medical tourism to India: Messages, images, and
the marketing of international patient travel. Social Science and
Medicine. 2011 Mar 1;72(5):726‑32.
33. Shum C, Gatling A, Shoemaker S. A model of hospitality
leadership competency for frontline and director‑level
managers: Which competencies matter more? Int J Hosp Manage
34. Podmetina D, Soderquist KE, Petraite M, Teplov R. Developing a
competency model for open innovation. Manage Decis 2018;56(6):
35. Ferrer M, Medhekar A. The factors impacting on the management
of global medical tourism service supply chain. GSTF J Bus
Rev (GBR) 2012;2(2): 206‑211.
36. Ayoub M. Medical tourism in Egypt: Opportunities and
challenges. American University in Cairo. Dept. of Public Policy
and Administration (Thesis); 2018;1‑83.
37. Sharma V. Patient satisfaction and brand loyalty in health‑care
organizations in India. J Asia Bus Stud 2017;11(1); 73‑87.
38. Tham A. Sand, surgery and stakeholders: A multi‑stakeholder
involvement model of domestic medical tourism for Australia’s
Sunshine Coast. Tour Manage Perspect 2018;25:29‑40.
39. Rahman MK, Zailani S, Musa G. What travel motivational
factors influence Muslim tourists towards MMITD? J Islam Mark
2017;8(1); 48‑73.
40. Pijl‑Zieber EM, Barton S, Konkin J, Awosoga O, Caine V.
Competence and competency‑based nursing education: Finding
our way through the issues. Nurse Educ Today 2014;34:676‑8.
41. Shariff NM, Abidin AZ, Kayat K, Zainol NA. Developing index
competency for the Malaysian tourism and hospitality graduates.
Adv Sci Lett 2015;21:2251‑5.
42. Wong SC, Lee PC. Competencies of training professionals
in the Hong Kong hotel industry. J Hum Resour Hosp Tour
43. Shukla UN, Kulshreshtha SK. United Arab emirates as a global
medical tourism destination: An explorative study. In: Global
Developments in Healthcare and Medical Tourism, India; IGI
Global; 2020. p. 277‑90.
44. Tsang L, Sham S, Winnie S, Shuk C, Tang S. Self‑perceived
competency‑based training needs of registered nurses:
A cross‑sectional exploratory study. Int Arch Nurs Health Care
45. Kesar O, Rimac K. Medical tourism development in Croatia.
Zagreb Int Rev Econ Bus 2011;14:107‑34.
46. Chang IC, Chou PC, Yeh RK, Tseng HT. Factors influencing
Chinese tourists’ intentions to use the Taiwan Medical Travel
App. Telematics Inform 2016;33:401‑9.
47. Han H. The healthcare hotel: Distinctive attributes for
international medical travelers. Tour Manage 2013;36:257‑68.
48. Leahy A. L. Medical tourism: The impact of travel to
foreign countries for healthcare. The surgeon: Journal of
the Royal Colleges of Surgeons of Edinburgh and Ireland.