This paper describes the roles of Universities of Medical Sciences in Iran in strengthening the family physician program and the referral system within the integrated education and service delivery structure. The main areas include training and capacity building of family physicians and health teams, development of clinical, communication and managerial competencies, community-based education, support for proper functioning of the referral system, applied research and evidence generation, pilot implementation of services, community empowerment and health literacy promotion, quality monitoring and evaluation, continuous professional education, participation in guideline and protocol development, establishment of health information and digital infrastructures, and intersectoral collaboration with a social determinants of health approach. Through these functions, universities contribute to improving service quality, enhancing referral system performance, and strengthening the overall effectiveness of the family physician program.