Background Graduate medical education, including family medicine residency, has historically focused on building clinical competencies with little attention paid to leadership skills, leaving residents feeling ill-prepared for leadership roles after training.

Objective To analyse the format, content and outcomes of leadership training programmes offered to family medicine residents.

Methods A MEDLINE (OvidSP) literature search from 1976 to October 2018 for articles on Family Medicine AND Residency AND Leadership Programs retrieved 184 articles. After reviewing inclusion and exclusion criteria, 12 articles were chosen for full review and synthesis.

Results Three articles described leadership training available to Family Medicine all residents while nine focused on a select group. Programme format and content varied, ranging from a 1-day programme on emotional intelligence to a 5-year integrated leadership track. The most comprehensive curricula were longitudinal and offered to a small group of residents. Inclusive programmes often taught leadership through the lens of a specific competency. Mixed teaching methods were valued including online learning, simulations, small group discussions, mentorship, reflection, placements and projects. Conceptual frameworks were inconsistently used and programme evaluation seldom addressed high-level or long-term outcomes.

Conclusions Leadership skills are important for all family physicians; however, there is limited literature on comprehensive leadership development during training. Existing curricula were described in this review and we suggest a longitudinal mixed-methods programme integrated throughout residency, covering basic comprehensive skills for all residents. However, evaluative data were limited, and a considerable gap remains in how to effectively approach leadership development in family medicine residency, warranting ongoing research.