Advocating the thesis that the planning of medical education must be oriented toward the articulastion of instruction with care, the authors note that the curricular reforms of the last 25 years, though reflected in the teaching-learning process, have led to no improvement in medical practice or in the health of the population. This failing, they assert, stems from the fact that these reforms begin and end within the educational institution itself, and ignore the interrelations between the education system and the user of the professional, and results in the production of physicians who are individualistic and of narrow vision. The article refers to the slight importance attached to the complementarity and interdependence of teaching and care work, and to the restriction of teaching to episodic contacts between specialized professors and groups of anonymous students, each in the limited confines of his own discipline, and the relegation of the student to the status of spectator and possible assistant in care work entrusted to him without any responsibility.