[A pragmatic vision of medical education]

Some aspects of the educative system at the Mexican Institute of Social Security are described. It is based on the perception of a problematic situation that constitutes a challenge. An educational process to enhance the quality of medical education is proposed, with the adoption of a participative model of self-constructive learning. This proposal is based on theoretical references in a both philosophical and sociological knowledge perspective of an individual related to institutional behavior, to end with a psychological view from which some learning theories are explored. An educational model is built with the inclusion of institutional elements, like the new evaluation system for residents; centers for educational investigation and a teacher training process. Three axes of the educational process are proposed: tutorial teaching, development of complex abilities of thought and critical reading. The evaluation system includes guides for measuring the operational process established and the professional responsibilities of the different participants.