[Teaching-service integration and primary health care]

The concept of the integration of teaching with service focuses on the social setting of health and is always discussed at the level of the internal functioning of the health professions and health systems and at the external level of society. The article describes the development of the concept and of its application in practice, which have been expanding since the fifties. At first, this integration was considered an isolated activity whose proper place was the department of preventive and social medicine. Today its expansion to the entire health manpower training institution is proposed, with the participation of the teaching staff, the student from the moment of his enrollment, and health services personnel. In articulation with the primary care strategy, the strategy of integrating teaching with service is an arrangement for service to the community and not just an innovative approach to personnel training. In this service, the scientific method must be broadened in order to bring about a qualitative transformation of health practice. Research will be pursued in response to health problems and will feed back to the education and service processes.