This paper was presented as a working document to the Second Meeting of the PAHO/WHO Program of Textbooks for the Integrated Teaching of Internal Medicine and its Specialties (Washington, D.C., 13-18 December 1976). The need to place the medical student in his environment from the first as an active member of the health team is stressed, and several considerations about the usual obstacles to this proposal are advanced. Reference is made to the subject of curricular integration as related to the length of medical studies and to the traditional use of the hospital in the teaching of internal medicine. The second part of the document reports on the results of the PAHO survey on how internal medicine is taught in Latin America, in which 84 faculties and schools in 15 countries of the Region participated.