The progress of medical education in this century can be divided in two periods: the first until 1960 based in the Flexner Report, aiming the reinforcement of the scientific education, the second, from then onwards, marked by important changes occurred as a result of the expansion of the number of medical schools and the number of students, of changes in the health system and of actions developed within the schools themselves. The importance of training human resources for a changing health system is pinpointed, with emphasis in the social compromise of the medical school. The influence on the quality of medical education, of the labour market, of the organization of health services and of the financial support are taken into account. The responsibility of the medical school on the definition of his goals, on the pedagogic training of teachers and on the strategies for the teaching-learning process is analyzed.