The author discuss in this paper the different options for a curricular reform in medical education presenting the difficulties to implement a curriculum with a broad abrangence. He consider the different possibilities for a curricular structure and evaluated the advantages and disadvantages of each (discipline-centered, body-system-based, problem-oriented and clinical presentation curriculum). He argue that most of the critical determinants of physician identity operate not within the formal curriculum but in a more subtle, less officially recognized hidden curriculum. He finish discussing that a significant component of medical training involves the development of a medical morality.