[Education-service integration].

The article broadly reviews the conceptual basis of the integration of service and education and the history of the process and of the programs in progress in the countries of the Americas. A study of the different definitions given and uses made of the concept and practice yields a definition of the integration of services and education as "a process of progressive articulation between institutions providing health services and those imparting instruction in the health field in order to improve health care and guide the generation of knowledge and the training of personnel on the basis of the epidemiological profile of a given region and population. This ongoing education process takes place in the course of work, which it is capable of changing by virtue of its own momentum." This definition embodies the features common to all those used: The process itself, articulation between teaching and service establishments, and objectives. The story of the process in the Old World is briefly reviewed; its stages in the New World are considered at greater length, and the positions taken by the Pan American Health Organization since 1963 are stated. The emphasis today is on the technical cooperation provided in the different aspects of the process: institutional and program development, program supervision, the setting of standards and priorities for research, personnel utilization, etc. The article closes with an account of the mechanisms for interaction (formal, informal, operational, and policy-making) and a discussion of the different fields, practices and coverage that have been affected by this process, and comes to the conclusion that the integration of service and education has been essential to the student's training in exposing him to the practical realities of the local and general situation of his country.