The research in this thesis investigated an innovative experience In medical education history and its practice in two medical schools in Brazil. As a former member of a curriculum reform committee I examined the limits of recent curriculum reforms in Brazilian medical schools, namely in regard to the integration of subjects. The thesis describes how in the 1960s, Prof Silvio Carvalhal (1917 -2008) developed an innovative teaching method and promoted an effective integration of teaching into the main medical subject course, namely, Internal Medicine. As a graduate and then a teacher his medical career spanned 37 years, during which time he set out to implement his 'method' in two medical schools in the Silo Paulo state, at UNICAMP (state run) and PUCC (private). The study aimed at locating the patterns of resistance and the sustainability of the method over time. The research examined the historical institutional context and the dynamics of political situations that ranged from, dictatorship, to re-democratisation and the neo-liberalism of the 1980s. The fate of innovation was examined, as was the impact of teachers' life cycles, personal factors and individual choices. I also examined the different subject traditions: the academic, the pedagogical and the utilitarian. A comparison sought to understand their influence on the paradigm of medical education. In the course of my analysis I examined individual experiences, individual concepts, generational viewpoints, changing contexts over time, the characteristics of change at specific periods and how these factors culminated in continuity or change. The analysis looked at a convergence of factors that contributed to the decline in the practice of 'method' in both schools. To some extent at UNICAMP the innovation left its mark, but eventually it succumbed to the external and internal factors of university dynamics and a policy that favoured the development of an academic and scientific community that mirrored international standards. At PUCC, the effects of financial constraints; the curriculum reform and the major obstacles posed by internal dynamics within its group of supporters were major obstacles for continuity or rediscovery of the method.