The purpose of this article is to present some epistemological ideas of Thomas Kuhn and Ludwik Fleck correlating them to each other and to medical knowledge and practice, especially with regard to the challenges posed by the reform of medical education. We assume here that the purpose of medical education is preparing competent general practitioners, willing to work in primary care in the Brazilian public health system. The concepts of paradigm and normal science as well as Kuhn's conception of scientific learning are consistent with Fleck's concepts of 'thought style' and initiation in the esoteric contexts of a 'thought collective'. Both theoreticians reinforce themselves mutually with regard do the pertinence of applying these categories to the field of medicine and medical education. They also point to the need of an early involvement of students in the practice of primary care and related abilities and practices, taught by professionals in these fields. Moreover, these theories favor recognition and management of "paradigmatic or stylist reductions" besides increasing the clinical abilities and ethical performance of professionals and students.
Education, Medical; Philosophy, Medical; Thinking; Models, Educational; Primary Health Care; Family Practice