In 2001 and 2002, Brazil published the National Curriculum Guidelines for undergraduate training in Medicine, Nursing, Speech Therapy, and other health professions, defining competencies and establishing the need for new teaching and learning methodologies, highlighting the importance of expanding practical activities in health services (beyond the university hospital). More recently, initiatives such as Promed and Pró-Saúde were launched by the Ministries of Education and Health with the objective of inducing curricular changes that include the health services network for the development of practical activities, especially in primary care. This report on the Pró-Saúde projects in Medicine, Nursing, and Speech Therapy at the Federal University in São Paulo discusses the main strategies aimed at institutionalization of the projects' action at the University and in the health services, with the objective of guaranteeing their consolidation and continuity, as well as the principal challenges in light of the political contexts in Greater Metropolitan São Paulo and the respective health care and management models.