Cervical cancer screening through the Papanicolaou test is a core preventive action in primary health care and a central responsibility of Family and Community Medicine. In Brazil, screening performance reflects the territorial organisation of services, workforce availability, and continuity of care. Medical schools influence local health systems by training physicians, supporting service provision, and strengthening integration between education and primary care networks. However, few studies explore how the spatial distribution of medical schools relates to regional performance of preventive services, particularly cervical cancer screening.Marked territorial inequalities persist in cervical cancer screening coverage across São Paulo State. Understanding whether regions hosting medical schools demonstrate different screening patterns may inform workforce planning and health policy strategies to strengthen primary care systems.We conducted an ecological spatiotemporal study including all 645 municipalities. Annual screening rates were calculated using secondary national data and aggregated by DRS. Medical schools were identified through administrative records and spatially linked to DRS. We used GIS to map spatial patterns and compared trends descriptively between DRS with and without medical schools.Screening rates displayed substantial spatial heterogeneity across São Paulo State between 2015 and 2024. DRS hosting medical schools comprised 29 regional units and concentrated mainly in urbanized and economically dynamic regions. These DRS consistently showed higher screening rates and greater temporal stability, including smaller declines during the COVID-19 pandemic. In contrast, DRS without medical schools exhibited wider variability and sharper reductions in screening activity. Regions sustaining higher screening intensity frequently overlapped with DRS that concentrate medical education institutions.The findings suggest that medical schools strengthen regional primary care capacity by improving workforce availability, supporting preventive actions, and fostering closer integration between education and service delivery. From a Family and Community Medicine perspective, medical education institutions appear to function as territorial anchors that enhance continuity of care and resilience of preventive services.Integrating medical education planning with regional health policies may reduce territorial inequalities and strengthen cervical cancer screening performance within primary health care systems.