I certainly think clinical relevance of things should be taught alongside physiology a lot more, although I can only work from my own experience regarding how it was done where I studied. I spent a lot of time in clinical years going 'oh so THAT is why we learnt about XYZ', especially anatomy and physiology. Mostly I think I'd forgotten it all. I think knowing the relevance helps you retain and apply the knowledge to practical situations much better.
The main big change I'd like to make would be to clinical placements. Hundreds of hours spent in a kind of suspended animation limbo sat at the back of clinic rooms, 'shadowing' endless ward rounds, generally lurking... and you're mandated to turn up to be signed off, unless you're bold enough to slack off and go on holiday, which certainly happened. It's like medical education is the greatest and most elaborate commitment to belief in the principle of osmosis.
I spent most of my placements staring out of windows wondering what on earth I was doing with my life. There HAS to be some kind of drive to make clinical learning relevant and engaging, and perhaps an acknowledgement that just 'being' somewhere doesn't equal learning. Even if you try to engage yourself and force some benefit out of the hours of passive placement by asking questions, trying to be involved etc., the 'yield' of such learning is mostly miniscule and the effort required feels pretty endless.
If the medical school are going to pay all these £££ to departments, the teaching organised should be dedicated time specifically for active teaching. In an ideal world. Certainly in places it happens! An hour of bedside teaching is worth days and days of randomly showing up to the wards to be a peripheral feature of some ward round, in terms of your education. Especially earlier on in clinics where there's more emphasis on learning the material and less on pretending to be an F1. That's what I think anyway! Clinical years sometimes felt interminable and whilst I learnt things, most of what I learnt I did in my own time or came from just a few hours in a whole week of showing up every single day.