The medical school library data have been derived in part from a survey conducted early in 1964 by the Association of American Medical Colleges together with estimates by the National Library of Medicine. The Division of Dental Public Health and Resources, BSS, PHS, provided the information on the dental school libraries. Data on the libraries of the osteopathic schools was obtained directly from those libraries or schools.

Estimated costs were obtained by studying space requirements and applying the figure of $40 per square foot based on data developed by the General Services Administration from its experience in constructing public buildings.

Section 393 of H.R. 3142 authorizes a 5-year program of assistance for the construction of medical library facilities. The amount of any grant would not exceed 75 percent of the necessary construction cost. Priority would be given to applications evidencing the greatest need.

Section 394 authorizes a 5-year program of grants for training in medical library sciences. Grants would be made to individuals to support traineeships and fellowships in the field of medical library science, in related fields pertaining to sciences related to health and in the field of the communication of information. Grants would also be made to individuals who are librarians or specialists in information on sciences relating to health to enable them to attain intensive training and retraining. This should help reduce the deficit of professional librarians and persons adequately trained at the subprofessional level.

Section 395 authorizes a 5-year program of grants for special fellowships to be awarded to physicians and scientists for the compilation of existing, or writing of original, contributions relating to scientific advancements in sciences related to health.

Section 396 authorizes a 5-year program of grants for projects of research and investigations in medical library science and the development of new techniques, systems and equipment for processing, storing, and retrieving and distributing information on sciences related to health.

Section 397 authorizes a 5-year program of grants for improving and expanding the basic resources of medical libraries. According to the Subcommittee on Facilities above referred to, one of the most significant inadequacies of the Nation's medical libraries "is that they have only about half the books, journals, and other resources they need." Information provided by the osteopathic colleges shows that their holding of volumes ranges from 6,000 to 23,225, and their annual budgets range from $10,500 to $23,500. Obviously, none of the colleges has a desirable number of volumes or adequate budget. Section 397 provides funds for acquisition of books, journals, photographs, motion picture and other films, and for cataloging and binding, and for acquisition of duplication devices, and new technological equipment to facilitate the use of the library. As pointed out in the Medical Education Facilities, Public Health Service Publication No. 1180-A-1b, budgeted expenses for books, subscriptions, and other supplies are as high for 64 students per class as for 96. A smaller class and a smaller faculty do not reduce the need for library reference materials. However, the increase in class size will call for more services or larger library staff and the library facilities will be more fully utilized.

An estimate of what the program envisaged in this bill can mean as applied to the Philadelphia College of Osteopathy is provided in the following comment by Dean Sherwood R. Mercer:

"(a) A long-term program of construction, beginning with a $7 million hospital project now under construction, includes a new college building in which will be a greatly enlarged library for a student body to be expanded from about 350 to 575 (based on increasing the first-year class from 100 to 150). The new library can be made an even more effective instrument in support of learning than is now possible under present plans, if we could enjoy the additional support as projected in H.R. 3142.

"(b) The library system of the college will be built around the main collection at the new city line campus where the building cited above will be located. A satellite collection will be housed in the presently used (and to be entirely renovated) college and hospital building at 48th and Spruce Streets. Another satellite collection will be located at our 20th and Susquehanna Avenue hospital. As is presently our practice, departmental libraries will be developed in all three locations.

"(c) Because the college is located in Philadelphia and in close proximity to some of the world's finest collections in medical libraries, our plans call for a more efficient intercommunication system with area libraries and we hope, through regional library facilities, with the entire county. Clearly, the intent of H.R. 3142 seems to support these projections.

"(d) We have begun the search for professional leadership for the library complex. Our discussions always included an exploration of our interest in training for careers in medical libraries. Here again we are fortunate in being close to the Graduate School of Library Science at Drexel Institute of Technology.

"(e) We are aware of the role of electronic equipment in the management of libraries more effectively to make them vital teaching centers. Because of costs we can do little other than to plan space into the new library where this equipment could be housed and used. H.R. 3142 would make possible application for support for this and other equipment, personnel, and facilities to make our new library a better one than we can now afford to plan.

"(f) In our discussions with candidates for the post of librarian we have outlined ideas for the education of faculty and students alike in the communication of ideas, new knowledge, and new techniques, so that the whole body of physicians will know how better to be informed and to inform."

We appreciate this opportunity of presenting our views on H.R. 3142, and we hope for early enactment of this most important legislation.

STATEMENT OF EDWARD C. ROSENOW, JR., M.D., EXECUTIVE DIRECTOR, AMERICAN COLLEGE OF PHYSICIANS

Congressman Harris, chairman of the Committee on Interstate and Foreign Commerce, I am Dr. Edward C. Rosenow, Jr. of Philadelphia-an internist who spent 20 years in the practice of medicine before becoming executive director of the American College of Physicians.

The president of the American College of Physicians, Dr. A. Carlton Ernstene, of Cleveland, has asked me to prepare a statement in support of H.R. 3142 and H.R. 6001, Medical Library Assistance Act, which was introduced in the House of the American College of Physicians.

For those who do not know of the American College of Physicians, I would like to describe our society. The college, which is 50 years old this year, represents 12,400 specialists in internal medicine and related fields.

Our principal interest is the continuing education of physicians. To work toward this goal, the college sponsors 2 national and 25 regional meetings each year; it conducts 18 postgraduate courses and publishes the monthly Annuals of Internal Medicine.

To aid in maintaining high standards of medical practice, the college participates in the administration of the certifying agency for internists-the American Board of Internal Medicine-and, with other medical organizations, operates the Joint Commission on Accreditation of Hospitals and the Commission on Professional and Hospital Activities.

Included among our leadership are the physicians responsible for the training of a large percentage of our Nation's undergraduate and graduate physicians. Because of its intense interest in the training of physicians and in the continuing education of internists, the American College of Physicians looks favorably on any Federal act that would improve medical library facilities.

We feel that these bills and their companion bill in the Senate, provide realistic solutions to a growing problem of collecting and retaining information vitally important to the present and future practice of medicine.

The act would assure the existence of adequate medical library facilities to serve physicians and other medical scientists in all regions of the United States. The American College of Physicians supports the provisions of H.R. 3142 and H.R. 6001 and commends Congressman Harris and Congressman Fogarty for sponsorship of the legislation.

Thank you very much.

RESOLUTION ON THE MEDICAL LIBRARY ASSISTANCE ACT OF 1965, ADOPTED BY THE YOUNG DEMOCRATIC NATIONAL COMMITTEE, AND THE NATIONAL EXECUTIVE COMMITTEE OF THE COLLEGE YOUNG DEMOCRATIC CLUBS

Whereas (1) the unprecedented expansion of knowledge in the health sciences within the past two decades has brought about a massive growth in the quantity, and major changes in the nature of, biomedical information, materials, and publications, and (2) there has not been a corresponding growth in the facilities and techniques necessary adequately to coordinate and disseminate among health scientists and practitioners the ever-increasing volume of knowledge and information and information which has been developed in the health science field,

and (3) much of the value of the ever-increasing volume of knowledge and information which has been, and continues to be, developed in the health science field will be lost unless proper measures are taken in the immediate future to develop facilities and techniques necessary to collect, preserve, store, process, retrieve, and facilitate the dissemination and utilization of, such knowledge and information; and

Whereas the "Medical Library Assistance Act of 1965" (S. 597 in the Senate and H.R. 3142 in the House of Representatives of the United States) is proposed and would provide the means to (1) assist in the construction of new, and the renovation, expansion, or rehabilitation of existing medical library facilities; (2) assist in the training of medical librarians and other information specalists in the health sciences; (3) assist, through the awarding of special fellowships to physicians and scientists, in the compilation of existing, and the creation of additional written matter which will facilitate the the distribution and utilization of knowledge and information relating to scientific, social, and cultural advancements in sciences related to health; (4) assist in the conduct of research and investigations in the field of medical library science and related activities, and in the development of new techniques, systems, and equipment for processing, storing, retrieving, and distributing information in the sciences related to health; (5) assist in improving and expanding the basic resources of medical libraries and related facilities; (6) assist in the development of a national system of regional medical libraries each of which would have facilities of sufficient depth and scope to supplement the services of other medical libraries within the region served by it; and (7) provide financial support to biomedical scientific publications: Be it therefore

Resolved, That the Young Democratic Clubs of America hereby endorse the Medical Library Assistance Act of 1965, and commend it to our elected representatives in the Congress for early passage.

Unanimously adopted by the Young Democratic National Committee, and by the National Executive Committee of the College Young Democratic Clubs of America, in simultaneous but separate meetings at Kansas City, Mo., April 10, 1965.

RESOLUTION ON MEDICAL ASSISTANCE ACT, ADOPTED BY THE STUDENT AMERICAN MEDICAL ASSOCIATION

Whereas the unprecedented expansion of knowledge in the health sciences within the past two decades has brought about a massive growth in the quantity and major changes in the nature of biomedical information, materials, and publications, and (2) there has not been a corresponding growth in the facilities and techniques necessary to adequately coordinate and disseminate among health scientists and practitioners the ever-increasing volume of knowledge and information which has been developed in the health science field, and (3) much of the value of the ever-increasing volume of knowledge and information which has been, and continues to be developed in the health science field will be lost unless proper measures are taken in the immediate future to develop facilities and techniques necessary to collect, preserve, store, process, retrieve, and facilitate the dissemination and utilization of such knowledge and information: Therefore be

it

Resolved, That the student American Medical Association endorses legislation that would (1) assist in the construction of new, and the renovation, expansion or rehabilitation of existing medical library facilities; (2) assist in the training of medical librarians and other information handling specialists in the health sciences; (3) to assist, through special fellowships, physicians, and scientists engaged in research involving health science information storage, distribution and utilization; (4) assist in the conduct of research and investigation in the field of medical library science and related activities, and, in the development of new techniques, systems, and equipment for processing, storing, retrieving, and distributing information in the sciences related to health; and (5) assist in improving and expanding the basic resources of medical libraries and related facilities.

The resolution was adopted by the national convention of the Student American Medical Association, meeting at Chicago, Ill., May 3-6, 1965.

[Telegram]

Hon. OREN HARRIS,

SANTA MONICA, CALIF., September 13, 1965.

Chairman, Committee on Interstate and Foreign Commerce,
Rayburn House Office Building, Washington, D.C.:

On behalf of the southern California chapter, of the special libraries association I report our unanimous support for H.R. 3142, to amend PHS Act to provide a program of grants to assist in meeting the need for adequate medical library services and facilities.

J. E. TALLMAN, Chapter President.

Hon. OREN HARRIS,

HOUSE OF REPRESENTATIVES, Washington, D.C., September 16, 1965.

Committee on Interstate and Foreign Commerce,
U.S. House of Representatives,

Washington, D.C.

DEAR MR. CHAIRMAN: Dean F. M. Walter, of the Kirksville College of Osteopathy & Surgery, which is located in my district, wrote in some detail in support of H.R. 3142. I believe Dean Walter's comments merit the attention and consideration of the members of your committee and respectfully request that his statement, as follows, be made a part of the official committee transcript.

"It is my understanding that this proposed act would provide Federal assistance in the construction of medical library facilities, medical library research, the training of medical librarians, and the establishing of regional medical libraries as branches of the National Library of Medicine in those cases where private resources are not available.

The continued rapid expansion of medical research and resulting literature makes the task of keeping current literature available for students extremely expensive and therefore quite difficult especially for the nonprofit private institutional libraries. The enactment of this proposed legislation could be of great assistance with this endeavor.

Thanking you in advance for your consideration, I remain,
Cordially yours,

Hon. OREN HARRIS,

WILLIAM L. HUNGATE.

AMERICAN HOSPITAL ASSOCIATION,
Washington, D.C., September 16, 1965.

Chairman, Committee on Interstate and Foreign Commerce,
Rayburn House Office Building, Washington, D.C.

DEAR CONGRESSMAN HARRIS: In this statement to you we wish to express the views of the American Hospital Association in respect to H.R. 3142, "Medical Library Assistance Act of 1965." The bill amends the Public Health Service Act so as to provide for a program of grants to assist in meeting the need for adequate medical library services and facilities.

The American Hospital Association approves the general purposes of the bill. There exists a vast unmet need for the dissemination of information in the health sciences. The very rapid advancements now being made in health research and in the treatment of illness have outpaced existing means of communication. There is also a failure to support the growth of library facilities and materials commensurate with the development of major health research. Adequate library and communication facilities and services are also necessary in all of the schools and educational programs directed to the training of health personnel.

The Congress has already enacted legislation looking toward a rapid acceleration in the training of physicians, dentists, public health workers, nurses, and others. It is imperative to the success of these efforts that we direct attention now to the sources of fundamental knowledge and toward the dissemination of such knowledge. Your committee recently voted out H.R. 3140, a bill with far-reaching implications for the health care of the American people. The kinds of proposals which are embodied in H.R. 3142 are of vital concern to the successful implementation of the Heart Disease, Cancer, and Stroke Amendments of 1965. For many years the health field has been aware of the problems developing because of the unmet needs for adequate health science libraries. We believe

perhaps the most urgent need is that of training more people in library science. At present, libraries are often staffed largely by either untrained or inadequately trained personnel. The overall objectives of the bill will be seriously handicapped without major emphasis on training. We sincerely hope that the Congress will move ahead rapidly in making available the assistance proposed in H.R. 3142. Our general approval of the bill is limited only by what we believe are limitations in the language of the bill.

RECOMMENDATIONS ON SPECIFIC PROVISIONS

We strongly urge that the title of the act which cites overall intent be broadened beyond its present limited language and that the act may be cited as the "Health Science Library Assistance Act of 1965." The term "medical" is far too limited in light of the essentially broad purposes of the act. We urge that the appropriate language changes be made throughout the bill to accomplish this purpose.

Section 390 (b) (3) provides for special fellowships for the creation of written matter. The purpose of the provision is not at all clear. However, written material in any way essential to research is part of research projects. We, therefore, do not support the inclusion of this provision in the bill.

Section 391 (1) should be broadened so as to include the term "hospital administration" following the term "public health" on line 22. There are at the present time 16 university programs providing master's degrees in hospital administration. We believe the bill should provide assistance in its various purposes to such libraries and programs.

Paragraph (3) of this section, line 4, should be amended by deleting the word "medical" and inserting the phrase to any "health science" library.

We recommend that Section 393: Assistance for Construction of Facilities; Section 397: Grants for Improving and Expanding the Basic Resources of Medical Libraries and Related Instrumentalities should clearly provide for assistance to all teaching hospitals and other hospitals maintaining such essential health science information on behalf of their staffs and students.

In section 399 (a) we question both the necessity and desirability of the section. We believe it will tend to promote the unnecessary publication of material. It can further burden libraries with materials in an area which appears to be adequately served. There is the definite likelihood of publishing material that recognized scientific channels and publications will not carry because they deem it to be inadequate.

Section 3, part (h) of title II of the Public Health Service Act which deals with the National Library of Medicine is amended so as to provide regional branches of the national library.

We would urge that this section not be limited, as it appears to be at present, so as to make it essential that such extended facilities be separate and independent facilities. The bill should provide that insofar as possible, such regional branches be located in existing hospitals and medical centers which may serve a large geographic area.

We appreciate this opportunity of submitting to you the views of the American Hospital Association on H.R. 3142. We would appreciate your making this statement a part of the record of the hearings on this bill.

Sincerely yours,

Hon. OREN HARRIS,

KENNETH WILLIAMSON, Associate Director.

House of Representatives, Washington, D.C.

HARVARD MEDICAL SCHOOL, Boston, Mass., September 10, 1965.

DEAR MR. HARRIS: Those of us who are close to medicine and medical education on a day-to-day basis hope very much that you continue to give high priority to the passage, during the present session, of the Medical Libraries Assistance Act.

This legislation must not languish. Our medical schools and medical centers are making hopeful progress with the complex task of improving the quality of medical education, with the training of additional doctors and with research in the medical sciences. In most of our medical schools we are hampered in our efforts because of inadequate libraries.