A system of regional reservoir libraries should be established in the United States, encouraged and supported by the National Library of Medicine through the granting of funds, the development of an improved bibliographic apparatus, and the development of an improved communications network. The systems already proposed in Kentucky, Massachusetts, Nebraska, New York State, and Wisconsin should act as pilots.

If science information centers develop with the aid of federal funds, maximum advantage should be taken of existing library resources in order to minimize useless and costly duplication.

Federal funds should be appropriated to initiate a vigorous program of recruitment, education, and training of medical librarians aimed at raising the standards of medical librarianship and creating a manpower pool. These funds should support and expand the Medical Library Association's present programs of scholarships, fellowships, internships, and continuing education. In addition, funds should be made available to qualified academic institutions for the initiation or improvement of their training facilities in this area.

Federal matching funds should be made available for the constructing, equipping, and renovating of medical school library facilities under the Research Facilities Construction Program. Federal grants to new medical schools for library construction and equipment should be provided under the proposed Educational Facilities Construction Pro

gram.

A program should be established whereby non-recurring federal grants for special projects would be made available directly to medical school libraries. These would tend to be small in amount and for the purpose of catching up with existing backlogs.

Experimentation in new electro-mechanical and reproductive devices relevant to library problems should be encouraged and funded.

REFERENCES

1. U. S. Dept. of Health, Education, and Welfare. The Advancement of Medical Research and Education Through the Department of Health, Education and Welfare. Final Report of the Secretary's Committee on Medical Research and Education. June 27, 1958. Washington, D. C., 1958.

2. U.S. Public Health Service. Physicians for a Growing America. Report of the Surgeon General's Consultant Study Group on Medical Education, October, 1959. (PHS Publ. No. 709.) Washington, D. C., 1959.

3. U.S. Senate Committee on Appropriations. Subcommittee on Departments of Labor and Health, Education, and Welfare. Committee of Consultants on Medical Research. Federal Support of Medical Research. Report of the Committee. May, 1960. Washington, D. C., 1960.

4. DRYER, B. V. Lifetime Learning for Physicians. J. Med. Educ., 37: June, Part II, 1962.

5. U.S. National Institutes of Health. Manpower for Medical Research; Requirements and Resources, 1965-70. Summary of a Report Submitted to the Subcommittee on Departments of Labor and Health, Education, and Welfare, and Related Agencies' Appropriations of the Committee on Appropriations, House of Representatives. Washington, D.C., Public Health Serv ice, 1962.

6. U.S. Public Health Service. Resources for Medical Research. Report No. 1. (PHS Publ. No. 969.) Washington, D.C., 1962.

7. Sponsored Research at New York University 1960-1961. New York: New York University Office of Research Services, 1962.

8. U.S. National Institutes of Health. Division of Research Grants. Research

Grants Index, Fiscal Year 1961. (PHS Publ. No. 925.) Bethesda, 1962. 9. VOIGT, M. J. Scientists' Approaches to Information. (ACRL Monograph, No. 24.) Chicago: American Library Association, 1961.

10. Based on the Formula of Valuation of Collections of the National Library of Medicine.

11. ROGERS, F. B. Unpublished data. 12. ESTERQUEST, R. T. Proposals for Strengthening Medical Library Resources and Services in New York State. Albany: New York State Library, 1962.

13. MEYERHOFF, E. Personal communication.

14. Biomedical Serials, 1950-1960. Washington, D. C., National Library of Medicine, 1962.

15. U.S. Office of Education. Library Services Branch. The Cost of Library Materials. By Frank L. Schick and William H. Kurth. Washington, D.C., 1961. (Library Statistics OE-152029 A.) Supplement, 1962.

16. KILGOUR, F. G. Personal communication.

17. HETZNER, B. M. Personal communication.

18. Report of the Commissioner's Committee on Reference and Research Library Resources. Albany: University of the State of New York. New York State Library, 1961.

19. FRY, A. and ADAMS, S. Medical Library Architecture in the Past Fifty Years. Bulletin Med. Library Assoc., 45: 471, 1957.

20. BEATTY, W. K. Personal communication.

21. Sixth Annual Report of Surgeon General of Public Health Service, Message from President of United States Transmitting Report Summarizing Activities of Health Research Facilities Program (House doc. 375). April 2, 1962. Washington, D. C., 1962.

22. DEITRICK, J. E. and BERSON, R. C. Medical Schools in the United States at Mid-Century. New York: McGrawHill, 1953.

23. New York. State Education Department. Knowledge is Power. (Rev. ed.) Albany: University of the State of New York, 1962.

49-825 O - 65 - 12

Ten years ago the Survey of Medical Education in its report, Medical Schools in the United States at Mid-Cehtury (1), discussed the plight of the medical libraries. The Deitrick report noted that all was not well. In the ten years preceding the report, expenditures for research had increased eightfold whereas the amounts spent on libraries by the 59 schools had but doubled. This lag had a depressing effect on the services which the libraries could provide in support of medical research. The report concluded that "little evidence was found by the Survey of attempts to meet the libraries' increased needs during a period of tremendous expansion in the research and other activities of the schools. "Faculty members, research workers, and students," it continued, "will be severely handicapped unless the new demands placed upon the libraries are met by careful administrative and budgetary planning. In a nation dependent upon medical research to a greater degree than ever before, surprisingly little is being expended on the housing of the reports of that research and on making those reports available."

Today, ten years and some hundreds of millions of research dollars later, it is stated with increasing frequency that the medical libraries are worse off than ever before. Last November the National Advisory Health Council submitted a resolution to the Surgeon General. "The medical library network," the resolution

Presented at the 73rd Annual Meeting, Association of American Medical Colleges, Los Angeles, California, October 29, 1962. + Deputy Director.

reads, "which has been designed to make the published record of medicine available, is in dire trouble. During a period of intensive development of research institutions, medical schools, and other medical facilities, their essential library support has been seriously neglected. In recent years the needs for adequate library working and storage space, for more trained library personnel, and for new methods of handling and disseminating the growing scientific medical literature have become acute."

The National Advisory Health Council is but one of several groups which have described the medical library situation as critical. For years medical librarians have pointed out the deficiencies in their institutions, medical educators in many instances have joined with them, and research administrators are increasingly concerned.

Where does the school library in fact stand today in its efforts to service the twin requirements of medical education and research? Have the libraries kept pace or lagged? Are they, or are they not, adequate for the purposes of modern biomedical research? In order to provide some current data from which an estimate of progress, or lack of it, over the past ten years could be made, the National Library of Medicine asked the Assistant Librarian of the Harvard University Schools of Medicine and Public Health, Mr. Harold Bloomquist, to collect data. His study, which will be available shortly, collected information from 84 schools as compared to the 59 schools covered by Deitrick. Within the time limitation it could not be an extensive

inquiry; the selected data offered here must be considered preliminary.

LIBRARY SUPPORT

We might first look at the resources available for library development. The total amount spent in 1961 by the schools on their medical libraries was $5,030,000. This compares to the $1,377,000 spent in 1951 by 59 schools. Over the same period, the total expenditures of the schools grew from $91,347,000 to $328,158,000. The average library's share of the total expenditures has therefore remained constant at 1.5 per cent. One important school, however, reported a decrease from 1.9 per cent to 1.2 per cent. Compared to the increase of funds spent for sponsored research, however, the average library share has declined. Research funds increased fourfold during the same period to a 1961 total of $135,000,000. The proportion of research funds devoted to library support decreased from 4.1 to 3.7 per cent.

Several points can and should be made. First, 1.5 per cent of the total expenditures was not adequate in the opinion of the 1951 Survey to meet the current needs of 1951, much less to repair the then accumulated deficits. Second, this percentage is even less adequate today. The median spent by universities for their general research libraries is 3.3 per cent of the university budget. Third, the granting agencies have not yet found a mechanism to provide that an "adequate portion of the funds restricted to research is made available for the strengthening of the library,” as recommended by the Survey group ten years ago.

COLLECTIONS

The largest collection held by a school library was 340,446 volumes, the smallest 12,000, and the median of 84 libraries 54,779. The total book and journal resources represented by the school librar

ies represent a capital investment by society of approximately $270,000,000. The highest amount spent for books and journals in 1961 was $90,000, the lowest $4,000, with a median expenditure of $19,000. The median number of volumes added during the year was 2,647. Again, I should like to make a few points.

First, the median of 54,779 is about one-half the total collection generally agreed on as minimal for the support of a comprehensive biomedical research program. The target should be set at 100,000 volumes now. Second, contemporary biomedical research requires a difference in kind of material collected, as well as a difference in amount. In general, the libraries are sadly lacking in the basic literature of scientific disciplines from which biomedicine derives its concepts, methodologies and data: the physical and chemical sciences, engineering, and the social sciences. We are in a multidisciplinary revolution in medical research, and the libraries are not prepared to cope with the new types of demands.

LIBRARY BUILDINGS

Seventy per cent of the school libraries currently occupy buildings more than ten years old; 50 per cent of the buildings are 30 years old or older.

In 1957, a survey (2) disclosed that over half of the libraries were either filled to capacity, or exceeded it. The warehousing of books and journals with all the attendant problems of inaccessibility and inefficient service, is a common practice.

This same survey showed that 88 per cent of the libraries responding were in need of significant alterations; 31 per cent needed entirely new buildings.

Some general comments follow. First, too many of the facilities were planned years ago by architects and administrators with limited understanding of the

organic functions and growth rates of libraries. In general, book stack areas, work space, reader space were all underplanned to accommodate normal library growth, much less the abnormal pressures of an increasing literature. This is not to be construed as a universal condemnation of architects. It is easy to understand these shortcomings in retrospect, but how many of us can visualize the impact of the trends toward miniaturization and computer installations on the planning of tomorrow's libraries?

Second, the space needs are both universal and critical, and except in isolated instances, local resources have not been found to satisfy them; nor has the federal government yet made grants for the construction of medical library facilities. The last Congress considered two bills, both of which failed to be enacted. Both H.R. 4999 (the Health Professions Educational Assistance Act) and H.R. 8900 (the College Academic Facilities Act) included authorization for school library construction.

The Research Facilities Construction Program however, was, approved by the Congress for three more years. New administrative regulations have been written which define "research and related purposes" [the hitherto limiting feature of this Act] as "research and activities having related purposes (including research training and the use for medical libraries to the extent that they support research and research training)."

This change would appear to admit medical libraries to the competition for federal research facility construction funds, insofar as they can demonstrate support for research and research training. The question which has concerned many of us lies in this competitive status. At the school level, how effectively will the libraries compete with new labora

tory buildings? This question is for the medical schools to answer.

LIBRARY PERSONNEL

We might next look at the manpower resources available to the medical libraries. At present the medical schools employ a total of 324 professional librarians. The largest number employed in any one library is eleven; the smallest, one. The median number of professional personnel for the 79 libraries is three.

The highest salary paid to a chief librarian is $14,500; the lowest, $4,500, with a median of $7,680. The median salary paid to professional librarians by the schools is $5,400.

The problem of manpower resources is simultaneously one of quantity and quality. It is difficult to believe that medical research conducted in this country at schools of medicine depends upon a pitifully small national pool of 324 persons for its library information services. Still more shocking is the median salary of $5,400 paid to a professional librarian presumably with a graduate degree, and hopefully with a background in the sciences.

All indications point to a critical national shortage of well qualified medical librarians. With job opportunities so restricted it is no wonder that there have been acute difficulties in attracting qualified personnel.

SERVICES

The Bloomquist study did not collect data on the services offered by the medical libraries. Invariably, however, the librarians expressed a desire to enlarge both the scope and the volume of their services to the school community. They have felt inhibited by lack of budget, lack of personnei, lack of journal and equipment resources in providing the following types of service to researchers, educators, and students: continuous bib