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A brief historical sketch, tracing the development of the College of Physicians and Surgeons and its library from the Royal charter date of 1754, is presented. Little is recorded of library development prior to 1928, when the departmental libraries were united with the Reference Library to form the core of the present library. The planning processes for the new library are discussed, noting the involvement of the entire library staff. Four floors in a twenty-story tower are devoted to library services, and each floor is described. Several of the major compromises made during the planning process are documented. Photographs and floor plans of two of the floors help illustrate the text.

A regionally cooperative method of distributing responsibility for every serial title in a region is outlined. The system assures the equitable distribution of the number of titles for which each library is committed. Later refinements suggest an equalization of cost commitments on the basis of fiscal resources available for serial purchases. It is pointed out that fiscal realities will force some sort of serial acquisition cooperation for all viable medical libraries.

Integrated library systems have not yet been created, although they have been emphasized for nearly two decades. Now and in the future, the task is even more complex because the principal issue is access to information itself, wherever it is located and in whatever form it may exist. The goal becomes more feasible because of changes in library practices achieved with technological innovation. Although individual elements of a campus-wide information system may already exist, the details for implementation are yet to be articulated.

Communication patterns and working relationships between large health sciences libraries and departmental libraries are examined and discussed. The results of a telephone survey to obtain information on the experiences of twenty-one large New York metropolitan area health sciences libraries with their departmental libraries are reported. Discussion includes the experiences of Columbia University's Augustus Long Health Sciences Library with departmental libraries within the Columbia/Presbyterian Medical Center (C/PMC). A mediated survey of C/PMC departmental libraries and over thirty years of cooperation with some of these departments are reported. The potential detrimental effects of departmental libraries are acknowledged, but the substantial positive benefits of cooperation and ways to achieve this cooperation are emphasized.

MLA committee membership by category (medical school, society and hospital) for the past three years is examined revealing a heavy reliance upon medical school librarians for committee members. A ten-year examination of committee membership and turnover in individual committee membership rosters points out those committees whose rate of turnover is greatest. Opportunities for service by new MLA members is examined as is committee tenure as experienced during the last decade. Turnover, tenure, and frequency of leadership is examined for the ten-year period. Pointing out that only 360 individuals have served MLA in committee positions listed in the Bulletin, the Ad Hoc Committee to Review the Goals and Structure of the Medical Library Association is urged to more actively seek the opinions of the membership and to consider the service patterns of the past in recommending a course for the future.

The historical development of the Medical Branch Library from the Medical Department of Soulé University, established in 1861, to the present is traced. The powerful growth stimulus that was provided by Dr. Chauncey Leake is recognized as is the important influence more recently of Dr. Truman G. Blocker, Jr. The new Moody Medical Library Building and the services and financing of the library are described.