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Open access (OA) publications on the Internet are increasing and assuming important routes for disseminating scholarly information. Consequently, Open access management has become an inescapable feature of modern library services. The study examined knowledge of open access models, licensing types, resources, and practices in medical libraries in Nigeria. Questionnaire was the instrument for data collection. Participants were Fifty-one librarians from thirty-six medical libraries. Result shows high (e"72.5 percentage) awareness of open access green, gold, hybrid models, creative commons and public domain licensing types. However, less than half understand the full meaning and implementations of the models. Understanding was higher for OA licensing types. There was also high awareness of OA databases and resources but low use of the resources for information services. Open access services offered by the respondents are creating links to open access databases on library websites and directing patrons to OA publications. The study concludes that medical librarians need to improve their knowledge and skills of open access management to enable them build diverse collections that are relevant to Medical library patrons in the digital age. [ABSTRACT FROM AUTHOR]