One year ago, on 15 March 2024, the College of Physicians and Surgeons of BC (CPSBC) decided to close our medical library. In response, I wrote an editorial expressing my disappointment.[1 [10]] As you may recall, this closure was made without consulting registrants and with minimal notice to physicians and staff.

The BCMJ received a record number of letters in response—more than on any other topic in recent memory. Dr Koehler wrote that although information on the Internet is easily accessible, it can be inadequate and biased. Dr Koehler hoped the CPSBC would recognize its members’ need for accurate information.[2] Dr Kope pointed out that the CPSBC’s rationale to close the Library due to a “significant decrease in library use” stands in contrast to important principles for health promotion in medicine despite declining uptake, such as the case of immunizations.[3] Many physicians shared that they relied on the Library to tackle complex clinical questions and valued the monthly Cites & Bytes newsletter. Additionally, I received numerous private messages, emails, and other personal communications from physicians who expressed that the CPSBC Library was an invaluable resource.

On a personal note, the closure of the Library has significantly impacted my research mentorship for medical students and residents. I depended on the Library’s support for literature searches and reviews, which helped students refine their research questions and improve their study design. Moreover, in preparing my annual lectures for University of British Columbia undergraduate classes, the CPSBC Library team made it far easier to stay current on new publications related to my topics. Without their assistance, this task has become far more time-consuming.

Dr Gillespie suggested a possible “win–win solution”: that Doctors of BC take over the medical library.[4] This suggestion received several notes of support. However, given the current economic climate, this option seems unlikely in the near term.

For perspective, I calculated that in 2023, we paid approximately $125.54 annually per active registrant for access to library services, which is comparatively smaller than the $25 paid in 1963, considering inflation.[1] Recently, I reached out to the CPSBC again to ask if it might be open to discussing the Library’s closure with the BCMJ—particularly whether there were any plans to consult registrants about potentially reopening the Library or reallocating the Library’s budget. According to the CPSBC’s 2024–2028 strategic plan, there is an emphasis on transparency, particularly in “provid[ing] clear, relevant, and timely information about [its] mandate and work.”[5] This seems relevant, as many have asked how the Library’s $1.86 million budget will be redirected. The CPSBC communications team responded to me: “While we understand that the decision to close the library is disappointing to some registrants, CPSBC will not reconsider it. It is the role of the CPSBC Board to determine strategic and financial priorities. The decision to close the library was made by the board after careful consideration showing significant decrease in use over the years.”

If the closure is indeed the result of necessary budget cuts—an unfortunate but perhaps inevitable reality—we may need to accept that this is the cost of doing business in today’s inflationary times. There’s no denying the utility of digital platforms such as UpToDate, which provide immediate access to clinical information. For those of us with academic or health authority affiliations, we may still have access to resources through hospital librarians or UBC. But many of us relied entirely on the CPSBC Library for access to journals, books, point-of-care tools, pharmacopeia, drug interaction checkers, reading lists, videos, and more. According to CPSBC’s committee reports for the 3 years prior to the closure, an average of 1710 physicians submitted over 10 000 queries, and roughly 46 500 articles were downloaded through the CPSBC Library website. If you were one of those physicians, what do you do now?

In our Letters to the Editor in this issue, Rachael Bradshaw, Melissa Caines, and Jane Jun write on behalf of the Health Libraries Association of BC’s executive board to share their thoughts on the enduring value of librarians.[6] Out of respect and gratitude for the former CPSBC Library team, we’re publishing this letter despite the uncertain prognosis for this cause. When we look back on this moment—5, 10, or 25 years from now—perhaps we will regard this period as a sign of the times. Free and reliable forms of artificial intelligence may have stepped into the gap left by the Library. Yet, I suspect that the transition will not be as swift or seamless as some anticipate. For now, patients rely on our expertise, and in turn we rely on the resources that help us provide the best care possible. Libraries remain essential to that mission.
—Caitlin Dunne, MD, FRCSC

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License [11].

References

1.         Dunne C. The CPSBC closed our medical library. BCMJ 2024;66:104-105.

2.         Koehler B. Closure of the CPSBC medical library. BCMJ 2024;66:191.

3.         Kope TM. Closure of the CPSBC medical library. BCMJ 2024;66.191.

4.         Gillespie I. Closure of the College Library: A proposal. BCMJ 2024;66:106.

5.         College of Physicians and Surgeons of BC. Strategic plan 2024–2028. Accessed 10 February 2024. www.cpsbc.ca/about/corporate/strategic-plan [12].

6.         Bradshaw R, Caines M, Jun J. Re: Closure of the CPSBC medical library. BCMJ 2025;67:47.