Last year has been busy and eventful on many fronts. Though we may not have made as much progress towards our strategic goals as we would have liked, we are energized, organized and poised for continued progress. Thanks to our Director, Dr. Kohane, the CHOM Director, Dr. Podolsky and HMS Executive Dean, Rick Mills their leadership and not the least, Roz Vogel, the BML administrator.
Even as your leadership is vigorously pursuing the strategic plan goals, Appendix 2, as outlined below, the Board reviewed our progress, did a SWOC (Strengths, Weaknesses, Opportunities and Challenges) analysis and reaffirmed on February16, 2012 the Plan and Priorities for the future. Our partner, Harvard University, has restructured the 73 separate Harvard libraries into a more coordinated Harvard Library under the leadership of Senior Associate Provost for the Harvard Library, Mary Lee Kennedy and Executive Director, Helen Shenton. The new arrangement came into being on August 1, 2012. Three library services are aligned across the libraries into Harvard Library (HL) wide service with staff reporting to the central unit. The individual Harvard libraries obtain services delineated in individual MOUs for each library and funding by the individual libraries to the Harvard Library will be determined in time. The three Services are Access, Information and Technology, and Digital and Imaging respectively. These span most of Countway Library services, but exclude Special Collections such as our Center for the History of Medicine which will continue its affairs unchanged at this time. This restructuring is planned to be a trial.
Your leadership has been working on an ongoing basis with the Countway Director, Dr. Kohane and Harvard Medical School (HMS) Executive Dean for Administration, Richard Mills. Our Director, Dr. Kohane assures us that the Countway MOU protects the BML interests and services to our constituencies and that he is working with the leaders of the three Library Services to integrate the BML strategic priorities into the overall HL plans. He plans to have your officers join him when necessary to meet with the relevant HL Service Heads to help ensure such inclusion and action.
A. Your leadership is actively engaged in the pursuit of our strategic goals 1, 2 and 4: Dissemination of Knowledge; Promotion of Medical Education; and Developing Infrastructure to Support the BML Goals - as it applies to our primary constituency of interest - the practicing physician.
1. I reported to you last year that the challenges faced by the Countway leadership in the Harvard Library reorganization has been an added factor in the BML strategic priorities not receiving adequate attention and efforts from them. Another major dynamic is the changed role of the Countway Director since the transition of the leadership to Dr. Kohane in 2005. The previous director was engaged actively in the BML and its goals. We have been unable to replicate that paradigm. Dean Mills suggests and is supportive of a Countway staff person at a senior level being responsible and responsive to the BML goals with authority deriving directly from the
Director and direct accountability to the BML leadership and the Director. This would be the next best and necessary step for the BML’s agenda to move forward. This effort has also been delayed by the Harvard Library transition, but your leadership is pursuing it actively.
2. One of our priorities has been the pursuit of grant applications for research into physician lifelong learning and how a medical library such as ours focused on the practicing physician may be of service in today’s changing world. For the reasons cited above, we have not made much progress.
3. This is not just a BML goal; it needs to be a joint mission of both the BML and HMS. After all, the BML’s primary mission is not too far from Harvard Medical School’s mission. If the goal of medical education is ultimately the betterment of the health of the public and treatment of suffering, what good would it do to create new knowledge from research and educate students and others within the walls of the institution and ignore their continued learning needs once they step outside those walls in order to serve those very needs of the community throughout their professional career? Given the standing and intellectual resources of the two partner institutions; mutuality of the goals; and the importance to our end constituency, society at large especially in these times of challenges and momentous advances; the Countway is most well equipped and situated to lead in this field of lifelong learning by physicians in practice. The BML’s partnership with the MMS, the other three medical schools of Massachusetts, the Boston Public Library etc. lends a very powerful additional dimension.
4. The world of learning, knowledge management and information along with the understanding of and demand to quantify physician competence and performance are undergoing quantum changes. It is our role as leaders to explore and exploit the inherent opportunities. We cannot fail in this; we do not have the choice of staying in the 20th century. Harvard University and MIT are engaging in a free for the user, web based learning program titled EdX. It is planned to be tried initially in the Faculty of Arts and Sciences. Dean Mills has been engaged on behalf of the BML with the Provost on this and the plan is to explore in Fall 2013 opportunities in this program to advance the BML goal of helping physician lifelong learning.
5. Physician CME is in transformation- even the title is morphing into CPD (continuous professional development). While traditional CME is and will continue, other learning avenues are being explored along with the recognition of different learning needs and demands- such as POS (point of service) needs, performance and quality improvement needs, aids to more effectively learn from one’s own practice etc. See attached grid- Appendix 3. Harvard Medical School’s CME division is undergoing major changes because of these and industry funding concerns. Your leadership is engaged in this area and we need to apply our brain trust to this to see where and how a first quarter 21st century (a whole century is too long a time period at current transition rates!) library fits in.
6. Harvard Medical School requires, under a program called Scholars in Medicine (SIM), all medical students to undertake a scholarly project of their own choosing for the purpose of igniting curiosity, fostering critical thinking and cultivating skilled practitioners who will both master and create knowledge. Your President has offered to mentor under this program a student jointly with David Osterbur, Director of Access and Public Services at Countway, on the scholarly question: How do physicians maintain their lifelong learning over decades of practice while knowledge and skills are evolving increasingly rapidly? A focus would be the learner’s needs and role of libraries.
7. Harvard Medical School has recently established a Center for Primary Care. Your leadership will soon engage in a dialogue with its leadership to explore potential synergies.
8. The Massachusetts Medical Society surveyed its members on behalf of the BML in the Spring of 2012 regarding member library habits, BML use, needs etc. There were 190 respondents, 75% specialists and 25% in primary care; 68% male and 32% female.
Here are some of the highlights:
- Sites most searched for information to help practice: Google 79%, Pubmed 73%, Uptodate 57%, WebMD 31%
- Comments regarding sites used: Some used Tufts, Partners and HMS website
- 77% had not used the BML in the past 3 months
- What educational programs by BML would benefit you most? How to search: Pubmed 44%, Internet 29%, Google 10%
- Other comments regarding educational programs:
How to use citation software; How to access the library
- Preferred smart library use learning format: Online 51%, In person 30%
- General comments: Need reference service; Access to e- sources; How to structure searches; More info on how to use already available resources to MMS members; More timely librarian help
9. The BML branch library at the Massachusetts Medical Society (MMS) in Waltham serves MMS members and staff for its twelfth year. Continued efforts are ongoing to maximize the branch library’s efficiency, utility and user – friendliness. One on-site in person hands-on educational program was presented in the Spring. Two to three programs are being planned annually. Participant feedback has been positive with some guidance for future direction.
10. The MMS HOD includes in its Interim meeting agenda a short BML report. The MMS HOD Handbook will have a page for the BML at each meeting. At the December 2, 2011 MMS HOD Interim meeting, the BML podium report included a well received brief presentation by David Osterbur, Director of Access and Public Services for the Countway Medical Library, on how we can benefit from learning to be smart users of today’s and tomorrow’s library resources. At the next interim meeting of the HOD on November 30th, I plan to invite, in my podium report, a short
presentation of the experience of one of the participants in the Spring hands-on training program.
11. The BML office on the fifth floor (originally the floor for the administrative offices of Countway) created in accordance with the Countway enabling document was moved in 2006 ‘temporarily’ to a cubicle on the 4th floor, which floor currently houses the hub of the Countway administration. A BML office is now reality on the 4th floor.
B. The BML goal of “Preservation and Celebration of History of Medicine,”is continued to be advanced under the leadership of Dr. Scott Podolsky, Director of the Center for the History of Medicine (CHOM). Efforts this year include:
1. BML Countway Fellowship
In 2002, the BML inaugurated its fellowship program, the Francis A. Countway Library Fellowship in the History of Medicine funded by the Abel Lawrence Peirson fund. It offers an annual total stipend of up to $10,000 to go to successful applicants to use the resources in the library’s Center for the History of Medicine. Three Fellowships were awarded for 2012-2013 year (the list of recipients is in Appendix 1. We have several outstanding applicants and we need to develop funding to increase the annual grant.
2. Oral History Project:
Your Board authorized and funded projects to record oral history at the request of the CHOM Director, Scott Podolsky, MD. Lesley Schoenfeld has been selected to be the interviewer for the project.
One project is a general Countway project of selected leaders in medicine. The first subject under this project is Ronald Arky, MD, Charles S. Davidson Professor of Medicine and Master of the Francis Weld Peabody Academic Society at Harvard Medical School, Chief of Diabetes and Metabolism at the Brigham and Women’s Hospital; and one of the founders of the American Diabetes Association and its Past President.
The other is to record the history of the BML. It was last recorded up to the early 1960s and published in a book authored by Dr. Joseph Garland in 1975. The first subject planned is Grant Rodkey, MD, President of the BML from 1988 to 1997 and a long time Trustee and Fellow.
3. J. Worth Estes Lecture
An effort to create an endowment for an annual lectureship named after esteemed BML Trustee, J. Worth Estes, MD, was started by our former President, Dr. Leonard Morse. Unfortunately, the effort was funded only partially. Lectures have been suspended after a few years. Plans are being made to restart the lectureship and also to obtain funding to reach the target of $100,000.
4. Among the notable historic acquisitions last year
The Boston Medical Library’s Norman E. Himes Book Fund allows for the purchase of rare titles particularly items relating to birth control as a tribute to Dr. Himes’ area of
particular interest. Through the Himes Fund we purchased a copy of an 1846 (possibly unauthorized) edition by Ralph Glover of Robert Dale Owen's Moral physiology, the first American work on contraception; a first (1831) edition of the Owen text is also in the collection, along with a copy of the third Glover edition (1847). Himes, in his Medical history of contraception (1936) described Ralph Glover as “probably a quack,” though he did have an 1826 degree from Jefferson Medical College. Glover’s original contribution to the Owen text is the promotion of an electric contraceptive device of his own manufacture, identified in a later work as the Electrogalvania. A number of other items related to contraception were acquired through the Himes Fund, including Robert-Henri Barbe’s thesis, Les conséquences pathologiques des pratiques anticonceptionelles chez la femme (1937), Self-control by Samuel Swedour (1870), Pye Henry Chavasse’s Physical life of man and woman (1871), Anne H. Rowland, What birth control means today (1934), and Dr. Bate’s true marriage guide (1889).
Rare works on neuroscientific subjects are often acquired for the Boston Medical Library through the Franc D. Ingraham Memorial Book Fund. During the past year, we purchased a number of unusual items in this area, including a copy of the Erste Heilung eines traumatischen Gehirnabscesses by Wilhelm Theodor Renz (1867); a sixth edition of Franz Ludwig Fick’s Phantom des Menschenhirns (1891), with moveable parts depicting the anatomy of the brain; Die Färbentechnik des Nervensystems by Bernhard Pollack (1897); and C. Worster-Drought’s Neurosyphilis (1940).
The Boston Medical Library’s John Warren Fund allows for the purchase of rare medical books, particularly works of anatomical interest. During the past year, we acquired a copy of the sixth edition of L’anatomie de l’homme, suivant la circulation du sang, et les nouvelles découvertes (Paris, 1780) of Pierre Dionis; the library now holds specimens of all the early editions of this text with the exception of the first (1690). The Warren Fund was also used for the purchase of a flap obstetrical text by Etienne Rabaud, Notions élémentaires sur l'anatomie, la physiologie et l'hygiène de la grossesse (Paris, 1907), and an early work by Jean Vigier, Enchiridion anatomic, auquel est sommairement & méthodiquement descripte l'histoire anatomique du corps humain (Paris, 1628).
5. Medical Heritage Library
The Medical Heritage Library (MHL), established in spring 2010, is a digital curation collaborative including the College of Physicians of Philadelphia, Columbia, Countway, Johns Hopkins, New York Public Library, and the National Library of Medicine. The mission of the Medical Heritage Library is “to provide the means by which readers and scholars across a multitude of disciplines can examine the interrelated nature of medicine and society, both to inform contemporary medicine and strengthen understanding of the world in which we live.” This mission furthers the respective missions of partners as well as the interests of the history of medicine community by meeting the needs of a broad audience of users.
The first phase of digitization concluded June 30, 2012. Over the two year project, Countway CHOM reviewed 29,500 volumes for inclusion and digitized 8,520 volumes
(3,144,565 pages) which are now available on line. MHL has a total of 44,000 digital objects now from the 10 contributing libraries and is growing.
The collections combined at the MHL are more visible to the benefit of users, particularly those who are not familiar with history of medicine special collections. Such users include interdisciplinary scholars, students, the general public, and foreign scholars. Our joint promotional efforts include an active blog, emailing to listservs, a Twitter feed, and Facebook page. The blog (www.medicalheritage.org) currently receives 250 visitors a week, some 15% of which originate in Europe.
The MHL collection is now so large and encompasses so many subject areas that CHOM routinely direct researchers to its resources. This remote access eliminates visit to the library except for research into items available only in print form.
6. Preservation, Collections Care and Digitization- BML’s Preservation Project
Through BML funding, the Center continued its survey and rehousing project:
The BML also funded intensive conservation work (e.g. repair/replace bindings, hinges; remove rot, grime) on thirteen rare and important volumes. These included:
- 72 BML bound manuscripts were surveyed and 200 rehoused; new or improved catalog records were created for 218 BML manuscripts
- 246 HML volumes were surveyed, 103 rehoused, and 29 catalog records were created
- 3,437 BML books, including works from the Tiedmann Library, were surveyed for rehousing, with
1,549 volumes identified as needing enclosures
- James, William. Priniciples of Psychology. New York, 1905. 1905 printing of the first edition of James’ groundbreaking work in two volumes.
- Hill, John. The useful family herbal. London, 1770. 3rd edition, annotated in an 18th-century hand plates.
- Culpeper, Nicholas. The English physician enlarged. London: 1799. One of the many 18th-century editions of a classic 17th-century work.
- Drake, R. An essay on the nature and manner of treating the gout. London, 1758. Armorial bookplate of the Drake family.
- Arnault de Nobleville, Louis-Daniel. Manuel des Dames de Charité. Orléans, 1747. First edition of a pharmacopoeia of medicinal plants used in the treatment of the poor.
7. Publication of Artwork
The Boston Medical Library's Robert C. Hinckley painting First Operation under Ether anesthesia was used in a number of venues, including the Boston Globe magazine, as part of a bicentennial article on the New England journal of medicine; the 4th edition of Jan Smith’s Organic chemistry (2013) and 2nd edition of General, organic, and biological chemistry (2012); Nicholas L. Tilney’s Invasion of the body: five surgical revolutions (2012); in an article by Janet Serwint, “Humanism through the lens of the Academic Pediatric Association,” in Academic pediatrics (2011). A reproduction of the painting
was also displayed at Massachusetts General Hospital as part of the ether day commemoration (2011).
A number of photographs from the collection, along with the Hinckley painting, were reproduced and used by Nancy Porter Productions in a film, Getting better: 200 years of medicine, for the bicentennial of the New England journal of medicine.
8. Loan Of Material
Dr. Susan Dackerman, the Carl A. Weyerhaeuser Curator of Prints at the Harvard Art Museums, presented two copies of Prints and the pursuit of knowledge in early modern Europe, her lavish catalog which accompanied the 2011-2012 exhibit incorporating a number of early anatomical works, including the Epitome of Vesalius and the two 1544 flap anatomical prints from the Boston Medical Library collection in the Countway. That exhibit was on display at the Sackler Museum in Cambridge and then moved to the Mary and Leigh Block Museum of Art at Northwestern University, in Evanston, Illinois.
A number of early anatomical works relating to fetal development, including Adriaan van de Spiegel’s De formato foetu (1626) were loaned for a one-day seminar at the Houghton Library, sponsored by Harvard’s Department of Human Evolutionary Biology, and three rare volumes, including the Ole Worm Museum Wormianum (1655) from the Tiedemann Collection of the Boston Medical Library were loaned for an exhibit, Cabinets of curiosity and rooms of wonder, at the Houghton Library (2011-2012).
Our gratitude to Dr. Adam Moore, former BML Trustee for many years, who has painstakingly continued to present the “BML” exhibits from his collection on the history of medicine at the MMS offices in Waltham. He changes the exhibit frequently to celebrate and enhance environmental events and themes (List of Exhibits in Appendix 4. I urge you to visit these interesting and instructive exhibits.
The 36th Annual Joseph E. Garland Memorial Lecture was delivered on October 25, 2011 by David Blumenthal, MD, MPP, Samuel O. Thier Professor of Medicine, Professor of Health Care Policy, HMS Mongan Institute for Health Policy, MGH on
“Bringing Health Information to Life.” His service as the National Coordinator of the Federal Office of Health Information Technology for its first two years informed his presentation. It was very well received.
The 37th Annual Joseph E. Garland Memorial Lecture will be delivered today by Siddhartha Mukherjee, MD, DPhil, Assistant Professor of Medicine and Oncologist at, Columbia University Medical Center. He is the author of The Emperor of All Maladies:
A Biography of Cancer which was awarded the 2011 Pulitzer Prize for General Nonfiction. He will speak on “Writing a History of Cancer: An epilogue.” There has been overwhelming registration for this and we have arranged for overflow in the Cannon Room with video streaming.
S. Jay Jayasankar, MD
October 11, 2012
2012-2013 Recipients of the Boston Medical Library’s Francis A. Countway Library Fellowship in the History of Medicine funded by BML’s Abel Lawrence Peirson fund:
Kaara L. Peterson (Miami University)
“Negotiating virtue: Elizabeth I and depictions of virginity in 16th and 17th century English art and culture”
Rafico Ruiz (McGill University)
Alexander Forbes, Sir William Grenfell, and the mapping of the coast of Labrador
Catherine L. Thomspon (University of Connecticut)
“Patient expectation: therapeutics in the early Republic”
List of current and previous years’ fellows may be accessed at:
Boston Medical Library Strategic Plan Priority Objectives
(Adopted by the Board on December 9, 2004
Progress Reviewed and reaffirmed February 16, 2012)
A. Objectives under Goal #1: Dissemination of Knowledge
B. Objectives under Goal #2: Promotion of Medical Education
- Remote access
- Offer training programs for physicians in electronic access and knowledge management
C. Objectives under Goal #3: Preservation and Celebration of History of Medicine
- Explore ways to increase awareness/access to learning programs for practicing physicians to maintain their lifelong professional development
D. Objectives under Enabling Goals -Infrastructure to support BML Goals and Objectives
- Cataloguing and preservation of and newer means of access to BML collection - e.g. digitization
- Programs with/without exhibits:
- Didactic/ Interactive
- Exhibits- on site, off site
- Publication of articles based on collection, periodically in journals
- Occasional publication of outstanding books
- Increase opportunities for promoting scholarship
- BML is true partner in developing plans for the Coutnway
- Responsiveness and leadership of Countway staff for BML needs, programs and services
- Staff and organizational structure to implement programs
- Staff and structure to enable grant/proposal writing and external partnership development
“To be a Library for the dissemination of medical knowledge, the promotion of medical education and scholarship, and the preservation and celebration of medical history, and thereby to advance the quality of health and healthcare of the people.”
1. [Professional Development-Technical] Lifelong learning (professional development)- upkeep and learning of new technical knowledge, technical skills (ACGME a, b)
2. [Professional Development-Professionalism] Lifelong learning (professional development)- upkeep and learning of new general professional knowledge and skills (ACGME competencies) (ACGME a, d, e)
3. [Professional Development –System Practice/Learn From Practice] Lifelong learning (professional development)- upkeep and learning of system based practice and practice based learning (ACGME c, f)
4. [Point of Care Needs] “Point of Care” learning- Learning knowledge / skills for specific patient need or avail of improved management (diagnosis or treatment)
5. [Focused-Learning Exercise] Focused preparatory learning for teaching/learning exercise
6. [Focused-Prep for Assessment] Focused learning to meet needs for specific physician assessment events (e.g. MOC)
7. [Business, managerial, compliance, political learning] Learning to meet business, managerial and political needs of practice/employment/leadership
ACGME General Competencies
a. Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
b. Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social behavioral) sciences and the application of this knowledge to patient care
c. Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care
d. Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals
e. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
f. Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value
The Adam Moore BML exhibits which have appeared in the three 46x22” MMS cases:
02 Jun 04 – 31 Oct 04: MEDICAL BOTANY
in support of MMS' medicinal garden
01 Nov 04 – 05 Dec 04: WHAT ON EARTH
introducing the specialty-based series of exhibits
05 Dec 04 – 05 Jan 05: THE HEART OF IT ALL
cardiology: pulse & stethoscopes, auscultation
05 Jan 05 – 15 Feb 05: MEDICAL MINERALS
pharmacology & materia medica
15 Feb 05 – 19 Mar 05 : MICROSCOPY
laboratory & medical education
19 Mar 05 – 28 Apr 05: SMALLPOX & VACCINATION
infectious disease & public health
28 Apr 05 – 08 Jun 05: OPHTHALMOSCOPY
The instrument’s development and forms
08 Jun 05 – 26 Jun 05: CRIMEAN
26 Jun 05 – 09 Aug 05: TUBERCULOSIS
recent case in a medical student
09 Aug 05 – 27 Sep 05: PHYSICIAN WRITERS (Summer Reading)
27 Sep 05 – 13 Nov 05: MANIKINS
examples from three centuries
13 Nov 05 – 08 Jan 06: CLINICAL THERMOMETRY
08 Jan 06 – 08 Mar 06: MEDICAL PHILATELY
postage rate increase effective 8 Jan 06
08 Mar 06 – 20 Apr 06: DOCumentation
It's Not Just a Paper Chase: Making Case for Documentation March 29, 8-12 MMS Hq
20 Apr 06 – 23 Jun 06: PLEASE PASS THE KNIFE
23 Jun 06 – 02 Aug 06: SPECTROSCOPY
02 Aug 06 – 24 Oct 06: STITCH IN TIME (sutures & ligatures)
24 Oct 06 – 04 Jan 07: HAPPY 225th!
MMS pubs in conjunction with loans for preparation of a commemorative video
04 Jan 07 – 15 Mar 07: COLORBLINDNESS
15 Mar 07 – 30 Apr 07: JUST IMAGING !
Imaging and Treatment Strategies in Primary Care Medicine, April 6,MMS Hq all day Jointly sponsored by Tufts School of Med., St. Elizabeth’s, & Tufts Health Care Institute
30 Apr 07 – 30 Jul 07: HERBALS
In support of MMS' medicinal garden
30 Jul 07 – 16 Oct 07: DOCTOR EXPLORERS
16 Oct 07 -22 Jan 08: MAPPING MEDICINE
22 Jan 08 – 13 Mar 08: RAZOR’S EDGE TO THE CUTTING EDGE
Related to Careers event in early February at MMS Hq
13 Mar 08 – 20 May 08: DOCTOR AT SEA
20 May 08 – 18 Sep 08: MMS HORTUS MEDICUS’ ORIGINS
In support of MMS' medicinal garden
18 Sep 08 – 19 Nov 08: ELEGANT TOOLS
19 Nov 08 – 30 Mar 09: TAKE YOUR MEDICINE
30 Mar 09 – 28 May 09: CALL AN AMBULANCE
Related to MMS' Hq 3/31 “Disaster & Primary Care: how to protect pts & practice”
28 May 09 – 20 Aug 09: PHYSICIENNES – I
Related to MMS' Hq program, 24 June, on early women members of the Society
28 Aug 09 – 22 Nov 09: PHYSICIENNES - II
Related to second MMS' Hq program, 25 Sep 09, on early women members of the Society
22 Nov 09 – 07 Jan 10: EPONYMOUS
17 Jan 10 – 17 July 10: WHAT’S BUGGING YOU!
17 July 10 – 12 Nov10: BALLOONS: BOSTON AND BEYOND
12 Nov 10 – 07 Dec 11: FINGERPRINTS
07 Dec 11 – 12 Apr 12: TONSIL TIME
15 Apr 12 -- 09 Oct 12: NEJM 200th
?" Playmates / 200th / ContemporariesOctober 11, 2012