The Medical Library Association's International Fellowship Programs* BY URSULA H. POLAND, Professor and Librarian
Schaffer Library of Health Sciences Albany Medical College Albany, New York ABSTRACT This article describes the two international fellowship programs administered by the International Cooperation Committee of the Medical Library Association: (1) the program supported by the Rockefeller Foundation from 1948 to 1963; (2) the Eileen R. Cunningham program, supported by Mrs. Cunningham's bequest to the association, from 1971 to date. Comments and suggestions received from Cunningham Fellows in response to a letter sent to each by the author in the summer of 1977 are listed. The cost of the fellowship program, not only in terms of financial support but also in terms of human resources, is documented. While the program receives enthusiastic support from the International Cooperation Committee and many members of MLA, the membership needs to examine its mission with regard "to the training of medical librarians from other countries, to determine whether future funding is to be sought.
FOR
Mary Louise Marshall set the stage for the fellowship program in her paper on training for medical librarianship in 1946. There she described the few specialized courses then available for medical librarianship and the one-year internship program she had successfully begun in New Orleans. She identified "three factors of equal importance which lead to good medical librarianship-(l) Recruitment of carefully selected and properly qualified personnel; (2) Education both general and professional; and (3) Experience, preferably supervised experience as represented by internship in a medical library"[ l]. It was this spirit and the realization that medical librarians have a role in furthering the excellence of their profession in other parts of the world that led to the formation of a new committee in 1948. First called the Committee on International and National Cooperation, it was organized during Eileen Cunningham's presidency. Mrs. Cunningham and Miss Janet Doe had attended the first national conference of the national commission on the United Nation's Educational, Scientific and Cultural Organization (UNESCO), which was held in Philadelphia in March 1947. This gave them insight not only into the general goals of UNESCO but, more specifically, into the goals of the Section on Books and Libraries, under the chairmanship of the Librarian of Congress, Luther H. Evans. The Section on Books and Libraries took up a review of nine projects in its field, including the exchange of librarians. We can thus trace what provided the stimulus for the formation of the new MLA committee. Its mission, in Eileen Cunningham's words, was
many years Medical Library Association members have shared their knowledge and experience in medical librarianship with people of other nations. Although many fine programs and knowledgeable librarians have promoted this service both here and abroad, this article will describe those programs that have been and are administered by the Medical Library Association through its International Cooperation Committee. There have been principally two programs: the first was the International Fellowship Program, administered by MLA and funded by the Rockefeller Foundation from 1948 to 1963; and the second is the Eileen R. Cunningham International Fellowship Program, which began in 1971 and is currently active. The Rockefeller Program began during an era when we had made the world safe for democracy. We were optimistic, and we were ready to rebuild to help build up collections of medical books and the bridges that had been broken during the war journals, especially in countries where medical libraries areas devastated by years. We began to look outward once more. were not yet well developed or in from other countries war, and [to] try to bring librarians for periods of study and observation in the medical li*Presented October 28, 1977, at the Annual Meeting braries of the United States [2].
of the North Atlantic Health Sciences Libraries, Montreal, Quebec. Bull. Med. Libr. Assoc. 66(4) October 1978
The plans for providing books and journals to li-
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braries overseas were carried forward but will not be followed here.
The committee deemed it important that candidates: (1) were persons working in a medical library or involved in education for medical librarianship; (2) provided assurance from a responsible person in their institution that employment on their return to their native country was guaranteed for a minimum of two years; (3) understood in accepting the grant that they were obligated to work in their own country toward promoting medical librarianship for a minimum of two years; (4) were primarily chosen from areas where new medical libraries were being organized, constructed, or reorganized; (5) contribute the cost of transportation to this country either from their own means or from other special grant funds; and (6) provide proof of their ability to read and speak English fluently enough to be able to follow courses in English. The application process was carefully monitored, and much thought was given to arranging a program that best fitted the needs of the individual in the context of his institution. Candidates used the application form furnished by the Institute of International Education, and provided records of their previous education and library training or experience and letters of recommendation, including letters from U.S. officers of information, representatives of the Institute of International Education, or other professional North Americans working in the applicant's country, as well as letters from compatriot librarians from the applicant's country. Programs were, whenever possible, planned so
that candidates could attend scheduled meetings of the Medical Library Association and special courses in medical librarianship. The programs initially consisted of a fairly flexible schedule of periods of study, either in medical libraries or in library schools where courses could be combined with practical work in a nearby medical library. Eventually the program provided two distinct fellowships: first, a study fellowship, which would generally be for one year and could include attainment of a master's degree in library science; second, a travel fellowship, spanning from six to nine months spent on visits to several libraries and attendance at a medical librarianship course. The first grant from the Rockefeller Foundation was for one year. It enabled the committee to award three fellowships. The Rockefeller Foundation stipulated that these fellowships be used for Latin American candidates only. This stipulation was followed when awarding the second annual award, again for three fellowships. The third annual renewal of the Rockefeller Foundation permitted extension of the program to countries other than Latin America. By this time the fellowship program was deemed sufficiently successful by the Rockefeller Foundation that the'latter changed its funding from annual grants to triernial awards. Altogether there were three annual grants and four triennial awards, a total of $87,500. This sum provided thirty-eight fellowships for fellows from twenty-five countries over a period of fifteen years. Rockefeller fellows came from the following countries: Argentina, Austria, Brazil, Chile, Colombia, Cuba, El Salvador, Finland, Ghana, India, Israel, Japan, Korea, Mexico, the Netherlands, New Zealand, Nigeria, Northern Ireland, Norway, the Philippines, the Republic of South Africa, Senegal, the Territory of Papua and New Guinea, Thailand, and Uruguay. What was accomplished? We have two summary reports [2, 3], as well as the annual reports of the Committee of International Cooperation. Mrs. Cunningham's 1951 paper cites reports from the fellows after they returned to their country, as well as reports from representatives of foundations working in the international field. Such representatives found that those trained under the Rockefeller program were making excellent contributions in their own country. To gain some more insight into the human dimensions of this program, I wish to quote Mrs. Cunningham again:
*Janet Doe, Dr. Sanford V. Larkey, Scott Adams, Sarah Mayer, and Eileen R. Cunningham.
In an undertaking of this type it is impossible to expect 100 per cent success. We hope that most of the fellowships will be immediately useful as planned.
THE ROCKEFELLER FELLOWSHIP PROGRAM The committee members* planned the program with great care. Mrs. Mayer, in a later review of the scholarship program, stated: Before drafting a training program, Janet Doe, the first Chairman of the Committee, and Eileen Cunningham, Chairman, 1949-55, carried on extensive correspondence and consultations with individuals and organizations, such as ALA, the Department of State, UNESCO, and WHO, that were concerned with similar projects in other fields. It was due to the untiring efforts of Miss Doe and Mrs. Cunningham that the policies and details of the scholarship program, from the objectives to be served to the requirements and terms of the awards, were decided upon and the program was actually started [3].
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Bull. Med. Libr. Assoc. 66(4) October 1978
MLA INTERNATIONAL FELLOWSHIP PROGRAMS However, we are living in a world of political unrest, and because of unexpected turns of the wheel of fortune, the recipients of fellowships may not always continue to work under the circumstances we had hoped they would when the award was made. Nevertheless, experience with scholarships and fellowships has shown that frequently one which looks as though it were a complete loss several years later has again become exceedingly useful and the recipient is found organizing a medical library or a technical library in the same country or some other area close by [2].
1970 the board of MLA decided to release the principal of Mrs. Cunningham's bequest for the resumption of the fellowship program. Thus, the current program began in the name of the person who not only contributed her abilities and energies to the fellowship program from its inception but also made it possible to continue the program after her death. Eileen Cunningham's remarkable contributions are described by Langner [5] and Keys [6]. Let Mrs. Mayer, in her 1960 review, reports "that me only quote Langner's beginning paragraph in all but two fellows [out of twenty-nine] fulfilled the obituary notice published in the MLA Bulletin their two-year minimum requirement of in 1966: postfellowship work and that most of them were continuing in the medical library field beyond that September 21, 1965, brought to a close the career of
period"[3]. At annual meetings fellows were asked to address the members of MLA, and some of them conveyed their story with great eloquence. Annual meetings must have been more leisurely affairs then. To the best of my knowledge a review of the current activities of Rockefeller Fellows has not been undertaken. We know that many continue to practice medical librarianship. The Rockefeller program ceased in 1963. Annual reports of the Committee on International Cooperation in the mid-1960s document the many attempts made to secure funding from other sources in order to rekindle Rockefeller Foundation interest on a matching basis. All these efforts proved unsuccessful. In September 1965 Eileen Roach Cunningham died, and at the 1966 annual meeting her successor at Vanderbilt University School of Medicine, Eleanor Steinke, proposed that a memorial fund be established in the name of Eileen R. Cunningham. The MLA board was receptive, stipulating only that Vanderbilt University would jointly sponsor such an effort. The 1967 annual report of the Committee on International Cooperation stated: The board, at its meeting on June 6-7, 1966, accepted a proposal from the Vanderbilt University School of Medicine to establish an Eileen R. Cunningham Fund for International Library Cooperation. On March 1, 1967, the Executive Secretary received a check for $33,068.64 from the estate of the late Mrs. Cunningham, which will form the nucleus of this fund. The income from this fund will be used to reestablish the MLA foreign fellowship program [4].
The plan was to have Vanderbilt University contact possible donors to the fund first, before MLA would solicit funds from its members. Unfortunately, neither solicitation took place, and in Bull. Med. Libr. Assoc. 66(4) October 1978
Eileen Roach Cunningham, one of the Medical Library Association's most brilliant leaders. She was born in Baltimore, Maryland, and died seventy-one years later in Nashville, Tennessee. Both of these cities had been home to her, but little was the time she spent in either, because from her earliest years she was constantly traveling to distant places. She had been abroad several times before she was ten years old, and she continued this active pace throughout her life-always delving into new things, meeting new people, learning, absorbing, and living the international aspect of life [5].
Keys, in his 1975 paper, "Past presidents I have known," has a section on Eileen Cunningham, which elaborates further Mrs. Cunningham's "philosophy not only concerning her internationalism, but also of her interest in young people and in small libraries as well as large ones" [6]. THE EILEEN R. CUNNINGHAM INTERNATIONAL FELLOWSHIP The Committee on International Cooperation, under the capable chairmanship of Carroll Reynolds, approached the new program cautiously and decided initially to offer one six-month combined study and training fellowship per year, which would include travel within the United States to permit the fellow a visit to the National Library of Medicine, other medical libraries, and if possible attendance at an annual meeting of MLA. It required some time to publicize the program once more. This was done principally by sending announcements to MLA individual and institutional members in other countries and to the Unesco Bulletin for Libraries. More recently, the announcements have gone to editors of other library journals abroad and, most importantly, have been included in the World Health Organization's Health Literature Topics. The first award was made in 197 1. In 1974 (when the Committee on International Cooperation became the International Cooperation Committee, to appear more
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logically in the alphabet of MLA committees) the committee petitioned the board to permit it to offer not only a six-month fellowship, but also a oneyear fellowship, to give candidates an opportunity to earn a master's degree while in the United States or Canada. The guidelines were more firmly drawn up; they greatly parallel the Rockefeller Fellowship Program in purpose, as well as in the terms and qualifications demanded of candidates [7]. Both the International Cooperation Committee and the MLA Board concluded that a solid demonstration of what can be done in this program, even though it might more rapidly diminish the Cunningham funds, could be more helpful in garnering future financial support. Thus, since 1975 the program has sponsored up to two fellows per year. To date eight six-month fellowships have been awarded and two one-year fellowships. These ten fellows have come from ten different countries in a period of seven years: India, Japan, Nigeria, Malaysia, the Philippines, Portugal, Rhodesia, Scotland, Sweden, and Thailand. (See Appendix.) Both the Rockefeller Program and the current program select candidates from developed, as well as developing, countries. What is being accomplished? Only this year (1977/78) have we made an organized attempt to contact each of the Cunningham fellows who have completed their fellowships. We have heard directly from all but one of the fellows to date. Just as Mrs. Cunningham found in 1951, "it is impossible to achieve 100 per cent success" [2] in such a program. All but one of the fellows returned to their country to resume work in the libraries they came from. Fellows' achievements subsequent to their training in the United States include: the publication of several papers and a translation of the National Library of Medicine Classification; direction of workshops; addresses to colleagues and members of library associations on experience gained in the United States; substantial reports to parent institutions outlining plans for improved library services and facilities; assistant editorship of a medical journal; application of computerized bibliographic searching skills; promotion to higher positions. There are reports of frustration also, especially fro,n fellows who returned to countries where the lack of resources provide few opportunities to meaningfully apply newly gained skills. In my letter to the past fellows, I posed a number of questions and also encouraged them to send suggestions, comments, critiques, and
450
recommendations. Let me summarize these first and then refer to some aspects of the program as they affect not only members of the International Cooperation Committee but members of the Medical Library Association as a whole. Comments included the following: (1) Fellows who did not have the opportunity to come for a one-year fellowship applaud this newly added possibility. One fellow wishes this period could be extended to cover study for a doctorate. On the other hand, another fellow favors concentration on six-month fellowships, in order to allow more people to participate, with special emphasis on practical experience in U.S. or Canadian libraries. (2) All fellows felt that receiving training in the United States or Canada was preferable to sending qualified teachers to their country for concentrated courses in medical libriarianship. Yet one of the fellows is coordinator for a conference on medical librarianship in developing countries, proposed for August 1978, that hopes to work out plans to bring education for medical librarianship to developing countries. (3) All fellows, to a greater or lesser degree, felt that the fellowship not only had enhanced their own professional growth, but had also contributed to that of others in their country. Suggestions included: (1) Selection and announcement of the Cunningham award should take place earlier in the year than it now does to enable the fellow to make his travel preparations in good time (applications are currently accepted until March 1, and the award is announced in mid-May). (2) A certificate from MLA should be given to the Cunningham Fellow at the completion of his fellowship. (3) Gratis MLA membership should be an ongoing perquisite for Cunningham fellows. ^ (4) Fellows, especially those who have not visited a Western country in the past, should be given a period of time in which to adjust to the cultural and physical change. (5) In developing countries the selection of the candidate should involve a relevant government agency to assure that the best possible candidate is selected. (6) The problems existing in the countries from which the candidates come should be known to the U.S. or Candian mentors so that they can propose more realistic solutions to these problems. These comments and suggestions have much merit and will be seriously considered by the International Cooperation Committee. Bull. Med. Libr. Assoc. 66(4) October 1978
MLA INTERNATIONAL FELLOWSHIP PROGRAMS
Now let us consider the program as it affects us as members of MLA. In 1960 Louise Darling, then chairman of the Committee on International Cooperation, wrote of the frustrations of receiving thirteen applications from eleven countries and the "incredible amount of correspondence and co-ordination required in proper planning of schedules" [8]. In 1976 and 1977 requests for applications numbered over sixty, with as many as twenty-one candidates completing the quite complex application procedure. Selection of at most two candidates proves a difficult task for the subcommittee. Too many candidates are left disappointed. During the Rockefeller program, the committee consisted of five persons, who managed the entire fellowship program. Hospitality committees were established in major cities, and I need not stress that then, as now, numerous members of MLA were intensely involved in the fellowship program as teachers, librarians providing training programs, hosts for short visits, itinerary planners, port of entry greeters, and so on. Without the support of the membership the program could not exist. Currently the administrative work falls principally on the chairman of the committee and a subcommittee of the International Cooperation Committee. MLA headquarters began in 1977 to assume responsibility for publicizing the program and for providing the initial contact with candidates, freeing the committee of some of the burden of correspondence. The human problems remain the same and cannot accurately be
foreseen. A recent conversation with Anna Frances Burke, who was chairman of the Committee on International Cooperation from 1957-1959 confirms that our experiences, though almost twenty years apart, are quite similar. We must not and should not expect fellows to possess the degree of organization, capacity for work, and ease of communication that we expect of ourselves. We must allow time for adjustment to our time schedules, our food, our money and transportation systems, our whole mode of life. In 1949 the first Rockefeller fellow was given a six-week general orientation course at Wellesley College before beginning library training. In recent years we have not necessarily given such considerate treatment to fellows who would have appreciated it. It is difficult to explain to fellows that the money provided by the stipend must be carefully husbanded to stretch the entire course. Some fellows manage beautifully, learn to look Bull. Med. Libr. Assoc. 66(4) October 1978
ahead, and live frugally during their study/training period, so as to be able to have enough money left over for the more expensive period of travel and attendance at meetings. Others, however, have experienced difficulties, especially those who have no private resources of their own to fall back on. To some questions such as "How can we improve the selection process?" and "How can we better adjust the education and training to the fellow's needs in terms of his own country's development?" we only have partial answers. In order to select the best possible candidate, one who possesses the qualities necessary to influence his colleagues on his return to his country, I would suggest the following additions to the present application procedure: (1) A personal interview in the candidate's country by a U.S. educational officer or equivalent to assess the personal qualities of candidates more accurately. (2) Submission of an essay by the candidate, which should include a description of his library, his duties, his goals and aspirations, and indication of his study/training needs. (3) A letter from the candidate's parent institution guaranteeing not only reemployment but also the opportunity for the candidate to impart his training to others. To address ourselves meaningfully to the question of how we can better adjust the education and training to the fellow's needs in terms of his own country's development is much more difficult. Some library schools are making provision for courses in international librarianship and are addressing themselves to library problems in developing countries. In developing training programs for specific fellows, we must become more aware of their country's attitude toward the profession of librarianship and their country's method of training librarians. Estelle Brodman, in her 1964 paper on education for medical librarians around the world touches on both these points: she talks about the low status of librarians as a social and economic group, especially in South America and Asia, and the consequent frustrations [9]. Library training methods, she states, have fallen into three groups since the replacement of apprenticeship by formal training: "The guild system is characteristic of British and Commonwealth countries, the European university system is mirrored in German practice, and the Americans tend to use the technological school approach" [9]. In arranging programs for fellows, we have of necessity imposed the American system upon
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them, and this is not totally satisfactory for those coming from countries nurtured on the British system, as India, for instance. Further questions to which we need to address ourselves are: (1) Are we frustrating some of those we bring to the United States and Canada, when the resources they return to are so inadequate as to make it impossible to put their acquired knowledge and training into practice? (2) Should we, therefore, not select fellows from such countries? (3) Instead of fragmenting our efforts in all parts of the world, should we concentrate on one region, or a few countries only, as the Rockefeller program initially did? The International Cooperation Committee needs assistance from the general membership to find answers to these questions. Thus far I have referred to the investment of our time and skills; something needs to be said about the program as it affects us financially. The Rockefeller Foundation contributed $87,500 to the program over a period of fifteen years. This provided nineteen study fellowships and nineteen travel fellowships for twenty-four women and fourteen men. The Eileen R. Cunningham bequest, by remaining untapped while it awaited contributions from both Vanderbilt University and the members of the Medical Library Association, gained over $9,000 in interest before the current fellowship program began, raising the total to $42,458. The fund is earning less interest now, as it is being used. The annual report distributed at the Seventy-seventh Annual Meeting of MLA in Seattle in 1977 showed the fund at $31,290 for 1976. The actual cost of the program, exclusive of funds for the 1977/78 fellows, has been $28,829.78, providing one one-year and seven sixmonth fellowships to five women and three men. In addition, MLA has provided financial support to administer the fellowship, and in the past two years the association has added perquisites to the fellowships, such as a one-year associate membership in MLA during the period of the fellowship and attendance at a continuing education course and certain functions during MLA annual meetings. The Rockefeller program ended because MLA was unable to find matching funds demanded by the Rockefeller Foundation if the latter was to support the program further. The Cunningham program may similarly end if we do not, ourselves, begin to build up a fund for interna452
tional fellowship purposes, or if we fail to identify and capture outside sources of funding. Is it worth it? In terms of human gains, I speak for many MLA members when I resoundingly answer "yes." The positive testimony built up by both Rockefeller and Cunningham fellows is hard to refute. One of the recent fellows writes: The fellowship program proved to be most useful both directly and indirectly. The direct results of the experience would be in the form of new policies and procedures learned that are applicable to the day-to-day routine of our library. The indirect benefit comes in the form of an improvement on the personality of the fellow; the program results in a more confident and more forward-looking decision maker. The direct benefits come mainly from the work experience at the Columbia University Health Sciences Library and also from information obtained from the visits to libraries. The indirect benefit comes with the exposure to a more advanced medical library environment and hence ability to use the experience as a guide in the decision-making process [10].
1. 2.
3.
4.
5.
REFERENCES MARSHALL, M. L. Training for medical librarianship. Bull. Med. Libr. Assoc. 34: 247-265, Oct. 1946. CUNNINGHAM, E. R. Evaluation of a three-year program of international cooperation in medical librarianship. Bull. Med. Libr. Assoc. 39: 295-305, Oct. 1951. MAYER, S. International co-operation in medical librarianship: a review of the scholarship program of the Medical Library Association, 1948-1960. Bull. Med. Libr. Assoc. 48: 239-242, July 1960. Report of the Committee on International Cooperation. Proceedings, Sixty-sixth Annual Meeting, Medical Library Association, Inc., Miami, Florida, June 11-16, 1967. Bull. Med. Libr. Assoc. 55: 457-458, Oct. 1967. LANGNER, M. C. Obituaries: Eileen Roach Cunningham, 1894- 1965. Bull. Med. Libr. Assoc. 54:
93-95, Jan. 1966. 6. KEYS, THOMAS E. Past presidents I have known. Bull. Med. Libr. Assoc. 63: 54-56, Jan. 1975. 7. Proceedings, Seventy-fifth Annual Meeting, Medical Library Association, Inc., Minneapolis, Minnesota, June 14-17, 1976. Appendix 1: Medical Library Association. International Cooperation Committee. Bull. Med. Libr. Assoc. 65: 159-160, Jan. 1977. 8. Proceedings, Fifty-ninth Annual Meeting, Medical Library Association, Inc., Kansas City, Missouri, May 16-20, 1960. Committee on International Co-operation [report]. Bull. Med. Libr. Assoc. 48: 502-503, Oct. 1960. 9. BRODMAN, E. Education for medical librarians around the world. Bull. Med. Libr. Assoc. 52:
99-116,Jan.1964.
10. AHMAD, MISKIAH. Personal communication, 1977.
Received March 10, 1978; revision accepted June 7, 1978. Bull. Med. Libr. Assoc. 66(4) October 1978
MLA INTERNATIONAL FELLOWSHIP PROGRAMS
APPENDIX EILEEN R. CUNNINGHAM INTERNATIONAL FELLOWS*
Year
Name
U.S. training
1971/72
Mr. A. Majid Pathan St. John's Medical College Library Bangalore, India Miss Shinako Honda National Cancer Research Institute Tokyo, Japan Miss Jean Adams Central Medical Library Edinburgh University Edinburgh, Scotland Miss Lucita B. Dones Science Library Philippine Women's University Manila, Philippines Mr. B. Lennard Erikson University of Umea Umea, Sweden Mr. Godfrey Belleh College of Medicine University of Lagos
Falk Library University of Pittsburgh Pittsburgh, Pennsylvania Shiflman Medical Library Wayne State University School of Medicine Detroit, Michigan Bio-Medical Library University of Minnesota Minneapolis, Minnesota
1972/73
1973/74
1974/75
1975/76
1975/76
1976/77
1976/77
1977/78
1977/78
Nigeria Mrs. Miskiah Ahmad Medical Library University of Malaysia Kuala Lumpur, Malaysia Mrs. Wilawan Vongsuphar Chulalongkorn Medical College Bangkok, Thailand
Mrs. Dulcinea Tavares Nunez Faculty of Medicine Library Lisbon, Portugal Miss Susan Flegg Medical Library University of Rhodesia Salisbury, Rhodesia
Biomedical Library University of California, Los Angeles Los Angeles, California Bio-Medical Library University of Minnesota Minneapolis, Minnesota Health Sciences Library Case Western Reserve University Cleveland, Ohio Health Sciences Library Columbia University New York, New York
Schaffer Library of Health Sciences Albany Medical College Albany, New York Scott Memorial Library Thomas Jefferson University Philadelphia, Pennsylvania Mayo Clinic Library Rochester, Minnesota University of Oregon Health Science Library Portland, Oregon Treadwell Library Massachusetts General Hospital Boston, Massachusetts College of Library Science University of Kentucky Lexington, Kentucky
*For a list of Rockefeller Fellows see: FRASER, D. The Medical Library Association: the span of its international activities. A chronology. Bull. Med. Libr. Assoc. 59:509-5 10, July 1971.
Bull. Med. Libr. Assoc. 66(4) October 1978
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Schaffer Library of Health Sciences Albany Medical College Albany, New York ABSTRACT This article describes the two international fellowship programs administered by the International Cooperation Committee of the Medical Library Association: (1) the program supported by the Rockefeller Foundation from 1948 to 1963; (2) the Eileen R. Cunningham program, supported by Mrs. Cunningham's bequest to the association, from 1971 to date. Comments and suggestions received from Cunningham Fellows in response to a letter sent to each by the author in the summer of 1977 are listed. The cost of the fellowship program, not only in terms of financial support but also in terms of human resources, is documented. While the program receives enthusiastic support from the International Cooperation Committee and many members of MLA, the membership needs to examine its mission with regard "to the training of medical librarians from other countries, to determine whether future funding is to be sought.
FOR
Mary Louise Marshall set the stage for the fellowship program in her paper on training for medical librarianship in 1946. There she described the few specialized courses then available for medical librarianship and the one-year internship program she had successfully begun in New Orleans. She identified "three factors of equal importance which lead to good medical librarianship-(l) Recruitment of carefully selected and properly qualified personnel; (2) Education both general and professional; and (3) Experience, preferably supervised experience as represented by internship in a medical library"[ l]. It was this spirit and the realization that medical librarians have a role in furthering the excellence of their profession in other parts of the world that led to the formation of a new committee in 1948. First called the Committee on International and National Cooperation, it was organized during Eileen Cunningham's presidency. Mrs. Cunningham and Miss Janet Doe had attended the first national conference of the national commission on the United Nation's Educational, Scientific and Cultural Organization (UNESCO), which was held in Philadelphia in March 1947. This gave them insight not only into the general goals of UNESCO but, more specifically, into the goals of the Section on Books and Libraries, under the chairmanship of the Librarian of Congress, Luther H. Evans. The Section on Books and Libraries took up a review of nine projects in its field, including the exchange of librarians. We can thus trace what provided the stimulus for the formation of the new MLA committee. Its mission, in Eileen Cunningham's words, was
many years Medical Library Association members have shared their knowledge and experience in medical librarianship with people of other nations. Although many fine programs and knowledgeable librarians have promoted this service both here and abroad, this article will describe those programs that have been and are administered by the Medical Library Association through its International Cooperation Committee. There have been principally two programs: the first was the International Fellowship Program, administered by MLA and funded by the Rockefeller Foundation from 1948 to 1963; and the second is the Eileen R. Cunningham International Fellowship Program, which began in 1971 and is currently active. The Rockefeller Program began during an era when we had made the world safe for democracy. We were optimistic, and we were ready to rebuild to help build up collections of medical books and the bridges that had been broken during the war journals, especially in countries where medical libraries areas devastated by years. We began to look outward once more. were not yet well developed or in from other countries war, and [to] try to bring librarians for periods of study and observation in the medical li*Presented October 28, 1977, at the Annual Meeting braries of the United States [2].
of the North Atlantic Health Sciences Libraries, Montreal, Quebec. Bull. Med. Libr. Assoc. 66(4) October 1978
The plans for providing books and journals to li-
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braries overseas were carried forward but will not be followed here.
The committee deemed it important that candidates: (1) were persons working in a medical library or involved in education for medical librarianship; (2) provided assurance from a responsible person in their institution that employment on their return to their native country was guaranteed for a minimum of two years; (3) understood in accepting the grant that they were obligated to work in their own country toward promoting medical librarianship for a minimum of two years; (4) were primarily chosen from areas where new medical libraries were being organized, constructed, or reorganized; (5) contribute the cost of transportation to this country either from their own means or from other special grant funds; and (6) provide proof of their ability to read and speak English fluently enough to be able to follow courses in English. The application process was carefully monitored, and much thought was given to arranging a program that best fitted the needs of the individual in the context of his institution. Candidates used the application form furnished by the Institute of International Education, and provided records of their previous education and library training or experience and letters of recommendation, including letters from U.S. officers of information, representatives of the Institute of International Education, or other professional North Americans working in the applicant's country, as well as letters from compatriot librarians from the applicant's country. Programs were, whenever possible, planned so
that candidates could attend scheduled meetings of the Medical Library Association and special courses in medical librarianship. The programs initially consisted of a fairly flexible schedule of periods of study, either in medical libraries or in library schools where courses could be combined with practical work in a nearby medical library. Eventually the program provided two distinct fellowships: first, a study fellowship, which would generally be for one year and could include attainment of a master's degree in library science; second, a travel fellowship, spanning from six to nine months spent on visits to several libraries and attendance at a medical librarianship course. The first grant from the Rockefeller Foundation was for one year. It enabled the committee to award three fellowships. The Rockefeller Foundation stipulated that these fellowships be used for Latin American candidates only. This stipulation was followed when awarding the second annual award, again for three fellowships. The third annual renewal of the Rockefeller Foundation permitted extension of the program to countries other than Latin America. By this time the fellowship program was deemed sufficiently successful by the Rockefeller Foundation that the'latter changed its funding from annual grants to triernial awards. Altogether there were three annual grants and four triennial awards, a total of $87,500. This sum provided thirty-eight fellowships for fellows from twenty-five countries over a period of fifteen years. Rockefeller fellows came from the following countries: Argentina, Austria, Brazil, Chile, Colombia, Cuba, El Salvador, Finland, Ghana, India, Israel, Japan, Korea, Mexico, the Netherlands, New Zealand, Nigeria, Northern Ireland, Norway, the Philippines, the Republic of South Africa, Senegal, the Territory of Papua and New Guinea, Thailand, and Uruguay. What was accomplished? We have two summary reports [2, 3], as well as the annual reports of the Committee of International Cooperation. Mrs. Cunningham's 1951 paper cites reports from the fellows after they returned to their country, as well as reports from representatives of foundations working in the international field. Such representatives found that those trained under the Rockefeller program were making excellent contributions in their own country. To gain some more insight into the human dimensions of this program, I wish to quote Mrs. Cunningham again:
*Janet Doe, Dr. Sanford V. Larkey, Scott Adams, Sarah Mayer, and Eileen R. Cunningham.
In an undertaking of this type it is impossible to expect 100 per cent success. We hope that most of the fellowships will be immediately useful as planned.
THE ROCKEFELLER FELLOWSHIP PROGRAM The committee members* planned the program with great care. Mrs. Mayer, in a later review of the scholarship program, stated: Before drafting a training program, Janet Doe, the first Chairman of the Committee, and Eileen Cunningham, Chairman, 1949-55, carried on extensive correspondence and consultations with individuals and organizations, such as ALA, the Department of State, UNESCO, and WHO, that were concerned with similar projects in other fields. It was due to the untiring efforts of Miss Doe and Mrs. Cunningham that the policies and details of the scholarship program, from the objectives to be served to the requirements and terms of the awards, were decided upon and the program was actually started [3].
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MLA INTERNATIONAL FELLOWSHIP PROGRAMS However, we are living in a world of political unrest, and because of unexpected turns of the wheel of fortune, the recipients of fellowships may not always continue to work under the circumstances we had hoped they would when the award was made. Nevertheless, experience with scholarships and fellowships has shown that frequently one which looks as though it were a complete loss several years later has again become exceedingly useful and the recipient is found organizing a medical library or a technical library in the same country or some other area close by [2].
1970 the board of MLA decided to release the principal of Mrs. Cunningham's bequest for the resumption of the fellowship program. Thus, the current program began in the name of the person who not only contributed her abilities and energies to the fellowship program from its inception but also made it possible to continue the program after her death. Eileen Cunningham's remarkable contributions are described by Langner [5] and Keys [6]. Let Mrs. Mayer, in her 1960 review, reports "that me only quote Langner's beginning paragraph in all but two fellows [out of twenty-nine] fulfilled the obituary notice published in the MLA Bulletin their two-year minimum requirement of in 1966: postfellowship work and that most of them were continuing in the medical library field beyond that September 21, 1965, brought to a close the career of
period"[3]. At annual meetings fellows were asked to address the members of MLA, and some of them conveyed their story with great eloquence. Annual meetings must have been more leisurely affairs then. To the best of my knowledge a review of the current activities of Rockefeller Fellows has not been undertaken. We know that many continue to practice medical librarianship. The Rockefeller program ceased in 1963. Annual reports of the Committee on International Cooperation in the mid-1960s document the many attempts made to secure funding from other sources in order to rekindle Rockefeller Foundation interest on a matching basis. All these efforts proved unsuccessful. In September 1965 Eileen Roach Cunningham died, and at the 1966 annual meeting her successor at Vanderbilt University School of Medicine, Eleanor Steinke, proposed that a memorial fund be established in the name of Eileen R. Cunningham. The MLA board was receptive, stipulating only that Vanderbilt University would jointly sponsor such an effort. The 1967 annual report of the Committee on International Cooperation stated: The board, at its meeting on June 6-7, 1966, accepted a proposal from the Vanderbilt University School of Medicine to establish an Eileen R. Cunningham Fund for International Library Cooperation. On March 1, 1967, the Executive Secretary received a check for $33,068.64 from the estate of the late Mrs. Cunningham, which will form the nucleus of this fund. The income from this fund will be used to reestablish the MLA foreign fellowship program [4].
The plan was to have Vanderbilt University contact possible donors to the fund first, before MLA would solicit funds from its members. Unfortunately, neither solicitation took place, and in Bull. Med. Libr. Assoc. 66(4) October 1978
Eileen Roach Cunningham, one of the Medical Library Association's most brilliant leaders. She was born in Baltimore, Maryland, and died seventy-one years later in Nashville, Tennessee. Both of these cities had been home to her, but little was the time she spent in either, because from her earliest years she was constantly traveling to distant places. She had been abroad several times before she was ten years old, and she continued this active pace throughout her life-always delving into new things, meeting new people, learning, absorbing, and living the international aspect of life [5].
Keys, in his 1975 paper, "Past presidents I have known," has a section on Eileen Cunningham, which elaborates further Mrs. Cunningham's "philosophy not only concerning her internationalism, but also of her interest in young people and in small libraries as well as large ones" [6]. THE EILEEN R. CUNNINGHAM INTERNATIONAL FELLOWSHIP The Committee on International Cooperation, under the capable chairmanship of Carroll Reynolds, approached the new program cautiously and decided initially to offer one six-month combined study and training fellowship per year, which would include travel within the United States to permit the fellow a visit to the National Library of Medicine, other medical libraries, and if possible attendance at an annual meeting of MLA. It required some time to publicize the program once more. This was done principally by sending announcements to MLA individual and institutional members in other countries and to the Unesco Bulletin for Libraries. More recently, the announcements have gone to editors of other library journals abroad and, most importantly, have been included in the World Health Organization's Health Literature Topics. The first award was made in 197 1. In 1974 (when the Committee on International Cooperation became the International Cooperation Committee, to appear more
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logically in the alphabet of MLA committees) the committee petitioned the board to permit it to offer not only a six-month fellowship, but also a oneyear fellowship, to give candidates an opportunity to earn a master's degree while in the United States or Canada. The guidelines were more firmly drawn up; they greatly parallel the Rockefeller Fellowship Program in purpose, as well as in the terms and qualifications demanded of candidates [7]. Both the International Cooperation Committee and the MLA Board concluded that a solid demonstration of what can be done in this program, even though it might more rapidly diminish the Cunningham funds, could be more helpful in garnering future financial support. Thus, since 1975 the program has sponsored up to two fellows per year. To date eight six-month fellowships have been awarded and two one-year fellowships. These ten fellows have come from ten different countries in a period of seven years: India, Japan, Nigeria, Malaysia, the Philippines, Portugal, Rhodesia, Scotland, Sweden, and Thailand. (See Appendix.) Both the Rockefeller Program and the current program select candidates from developed, as well as developing, countries. What is being accomplished? Only this year (1977/78) have we made an organized attempt to contact each of the Cunningham fellows who have completed their fellowships. We have heard directly from all but one of the fellows to date. Just as Mrs. Cunningham found in 1951, "it is impossible to achieve 100 per cent success" [2] in such a program. All but one of the fellows returned to their country to resume work in the libraries they came from. Fellows' achievements subsequent to their training in the United States include: the publication of several papers and a translation of the National Library of Medicine Classification; direction of workshops; addresses to colleagues and members of library associations on experience gained in the United States; substantial reports to parent institutions outlining plans for improved library services and facilities; assistant editorship of a medical journal; application of computerized bibliographic searching skills; promotion to higher positions. There are reports of frustration also, especially fro,n fellows who returned to countries where the lack of resources provide few opportunities to meaningfully apply newly gained skills. In my letter to the past fellows, I posed a number of questions and also encouraged them to send suggestions, comments, critiques, and
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recommendations. Let me summarize these first and then refer to some aspects of the program as they affect not only members of the International Cooperation Committee but members of the Medical Library Association as a whole. Comments included the following: (1) Fellows who did not have the opportunity to come for a one-year fellowship applaud this newly added possibility. One fellow wishes this period could be extended to cover study for a doctorate. On the other hand, another fellow favors concentration on six-month fellowships, in order to allow more people to participate, with special emphasis on practical experience in U.S. or Canadian libraries. (2) All fellows felt that receiving training in the United States or Canada was preferable to sending qualified teachers to their country for concentrated courses in medical libriarianship. Yet one of the fellows is coordinator for a conference on medical librarianship in developing countries, proposed for August 1978, that hopes to work out plans to bring education for medical librarianship to developing countries. (3) All fellows, to a greater or lesser degree, felt that the fellowship not only had enhanced their own professional growth, but had also contributed to that of others in their country. Suggestions included: (1) Selection and announcement of the Cunningham award should take place earlier in the year than it now does to enable the fellow to make his travel preparations in good time (applications are currently accepted until March 1, and the award is announced in mid-May). (2) A certificate from MLA should be given to the Cunningham Fellow at the completion of his fellowship. (3) Gratis MLA membership should be an ongoing perquisite for Cunningham fellows. ^ (4) Fellows, especially those who have not visited a Western country in the past, should be given a period of time in which to adjust to the cultural and physical change. (5) In developing countries the selection of the candidate should involve a relevant government agency to assure that the best possible candidate is selected. (6) The problems existing in the countries from which the candidates come should be known to the U.S. or Candian mentors so that they can propose more realistic solutions to these problems. These comments and suggestions have much merit and will be seriously considered by the International Cooperation Committee. Bull. Med. Libr. Assoc. 66(4) October 1978
MLA INTERNATIONAL FELLOWSHIP PROGRAMS
Now let us consider the program as it affects us as members of MLA. In 1960 Louise Darling, then chairman of the Committee on International Cooperation, wrote of the frustrations of receiving thirteen applications from eleven countries and the "incredible amount of correspondence and co-ordination required in proper planning of schedules" [8]. In 1976 and 1977 requests for applications numbered over sixty, with as many as twenty-one candidates completing the quite complex application procedure. Selection of at most two candidates proves a difficult task for the subcommittee. Too many candidates are left disappointed. During the Rockefeller program, the committee consisted of five persons, who managed the entire fellowship program. Hospitality committees were established in major cities, and I need not stress that then, as now, numerous members of MLA were intensely involved in the fellowship program as teachers, librarians providing training programs, hosts for short visits, itinerary planners, port of entry greeters, and so on. Without the support of the membership the program could not exist. Currently the administrative work falls principally on the chairman of the committee and a subcommittee of the International Cooperation Committee. MLA headquarters began in 1977 to assume responsibility for publicizing the program and for providing the initial contact with candidates, freeing the committee of some of the burden of correspondence. The human problems remain the same and cannot accurately be
foreseen. A recent conversation with Anna Frances Burke, who was chairman of the Committee on International Cooperation from 1957-1959 confirms that our experiences, though almost twenty years apart, are quite similar. We must not and should not expect fellows to possess the degree of organization, capacity for work, and ease of communication that we expect of ourselves. We must allow time for adjustment to our time schedules, our food, our money and transportation systems, our whole mode of life. In 1949 the first Rockefeller fellow was given a six-week general orientation course at Wellesley College before beginning library training. In recent years we have not necessarily given such considerate treatment to fellows who would have appreciated it. It is difficult to explain to fellows that the money provided by the stipend must be carefully husbanded to stretch the entire course. Some fellows manage beautifully, learn to look Bull. Med. Libr. Assoc. 66(4) October 1978
ahead, and live frugally during their study/training period, so as to be able to have enough money left over for the more expensive period of travel and attendance at meetings. Others, however, have experienced difficulties, especially those who have no private resources of their own to fall back on. To some questions such as "How can we improve the selection process?" and "How can we better adjust the education and training to the fellow's needs in terms of his own country's development?" we only have partial answers. In order to select the best possible candidate, one who possesses the qualities necessary to influence his colleagues on his return to his country, I would suggest the following additions to the present application procedure: (1) A personal interview in the candidate's country by a U.S. educational officer or equivalent to assess the personal qualities of candidates more accurately. (2) Submission of an essay by the candidate, which should include a description of his library, his duties, his goals and aspirations, and indication of his study/training needs. (3) A letter from the candidate's parent institution guaranteeing not only reemployment but also the opportunity for the candidate to impart his training to others. To address ourselves meaningfully to the question of how we can better adjust the education and training to the fellow's needs in terms of his own country's development is much more difficult. Some library schools are making provision for courses in international librarianship and are addressing themselves to library problems in developing countries. In developing training programs for specific fellows, we must become more aware of their country's attitude toward the profession of librarianship and their country's method of training librarians. Estelle Brodman, in her 1964 paper on education for medical librarians around the world touches on both these points: she talks about the low status of librarians as a social and economic group, especially in South America and Asia, and the consequent frustrations [9]. Library training methods, she states, have fallen into three groups since the replacement of apprenticeship by formal training: "The guild system is characteristic of British and Commonwealth countries, the European university system is mirrored in German practice, and the Americans tend to use the technological school approach" [9]. In arranging programs for fellows, we have of necessity imposed the American system upon
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them, and this is not totally satisfactory for those coming from countries nurtured on the British system, as India, for instance. Further questions to which we need to address ourselves are: (1) Are we frustrating some of those we bring to the United States and Canada, when the resources they return to are so inadequate as to make it impossible to put their acquired knowledge and training into practice? (2) Should we, therefore, not select fellows from such countries? (3) Instead of fragmenting our efforts in all parts of the world, should we concentrate on one region, or a few countries only, as the Rockefeller program initially did? The International Cooperation Committee needs assistance from the general membership to find answers to these questions. Thus far I have referred to the investment of our time and skills; something needs to be said about the program as it affects us financially. The Rockefeller Foundation contributed $87,500 to the program over a period of fifteen years. This provided nineteen study fellowships and nineteen travel fellowships for twenty-four women and fourteen men. The Eileen R. Cunningham bequest, by remaining untapped while it awaited contributions from both Vanderbilt University and the members of the Medical Library Association, gained over $9,000 in interest before the current fellowship program began, raising the total to $42,458. The fund is earning less interest now, as it is being used. The annual report distributed at the Seventy-seventh Annual Meeting of MLA in Seattle in 1977 showed the fund at $31,290 for 1976. The actual cost of the program, exclusive of funds for the 1977/78 fellows, has been $28,829.78, providing one one-year and seven sixmonth fellowships to five women and three men. In addition, MLA has provided financial support to administer the fellowship, and in the past two years the association has added perquisites to the fellowships, such as a one-year associate membership in MLA during the period of the fellowship and attendance at a continuing education course and certain functions during MLA annual meetings. The Rockefeller program ended because MLA was unable to find matching funds demanded by the Rockefeller Foundation if the latter was to support the program further. The Cunningham program may similarly end if we do not, ourselves, begin to build up a fund for interna452
tional fellowship purposes, or if we fail to identify and capture outside sources of funding. Is it worth it? In terms of human gains, I speak for many MLA members when I resoundingly answer "yes." The positive testimony built up by both Rockefeller and Cunningham fellows is hard to refute. One of the recent fellows writes: The fellowship program proved to be most useful both directly and indirectly. The direct results of the experience would be in the form of new policies and procedures learned that are applicable to the day-to-day routine of our library. The indirect benefit comes in the form of an improvement on the personality of the fellow; the program results in a more confident and more forward-looking decision maker. The direct benefits come mainly from the work experience at the Columbia University Health Sciences Library and also from information obtained from the visits to libraries. The indirect benefit comes with the exposure to a more advanced medical library environment and hence ability to use the experience as a guide in the decision-making process [10].
1. 2.
3.
4.
5.
REFERENCES MARSHALL, M. L. Training for medical librarianship. Bull. Med. Libr. Assoc. 34: 247-265, Oct. 1946. CUNNINGHAM, E. R. Evaluation of a three-year program of international cooperation in medical librarianship. Bull. Med. Libr. Assoc. 39: 295-305, Oct. 1951. MAYER, S. International co-operation in medical librarianship: a review of the scholarship program of the Medical Library Association, 1948-1960. Bull. Med. Libr. Assoc. 48: 239-242, July 1960. Report of the Committee on International Cooperation. Proceedings, Sixty-sixth Annual Meeting, Medical Library Association, Inc., Miami, Florida, June 11-16, 1967. Bull. Med. Libr. Assoc. 55: 457-458, Oct. 1967. LANGNER, M. C. Obituaries: Eileen Roach Cunningham, 1894- 1965. Bull. Med. Libr. Assoc. 54:
93-95, Jan. 1966. 6. KEYS, THOMAS E. Past presidents I have known. Bull. Med. Libr. Assoc. 63: 54-56, Jan. 1975. 7. Proceedings, Seventy-fifth Annual Meeting, Medical Library Association, Inc., Minneapolis, Minnesota, June 14-17, 1976. Appendix 1: Medical Library Association. International Cooperation Committee. Bull. Med. Libr. Assoc. 65: 159-160, Jan. 1977. 8. Proceedings, Fifty-ninth Annual Meeting, Medical Library Association, Inc., Kansas City, Missouri, May 16-20, 1960. Committee on International Co-operation [report]. Bull. Med. Libr. Assoc. 48: 502-503, Oct. 1960. 9. BRODMAN, E. Education for medical librarians around the world. Bull. Med. Libr. Assoc. 52:
99-116,Jan.1964.
10. AHMAD, MISKIAH. Personal communication, 1977.
Received March 10, 1978; revision accepted June 7, 1978. Bull. Med. Libr. Assoc. 66(4) October 1978
MLA INTERNATIONAL FELLOWSHIP PROGRAMS
APPENDIX EILEEN R. CUNNINGHAM INTERNATIONAL FELLOWS*
Year
Name
U.S. training
1971/72
Mr. A. Majid Pathan St. John's Medical College Library Bangalore, India Miss Shinako Honda National Cancer Research Institute Tokyo, Japan Miss Jean Adams Central Medical Library Edinburgh University Edinburgh, Scotland Miss Lucita B. Dones Science Library Philippine Women's University Manila, Philippines Mr. B. Lennard Erikson University of Umea Umea, Sweden Mr. Godfrey Belleh College of Medicine University of Lagos
Falk Library University of Pittsburgh Pittsburgh, Pennsylvania Shiflman Medical Library Wayne State University School of Medicine Detroit, Michigan Bio-Medical Library University of Minnesota Minneapolis, Minnesota
1972/73
1973/74
1974/75
1975/76
1975/76
1976/77
1976/77
1977/78
1977/78
Nigeria Mrs. Miskiah Ahmad Medical Library University of Malaysia Kuala Lumpur, Malaysia Mrs. Wilawan Vongsuphar Chulalongkorn Medical College Bangkok, Thailand
Mrs. Dulcinea Tavares Nunez Faculty of Medicine Library Lisbon, Portugal Miss Susan Flegg Medical Library University of Rhodesia Salisbury, Rhodesia
Biomedical Library University of California, Los Angeles Los Angeles, California Bio-Medical Library University of Minnesota Minneapolis, Minnesota Health Sciences Library Case Western Reserve University Cleveland, Ohio Health Sciences Library Columbia University New York, New York
Schaffer Library of Health Sciences Albany Medical College Albany, New York Scott Memorial Library Thomas Jefferson University Philadelphia, Pennsylvania Mayo Clinic Library Rochester, Minnesota University of Oregon Health Science Library Portland, Oregon Treadwell Library Massachusetts General Hospital Boston, Massachusetts College of Library Science University of Kentucky Lexington, Kentucky
*For a list of Rockefeller Fellows see: FRASER, D. The Medical Library Association: the span of its international activities. A chronology. Bull. Med. Libr. Assoc. 59:509-5 10, July 1971.
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