This study examines continuing education and professional development of 210 health sciences librarians affiliated with 70 academic medical libraries in the United States, which has the most advanced system of education in librarianship in the world. Of the 102 respondents, the largest categories were library directors/administrators and public services librarians, of whom 56% possess the MLS (Master of Library Science) degree with formal courses in health sciences librarianship. Even though they are employed in a scientific field, 42% have a humanities undergraduate background; about 50% have a pure science or applied science background. Among difficulties described are learning the nomenclature of the field and a lack of subject background knowledge. An overwhelming majority (90%) indicate they acquired their specialized skills on the job. The most popular means of staff development is through personal coaching or training by other library personnel. Findings reveal that the Medical Library Association (MLA) and the National Library of Medicine's (NLM) continuing education courses are focused efforts in bettering health sciences librarianship in the United States. It is also indicated that the traditional master's degree is not perceived by librarians as adequate to prepare health sciences librarians for survival in the health information environment. Survey instrument and cover letter are appended. (Contains 51 references.) (Author/TMK)