The study aims to explore the professional activities, needed competencies and education/training needs of medical librarians in Pakistan. The following questions guided the study: what are the current professional activities of medical librarians in Pakistan? What is their perception of the competencies needed of medical librarians? And what are their training and education needs? Twenty medical librarians were identified through purposive sampling. An interview guide was prepared after expert review and pilot testing. Personal and telephone interviews were conducted to collect the data. Data were analysed using content analysis methods. Sixteen (80%) out of 20 medical librarians could be approached. The findings reveal that the medical librarians were generally involved in traditional kinds of professional activities. They were unaware of the latest trends in medical librarianship. Out of ten competencies mentioned by the respondents "ability to use ICT and integrated library software", "verbal and written communication skills" and "extensive knowledge of Pub Med and other medical databases" were ranked first, second and third respectively. The opportunities of specialized education and training are also limited for medical librarians. Based on the findings of the study it was recommended that formal training programs should be initiated for medical librarians in Pakistan by MELAP, CPSP and library schools. (Contains 3 tables.)