This article examines the behaviors and preferences of medical and nursing students in relation to their required textbooks and library reserves. The findings are based on an April 2015 survey at the University of Illinois-Chicago satellite Library of the Health Sciences in Urbana, where the library provides access to textbooks through traditional "closed" reserves in addition to an "open" reserves collection. Results indicate several barriers to usability regarding traditional reserves services and suggest that students prefer open reserves for convenience and savings. While broad applicability of the model warrants further investigation, academic libraries may be better able to meet patron needs by implementing open textbook reserves.