Educational Continuum Coverage by Library Organizational Model: Visualizing Service Reach, Organizational Barriers, and Support Fragmentation

<p dir="ltr">This figure visualizes how different library organizational models support (or fail to support) physicians across the educational continuum from undergraduate medical education (UME) through graduate medical education (GME), continuing medical education (CME), and independent practice. The figure uses a coverage area metaphor where the x-axis represents progression through the continuum and the y-axis represents service intensity and organizational reach.</p><p dir="ltr">Three organizational models are overlaid for direct comparison:</p><ul><li><b>Independent (school-based) libraries</b> (blue): Strong support during UME but terminate abruptly at the school-hospital governance boundary</li><li><b>Integrated (university library) models</b> (green): Extend slightly further but fade significantly after training ends</li><li><b>Hub-spoke (distributed) models</b> (purple): Maintain meaningful coverage across the entire continuum</li></ul><p dir="ltr">Vertical hatched barriers represent organizational boundaries—governance transitions where library support typically drops:</p><ul><li><b>Barrier 1 (UME→GME):</b> Medical school library reports to Dean; residency programs report to hospital GME office. Different governance creates no handoff mechanism.</li><li><b>Barrier 2 (GME→CME):</b> Training ends; alumni status begins; authentication and access change.</li><li><b>Barrier 3 (CME→Practice):</b> Institutional relationship ends entirely for practitioners in external settings.</li></ul><p dir="ltr">A dashed learner journey line traces an individual's progression through the system, encountering each barrier. Red indicators (✕) mark specific points where library support typically drops.</p><p dir="ltr">The figure demonstrates that continuum fragmentation is not accidental but results from predictable organizational boundaries. Only hub-spoke models with intentional continuum design can bridge these governance barriers and maintain support across all phases of physician development.</p>