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The University of California, San Francisco, is an academic health sciences campus that is part of a state public university system. Space is very limited at this urban campus, and the library building's 90,000 square feet represent extremely valuable real estate. A planning process spanning several years initially proposed creating new teaching space utilizing 10,000 square feet of the library. A collaborative campus-wide planning process eventually resulted in the design of a new teaching and learning center that integrates clinical skills, simulation, and technology-enhanced education facilties on one entire floor of the building (21,000 square feet). The planning process resulted in a project that serves the entire campus and strengthens the library's role in the education mission. The full impact of the project is yet unknown as construction is not complete.

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Health sciences librarians work within a complex environment, one that quickly adopted access to electronic resources. The open access movement evolved as an alternative to traditional publishing as prices for STM e-journals steadily increased, but it also raised issues and concerns for authors within the more traditional biomedical culture. The National Institutes of Health (NIH) Public Access policy provided an opportunity to support researchers' compliance with the policy, while advocating for open access and author rights. As an outgrowth of the NIH policy, health sciences libraries have promoted open access through a variety of activities within their academic health centers.