Objective: The research describes an extensible method of evaluating and cancelling electronic journals during a budget shortfall and evaluates implications for interlibrary loan (ILL) and user satisfaction.Methods: We calculated cost per use for cancellable electronic journal subscriptions (n¼533) from the 2013 calendar year and the first half of 2014, cancelling titles with cost per use greater than $20 and less than 100 yearly uses. For remaining titles, we issued an online survey asking respondents to rank the importance of journals to their work. Finally, we gathered ILL requests and COUNTER JR2 turnaway reports for calendar year 2015.Results: Three hundred fifty-four respondents completed the survey. Because of the level of heterogeneity of titles in the survey as well as respondents' backgrounds, most titles were reported to be never used. We developed criteria based on average response across journals to determine which to cancel. Based on this methodology, we cancelled eight journals. Examination of ILL data revealed that none of the cancelled titles were requested with any frequency. Free-text responses indicated, however, that many value free ILL as a suitable substitute for immediate full-text access to biomedical journal literature.Conclusions: Soliciting user feedback through an electronic survey can assist collections librarians to make electronic journal cancellation decisions during slim budgetary years. This methodology can be adapted and improved upon at other health sciences libraries.