In 2000, three groups of health sciences librarians-new library school graduates, those currently working at a medical library, and medical library directors-were interviewed about the status and future of medical reference librarianship. Five years later this follow-up article summarizes the responses from many of the same librarians about the biggest changes, newest trends, evolving roles, challenges, and hopes for the future. © 2005 by The Haworth Press, Inc. All rights reserved.