The development of a foreign journal collection that fully meets the current needs of users is an everlasting problem for medical libraries. This problem is also seen in the Library Services Division (medical library), Medical Information Center for Education and Research, The Jikei University School of Medicine. There are is great demand for new subscriptions to foreign journals, but it is impossible to fulfill all such requests because of the limited budget of the medical library. In contrast, there seem to be jourual titles which are not currently useful in terms of the educational and research activates of this school, although they were fully evaluated in the past. To develop a more useful and effective journal collection in the medical library, in 1987 and 1988, two large surveys were conducted to re-evaluate the usefulness of current subscriptions to foreign journals, to find more valuable journals which have not been subscribed to yet, and to replace non-active journal titles identified by the reevaluation with more useful titles recognized by various sources, including the demand from library users. The sources used were library statistics, researchers' opinions, impact factors, prices, and so on. As a result, 60 current foreign journals were cancelled and 43 new journals were added to the medical library.