RCH Medical Record Librarian School First in BC

The Canadian Health Information Management Association (CHIMA) celebrated its 65th anniversary in 2007.

CHIMA represents more than 3,700 certified Health Information Management (HIM™ ) professionals from across Canada in addition to 1,300 affiliate, student and retired members. HIM professionals are employed in hospitals; in the community health and extended care sectors; government; health and education institutions; the private sector including insurance and pharmaceutical companies; technology vendors; and consulting firms. The skills and knowledge of the HIM professionals support clinical research and provide information for medical and health care statistics. But this area of health care is relatively new.

In 1913, the American College of Surgeons was founded with the goal of enhancing the quality of surgery performed through better surgical training. To standardize the training performed, quality health records were deemed an essential factor. In the 1920s, Royal Columbian Hospital had difficulty with case history reports and medical record keeping to the extent that in 1922, it was removed from the list of standardized hospitals. By 1931 RCH, along with ten other BC hospitals, regained “approval” by the American College of Surgeons, based on what the College described as “competent medical staff keeping accurate and complete records of all cases”. However, because of a shortage of both funds and trained staff to organize and maintain medical records, RCH again lost its “approved” status.

Probably as a direct result of the inability to obtain and keep accreditation, RCH instituted a Medical Records department in 1949 with the appointment of Mrs. Ruth Melby as Chief Medical Record Librarian.

During the following year, she established a cross index based on the standard classification of disease and operations, as well as numbering and filing medical records by the unit system. The next year, the hospital purchased a dictating-transcribing machine for the use of medical staff and 75% of admissions had type-written histories. Mrs. Melby could now state in the annual report, “with the accumulation of two years of cross indexing of diseases and operations, statistics are now available for the first time for any physicians who wish to carry out medical research projects.”

In 1954, RCH was approved for training by the Canadian Association for Medical Record Librarians and the school, the 7th in Canada, opened September 26, 1954. Four students began classes the following year after arrangements had been made for them to receive their training in anatomy and physiology with the student nurses. The Vancouver Sun of May 16, 1956 published the following article describing the school and the careers it made possible.


Hospital authorities aren’t just being nosey when they ask you all those questions. The fact that you’re allergic to artichokes might help someone engaged on an important research project. First of its kind in BC, a school for medical record librarians at Royal Columbian Hospital in New Westminster trains people to make use of all the information a hospital collects.

After a 52-week course, graduates are equipped to make quantitative analyses of medical records, to classify, code and index diseases and operations, to prepare statistical, medical, insurance and Blue Cross reports and to do research for doctors and medical associations.

In session now, with the first graduation ceremonies scheduled for August, the school opens up new job opportunities for those who qualify as trained specialists in the profession of medical record science. There is a big demand for medical record librarians in hospitals throughout Canada and the US, with the result that posts are plentiful and starting salaries, approximately $250 a month. Based on requirements of the board of registration of the Canadian Association of Medical Record Librarians, the course of training is divided into two parts, Junior and Senior, with one week’s vacation at Christmas. During the first three months most of the student’s time is spent in practical training. Classes commence in September and January and hours are from 9 to 4 weekdays and 9 to 12 on Saturdays. Lectures are given by members of the hospital’s medical record department staff and School of Nursing instructors. Guest lectures also are given by members of medical record departments of other hospitals in the greater Vancouver area.

On successful completion of the course, graduates receive a diploma and pin and become eligible to write Canadian registration examinations. When they have passed these exams, they are privileged to write RRL(Registered Record Librarian) after their name.”

A Medical Record Librarian from the Regina General Hospital who had graduated from the RCH school, described her career in glowing terms, “No two days are ever the same”, she said. Her daily work included analyzing medical records, classification, coding and indexing diseases and operations, statistical and medical reports and research work for medical associations and doctors. “One of the advantages of being a medical record librarian is that you know you are serving others – patient, doctor and hospital.”

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2 Comments on “RCH Medical Record Librarian School First in BC”

  1. Marial (Melby) Shea Says:

    I’m Ruth Melby’s daughter. It’s so nice to see her work mentioned here. I didn’t know she set up the first medical records department at RCH. I did know, however, that she was devoted to her job. Thanks for this history!

    • rch150 Says:

      Thanks so much for letting us know, Marial. We’re thrilled to have added a little to your family history! You must be very proud of your Mom – she was very important to RCH and its development.

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