The growth and rising cost of bibliographic materials require that attempts to make all medical libraries comprehensive and self-contained be replaced by the provision of selective collections devoted to the most used and useful materials, particularly in developing countries with limited resources. Journals constitute the most important and expensive component of a biomedical collection. While use data are important, a method is presented to guide selection in the absence of this information. The method identifies 35 nucleus journals and uses citation analysis to generate a list of 92 journals, partitioned into 31 medical specialty classes. Local expert consensus can guide selection of important local or regional literature not in the international archives. Careful selection results in efficient collections. Access to less used materials can be provided to individual libraries through resource sharing networks with affiliations to major comprehensive international libraries.