During the 68th annual conference of the German Association for Medical Informatics, Biometry and Informatics, the Working Group Medical Terminologies and Classifications held a terminology server challenge, investigating the boundary between general-purpose FHIR servers and purpose-built FHIR terminology servers. While direct comparisons between the implementations were not the goal of this challenge, it showed that such a boundary exists: General-purpose FHIR servers need to consider many different domains of the FHIR standard, and generally aren’t optimized for the very different terminology use cases.