Would you compare this as when long, long time ago, mame could not handle 2 or more screens,then someone here, (cant remember who) came out with a way to make mame displays 2 screens, then after that it was implemented in mame? But i remember that before that ,mame devs complain that it was hard and almost imposible to do.
things change with time..
some things which used to be harder to do are now easier, some thing which are now easy to do are going to get harder.
As multiple monitors etc. became more common the APIs to make use of them improved, directx support to access additional screens improved, video drivers improved. The task became easier.
Right now, as CRTs have almost entirely been made obsolete in the eyes of manufacturers we're instead losing the ability to set specific resolutions and refresh rates, I predict it will actually be impossible by the time Win 9 hits.
For Multi-slot it's not really the same. MAME was never designed with it in mind (it was designed to run one fixed set per game), however MESS needed it for several systems which had slots where carts and other hardware additions could be added and removed, often while the system was running. MESS therefore expanded on what MAME could do, providing the concept of multiple slots, and the 'software list' support to go with it and allow dynamic mounting / mounting of software. Cartridges afterall are a concept more commonly found in home systems and the NeoGeo is if anything closer to a home system than an arcade one.
Because MESS is MAME that code eventually got fed back into MAME, but obviously to take advantage of it the drivers need updating, they make assumptions which break if you want to do things with the multi-slot APIs that MESS provides.
So no, it's not REALLY the same, one is progress in operating systems, the other is progress in the emulators.
Most of the good stuff these days will be coming from MESS tho, because computers are so much more demanding in their requirements for accurate emulation and diversity + level to which they can be configured. That's one reason I've always said the projects should just exist as one as benefits filter through more quickly with active use cases in the codebase.