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Chapter 2, Part 1

Medical Science Publication No. 4, Volume II

MONDAY AFTERNOON SESSION
26 April 1954

MODERATOR
LIEUTENANT COLONEL DOUGLAS LINDSEY, MC


TRAINING PROGRAM IN THEATER AND ARMY AREA*

LIEUTENANT COLONEL DOUGLAS LINDSEY, MC

Ad bellum, pace parati is the motto of the Army's famed Command and General Staff College. Drawing liberally from the few Latin words we are enjoined to utilize the period of peace to get ready for the time of war. Defining period of peace nowadays is a rather difficult thing to do, but the injunction still serves us well. In every lull in actual battle, and at all times in cold war we must be bettering our position to meet what may come next.

The need for interminable cycles of training, regardless of the scope or quality of the initial education, is perhaps more evident to the medical profession than any other. None of us regard the M. D. degree, or the completed internship and state licensure, or board certification as appropriate points for medical education to stop.

The Need for Training in Military Medicine

Besides these general incentives to training, there are other reasons more indurate and more tangible why we will always be in the training business in the Army Medical Service, overseas as well as at home.

First, there is no pool of trained manpower to fill most of the jobs in the Military. The myth that Americans need only to hear the call to arms, and will rush in ready to fight, should have disappeared shortly after the Battle of Lexington. We have only the semblance of an organized and trained reserve. And the distribution of civilian skills does not match military needs. There are, for example, few legitimate civilian occupations which offer significant academic credit toward graduation as a qualified rifleman. The services can never use as many lawyers and pharmacists as will be caught in the draft. And there patently is no pool of young men trained and ready to go out as aidmen and resuscitate the seriously wounded.

Second, extensive re-training or supplemental training is usually required, even for those with a useful professional or technical civilian background. The company aidman is not just doing Boy Scout first aid on the field of battle. The excess pharmacists and college graduates in biology make good laboratory technicians, but not just at


*Presented 26 April 1954, to the Course on Recent Advances in Medicine and Surgery, Army Medical Service Graduate School, Walter Reed Army Medical Center, Washington,
D. C.


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the stroke of a personnel officer's pen; it takes training. The Medical Corps employs personnel in jobs more comparable to their civilian occupation than almost any other major branch of the Army, yet few people disagree that it is necessary to train the new medical officer in certain aspects of the military environment in which he works. And whether we admit it openly or not, the fact remains that many of our newly commissioned medical officers are not ready professionally to strike out on their own in the practice of military medicine. The practice and administration of psychiatry was the smoothest professional operation we had in Korea, and this I attribute to the fact that many of our psychiatrists were trained as psychiatrists in a military school, and virtually all of our psychiatrist replacements received a short orientation course at the Eighth Army psychiatric center before going out to their jobs with divisions.

Third, our military schools and training centers do not turn out a finished product. They do not claim to. They do not intend to. They cannot do it in the time allowed. In time of relative peace the pressure of time is the necessity of getting a useful period of duty out of a rapid turnover of short-term soldiers. In time of war it is the urgency of mobilization-to get men out to the units as fast as possible. The unit receiving the training center or service school product must be prepared to develop it further, by on-the-job training or a formal training program.

Fourth, there are the varying requirements of what we may call facility and utility. Cadres must be organized, trained and kept current. Unforeseen changes in mission, equipment and organization must be met with personnel resources at hand. A two-shift operation may have to be worked up from a single-shift allocation of personnel. The vacancies created by illness, emergency and death must be filled more rapidly than the time it takes to process a new personnel requisition. All these things require a degree of flexibility and versatility which in turn depends on supplemental training.

Last, but certainly as material as the other four reasons, is the fact that the replacement pipeline, and in fact all elements of the personnel machine, does not operate at or near 100 percent efficiency. Excluding even relative efficiency, it is hard to believe at the receiving end of the line that anything near the gross quantity that enters at one end comes out at the other. There is no doubt at either end that the qualitative distribution is undependable. At one time there is an excess of dental laboratory men; at another time these are scarce, and we are loaded with neuropsychiatric technicians. In the Medical Corps I have become resigned to the fact that the supply, by MOS, bears utterly no relation to the demand. Even in the versatile Medical Service Corps, tailor-made and specially procured for delimited


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military duties, the same discrepancy has existed. At one time in Eighth Army we had psychiatric social workers in foolishly lush numbers, yet we were having to get officers for medical supply-a key career field for the Medical Service Corps-by training completely raw second lieutenants on the job, while they were filling supply positions of great responsibility.

All this brings to mind a lecture in one of the service schools, in which the organization of the infantry regiment was described as including "3,800-odd men, hardy, intelligent, trained specialists, armed, equipped, and trained to fulfill their mission." If one ever finds a battle-tested infantry regiment in a combat theater with a full strength of 3,800 men, it will probably be because it has just had several hundred odd, confused, ill-equipped, mal-assigned, poorly motivated and physically questionable new basics, pardoned prisoners, and hospital returnees dumped on it as replacements.

For these reasons, and more, we will always have organized training, all the time, and everywhere, in the Army-in fixed installations in the Zone of Interior, and throughout the theaters of operations.

By title, the scope of my presentation on this subject embraces the whole of the Far East Command, for the entire period 1950-53. But implication from the criteria for the selection of speakers-on the basis of first-hand knowledge-exempts me from much of this. My actual experience in the theater outside of Korea is nil. My experience in Korea is confined to the latter half of the war. But my interest in the training of medical personnel for combat has led me to keep contact with that which I did not actually see.

Medical Training in Japan

The medical training in Japan during this period I choose to divide into three categories: in-service training, specialist training, and basic medical training. I do not think you are interested in the routine training of field medical units in Japan, or the few hours a week of mandatory common subjects training which was carried out in all the fixed medical installations in Japan.

The in-service training programs of which I have some knowledge were well planned, well organized, and well run. They did not contribute directly to the operation in Korea or, more strictly, to the level of training in Korea. They did contribute to the efficiency of the hospitals supporting Eighth Army from Japan. On the average only 60 percent of the technicians of these hospitals were school-trained, but unit and on-the-job training kept 95 percent of the technicians qualified for their jobs.

Of the specialist training in Japan, much of it was informal or individual in-service training in hospitals and other medical units.


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Of the organized training, examples are the course for nurse anesthetists at Tokyo Army Hospital and the 279th General Hospital; the training of physical therapy technicians in the hospital at Kyoto; and the basic medical equipment maintenance course at the Japan Medical Depot. About half of the output of this last course went to Korea. Although the graduates were not polished technicians and did not hold the 1229 MOS, they did much to ease the stress of the perpetual, severe shortage of medical maintenance personnel.

The Far East Medical Service Specialist School at Shinodayama Barracks trained enlisted men in the most frequently used specialities: medical technician, surgical technician, x-ray technician, laboratory technician, and pharmacy technician. Most of the students came from hospitals and separate medical units in Japan; few or none from pipeline. This school closed in June 1952, and its medical work was carried on, along with various courses by the other technical services, in a consolidated institution: the Eta Jima Specialist School. The medical branch at Eta Jima was the direct successor of the specialist school at Shinodayama, but the slant of the program changed, from specialist training to what amounted to medical basic-the training of medical aidmen.

Trainees came almost entirely from pipeline. Basic soldiers were tapped off from the stream, sent to Eta Jima for technical training, and then returned to pipeline for movement to Korea. Although the individual end-product of the school might not be highly skilled, the net result was to deliver to Eighth Army a replacement package more nearly resembling what it had requisitioned than did a cross-section of the raw stream as it arrived in Japan from the United States. The effect of the Eta Jima school was not widely known in Korea, but its sudden absence would have brought a sharp increase in conscious appreciation. So long as a man came into Korea bearing a needed MOS, and performed reasonably well in it, few people thought to ask him where he was trained. The fact that so few people were aware of the Eta Jima school is a credit to the quality of its graduates-they were successful.

The training period at Eta Jima for medical aidmen was 4 weeks. Since all the students had completed 16 weeks of training of some sort in the Zone of Interior, all training time could be devoted to technical or branch material subjects, and the scope of the course was then the approximate equivalent of 8 weeks' advanced individual medical training in the United States. Branch training was on a simple level, as is the case in the training of medical aidmen (MOS 1666) and medical corpsmen (MOS 5657) in medical replacement training centers in the Zone of Interior. The medical instruction at Eta Jima was even more closely limited to subjects directly perti-


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nent to the company aidman and litter bearer, omitting most of the hospital and attendant technics, even the simplest bed-pan maneuvers that are currently given in our lowest level of medical replacements.

Graduating aidmen were shipped out to Korea where many of them never served in their newly-acquired specialty. Receiving commanders often put them back in their original MOS, mostly as riflemen.

Medical Training in Korea

The medical training in Korea may be conveniently classified as follows:

    1. On-the-job training and small unit schools.

    2. Tactical training of medical units.

    3. Societies; consultants; professional specialists.

    4. Training of the Republic of Korea Army.

    5. Bulk training.

      a. Officers: replacement orientation, formal schooling.

      b. Enlisted men: formal schooling.

The necessity for on-the-job training was generally accepted as routine. A few commanders persisted in petulantly demanding the ready-made, fully qualified replacement to which they were admittedly entitled by Tables of Organization, but in most cases as a key man, or any man with an individually identifiable job was suddenly lost, or approached time for rotation, the most likely replacement locally available was moved over and trained in the position. Technicians became sergeants major, ward men became laboratory or x-ray technicians, and new replacements were trained in their specific clinical and technical duties.

Just as some aidmen were assigned as riflemen, we did get into medical units a number of riflemen to be made into medics. In divisions the most common on-the-job training system, and a surprisingly effective one, was to assign the new men to the collecting station or aid station to learn there what they could before losses in forward units demanded that they go out on their own. I have seen company men placed on the line after only 2 or 3 hours of medical instruction. On one occasion I found that the senior aidman out of a group of five on the hill had received only 3 days of instruction in the aid station before he went out. This is on-the-job training with a vengeance.

Small unit schools were handicapped by lack of training material. Official field manuals and technical manuals were scarce in the theater. A few of the more ambitious or more cautious young medical officers brought instructional material with them from their course at the Medical Field Service School, and they found it priceless. The field medical man badly needs something that the infantryman has in the


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Infantry School Quarterly and the Combat Forces Journal. The medical service has nothing remotely comparable.

Under the heading of unit training I include the strictly "tactical" training of medical units, as well as training in the team performance of the primary technical mission of the unit under field conditions.

How well we did in our training in the true tactical arts depends on what standard one measured it by. It was spotty, and certainly did not meet the standards of the infantry, but in comparison with the past I think it safe to say that the medical units in Korea learned a great deal about just plain soldiering. In most instances they furnished armed security for their own installations. And in accordance with training directives promulgated by various headquarters they could put into the field, on short notice, effective squads and platoons for their own defense. This ability did not just arise by the automatic assimilation of a tactical atmosphere, but took deliberate training.

In their ability to act in simulation of normal operations in support of active, moving warfare-to pack, load, and move; and to disperse, dig-in, black-out, operate and move again-our units varied widely. It is an odd statement on the face of it, and I cannot document its proof, but I believe that in the latter half of the war the surgical hospitals and other field army medical units did better in this respect than did the medical battalions of the divisions. These latter moved on line with their divisions, and then sighed in relief and settled down, secure and satisfied in the knowledge that they would stay put for 6 weeks or more. They were on line, and in combat and not inclined to train. Then after a few months the division went into reserve, and the infantry battalions trained and maneuvered while the medical battalion sat in the center of the reserve area and operated a clinic and infirmary for the division.

The surgical hospitals, however, sat in one location during most of the latter half of the war. In and from that one location, in periods of low flow of casualties, they could train for the future. Perhaps I sound too enthusiastic. It took some strong stimulation to make them train, and we had a few major training exercises, but on these they did well. Two of them, the 46th and 47th (formerly the 8225th and 8209th) Surgical Hospitals had excellent movement plans and good movement training. They restored my own faith in the mobility of the surgical hospital, a principle I began to doubt immediately on my arrival in Korea.

The field army medical units other than the hospitals were distinctly ragged in their training accomplishments. The absence of medical group headquarters and additional medical battalion headquarters was painfully noticeable in the training field.


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The question of the training function of medical societies, the utilization of visiting consultants for training, and the local production of professional specialists I would like to leave to Colonel Salyer. With regard to the last of these I will say only that it is possible and practical to turn out commendably competent professional specialists through either organized schools or on-the-job training in an active combat zone. And for the societies and consultants a single side remark: the combat medical officer's thirst for knowledge, and professional contacts is much emphasized, but I think exaggerated. It is not alone sufficient stimulus to assure a good attendance at a scientific meeting. They will sit in their tents and bunkers unless we propagandize and "beat the bushes" to get them out.

The whole vast project of training the Republic of Korea Army was one of the most important operations of the entire war. In less than 3 years' time, masses of rice-paddy laborers and the remanants of a constabulary were transformed into an organized field army, with dependable combat elements, and effective service support. The medical aspects of this operation are intriguing.

The Korean Military Advisory Group (KMAG) included a medical section. It was located in Taegu, and devoted most of its attention to The Surgeon General's Office and the general hospitals and other base-type installations of the Republic of Korea Army. A field grade medical service officer was maintained full time at the ROKA Medical Field Service School, which was patterned very much like our own school at Fort Sam Houston. It gave both officer and enlisted courses, basic branch specialist. It went beyond our school in one respect, that of operating a complete school of nursing-from probationer, through graduate, to commissioned officer.

KMAG medical representation in forward units was notably lacking. Not until the last 6 months of the war, and then only after an arduous campaign, were medical officers assigned as advisors to forward ROKA units. It was necessary to place these officers on temporary duty with KMAG, counting them against the already dangerously low manning level of U. S. medical units. The KMAG Table of Distribution never included more than a single Captain, MOS 3100, for each ROKA Corps KMAG detachment. This officer officially was there to furnish dispensary service for the combined U. S. advisory personnel of the corps and the divisions, but as the sole officer representative of the U. S. Army Medical Service he naturally assumed advisory duties, and in effect became a consulting staff surgeon to an Army corps in combat. The effect on ROKA was sometimes questionable, but the arrangement undoubtedly served to give valuable training to the U. S. officers concerned. I recall one young lieutenant, obviously and completely without field experience on his first assign-


66

ment in Eighth Army, who later was thrust by circumstance into one of these positions and was turned into a creditable corps surgeon.

The cultivation of the ROKA medical service was a continuous, gradual and sometimes tedious process, often with discouragingly long periods devoid of tangible progress. It involved improvement in the supply picture and in personnel status. Besides deliberate and recognizable training it required a tricky mixture of stubborn force and painstaking tact. In spite of their appearance of obsequity, the Koreans are a sincerely independent, and a highly sensitive people. An idea indirectly planted, to germinate in his own mind, and to be applied on his own authority, is far more valuable to a Korean officer and his unit than is any sweeping offer of technical assistance or formal training. I found that a few words of halting Korean were often more effective in putting a point across than was the most lucid and forceful English-even when the Koreans concerned were wholly fluent in the English language. One really had to live with a Korean unit or staff a little while in order to find out what was going on.

Over and above the fundamental process of organizing, training, supervising, advising and coordinating the operating field medical service of the Republic of Korea Army, there were a great many training projects of a special nature, both official and organized, and personal or informal, in which we trained the Koreans to help themselves. An excellent neurosurgical team was built from scratch. Individual officers were trained in psychiatry. Selected Korean officers and enlisted men were trained in our depots in supply accounting and storage and issue procedures. Korean nurses were trained in our operating rooms. Our medical societies were open to Korean personnel, and were well attended by them. Special societies for Koreans were fostered in addition, since many of their key personnel did not comprehend English. Internships were established in the hospitals of the communications zone. And, though not strictly pertinent to a discussion of training in a theater of operations, the training of certain senior Korean medical officers as "observers" in our hospitals here in the United States was strikingly effective in raising the quality of ROKA medical service.

I mentioned a moment ago the training of Koreans to "help themselves." We actually did a great deal of training of Koreans to help us. The use of KATUSA personnel (Korean Augmentation to U. S. Army) as riflemen in our squads was a measure hastily thrust upon us early in the war. Later it became a highly organized big business. The use of KATUSA's in medical units was not prominent. The few that we had were mostly litter bearers. We did use a great many KSC's (Korean Service Corps-a quasi-military group) and directly hired civilians. These were used mostly in unskilled labor positions,


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but some of them were trained to a high degree of efficiency in technical or clerical positions.

Late in the war the concept of Type B units was officially recognized. These were units with U. S. Army command and cadre, but with all the unskilled and most of the semi-skilled positions held by native personnel. Naturally the U. S. cadre will in most instances have to train their own troops. In this the units in Korea did an outstanding job. It is absolutely amazing to see a half-pint Korean in his canvas shoes and baggy uniform, with a mechanical background limited to the intricacies of a two-wheeled ox-cart, being trained in a few weeks to drive and maintain a U. S. Army ambulance.

The methodical training of medical personnel en masse was most conspicuous right at the end of the war, but it was a significant feature for a longer time, at least during the last 18 months of the campaign.

A systematic 2-day briefing of incoming officer replacements was instituted. It was more than just an orientation to the existing situation and organization. It actually amounted to a highly compressed postgraduate refresher course in the medical support of a field army in combat. This briefing was greatly expanded at the end of the winter of 1952-53 when an acute Army-wide shortage of medical officers necessitated a drastic cut in pipeline time. Officers were sent to Korea in the early months of 1953 after completion of only half of the Medical Field Service School basic courses, and even a few arrived direct from civil life-in Korea with as little as 2 weeks of military service behind them. For these groups a school was set up, and we went so far as to graduate them with diplomas-clever imitations of the MFSS certificate, suitably modified in heraldry and inscribed "Medical Field Service School, Korean Branch."

Although this was admittedly an abnormal situation and a stopgap measure, the success of the school brought to light many advantages of training in a theater of operations. We might file these away to refer to again under comparable circumstances.

First, these officers, although untrained, furnished the Army Surgeon an immediately available reserve of personnel for emergency use. This advantage is offset by the fact that the "pipeline time" for training is then charged against the theater rather than against the Zone of Interior. Instead of getting 18 months duty from these officers we got 17 months, after subtracting the month of training.

Second, the interest of the students was high. There was no longer any doubt in their mind as to whether they would go overseas, or whether they might beat the Far East and get Europe. They could see clearly the pertinence of the instruction. Their performance on the pistol range, for example, indicated that they appreciated the applicability of even the non-medical phases of the course.


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Third, our training could be more specific. We did not restrict the scope of the instruction to Korea and the Eighth Army. We could have done so if the press of time had demanded. We could, and did, emphasize local conditions, such as hemorrhagic fever, and specific procedures in the evacuation system of Eighth Army.

Fourth, our training was realistic. Instead of lice in a Petri dish we had lousy personnel to show, and we could demonstrate delousing on the spot. Instead of describing the organization and equipment of division artillery we could actually show to these men its disposition on the ground, and they stood in the gun pits while missions were fired. They observed infantry companies and battalions on training problems while in reserve areas. And some few of them received unscheduled instruction in the distinct difference between outgoing and incoming rounds.

Fifth, to our pleasure we found that this training strongly stimulated interest in and respect for field medicine. From each class we got more applicants for battalion surgeons' jobs than we had vacancies to fill. We had more men asking for a command, of any size, than we could accommodate between the vacancies existing and the dates of rank of the personnel involved.

As for the bulk training of enlisted men we had nothing similar to the briefing we gave the officers. Enlisted replacements were assigned to divisions and separate medical units direct from the replacement depot in Japan. Not until the very last, with the organization of the 30th Medical Group, and the consolidation of separate Army medical units under it, could there be any centralized orientation of enlisted personnel. The quality and scope of the orientation and processing by the individual medical units was quite variable.

The need for formal training of medical technical and clerical personnel within Eighth Army was recognized early, but our tight troop ceiling precluded the establishment of a separate school. Such of this training as was done was carried on in selected units which continued operating in their primary role while carrying on training at the same time. Other technical services did much the same, except that Ordnance was able to set up a provisional school battalion well before the end of the war.

An example of formal training given within an operating unit was the extensive course for laboratory technicians given for several cycles at the 1st Medical Field Laboratory. We had a number of courses for medical records clerks, given in several different units.

Not until the end of the war were we able to divert units and personnel and spaces to the full-time operation of a school center. This center included the 34th Medical Battalion, plus a separate clearing company and an ambulance company. In addition to the medical offi-


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cers occupying T/O positions in the clearing company the professional personnel on the faculty included two attached nurses. They proved to be invaluable additions.

The success of the school is measured by the fact that liberal quotas were set; quotas were not mandatory, but all quotas were met, often with demand for an increase in the capacity of the school. The school served both divisional and non-divisional units and offered the following courses:

Course

MOS

Duration

Medical corpsman

5657

3 weeks

Medical technician

1123

4 weeks

Medical records and reports

None

3 weeks

Medical equipment maintenance

None

2 weeks

Operating room technician

1861

8 weeks

Medical aidman

1666

4 weeks

Leadership (medical NCO)

None

4 weeks

These courses were developed to meet the actual and anticipated requirements of Eighth Army for medical personnel which were not set by training installations in the United States and Japan. From this standpoint it was soon evident that the medical aidman training should be carried on at two more levels of instruction-the lowest level to meet quantative deficiencies in basic medical replacements, the higher levels to provide for advancement of aidmen basically qualified, and already assigned.

As long as we have units and personnel to do the job, I believe that such a school could always be used to good profit in the field army, even in a moving situation. It could bounce along in the army rear at about the same pace as the larger depots and replacement installations. It would do much to cushion the deficiencies that we will always have in the replacement system.

Medical Training in Zone of Interior

I cannot help but mention training in the Zone of Interior, at least insofar as it affects the necessity for or the scope of the training program in a theater of operations.

I question the effectiveness of our military residency program. In the selection of residents, the orientation of the training, and the assignment of the end product I personally am skeptical that the taxpayer is getting his dollar's worth, or that the U. S. Army Medical Service is utilizing the program to the best advantage. The program is still deeply tinged with an element of inducement for procurement of officers, to some detriment of the over-all training of career rnedical service personnel. It does not help us in procuring officers interested in true military medicine, the people we need most as Regular officers, and the people most likely to stay on after their period of


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obligated service. The training appears to me to be so heavily slanted toward the attainment of specialty board certification, and so imitatively patterned after university hospital residencies, that it assiduously avoids all military attributes, and the military applications and implications.

Unfortunately I can quote little specific evidence of the qualifications and defects of Army-trained general surgeons in Korea. There were too pitifully few of them. The Regular Corps stayed away from Korea in conspicuous droves. A few residents were on temporary duty in Japan when the war broke out, and they served admirably in Korea. There was a strenuous effort to get them back to the States into their residencies, as if the moral obligation to continue their training was the most important consideration. There was just as strenuous an effort to keep residency training going thereafter uninterrupted and almost unabated, as if the residency program was a shining example of the culture we fight wars to defend. What are we training military residents for if not for medicine in support of any army at war? Why not pull residents out of training for 12 to 18 months of duty in Korea? What better training could a military surgeon get than a year or so of combat surgery sandwiched in between the years of his formal training?

I have seen little indication that our surgical residents reach board eligibility knowing any more about débridement than does a resident at New Haven. Actually the senior resident in surgery in an Army hospital should be a past master of the theory, and basically qualified in the technic. Our general hospitals see little acute trauma, but some arrangement could be made for tours of residents at station hospitals. What training are we giving in our obstetrical and orthopedic residencies to qualify these specialists to function as general military surgeons in the combat zone? No, of course it will not count for their boards, but surely we do not intend to keep all these officers back in the Zone of Interior in a major war, and I cannot see that we need all of them in their primary specialty overseas. What orientation are we giving our residents as to the why and how of the administrative processes they rub up against in military hospitals, to prepare them for future assignments as chiefs of service, or hospital commanders?

The answers to all these questions are discouraging.

In the field of enlisted training in the Zone of Interior the problems are different. On the simple question of what is the quality of our enlisted technicians-are they good or bad-there are discrepant opinions. Dr. Scott intensively studied a limited number of aidmen, and feels that they are deficient. Major Mallory had broader contacts with a larger number, and feels that we may possibly be over-


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training them. General Ginn left his position as Surgeon of Eighth Army and moved to command of the Medical Replacement Training Center just in time to receive a formal complaint, long in channels from Eighth Army, that the MRTC product had been found lacking. I feel that all of us are accurately appraising the quality of the current aidman, but we differ in our estimates and opinions of the theoretical standard. What do we expect of him? What is the ideal? I am inclined to concur with Dr. Scott that the field medical technicians should be men of judgment and dependability beyond what we are likely to find in the men we are getting into the job at present. Judgment, and the background on which to found the versatility necessary to assure a dependable result-both of these require experience, and experience is not offered in the medical personnel replacement scheme now operating.

Under the present program recruits are processed and then given a standard 8 weeks of basic combat training, designed to qualify them as soldiers no matter what their future assignment in the Army. After basic, some of them go to advanced medical training, others to ordnance, engineer or other technical training. The infantrymen, artillerymen and tankers continue on in training divisions for their advanced phase.

Medical trainees are split three ways. After 2 weeks of advanced training the men who are already classified as specialists on the basis of civilian experience (such as pharmacists and laboratory technicians) go directly out to assignments in the United States. Also at the end of 2 weeks certain men, varying in number with school quotas, are pulled out of advanced training and sent to the Medical Field Service School for special technical training, in courses such as physical therapy, preventive medicine or electroencephalography. These school courses, with one exception, make no provision for a significantly long applicatory phase. Men are sent out from the school direct to assignments in the United States and overseas. In spite of the fact that they may come to their jobs in a theater with all schooling and no experience I am not worried about them. All of them go to positions where they work under supervision. Not so with the aidman.

The men who do not go directly to schools, and who are to complete the full 8 weeks of advanced medical training, are divided into two groups with an approximate 40/60 split. Those with physical or mental limitations are trained for the lowest medical job; Medical Corpsman, MOS 5657. The larger number, with the best physical and mental qualifications, are trained for the job of Medical Aidman, MOS 1666. Following this training both groups are assigned to units, overseas or in the United States.


72

This selection of the best men, and the most intensive training we can give them in the time allowed, still does not assure that the 1666 graduate can do the job we expect of him without prior experience in the actual handling of sick and injured human beings. The job of company aidman is a position vacancy for a sergeant, five grades up the enlisted ladder from recruit. Yet our system puts privates in the job. I feel that arrangements must be made for the assignment of technicians to duty as company aidmen only after appreciable experience and demonstrated ability in a hospital or dispensary job.

Several times in this presentation I have hinted at the fact that the Army Medical Service does not have control over medical enlisted personnel. Nothing prohibits the replacement depot from reclassifying a medic, and making him an engineer. An infantry regimental commander can, and readily does, make an aggressive (or even a reluctant) medical private into a rifleman, or he can move an astute medical sergeant into headquarters or into the heavy mortar company. This distinctly magnifies our training problem, particularly in the matter of developing medical men for greater responsibility in the higher grades.

Although this discussion was set up to be a panoramic presentation of the actual experience with medical training overseas during the Korean War, leaving the moralizing to the later discussants, I would like in closing to make three points, not in summary exactly, since I have not so pointedly expressed them thus far:

1. The Army Medical Service needs better control of its enlisted personnel.

2. We need to re-orient our pattern of training, for both officers and enlisted men, toward a military medical career.

3. We must send the best men forward.

Even so, there will always be a need for a training program in the theater of operations.