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Chapter I

Contents

CHAPTER I

Preparations for World War II

TRAINING BETWEEN THE WARS

Training facilities of the U.S. Army Medical Department in 1939 reflected adaptation to peacetime medical requirements. From a World War I peak of over 340,000, the Medical Department's strength had been reduced to a little over 11,500 officers and enlisted men by June 1939. Enlisted personnel had been reduced by the National Defense Act, as amended in 1920, from a wartime concentration of nearly 10 percent of the Army's enlisted strength to a statutory maximum of only 5 percent. Because all but a fraction of the enlisted strength was needed to care for the garrison army, field training had been neglected. The five Medical Department field units that existed were either understrength or skeleton organizations; trained enlisted cadre could not have been provided in case of mobilization. Without enlisted personnel to man units, officer training could be little more than theoretical.1

Peacetime Components of the Medical Department

Under the National Defense Act, as amended in 1920, the Army was divided into three components: the Regular Army, the Reserves, and the National Guard.2 The Regular Army consisted of officers and enlisted personnel who were continuously on active duty. The Reserves were designed to meet immediate needs for manpower in the initial stages of mobilization, and the National Guard was a state organization intended for use in an emergency or in actual hostilities. The Medical Department was divided by function into seven basic components: the Medical, Dental, Veterinary, Sanitary, and Medical Administrative Corps, composed of officers of commissioned rank; the Army Nurse Corps, whose members held relative rank; and the enlisted personnel necessary to support the professional staff. These medical elements were represented in each of the Army's Reserve and Regular components, with the exception of the Sanitary Corps, which was found only in the Reserves, and the Army Nurse Corps, which was not organized in the National Guard.3

In the peacetime Medical Department, technical duties were performed by a variety of personnel, including commissioned and enlisted members of the Regular

    1(1) Committee to Study the Medical Department, 1942, Testimony, pp. 1-2. (2) Smith, Clarence McKittrick: The Medical Department: Hospitalization and Evacuation, Zone of Interior. United States Army in World War II. The Technical Services. Washington: U.S. Government Printing Office, 1956. (3) Medical Department, United States Army. Personnel in World War II. Washington: U.S. Government Printing Office, 1963. (4) 41 Stat. 766.
    241 Stat. 759.
    3See footnote 1 (3).


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Army, members of the Army Nurse Corps, and civilian specialists employed either under civil service regulations or by The Surgeon General under special contract. The commissioned Regular Army personnel consisted of physicians assigned to the Medical Corps, dentists assigned to the Dental Corps, veterinarians assigned to the Veterinary Corps, and nonprofessional administrative officers, who were assigned to the Medical Administrative Corps. Regular Army enlisted men were not assigned to corps but were utilized in administrative, clerical, training, and technical capacities for which they were qualified by civilian experience or Medical Department training. Civilians were employed at various installations, including hospitals, laboratories, supply depots, and offices, in a variety of positions, ranging from laborers and trained artisans to highly skilled technicians, therapists, and dietitians. The Surgeon General also employed a small number of doctors under special contract, usually for part-time duty at small posts.

To supplement these personnel in an emergency, the Army maintained a Medical Department Reserve. Commissioned members of the Medical Department Reserve were assigned to five Reserve corps: the Medical, Dental, Veterinary, Medical Administrative, and Sanitary Corps. Reserve officers in the first four of these corps had the same professional qualifications as officers in the corresponding corps of the Regular Army, and those in the first three corps were usually commissioned upon completion of the Reserve Officers' Training Corps program at civilian medical schools. The Sanitary Corps Reserve consisted of men with experience and college training in technical fields allied to medicine, such as chemistry, sanitary engineering, or hospital architecture. The Medical Administrative Corps Reserve consisted largely of World War I officers with administrative experience who continued in the Reserves after the war, senior active-duty noncommissioned officers who also held Reserve commissions, and, after 1936, graduates of accredited pharmacy schools who applied for Reserve commissions. The number of enlisted reservists was negligible. Reserve officers were required by law to attend periodic meetings, and the law permitted the Government to call them to active duty for 2 weeks each year. War Department policy, however, was to call them for such duty only upon their own application. Reserve officers were also required to complete a limited number of Army extension courses.4

In contrast to the Medical Department Reserve, which emphasized the training of individual officers, the Medical Department of the National Guard had a high level of enlisted strength and emphasized the training of field units (table 1). In addition to providing organic medical support for regiments and smaller units, the National Guard possessed a number of independent medical units designed to be attached to larger units. These included 19 regimental headquarters, 12 battalion headquarters, 20 collecting companies, 45 motorized ambulance companies, 29 hospital companies, and a number of veterinary and service companies. Taken together, they possessed a far greater capability for providing field medical service than did units of the Regular Army. In 1939, The Surgeon General reported that the National Guard had achieved the highest level of training in its history. Because of

    4The Army of The United States, Senate Document No. 91, 76th Congress, 1st Session. Washington: U.S. Govern ment Printing Office, 1940.


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    TABLE 1.-Approximate strength of peacetime components of the U.S. Army Medical Department, 1939

Component

Regular Army

Reserves

National Guard

Medical Corps

1,098

15,198

1,085

Dental Corps

221

5,063

234

Veterinary Corps

126

1,381

66

Medical Administrative Corps

64

1,243

145

Sanitary Corps

------

454

------

Army Nurse Corps

672

------

------

Enlisted personnel

8,643

16

12,500

    Total

10,824

23,355

14,030

    Source: (1) Annual Reports of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1940 and 1941. (2) The Army of the United States, Senate Document No. 91, 76th Congress, 1st Session. Washington: U.S. Government Printing Office, 1940, p. 117.

their low professional strength, however, National Guard units were thought to be better qualified in tactical training than in caring for the sick and wounded in the field. Members of the National Guard were under the jurisdiction of corps area commanders for training and were required to participate in weekly exercises, as well as 2 weeks of summer exercises.5

Training Responsibility

Full control over the training of Medical Department personnel was not vested in any single office. All training was under the technical supervision of The Surgeon General, but not all of it was under the same degree of control. In common with the other technical services, the Medical Department was an element of the War Department Special Staff, and The Surgeon General had direct access to the Chief of Staff. The Chief of Staff and the General Staff were responsible for coordinating the separate arms and services. Each of the chiefs of the arms and services acted as the immediate adviser to the General Staff in technical areas peculiar to his arm or service. Thus, The Surgeon General advised G-3, Operations and Training Division, on the technical training of Medical Department personnel and prepared master program guides, manuals, and instructional aids. In sum, The Surgeon General established the basic "doctrine" under which Medical Department troops were trained, regardless of their location or level of technical skill.

The degree of control exercised by The Surgeon General over the training of a particular body of Medical Department troops, however, was determined both by geographic location and by level of technical skill. The Surgeon General controlled the basic, advanced, and professional training of officers, the advanced technical training of enlisted men, and the routine training of enlisted personnel at the limited number of installations, known as exempted stations, under his direct control. The most important of these, from the standpoint of training, were the Medical Field

    5 Annual Report of The Surgeon General, U.S. Army, 1939. Washington: U.S. Government Printing Office, 1940.


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    FIGURE 1.-Carlisle Barracks, Pa., home of the Medical Field Service School, about 1939.

Service School of Carlisle Barracks, Pa. (fig. 1), and the Professional Service Schools at the Army Medical Center, Washington, D.C. At the professional schools in Washington, officers and enlisted technicians were trained in medical specialties and in the military aspects of medical, dental, and veterinary service. The Medical Field Service School trained enlisted men and officers of all corps in the field aspects and administration of the Medical Department. The routine and basic technical training of other troops was under the control of corps area commanders, except at the schools and the named general hospitals classified as exempted stations.

Medical Department officers and men assigned to medical installations and field units at posts, camps, and stations under corps area jurisdiction were no less a part of the Medical Department than those assigned to exempted stations, but they were isolated from the Medical Department by several levels of command and administration. Their numbers far exceeded those at exempted stations. Training at corps area level was the responsibility of the area commander, who usually delegated the responsibility to the corps area surgeon. The surgeon, in his dual capacity as a local staff officer and technical representative of The Surgeon General, was then responsible to the corps area commander for conducting training according toWar Department policies and to The Surgeon General for the technical content of instruction. The same command relationship existed on a lower level at posts, camps, and stations. Except for about 2 percent of the Reserve officers, who were assigned to The Surgeon General in event of mobilization, both the Reserves and the National Guard were under corps area control. In peacetime, the tendency of corps


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and station commanders not to interfere in medical matters allowed local surgeons a considerable degree of autonomy.6

Officer Training

The peacetime pattern for training Medical Department officers was designed to meet the dual need for professional medical personnel capable of performing command and staff functions in the operation of military medical installations and for supplementing civilian professional training with instruction in specialties having a different emphasis in military medicine. As a result of problems encountered during World War I, training facilities were established to meet each of these needs. In 1920, the Medical Field Service School was established at Carlisle Barracks to conduct a program of instruction designed to transform civilian doctors, dentists, and veterinarians into medical officers trained to assume command in medical installations and units. Three years later, the Army Medical Center was established in Washington, D.C., to conduct a postgraduate program of instruction in the military aspects of medicine, dentistry, and veterinary service.

The Army Medical Center was a multiple institution whose components functioned as separate installations before 1923. These included the Walter Reed General Hospital, the Army Medical School, the Army Dental School, and the Army Veterinary School. The three schools, usually referred to as the Medical Department Professional Service Schools, had conducted training programs of their own long before the center was established. Indeed, the Army Medical School had been created as early as 1893. But the establishment of the Medical Field Service School in 1920, and the Army Medical Center in 1923, marked the beginning of a two-phase program designed to give comprehensive training to Medical Department officers in both military and technical aspects of their profession. Facilities at the Army Medical Center were not usually available to officers of the National Guard and Reserve, but the Medical Field Service School offered special courses for their instruction.7

Regular Army officers.-The Medical Department basic training program for Regular Army officers provided an academic year of postgraduate study in the professional and military aspects of military medicine. Beginning in late August or early September each year, 4-month courses known as "Basic Graduate Courses" were offered at each of the three service schools at the Army Medical Center. These programs were "basic" in that they presented essential professional knowledge required for the military practice of medicine, dentistry, or veterinary service, as distinguished from the same practices in civilian life, and "graduate" in that students in the classes had degrees in their professional fields and were prepared to cope with subject matter presented in a manner characteristic of graduate schools at

    6(1) See footnote 1 (2), p. 1. (2) Medical Department, United States Army. Organization and Administration in World War II. Washington: U.S. Government Printing Office, 1963.
    7(1) Annual Report of The Surgeon General, U.S. Army, 1922. Washington: U.S. Government Printing Office, 1922. (2) Annual Report of The Surgeon General, U.S. Army, 1924. Washington: U.S. Government Printing Office, 1924. (3) Hume, E. E.: Training of Medical Officers for War Duty. War Med., vol. I, September 1941.


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civilian institutions. When these professional courses were completed in December, students transferred to the Medical Field Service School for a 5-month course of military indoctrination. This course, which emphasized tactics, logistics, administration, field sanitation, and instructional methods, was designated the "Medical Department Officers Basic Course," to distinguish it from the basic graduate courses at the Army Medical Center. After 9 months of intensive training, the officer was considered ready to assume duties as a member of the Regular Army Medical Department.8 Unfortunately, peacetime requirements for professional personnel made it impossible for each newly commissioned medical officer to participate in the basic training program, and the program was too cumbersome for use during mobilization.

In addition to basic officer training, the Medical Department offered opportunities for continuing education. A program of "Advanced Graduate Courses" at the Army Medical Center allowed medical officers to receive 4 months of training in technical subjects. More intensive training could be pursued through "Professional Specialists Courses," individual courses in medical specialties corresponding to residency at civilian hospitals, that varied in length from 2 to 4 years. Because of the administrative burden of formal reports required by regulations, the professional specialists courses were not formally offered in the closing years of the interwar period.9 The program was carried on the books to comply with regulations, but in practice, students were ordered to the Army Medical Center and became in fact, if not in name, regular duty officers at Walter Reed General Hospital, where they received informal training. Through these programs, the Medical Department attempted not only to keep its personnel abreast of developments in medical science but also to provide the specialists necessary for complex medical installations. At the Medical Field Service School, field grade officers were provided with additional training in command techniques by a 3-month "Advanced Course."

To supplement training available through formal courses at the Army Medical Center and the Medical Field Service School, the Medical Department offered extension courses and subsidized study at civilian institutions. Correspondence courses covering military and administrative subjects were prepared by the Department of Extension Courses of the Medical Field Service School. Regular Army officers were allowed to enroll in a series of basic extension courses designed for officers in Reserve components. The number of Regular Army officers taking such courses was always small, totaling only 59 in the 5-year period preceding 1940.10 During the same period, 369 Regular Army officers completed the "Special Extension Course for Medical Department Officers, Regular Army" for field grade

    8Annual Report of The Surgeon General, U.S. Army, 1936. Washington: U.S. Government Printing Office, 1936.
    9(1) Memorandum, Lt. Col. Charles B. Spruit, MC, Training Subdivision, Planning and Training Division, OTSG, for Col. Albert G. Love, MC, Chief, Planning and Training Division, OTSG, 16 Apr. 1940, subject: Schedule of Courses for Medical Department Special Service Schools, School Year 1940-41. (2) Annual Report of The Surgeon General, U.S. Army, 1940. Washington: U.S. Government Printing Office, 194l. (3) See footnote 7 (3), p. 5.
    10(1) Annual Report of The Surgeon General, U.S. Army, 1935. Washington: U.S. Government Printing Office, 1935. (2) Annual Report of The Surgeon General, U.S. Army, 1937. Washington: U.S. Government Printing Office, 1937. (3) Annual Report of The Surgeon General, U.S. Army, 1938. Washington: U.S. Government Printing Office, 1939.


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officers seeking promotion to grades of lieutenant colonel or colonel.11 Completion of this special extension course exempted officers from the portion of their promotional examination consisting of a medicomilitary problem, which probably accounts for the high level of participation. In addition, the National Defense Act, as amended in 1920, allowed up to 2 percent of the officers of the Regular Army to enroll in courses at civilian institutions in subjects not taught at service schools but essential to the efficient conduct of their duties. The number enrolled for such study varied from year to year, as did the subjects, length of courses, and institutions involved. In the 5-year period preceding 1940, 150 Medical Department officers participated in this program.12 Finally, a limited number of Medical Department officers were enrolled in service schools operated by other Army agencies, such as the Army War College and the Army Industrial College, Washington, D.C., the Infantry School, Fort Benning, Ga., the Command and General Staff School, Fort Leavenworth, Kans., the Chemical Warfare School, Edgewood Arsenal, Md., and the School of Aviation Medicine, Randolph Field, Tex. Most of these officers were being groomed for high-level command positions, and the number was always small.

Other facilities for special training were offered by the School of Aviation Medicine which had been established as a Special Service School in 1921. In name and function a Medical Department school, it was funded by the Air Corps and, exempted from corps area control, was under the command of the Chief of the Air Corps. Courses were offered to qualify members of the Medical Corps assigned to the Air Corps as flight examiners and flight surgeons and to train enlisted men as flight surgeon's assistants. The special school was formally justified by the need for special physical standards for flight personnel and the need for special methods to control disease in a highly mobile command. In common with other Special Services Schools, the School of Aviation Medicine offered extension courses for officers in Reserve components.13

Medical Administrative Corps officers in the Regular Army had neither the need nor the background for the professional courses offered by the Medical Department Professional Service Schools at the Army Medical Center. Commissioned and appointed to perform nonprofessional administrative duties, these officers were at first drawn exclusively from the enlisted ranks after at least 5 years of service, and after 1936, from graduates of recognized pharmacy schools. Once they had been commissioned, they were eligible to attend the basic course at the Medical Field Service School.14

National Guard and Organized Reserve Corps officers.-Reserve and National Guard officers were qualified for appointment through a variety of programs. For the Medical Department, the most important of these was the Reserve Officers' Training Corps, which had medical units in operation at the professional schools of colleges and universities. To qualify for commissions in the Medical Department, students were required to complete a 2-year basic course, a 2-year ad-

    11See footnotes 5, p. 3; and 8 and 10, p. 6.
    1241 Stat. 786.
    13See footnote 7 (2), p. 5.
    1441 Stat. 767.


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vanced course consisting of 5 hours of weekly instruction in military subjects, and a 6-week summer encampment, as well as their professional training. Summer camp training for students in Medical Department Reserve Officers' Training Corps was held at the Medical Field Service School and included indoctrination in sanitation and the administration and deployment of medical field units, as well as basic military instruction. Upon graduation, candidates were eligible for Reserve commissions or to compete for appointment to the Regular Army and were required to complete 5 years of Reserve duty. Another opportunity for commissioning was offered by Citizens' Military Training Camps. By attending four successive summer camps, each 1 month in length, interested civilians could also qualify for Reserve commissions. Others, who had no previous military service, or who had not attended military academies or colleges with Reserve Officers' Training Corps units, could qualify for National Guard commissions by successfully attending officer training camps.15

Once commissioned, Reserve and National Guard officers could participate in a variety of training programs, in addition to regular drills. Instead of the 5-month basic course for Regular Army officers at the Medical Field Service School, the basic training of officers in the Reserve components of the Medical Department was accomplished through a combination of summer camps and correspondence courses. A 2-week program, known as the Basic Summer Training Camp for Reserve Officers, was conducted for junior officers each June. Approximately 200 officers enrolled annually for instruction in basic military subjects, administration, field sanitation, and the operation of medical detachments. In July, a 2-week program designated the "Unit Training Camp for Reserve Officers" was held for officers assigned to medical regiments, squadrons, battalions, general hospitals, field hospitals, and evacuation centers. Approximately 350 officers of the Reserve components attended annually. To supplement camp training, the Medical Department offered a series of extension courses in the fundamentals of military science and tactics. With the retention of commissions and promotion providing incentives, these correspondence courses played a major role in the basic training of Reserve and National Guard officers. In 1939, for example, 7,445 officers of Medical Department components completed 15,848 subcourses of the extension courses, representing a total of 223,121 hours of work.

Advanced training for field grade officers and senior captains of Reserve components paralleled that of Regular Army officers. When authorized, the Medical Field Service School conducted a 6-week counterpart to the 3-month advanced course for Regular Army officers, known as the National Guard and Reserve Officers Course, that was designed to develop commanding officers, executive officers, and planning and training officers for medical field units. Eighteen officers were authorized to attend the session held in the fall of 1939. Extension courses were also a part of the advanced training of officers in Medical Department Reserve components, and promotion depended, in part, upon the completion of successive series of subcourses.

Opportunities for professional training for officers in Reserve components were

    15(1) See footnotes 5, p. 3; and 7 (3), p. 5. (2) 41 Stat. 781.


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much less extensive than those in military subjects. A course in forage inspection was open to National Guard officers at the Army Veterinary School, and inactive duty training could be pursued at civilian medical centers under the "Skinner Plan." Under this plan, medicomilitary courses were offered by various institutions, in the interest of national defense, at no expense to the Government or the officers attending. Reserve officers were not ordered to active duty while attending these courses and did not receive pay. They were, however, given credit for course completion. The pattern for inactive duty training was set by the Mayo Clinic, Rochester, Minn., which offered two courses annually: one of 4 to 6 weeks' duration in the spring, and another of 2 weeks, in the fall. During the morning hours, student officers studied purely medical subjects, and during the afternoon, attention was devoted to military subjects. The success of the program, both in keeping physicians abreast of current medical developments, and in creating interest in military medicine, encouraged the program's expansion. By 1939, similar courses were offered by medical groups in Cincinnati, Ohio, Cleveland, Ohio, St. Louis, Mo., Boston, Mass., Kansas City, Mo., Chicago, Ill., New Orleans, La., and Nashville, Tenn.16

Regular Army Enlisted Personnel

Training programs for enlisted personnel of the Medical Department reflected the critical shortage of personnel. To use personnel efficiently, the Medical Department neglected routine military and field training and relied on the specialization and division of labor, supplemented by on-the-job training. Limited by statute to a 5-percent strength allocation, barely adequate to provide routine medical care for a garrison army, the Medical Department found itself progressively squeezed between the need for technicians to support the increasing tendency toward specialization in medicine and the growing demands for medical service. In a number of installations, men served 12-hour shifts, and the rotation of duties was suspended.17

Enlisted soldiers in the Medical Department performed a wide variety of duties, in installations ranging in size and function from hospitals to dispensaries, laboratories, and medical supply agencies. Regardless of their assignment, all Medical Department enlisted personnel were required to engage in training basic to the trade of soldiering, such as dismounted drill, physical conditioning, military courtesy, and army administration. In addition, the medical soldier required instruction in the functions of the Medical Department and, depending upon his assigned duties, technical training in skills ranging from simple emergency medical treatment to complicated laboratory technique. Medical soldiers as a group required all the skills necessary for supplementing the professional services of a functioning medical installation. Responsibility for training the enlisted personnel of any medical detachment or installation, regardless of its size or specific mission, fell on the commanding officer.

    16Patterson, R. U.: The Medical Reserve Corps of the Army. Mil. Surg. 74 (5): 256-258, May 1934.
    17See footnotes 5,  p. 3; and 9 and 10,  p. 6.


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Skills were developed through on-the-job training. Training schedules were established for drill and physical exercise periods and for lectures and demonstrations on military courtesy, military law, and technical subjects. The degree to which such schedules were followed, however, depended upon the demands which routine care of the sick and injured made upon the time of instructors and students. Because these demands were usually heavy, more technical training was accomplished in wards, dispensaries, and operating rooms, where men could learn by "seeing and doing," than in classrooms. Since the length of peacetime enlistment was 3 years, and many men remained in the service for more than one term of enlistment, the more enterprising often became highly skilled specialists through on-the-job training. Those who desired technical ratings had to pass Armywide promotional examinations in both technical and military subjects.18

A limited number of courses for enlisted men were offered by the Medical Field Service School, the Army Medical Center, and the School of Aviation Medicine. The Medical Field Service School initiated an annual Noncommissioned Officers Course in 1924 designed "to teach noncommissioned officers correct and effective methods of instruction and the art of handling and training Medical Department troops of the components of the Army of the United States."19 This 8-week course included instruction in company administration, leadership techniques, logistics, tactics, map reading, sanitation, control of communicable diseases, first aid, and teaching methodology. It was particularly valuable to experienced enlisted men preparing for annual promotional examinations, although it was not a prerequisite. Between 1935 and 1940, numbers enrolled ranged between 41 and 100. Extension courses were offered to enlisted personnel through the Medical Field Service School also, but the number of participants was always small.20

In addition to the Noncommissioned Officers Course, four technical courses were conducted by the Professional Service Schools at the Army Medical Center. These included the X-ray Technicians Course and the Laboratory Technicians Course at the Army Medical School, the Dental Technicians Course at the Army Dental School, and the Veterinary Technicians Course at the Army Veterinary School. All were courses of long standing, established before the organization of the Army Medical Center, and army regulations required that they be offered annually. The courses were 4 months in length and could be offered twice yearly if enrollment requests warranted.21 In 1939, all courses, except the Veterinary Technicians Course, were lengthened to 12 months, and 12-month courses for pharmacy technicians and orthopedic appliance technicians were added to the program. Such courses were designed to contribute to the quality of Army medical service and to be of personal value to students who anticipated taking promotional examinations for advanced technical ratings. They were not prerequisites for examination, and between 1935 and 1939, enrollments were low. In no course did enrollments exceed 33, and in most, enrollments were below 12.22

    18Army Regulations No. 615-15, 25 May 1937.
    19Army Regulations No. 350-1030, 30 Dec. 1926.
    20See footnotes 5, p. 3; and 8, 9, and 10, p. 6.
    21See footnote 7 (2), p. 5.
    22See footnotes 5, p. 3; and 10, p. 6.


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The School of Aviation Medicine conducted a 3-month "Flight Surgeons Assistants Course." Offered twice annually, the course was designed to train students not only to prepare instruments used in examining applicants for flight duty but also to assist in examinations by taking pulse counts, blood pressure readings, and similar measurements. Enrollments were small, reaching a peak of 44 in 1939.

Field Training

At the close of the interwar period, tactical training continued to be the Medical Department's most striking training deficiency. With the exception of the men assigned to existing understrength field units, few medical soldiers received actual training in tactical medical operations. These units, consisting of the 1st Medical Regiment, which was used for demonstrations at Carlisle Barracks (fig. 2), the 2d Medical Regiment at Fort Sam Houston, Tex., the skeleton 1st Medical Squadron (Cavalry) at Fort Bliss, Tex., and the 11th and 12th Medical Regiments,

    FIGURE 2.-Members of the 1st Medical Regiment at the Medical Field Service School, Carlisle Barracks, Pa., load simulated patients on an ambulance at an ambulance loading post set up by the collecting company of the regiment during a field problem.


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    FIGURE 3.-Four-mule ambulances such as these were used in the training of Medical Department personnel at the Medical Field Service School, Carlisle Barracks, Pa., before World War II.

in Hawaii and the Philippines, respectively, were the only units receiving what was deemed adequate field training. Yet, on the field of battle, the mission of providing aid stations, collecting stations, and clearing stations for the first and second echelons in the chain of evacuation was basic to the Medical Department's combat mission.

Soldiers assigned to these units received tactical and field training that could not be given to members of the Medical Department assigned to duty in dispensaries and hospitals. Their training included instruction in such subjects as emergency medical treatment, first aid, litter carrying, ambulance service, and the establishment, movement, and operation of medical facilities in the field (fig. 3).

Opportunities for practicing actual field support were limited. The 1st Medical Regiment, in addition to its training program, acted as a demonstration unit at the Medical Field Service School and for the training camps operated at Carlisle Barracks for the Organized Reserves and Reserve Officers' Training Corps units. The 2d Medical Regiment, in addition to its routine activities, actively participated in 1938 and 1939 in the experimental exercises and maneuvers of the newly streamlined infantry division in Texas. Shortages of personnel handicapped the training of these units just as they handicapped the training of personnel in dispensaries and hospitals; the four medical regiments were maintained at "peacetime" strength, rather than mobilization strength, and the medical squadron was usually described as "skeletonized." As late as 1939, The Surgeon General reported that the "lack of adequate enlisted strength from which to form the required regimental medical detachments and Medical Department field units to be ready for use on M-day


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presents a problem as yet unsolved, in furnishing adequate medical service for units in the protective mobilization plan."  Units scheduled for activation in fiscal year 1939 were deferred until the following year because of manpower shortages. In a sudden mobilization, the Medical Department would have been unable to care for combat troops and, at the same time, to provide cadres for an expanding medical field service.23

Summary

Despite the effects of peace, disarmament, and depression on the machinery for mobilization, some developments of the interwar period proved beneficial. The Medical Department developed techniques and programs to train officers for their role in a technical service. In a like manner, programs were set up for the advanced training of enlisted technicians and noncommissioned officers. But, the Medical Department's training program was adapted to meet the needs of a small garrison army and would have to be restructured to function efficiently in a period of mass mobilization. Physical facilities, of course, would have to be expanded and, more important, tempo accelerated. The luxury of an academic year of training for newly commissioned officers, and a full year for enlisted technicians, would have to be abandoned to train a service expanding more than proportionally with the Army and to provide immediate medical care for mobilized troops. Skills acquired informally through on-the-job training, or by a gradual process of see-and-do, would have to be taught by formal methods. Medical Administrative Corps officers, who previously acquired their training through long years of enlisted service, would have to be trained in great numbers to free the limited number of available physicians from administrative duties. Had the Medical Department been confronted with mobilization in the summer of 1939, the problems of creating a functioning organization capable of providing both routine health care and field medical support might have proved insurmountable. The 2-year period that intervened provided an opportunity to adjust the program for the crisis that lay ahead.

PREPARATIONS FOR WAR

The gradual deterioration of international affairs between 1939 and the attack on Pearl Harbor allowed the Nation to mobilize gradually. Public opinion limited U.S. involvement in the wars of Europe and Asia, but defensive reaction to the deepening international crisis produced a continuous buildup of forces. By July 1941, the strength of the Army was comparable to that projected by mobilization planners for a point in time 8 months after a declaration of war. Expanding the Army from approximately 189,000 on 1 July 1939 to 1,461,000 on 1 July 1941,24 required not only restyling to adjust the training program for volume but also adjusting for

    23See footnote 6 (2), p. 5.
    24(1) Annual Report of the Secretary of War to the President, 1939. Washington: U.S. Government Printing Office, 1939. (2) Annual Report of the Secretary of War to the President, 1941. Washington: U.S. Government Printing Office, 1941.


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the changing quality of new soldiers. In the Medical Department of the Army, as in the entire Defense Establishment, piecemeal response to the deterioration of world affairs provided a cushion against sudden mobilization, but the buildup was a mixed blessing.

Staff mobilization planning continued unabated throughout the interwar period. Annual revisions of basic plans were required as a part of normal staff procedure, and periodic reassessments of basic planning were required by the growing obsolescence of stockpiles, the aging of men who served in World War I, and the changes in strength and diplomatic posture of foreign nations. Frequently, basic changes in mobilization planning coincided with the appointment of a new Chief of Staff. Following the disarmament conferences of the 1920's, staff planning was little more than an academic exercise. By the mid-1930's, growing international tensions and the obvious degeneration of U.S. military power focused staff attention on the need for more realistic planning.

The Protective Mobilization Plan of 1939

It was at this point that Gen. Malin Craig replaced Gen. (later General of the Army) Douglas MacArthur as Chief of Staff in October 1935. Less publicized than his predecessor, General Craig assumed command in a period of moderate economic recovery and slowly reviving concern about national defense. Distressed at commanding an Army ranking 18th among the world's powers, General Craig directed his staff to begin work on a new Protective Mobilization Plan in December 1936. General Craig's anxieties, which he revealed in subsequent statements, focused on the time necessary to train and equip men to fight increasingly technological warfare. He later wrote as follows:

     * * * This is an immensely rich nation, but all of its wealth, all of its industrial capacity, all of its intelligent manpower, is helpless before the inexorable demands of time in manufacture and training. The period has long passed when ineffectively armed or insufficiently trained men can succeed in war. We know to a day the time necessary to produce every item of armament and equipment-the time it takes to train our military specialists. As an instance, the sums appropriated this last year will not be fully transformed into military power for 2 years. This fact, that it takes years to resolve the will of the people into efficiently handled munitions of war, must be remembered. The same persons who now state that they see no threat to the peace of the United States would hesitate to make the same forecast through a 2-year period.25

As a result of staff efforts, a new Protective Mobilization Plan was formulated, revised, and approved as the Protective Mobilization Plan of 1939, in December 1938.26

The Protective Mobilization Plan of 1939 was designed to mobilize a balanced Army of moderate size, consistent with limitations on the procurement of men and materiel. At the beginning of hostilities, or on receipt of mobilization orders, the plan anticipated creation of a defensive Army of 400,000 men, designated the "Initial

    25Annual Report of the Chief of Staff to the Secretary of War. In Annual Report of the Secretary of War to the President, 1939. Washington: U.S. Government Printing Office, 1939.
    26Kreidberg, Marvin A., and Henry, Merton G.: History of Military Mobilization in the United States Army, 1775-1945. Washington: U.S. Government Printing Office, 1955. (DA Pamphlet 20-212.)


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Protective Force," consisting of the Regular Army, the Reserve, the National Guard, and a corps of volunteers who would act as fillers. Thirty days after the onset of mobilization, this force of four Regular Army and 18 National Guard divisions was to be ready to protect U.S. soil from attack. Once the Initial Protective Force had been prepared for action, the Protective Mobilization Plan called for a second phase of troop activation designed to bring the U.S. Army to a strength of approximately one million enlisted men, and the officer strength necessary to command them. Assuming that Selective Service would be functioning by the second month of mobilization, draftees and volunteers were to be inducted as rapidly as equipment could be supplied, and then trained by selected Regular Army or Reserve cadres either as fillers for existing understrength units or as new units. Material shortages limited the induction of personnel for new units to approximately 150,000 per month, although an additional number of fillers requiring only the issue of personal equipment could also be trained. A serious handicap to the program's success was the shortage of Regulars and Reservists to fill cadre positions and command the Initial Protective Force. Once the second phase was completed, some 8 months after M-day, it was assumed that superior trainees could be utilized as cadre, and the process could be either continued or expanded until manpower requirements for the particular emergency were satisfied.

To provide for the induction and training of new troops, the Protective Mobilization Plan specified the location of reception centers, enlisted replacement training centers, and unit training centers, and the location at which each unit would begin and complete its training. Under the program, recruits were first assigned to a corps area reception center, where they would be processed, classified, and issued basic clothing and equipment. Those assigned as fillers to understrength units would then report directly to their units for additional training. Others would be sent to enlisted replacement training centers for a vigorous 90-day training cycle. After a period of training, these men would be shipped overseas as fillers, sent to new units in training, or assigned for technical training at service schools or civilian trade schools. In general, troops were to be trained in the traditional military manner, beginning with the broad general problems of physical conditioning and discipline, and progressing gradually to more specialized subjects.

Officer training was to proceed along different lines. At the onset of mobilization, the Army War College and the Army Industrial College were to be closed, but the Command and General Staff School would offer special courses shortened to 3 months. Special service schools, such as the Infantry School and the Medical Field Service School, would offer short courses to refresh Reserve officers called to active duty, and give specialist training. If the emergency continued for more than 2 months, Officer Candidate Schools would be inaugurated at both special service schools and at other necessary locations.27

The Protective Mobilization Plan had many flaws. In spite of the realization that enlisted replacement training centers would not have enough Regular Army or prior service personnel to man them, no attempt was made to provide cadres for

    27(1) See footnote 26, p. 14. (2) Watson, Mark Skinner: Chief of Staff: Prewar Plans and Operations. United States Army in World War II. The War Department. Washington: U.S. Government Printing Office, 1950.


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these centers. Operating under the assumption that troops would be hurriedly trained in the South and shipped overseas for final training in a manner similar to that used by the American Expeditionary Forces in World War I, the plan did not provide for the construction of adequate housing. Plans for reservations large enough for division and corps maneuvers were neglected. Designed primarily for the mobilization of combat elements of field armies, provisions for the training of technical and support elements were admittedly inadequate. Plans for Zone of Interior hospitalization were inadequate, and War Department planners made no provision for the use of affiliated units, which had made important contributions to medical care in World War I. Despite these defects, the program outlined in the Protective Mobilization Plan of 1939 was more realistic than any offered before the war.

The Surgeon General's Protective Mobilization Plan, 1939

The plan issued by the War Department was brief but specific and designed to be supplemented by army regulations, mobilization regulations, and the progressively more detailed plans of subordinate units. Plans prepared by subordinate agencies, such as the Medical Department, followed a format parallel to that of the War Department and were more detailed only in providing general outlines for their specific areas of responsibility. Formulating plans for implementing the details of these general outlines was the responsibility of specific commands within the agency.

The War Department mobilization plan, within which Medical Department plans had to be framed, severely limited the scope for discretionary action. The sites of replacement training centers and unit training centers were specified, as well as the sites for unit activation, and the length and size of training cycles for both basic and technical training. Cycle length was standardized at 90 days throughout the Army. The Surgeon General's Protective Mobilization Plan, issued on 15 December 1939, reflected these strictures.

Providing for the routine health care of an expanding army and creating the support units for combat medical duty placed heavy burdens on the Medical Department. Within 120 days after receiving mobilization orders, the Medical Department was required to expand more than tenfold to a strength of over 140,000 officers and enlisted men, and this figure did not include members of the Air Corps and those assigned overseas. To achieve this strength, it was necessary to strain facilities to the limit and, in some instances, to omit the luxury of formal training and to rely on the assumption that men with suitable skills could be channeled directly into their military occupations by induction centers. Other new members of the Medical Department would be channeled through training programs.28

Officer training.-To meet requirements for officers, both for War Department overhead and for medical command, the Medical Department relied heavily

    28The Surgeon General's Protective Mobilization Plan, 1939, with annexes.


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on the Reserves. Because of prewar neglect of field training, efforts were concentrated on preparing officers for field medical service. Those officers required for units mobilized before the 30th day of mobilization were to receive only refresher course training in the troop schools of the unit to which they were assigned. Officers required by units after that time were to attend a 1-month refresher course at Carlisle Barracks, and other installations, designed to prepare them for duty in field medical units. Because officer candidate schools could be activated only with War Department approval, and the selection of officer candidates was a corps area responsibility, no formal plans were announced. The Medical Field Service School, however, was charged with the responsibility for preparing a 3-month training program in the event of such authorization. The peakload of trainees for both of these programs was estimated at 2,000 by the 60th day of mobilization.

Officers destined for duty outside field medical service units were to be trained by a variety of techniques. The Army Medical Center, charged with concentrating available facilities on the training of enlisted specialists, made no provision for the continuing training of incoming professional officers. General hospitals were charged with the responsibility of training key administrative officers for general, surgical, and evacuation hospitals. Medical supply depots were required to train officer replacements for similar depots destined for both the Zone of Interior and theaters of operations. Any officer not attending one of these facilities was to receive refresher training "in the troop schools of the units concerned." Enrollment and classification of nurses, dietitians, and highly trained technicians were responsibilities of the American Red Cross, and these people were to be given only routine training. Recruitment of nurses was a responsibility of the commanders of corps areas.29

Affiliated units.-The most serious defect of the War Department Protective Mobilization Plan, from the viewpoint of the Medical Department, was its failure to provide adequately for the creation of hospital professional staffs. On paper, the Medical Department was required simply to mobilize 32 general, 17 evacuation, and 13 surgical hospitals, in addition to the units required by corps, army, and General Headquarters Reserve, but in practice, the creation of a hospital required more than the simple assignment of professional personnel and the allocation of equipment according to tables of authorization. To carry out their mission, both mobile and fixed hospitals were required to be completely integrated units, with a harmonious staff of competent physicians and surgeons who could function as a team. During World War I, the use of affiliated units, hospital staffs drawn from a single parent civilian medical institution, demonstrated its value in allowing the Medical Department to avoid the time-consuming problem of solving the complicated equation of professional skills required by a medical team. After the war, the close relation between The Surgeon General and civilian institutions had continued, but in 1924, as a result of War Department policies requiring the decentralization of Reserve affairs, affiliated hospitals were transferred to corps area control, and in 1928, the Medical Department lost control of personnel assignments to these organizations. Between 1928 and 1939, age and frustration with the obstacles created

    29See footnote 28, p. 16.


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by corps area administration caused many key officers to resign or allow their commissions to lapse and many of the affiliated units disintegrated.30

The Surgeon General was convinced that the only possibility of developing a properly integrated peacetime reserve of medical units, particularly evacuation, surgical, station, and general hospitals, suitable for mobilization under the War Department Protective Mobilization Plan lay in the revitalization of affiliated units. Despite the failure of that plan to specifically include such units, authority for their utilization existed in a War Department publication, MR (Mobilization Regulations) 1-1, dated 14 August 1938, which stipulated that: "Procurement of entire organizations, where advantageous to expedite their formation with trained personnel or for other appropriate reasons, may be utilized for elements requiring a relatively large number of occupational specialists, as in the case of certain engineer, signal, and medical units. When corps area commanders desire to provide such procurement, they will request the authority of the War Department in each such case."

In March 1939, The Surgeon General recommended to the War Department that selected medical institutions be invited to create or maintain affiliated organizations. By October, after a lengthy struggle over personnel policies, the War Department authorized The Surgeon General to organize affiliated hospitals from a list of selected institutions and to appoint personnel. Planning for the organization of affiliated units was still not completed by the end of 1939, when The Surgeon General's Protective Mobilization Plan was issued. At that time, activation of units was a corps area responsibility when directed by the War Department, while the Medical Department retained control over organization and promotion. Few formal plans were made for training after activation, because the period between activation and utilization would be so short that performance depended heavily on the proper prior selection personnel.31

Enlisted personnel.-Training enlisted men to perform the duties of the Medical Department in a mobilized Army presented serious problems. For practical purposes, there was no reserve pool of skilled manpower comparable to that existing for Medical Department officers. The enlisted strength of National Guard medical units was inadequate for the support of mobilized National Guard divisions, and the Enlisted Reserve did not exist in meaningful numbers. But enlisted men were required for supporting duties ranging from the common specialties of truck driving, cooking, and litter bearing, to the technical specialties of X-ray technician, surgical technician, and dental assistant.

Under the prevailing system of War Department control, The Surgeon General was directly responsible for the activation of named general hospitals and installations classified as exempted stations. The activation and administration of other medical units, as well as the establishment of Medical Department, Unit Training Centers and Enlisted Replacement Training Centers, were corps area responsibilities. The Medical Department was responsible only for the technical supervision

    30Letter, The Surgeon General to The Adjutant General, 17 Mar. 1939, subject: Affiliation of Medical Department Units with Civil Institutions, and Appointment and Promotion in Medical Corps Reserve.
    31See footnotes 1 (3), p. 1; and 28, p. 16.


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of training at these installations for the preparation and issue of training programs. Enlisted training in the Medical Department followed lines laid down by the War Department for the entire Army. After a short period at corps reception centers, devoted to discipline and physical conditioning, recruits were to be selected and sent to branch replacement centers for initial training. Both Enlisted Training Centers and Unit Training Centers for the Medical Department were to be opened at Fort George G. Meade, Md., Fort Oglethorpe, Ga., and Fort Warren, Wyo., during the first 30 days of mobilization. Medical Department enlisted training was restricted to basic subjects and military discipline, on the principle that success lay "not in the actual technical training given the soldier, but in having suitable men for such training properly selected from those with similar civilian vocational training." Unit training centers, responsible for the training of nondivisional units, and divisional units activated after the 30th day of mobilization, were to be activated under similar controls.

Anticipating a shortage of critical technical skills, plans called for the activation of training facilities for nonprofessional enlisted specialists. Courses were to be offered to qualify men as X-ray, medical, surgical, pharmacy, dental, sanitary, and laboratory technicians. Installations charged with the responsibility for providing facilities included the Medical Field Service School, the Army Medical Center, and named general hospitals under The Surgeon General's direct control. Each installation was to be prepared to begin training on 10 days' notice and to draft programs of instruction to be incorporated in its own mobilization plan.

Mobilization cadres.-In addition to other requirements, the necessity of providing cadres for newly activated units placed a serious strain on the Medical Department's limited resources. During the first 30 days of mobilization, planners had to rely heavily on the expedient of draining trained manpower from existing units and installations. Three exempted installations alone-Army Medical Center, Fitzsimons General Hospital, and Army and Navy General Hospital-were to furnish 44 officers, 20 nurses, and 27 enlisted men during the first 30 days of mobilization. Other exempted installations and those under corps area command were to provide corps area commanders with 2,201 officers and 829 enlisted men for cadre duty during the same period. The following month, 1,070 officers and 1,122 enlisted men would be required, but it was hoped that these could be selected from less experienced personnel who could receive additional training at Unit Training Centers before being assigned to newly activated units. After this initial drainage, staff planners expected to draw cadre from officers in training and enlisted graduates of the replacement training centers.

The precipitous mobilization envisioned by staff planners would have severely strained the manpower and facilities of the Medical Department. Unlike a fighting arm, which could usually count on an indefinite period after basic training and unit training to improve its skill before being committed to combat, the Medical Department had to care for the health of an expanding Army and simultaneously prepare for its role in combat medical support. Peacetime experience had proved that over 80 percent of the Medical Department's statutory allocation of 5 percent of the enlisted strength of the Army was required in routine health care. But


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mobilization plans called for the use of over 20 percent of the Department's strength for cadre duty alone, with an unspecified force required for War Department overhead and training at special service schools. Fortunately, the precipitous mobilization envisioned by staff planners never occurred.

Negro troops.-The use of Negro troops presented a complex problem for War Department planners. Failure to achieve racial balance in mobilization for World War I had resulted in bitter criticism, and top level planners were determined to avoid repeating the mistake of discriminatory recruitment during the enlistment period and the subsequent disproportionate drafting of Negroes required to restore racial balance in later phases of mobilization. But, at the same time, fear that public endorsement of policies favoring racial balance would result in criticism of the disproportionately white peacetime Army led the War Department to keep its policies secret from all but a few top level planners. It was not until 1937 that new plans for the utilization of Negro troops were incorporated into mobilization regulations, which were then in the process of revision. This step resulted in only a limited dissemination of policies because access to mobilization regulations was restricted to a few headquarters, including corps area commanders and the chiefs of the arms and services. And even then, lag time in printing and the practice of issuing revisions in segments resulted in an unabsorbed and unfamiliar body of doctrine.

In theory, policies revealed in the revision of 1937 provided for the creation of a racially balanced, segregated Army. Negroes and whites were to be regarded as separate, but almost equal. Negro manpower was to be incorporated into mobilization plans in a ratio equal to their proportion of population of military age, and corps areas were to provide manpower according to manpower ratios in their respective geographical areas. Negroes and whites were to be utilized in representative proportions in both the arms and the services. Negro units could be commanded by either Negro or white officers, preferably Negroes when qualified officers were available. No decision was made concerning the level of command at which separate units would be organized.

On the eve of Pearl Harbor, the U.S. Army had failed to fully implement the policies of 1937. Negro manpower was well below the 9-percent level regarded as a representative proportion, and Negroes were distributed unevenly within the arms and services. Three-fifths of the entire number were almost equally divided between infantry, engineer, and quartermaster units. In the Air Corps, Medical Department, and Signal Corps, less than 2 percent of all enlisted men were Negroes.32

Within the Medical Department, plans for the utilization of Negro manpower were limited. Citing mobilization regulations, The Surgeon General's Protective Mobilization Plan provided that the percentage of Negro manpower in installations under his direct control would be at least equal to the percentage of Negroes in the total male population of military age. Specific provision for the mobilization of Negroes at exempted installations was not incorporated into the plan, and openings for Negroes in activities under corps area command, over which The Surgeon General had only indirect control, were far below population ratios.33

    32Lee, Ulysses: The Employment of Negro Troops. United States Army in World War II. Special Studies. Washington: U.S. Government Printing Office, 1966.
    33See footnote 28, p.16.


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It was not until 1940 that the Medical Department began to make plans for utilization of its share of Negro manpower. In October 1940, Negro wards were established at certain hospitals in the United States, and The Surgeon General recommended the establishment of a new type of unit to absorb most of the Negro increment of enlisted personnel. In November 1940, this "sanitary company" was authorized for the performance of unspecified general duties. At the same time, it was clearly stated that the Medical Department would not willingly create mixed detachments unless such a policy was adopted by both the arms and the services. Because The Surgeon General would not willingly adopt a policy which forced white soldiers to accept treatment by Negro physicians and personnel, further decisions on the size and type of Negro units had to be postponed until the War Department announced the size and type of Negro units the Medical Department would be servicing.34

The Limited Emergency

Within months after the publication of the War Department Protective Mobilization Plan, and even before The Surgeon General was able to issue the Medical Department's subordinate plan, events were set in motion that began to transform U.S. mobilization from the anticipated crash program to a gradual buildup of forces. The U.S. responses to the degeneration of world affairs in the late 1930's had been cautious, and even after the outbreak of hostilities in Europe, U.S. response was limited. Between 3 September 1939, when Britain and France declared war on Germany, and the Japanese attack on Pearl Harbor, U.S. mobilization was carried out not as a result of planning but in sporadic response to a gradually deepening world crisis. On 8 September 1939, 7 days after the beginning of World War II in Europe, President Roosevelt responded with the declaration of a limited national emergency, the meaning of which was not entirely clear. In the same proclamation, the President authorized an increase in the enlisted strength of the Army from 210,000 to 227,000, and an increase of National Guard strength to 235,000 men. Despite the disappointment of Army planners, who had hoped for authorization to increase the Army to its full peacetime enlisted strength of 280,000, the emergency proclamation and the 17,000 increase in troop strength were not without benefits. Limited emergency powers allowed the War Department to increase the number of National Guard armory drills from 48 to 60 per year and to increase the length of their summer camps to 3 weeks. Immediately following the President's declaration, Gen. (later General of the Army) George C. Marshall, Chief of Staff, issued orders reorganizing the Army from its three square divisions, consisting of four regiments, to five new triangular divisions of three regiments each. The new divisions, together with the troop increase, allowed the creation of corps and army headquarters to give higher commanders an opportunity to gain experience in the techniques of large-scale field operations. Late in the spring of 1940,

    34See footnote 1 (3), p. 1.


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some 70,000 Regular Army troops were assembled for the first corps and army maneuvers since 1918.35

In the months following the fall of Poland, fiscal caution and the fear that increased strength would lead to U.S. involvement in a European war led Congress to adopt a noncommittal attitude toward further military expansion. It was not until the German armies began the campaign on 10 May 1940 that by 22 June had forced evacuation of the British Expeditionary Force and the surrender of France that Congress was spurred to action. Within weeks of the renewal of the German offensive, Congress surpassed Presidential recommendations in two separate bills that brought the total authorized Army troop strength to 375,000 and increased War Department appropriations to nearly $3 billion. Two months later, when threatening German attitudes and the uncertain future of the French Fleet raised the possibility that most of the Regular Army would have to be dispatched to Latin America, leaving the Nation defended solely by raw recruits without adequate cadre to train them, Congress again took the bit in its teeth. Despite both Executive and General Staff restraint, Congress passed a joint resolution on 27 August authorizing the President to call the National Guard and Reserves to active duty for 1 year, and on 16 September, it passed the Burke-Wadsworth bill, authorizing Selective Service for 1 year. By two acts, Congress had, in effect, authorized the strength of the Army to be temporarily increased to 1.4 million men.36

Saddled with a massive expansion, the Army turned its full attention to inducting, training, equipping, quartering, and organizing its expanded forces. During the next year, the Army managed to overcome difficulties that have since become legend and organized a ground force consisting of four armies of nine army corps and 29 divisions, and an armored force of four divisions, including support troops. By staggering inductions and the activation of National Guard units, the Army was expanded sixfold during 1941. Even before expansion was completed, however, the General Staff faced the threat of demobilization when the authorization for Selective Service and National Guard activation expired. In Congress, a more relaxed national attitude toward the war, prompted by the persistence of British defenses and the diversion of German offensive forces against Russia, weakened the hand of interventionists and threatened the continuation of mobilization efforts. It was only at the last moment, and by a narrow margin, that Congress, on 12 August 1941, extended the service of men on active duty for 1 year and voted to continue Selective Service.37

By December 1941, when Japanese attacks ended debates over U.S. commitment, the Army was more thoroughly prepared for the outbreak of war than ever before in its history. Troop strength projected for the third phase of the Protective Mobilization Plan of 1939 had already been reached, and 36 divisions, with their support troops, had been activated. Many of these units were admittedly understrength, poorly equipped, and manned by recruits with limited training. It would

    35(1) Biennial Report of the Chief of Staff of the United States Army to the Secretary of War, 1 July 1939 to 30 June 1941. Washington: U.S. Government Printing Office, 1941.
    (2) See footnote 26, p.14. (3) Weigley, Russell F.: History of The United States Army. New York: The Macmillan Co., 1967.
    36See footnotes 26, p. 14; and 35 (1) and (3).
    37See footnote 35 (3).


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be many months before the Nation could do more than assume the defensive and minimize the loss of outlying possessions but, at the same time, industry had begun its retooling, supplies had been ordered, the machinery for induction and training had been established, and the cadre for expansion was being created. As inadequate as these preparations would appear, once war had begun, mobilization was accomplished less painfully than it could have been from the troop base of 1939.

In the months preceding Pearl Harbor, the Medical Department expanded even more rapidly than the Army as a whole, sharing in common its problems and growing pains. Between June 1939 and December 1941, Medical Department enlisted strength grew from less than 10,000 to over 107,000, increasing proportionally from less than 5 percent to 6.4 percent of the strength of the entire army. Officer strength increased similarly from 6.1 percent to over 7.7 percent of the strength of the officer corps. This more than proportional expansion, made necessary by the requirement to create field medical units as well as administer routine medical care, began in 1940, when Congress lifted the statutory strength limitation of the Medical Department from 5 to 7 percent, and authorized the President to make further increases in the event of hostilities.38 By June 1941, all tactical units attached or assigned to field forces had been activated at table-of-organization strength, including the organic medical units below division level; 34 divisional medical battalions, regiments, and squadrons; nine corps level medical battalions; and seven army level medical regiments.

The activation of so many new units would have been a difficult task, even had a large number of field medical units existed from which trained cadres might have been drawn. As it was, hospitals assigned to the field forces had to be activated on the basis of one-half enlisted and nominal officer strength. Numbered general hospitals, for example, were activated with five officers and 250 enlisted men, when their table of organization entitled them to 73 officers, 120 nurses, and 500 enlisted men. These units, including 22 station hospitals, 22 general hospitals, 17 evacuation hospitals, and eight surgical hospitals, were activated in the belief that their limited strength would provide a trained nucleus of enlisted personnel for the activation of affiliated units if and when called to duty and to train the cadre for additional units. Finally, a number of Medical Department installations, including nine named general hospitals (750-2,000 bed), 10 supply depots, eight corps area laboratories, and 175 station hospitals (50-2,000 bed) were fully staffed, equipped, and placed in operation. The strain placed on the Medical Department, even by the comparatively gradual expansion of 1940-41, stretched its facilities to the limit and pointed up the need for having medical facilities available before mobilization began.39

Training the Expanding Army, 1939-41

With the passage of time, the problems of training the Army created between 1939 and 1941 have become legendary. Ideally, an army should be built from the

    38See footnote 1 (3), p. 1.
    39(1) Annual Report of The Surgeon General, U.S. Army, 1941. Washington: U.S. Government Printing Office, 1941. (2) Wakeman, F. B.: Medical Department Training. Army M. Bull. 57: 46-49, July 1941.


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bottom up, beginning with the conditioning and training of the basic soldier, and progressing through unit tactics from the lowest to the highest level of field organization, in order to weld individuals into seasoned, efficient combat teams and to develop the command leadership and staff techniques necessary for managing large units on the battlefield. With the activation of the National Guard and the passage of Selective Service legislation, manpower became immediately available. But the timelag required between appropriations and the procurement of equipment and facilities, in combination with the drainage of critical material through lend-lease, forced the implementation of less than ideal training procedures.

During the year between the President's declaration of a limited emergency and passage of the Selective Training and Service Act, training programs centered on integrating the additional troops authorized in 1939 into the Army's new triangular divisions and field testing these divisions in large-scale maneuvers. During September and October, armory drills for the National Guard were increased by 12, and 7 additional days of summer field training were authorized. Five complete Regular Army divisions and one cavalry division were assembled for intensive field training, and corps area commanders were ordered to assemble their nondivisional troops for similar training. In January 1940, the 3d Division, assembled at Fort Lewis, Wash., participated in amphibious exercises near Monterey, Calif. In April 1940, 3 weeks of corps maneuvers were held at Fort Benning, Ga. During the same period, division and corps troops maneuvered in eastern Texas, followed by 3 weeks of corps against corps maneuvers in the Sabine River area of Louisiana. The spring maneuvers of 1940 focused attention on the training weaknesses of the Army: lack of equipment, poor minor tactics, lack of basic leadership in many units, and some inept command leadership by senior officers. Such weaknesses could be corrected only by the tedious process of basic, small unit training. Maneuvers reinforced the idea that training must begin at the bottom and provide uniform and standardized instruction focused on the fundamentals of soldiering.40

Little could be done to correct deficiencies without additional appropriations. Shortages of equipment and facilities were aggravated by the sudden decision to federalize the National Guard and to inaugurate Selective Service. The original request for National Guard federalization had been made in May, not only to gain control of its manpower and equipment, but also to utilize summer camps while preparing winter quarters. The prolonged debate that followed consumed most of the summer, and resulted in the activation of the National Guard, Selective Service, and the prospect of having to give basic training to a large number of raw recruits. In contrast to World War I, in which newly activated units were given basic training and shipped overseas, the Army now faced the unanticipated problem of housing its expanded troop strength for a protracted period, and providing large unit training areas. Supply bottlenecks and the onset of winter forced planners to place the rate of induction and activation below planned schedules and to pursue less than ideal training programs.

Until replacement training centers could be completed, selectees were assigned

40See footnote 26, p. 14; 27 (2), p. 15; and 35 (1) and (3), p. 22.


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directly to Regular Army and National Guard units, where basic training and advanced unit training were conducted concurrently. Although the replacement training center program was initiated immediately and 21 centers opened as rapidly as construction could be completed, the majority did not begin operating until March and April 1941 and did not reach maximum capacity until June. In the meantime, an annual training cycle was prescribed that divided the year into three 4-month periods: The first devoted to individual and small unit training; the second, to progressive combined arms training; and the third, to corps and army training. After replacement training facilities became available, selectees and recruits were subjected to basic training in their arm or service for a period of 13 weeks before being assigned to their units. The unit training centers called for in the Protective Mobilization Plan were never activated. When Pearl Harbor thrust new demands on the Army, the machinery for enlisted training was functioning. Tests conducted during the fall maneuvers in 1941 did not produce entirely satisfactory results, but the performance of units was well above that demonstrated in the spring of 1940.

Service schools.-During the initial phases of mobilization, service schools followed the policies laid down in the Protective Mobilization Plan and mobilization regulations. The Army War College and the Army Industrial College suspended operations in June 1940, and the Command and General Staff School shifted to a short course program in November 1940. Special service schools discontinued peacetime courses in June 1940, and initiated short courses designed to give refresher and specialist training to those Reserve and National Guard officers who could be spared to attend. In most instances, refresher courses were designed not only to provide basic instruction for company grade officers but also to teach them in such a manner that they would become capable instructors.

Because the pool of National Guard and Reserve officers was adequate for the mobilization of an army of 1.4 million, the officer candidate program was postponed through the 1940 phase of mobilization. Opposition to activating the officer candidate program was based on the fear that it would create a surplus of officers who would become a personnel problem for the Army. After General Marshall became convinced that the opportunity to earn commission would improve the morale of selectees, the officer candidate program was activated on a limited basis in July 1941. By the end of the year, officer candidate schools had graduated only 1,389 officers. Mass training was delayed until after Pearl Harbor. Had the program been delayed much longer, the time consumed in establishing programs and facilities might have produced a critical shortage of officers.

Doctrinal publications and training aids.-Among the lessons learned from mass mobilization for World War I had been the need for training literature. Following the war, both the General Staff and the Army War College conducted extensive studies on its preparation and use. By 1930, four types of War Department training publications were being issued-training regulations, technical regulations, training manuals, and field manuals. In practice, field manuals were most frequently used in military instruction. During the 1930's, the volume of training literature was expanded by the publication of new manuals and regulations designed to explain the use of new weapons and organizations. Finally, in


26

1938, the existing training literature was simplified by eliminating training regulations and replacing them with revised and expanded field manuals. Such revision became necessary, in any event, when the far-reaching organizational changes of 1939-40 and the new weapons and materiel being furnished under the rearmament program made nearly all field manuals obsolete. Revision of the old manuals was well underway by the end of 1941, but for most of the emergency period, training facilities had to either depend on obsolete manuals or create their own materials.

Responsibility for the revision of training literature was not vested in a single agency but was distributed among the service schools and special boards. Directives for the revision of field manuals made it clear that simplicity was as important an objective as bringing the material up to date; lecture-style writing, duplication, and complexity were to be eliminated at all costs. Most of the actual writing was done by the faculties of the Command and General Staff School and the service schools, in the belief that people who were experienced in teaching and instructional methods would be able to write better training manuals than specialists in a given subject. Despite dissatisfaction at the slowness of the work, and the difficulty of coordinating the work of different service schools to avoid duplication and contradiction, the policy of decentralized preparation continued throughout the war.

Supplementing written manuals and doctrinal publications were a wide variety of training aids. After World War I, Army service schools had developed an increasing number of devices, including charts, films, filmstrips, tables, mockups, and models, and other aids to add depth to ideas created by written and spoken words. Instructors in service schools had come to depend heavily on such devices, but with manuals, they were often not readily available in the early stages of expansion. When funds became available in increasing amounts after 1940, the training aids program was expanded, and by the middle of the war, maps, films, and filmstrips were available in ever increasing quantities. Eventually, the resources and experience of the motion picture industry were harnessed to the production of training aids. Throughout the war, however, many of the auxiliary tools of training were produced by small units, either for special purposes or because of individual inspiration on the part of unit commander, in training aids shops that were established down at least as far as the regimental level.

Before 1940, training schedules did not conform to any rigid pattern. Small units at company level and above usually prepared a master schedule for the entire year that included mandatory training subjects, but the sequence and hours allotted to them were left to the discretion of the unit commander and were subject to the availability of time and facilities. The Protective Mobilization Plan, however, included in its subsidiary plans a provision for mobilization training programs, which prescribed time allotments for training subjects in a desired sequence. The mobilization training programs, which were issued for each arm and service late in 1940, were rigid training schedules, allowing only such changes as were made necessary by local conditions. Experiences of the war were reflected by successive changes of the mobilization training programs and by changes in the length of the training period. The overall length of the replacement training program, for instance, varied from 13 weeks to 17, to 8, to 14, back to 13, and again to 17, usually to meet


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a heavy demand for replacements in theaters of operations. The mobilization training programs standardized training and were useful to inexperienced officers. At times, however, they were not flexible enough to allow experienced officers to take advantage of their ingenuity and professional skill.

As teaching programs, mobilization training programs were in turn supplemented by subject schedules, which were, in effect, a syllabus for subjects specified in mobilization training programs. Prepared by the branch schools, these schedules consisted of an outline of the subject, instructions on how it was to be taught, and lists of required training aids and equipment necessary or desirable for a particular lesson. Training programs were also supplemented by a variety of devices by which higher commanders could influence the conduct of training. War Department training circulars were used to institute changes in training manuals until a given manual could be revised, and similar directives were published by subordinate commands. Many of these communications established broad training policies, emphasized current deficiencies, and prescribed special training. In sum, a body of regulations was created that not only outlined the training to be given but also specified its conduct and content.

Although mobilization made on-the-job training impractical, the Army continued to emphasize "learning by doing" in its training programs, disguised by the cumbersome phrase "applicatory training." In practice, methods of instruction emphasized five basic principles: preparation, explanation, demonstration, application, and examination. The technique was efficient for mass transmission of a limited body of knowledge but was often limited by the availability of equipment and training aids, particularly in the early stages of mobilization. To overcome this handicap, training centers frequently had to pool resources and utilize training committees composed of officers and noncommissioned officers specially trained for some phase of instruction. Testing, at all stages of instruction, was used to measure the effects of training.

The Administration of Training

Until the fall of France, the Army within the continental United States was administered through nine geographic divisions known as corps areas. Commanders of corps areas not only controlled the "housekeeping" functions of the Army in the Zone of Interior but also were responsible for the training programs of the arms and services, except for those activities directly under branch control. In theory, a framework of four army areas was superimposed on this structure, which, in case of hostilities, would become responsible for tactical training and operations. In the event of mobilization, plans called for the activation of a General Headquarters to command the field forces in army areas.

The headquarters envisioned by Army planners was created and injected into the Army command structure on 26 July 1940. When activated, General Headquarters consisted of a Chief of Staff and a small group of officers selected to perform its initial function-the supervision and training of tactical ground forces in the continental United States. On 3 August 1940, Brig. Gen. (later Lt. Gen.) Lesley J.


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McNair was appointed to command General Headquarters. A second step toward a wartime organization was taken in October 1940, when command of the four field armies was separated from that of the corps areas.

In theory, responsibility for the several phases of training was clearly delineated in the General Headquarters concept. Commanders of corps areas and the chiefs of the arms and services continued to exercise their preemergency control of the basic training of personnel in their spheres of responsibility and in the newly activated replacement training centers. General Headquarters was designed to take over when these commanders had completed their responsibility and to train the units filled by graduates of replacement training centers. In garrison, troops remained under the jurisdiction of corps area and post command, but in the field, command and support became the responsibility of General Headquarters. Ideally, the system should have created four independent field armies capable of prompt and effective tactical movement, but in practice, the ideal was never achieved. Army commanders were never fully liberated from the responsibility for post command, the delegation of training responsibility remained incomplete, and General Headquarters remained subject to War Department General Staff, G-4, in matters of supply. Until March 1941, when replacement training centers began to function, newly activated units of the forces under General Headquarters command were filled with selectees directly from civilian life. Much of General Headquarters energy was consumed in training raw recruits, tactics, discipline, and the use of weapons, instead of the advanced unit training for which it was intended.

The duties of General Headquarters were, for the most part, of a general nature. Seven officers were assigned to General Headquarters in August 1940, and as late as June 1941, as few as 23 were on its staff. General McNair's energy and ability enabled him to translate the Chief of Staff's strong views on the necessity of step-by-step training into action, as well as the traditional Army view that training should begin from the ground up. But aside from these accomplishments, General Headquarters ambiguous position and limited strength made it a difficulty to function as intended. When the addition of command and planning responsibilities in the summer of 1941 brought it into conflict with the War Plans Division, the War Department began to consider reorganization.41

The Reorganization of March 1942

The Army reorganization of March 1942, which served as the basis for Zone of Interior administration throughout the war, was the product of conflicts produced by overlapping responsibilities under the existing War Department structure and the increasing administrative burden on the Chief of Staff created by Army expansion. After a lengthy period of study, reorganization was effected by Executive order on 9 March 1942.42

    41(1) Greenfield, Kent Roberts, Palmer, Robert R., and Wiley, Bell I.: The Organization of Ground Combat Troops. United States Army in World War II. The Army Ground Forces. Washington: U.S. Government Printing Office, 1947. (2) Millett, John D.: The Organization and Role of the Army Service Forces. United States Army in World War II. The Army Service Forces. Washington: U.S. Government Printing Office, 1954.
    42See footnote 41 (2).


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Under the new organization, only a limited number of officers had direct access to the Chief of Staff, including the General Staff and the three chiefs of Zone of Interior administrative agencies. The General Staff was to be composed of a small group of officers who would assist the Chief of Staff in strategic planning and coordinate the activities of theater commanders with Zone of Interior agencies. Zone of Interior administration would be accomplished through three commands reporting directly to the Chief of Staff: Army Air Forces, Army Ground Forces, and Army Service Forces. The new air command had its own general and administrative staffs and the responsibility for training and equipping air units both for independent operations and for combined exercises. Army Ground Forces became responsible for organizing and training ground combat troops previously controlled by General Headquarters and absorbed most of the functions controlled by the previously semiautonomous chiefs of the combat arms. Army Service Forces was charged with relieving the fighting arms of the problems of supply, procurement, and housekeeping administration. Because the Chief of Staff was determined that no more than three commands in the United States would report to him, Army Service Forces assumed all responsibilities which did not fit into the structure of Army Air Forces and Army Ground Forces, including the technical services. The Medical Department, as one of the technical services, now reported directly to the Commanding General, Army Service Forces, instead of to the Chief of Staff.43

In addition to its mission of supply and procurement, Army Service Forces was charged with routine administrative and housekeeping duties, including certain Armywide functions, such as "premilitary training, manpower mobilization, and labor relations; operation of reception centers, replacement training centers, and training schools for the supply arms and services; technical training of individuals, basic training of service troops, and technical training of service units; and the furnishing of ASF personnel to the Army Air and Ground Forces, theaters of operations, and overseas forces *   *   * ."44 To carry out this mission, Army Service Forces was given control of those installations responsible for administrative and housekeeping duties, including the corps areas, and many installations which had previously been under the control of the chiefs of the arms and services. To emphasize this change, the title of the corps areas was changed to Service Commands, Army Service Forces. To facilitate administrations, all Army field installations in the Zone of Interior were placed under four categories of control. Those under the direct control of Army Service Forces, including supply and training facilities, and all named general hospitals, except the Army Medical Center, were categorized as class I installations and placed under the commanding generals of service commands. Class II installations were those where Army Ground Forces units were stationed, and Army Service Forces duties were confined to housekeeping and administration. Class III installations were those similarly occupied by Army Air Forces units. Class IV installations were those that, because of their technical nature, remained under the direct command of a supply or administrative service.

    43Initially called SOS (Services of Supply), the name of the command was changed to ASF (Army Service Forces) by War Department General Orders No. 14, 12 Mar. 1943. It is best known by this designation, which will be used hereafter.
    44See footnote 41 (2), p. 28.


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In this redistribution of authority, The Surgeon General not only lost direct control of most of the Medical Department's exempted installations but also lost a great deal of control over the activities of the Air Surgeon and the medical service he commanded.45

The reorganization of 1942 placed a capstone on the structure of command and control which had gradually been evolving since the introduction of the General Staff system. Throughout the interwar period, as part of the special staff, the chiefs of the technical services had acted as technical advisers to War Department General Staff, G-3, in matters of troop training. Well before 1939, The Surgeon General had become established as the final source of technical doctrine for the training of medical troops, and the War Department had charged the Surgeon General's Office with the responsibility for developing programs for the individual and unit training of all medical troops, as well as preparing Medical Department training materials for publication. The Surgeon General continued to be the ultimate source of training doctrine and official War Department training guides and materials for all medical soldiers throughout the war. The War Department reorganization of March 1942, which reduced the staff level of the chiefs of technical services and placed them under the Commanding General of Army Service Forces, modified only administratively The Surgeon General's responsibility for the formulation of Medical Department training doctrine, program guides, and instructional materials. Before the reorganization, The Surgeon General discharged this responsibility as an agent of the War Department; after the reorganization, he discharged it as an agent of the Commanding General, Army Service Forces.46

In contrast with the control of technical doctrine, The Surgeon General's command relationship to the staffs of installations training medical troops was seriously modified by the reorganization of 1942. During the interwar period and the first 2 years of the emergency, direct command of the facilities and staff for training medical troops was divided between corps area commanders and The Surgeon General. Corps area commanders had immediate jurisdiction over the training of medical soldiers at all posts, camps, and stations that were not reserved for The Surgeon General by War Department directive. At the beginning of the limited emergency, the exempted stations consisted of the Medical Field Service School; Army Medical Center, including Walter Reed General Hospital; the other four named general hospitals; and medical supply depots.47 Commanding officers of exempt installations were directly responsible to The Surgeon General for all administrative and supervisory activities affecting training. They were responsible to corps area commanders in matters of supply, communication, courts-martial, and the discipline and military bearing of their troops. Because all service school courses were conducted at either the Medical Field Service School or the Army Medical Center, The Surgeon General had direct control over all such courses. Control of the basic training of recruits was shared by The Surgeon General and the commanders of corps areas; recruits at exempted stations were trained by their commanders, and

    45See footnote 6 (2), p. 5 .
    46Army Regulations No. 170-10, 10 Aug. 1942.
    47Army Regulations No. 170-10, 10 Oct. 1939.


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others were trained under corps area jurisdiction. As the Army expanded to meet emergency and wartime needs, facilities for training medical troops were dramatically expanded. Changes in the command authority over Medical Department training facilities were so frequent and diverse that they must be reviewed by category to be meaningful.

Control of basic training.-In the interwar years, the initial training of a Medical Department recruit was usually accomplished on-the-job at the dispensary or hospital to which he was assigned. Compared with basic training during the war, little emphasis was placed on drill and field training. When Selective Service began to bring large numbers of new men into the Medical Department, recruits were sent from reception centers either to Medical Department field units, which were activated in increasing numbers after July 1940, or to the Medical Replacement Training Centers, which began being activated in February 1941.48

The Surgeon General's relationship to the Medical Replacement Training Centers had a checkered history. The first centers, established at Camp Lee and Camp Grant in January 1941 and at Camp Barkeley in November 1941, were corps area installations49 even though plans for the centers were developed in the Office of The Surgeon General. In December 1941, these centers were designated exempt stations and placed under command of The Surgeon General.50 Camp Joseph T. Robinson, Ark., established in January 1942, operated under a different command relationship to The Surgeon General for a period of 8 months, being placed under the control of the Chief of Infantry for administration and The Surgeon General for training.51

The War Department reorganization of March 1942 made no immediate change in The Surgeon General's relationship to the Medical Replacement Training Centers at Camps Lee, Grant, and Barkeley, which were exempted stations, but the center at Camp Robinson became an installation of the newly created Army Ground Forces when that command absorbed the functions of the Chief of Infantry. In July 1942, the Surgeon General's Office requested that the center at Camp Robinson be placed on exempted status to eliminate the "long and circuitous procedure of securing concurrences before ordering personnel in and out of this center."52 The request was not approved, and Camp Robinson remained under the administrative control of Army Ground Forces until August 1942, when it became a class I installation of Army Service Forces.53 Meanwhile, in June, the Medical Replacement

    48See footnote 5, p. 3.
    49(1) Letter, The Adjutant General to Commanding Generals, Second thru Ninth Corps Areas; Commanding General, GHQ, Air Force; Commanding Officer, Edgewood Arsenal, Md.; and Commanding Officer, Aberdeen Proving Grounds, Md., 13 Jan. 1941, subject: Replacement Centers. (2) Letter, The Adjutant General to Commanding Generals, Seventh and Eighth Corps Areas; Chief Signal Officer; The Surgeon General; and Chief of Infantry, 23 Oct. 1941, subject: Activation of Replacement Training Centers.
    50(1) Telegram, The Adjutant General to Commanding Generals, Medical Replacement Training Centers, Camp Grant, Ill., Camp Lee, Va., and Camp Barkeley, Tex., 20 Dec. 1941. (2) See footnote 6 (2), p. 5.
    51Letter, The Adjutant General to Commanding Generals, Third, Sixth, Seventh, and Eighth Corps Areas, Infantry Replacement Training Centers; Chief of Infantry; and The Surgeon General, 3 Jan. 1942, subject: Constitution and Activation of Medical Replacement Training Center, Camp Joseph T. Robinson, Ark.
    52Memorandum, The Surgeon General for Director of Training, Services of Supply, 6 July 1942, subject: Exempted Status Medical Replacement Training Center, Camp Joseph T. Robinson, Ark.
    53Memorandum No. W170-1-42, The Adjutant General, 22 Aug. 1942, subject: Status of the Medical Replacement Training Center, Camp Joseph T. Robinson, Ark.


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Training Center at Camp Lee was transferred to Camp Pickett,54 and, in August, the exempted stations also became class I installations under the newly created service commands of Army Service Forces.55

By this reorganization, the Medical Department lost direct command of the Medical Replacement Training Centers and was required to exert its influence through channels. Throughout the war, the formulation of doctrine remained a prerogative of The Surgeon General, along with the authority to draft training programs. Doctrine and training programs could be forwarded to the Medical Replacement Training Centers directly through the Commanding General, Army Service Forces, who retained direct control over these areas. The selection, assignment, and relief of staff and faculty personnel were similarly retained by the headquarters of Army Service Forces, and in December 1942, regulations were loosened to allow direct communication between the chiefs of technical services and training activities in matters of program, doctrine, and staff assignments. With the exception of the responsibility for faculty and staff assignment, which was transferred to service command jurisdiction in April 1943, these policies remained in effect until after the end of the war.56

Control of units in training.-At the beginning of the limited emergency, only five medical field organizations were in existence. Of these, only the 1st Medical Regiment was under the direct command of The Surgeon General, and that because it was assigned to the Medical Field Service School as a demonstration unit. The other four units were responsible to the commanders of corps areas. Activation of new medical field units did not get underway until the middle of 1940, following the callup of National Guard units and the inauguration of Selective Service. Because these units were attached or assigned to corps, armies, and divisions for training, they came under the control of General Headquarters. The exceptions to this procedure were a few numbered general hospitals activated at full strength. Until the reorganization of 1942, The Surgeon General, as a member of the War Department Special Staff, was as responsible for the training of a medical battalion or an evacuation hospital, which would later have been classified as an Army Ground Forces-type unit, as he was with those later classified as Army Service Forces-type units, such as numbered general or station hospitals. The Surgeon General was frequently called upon for guidance by the commanders of both field and support units, and his representatives inspected both types of units.57

The War Department reorganization of March 1942 radically modified this supervision by placing certain types of medical units under Army Ground Forces, others under Army Air Forces, and still others under Army Service Forces for training.58 Control was complicated by The Surgeon General's new status, as far as

    54Radiogram, Commanding General, Medical Replacement Training Center, Camp Pickett, Va., to The Surgeon General, 21 June 1942.
    55See footnote 46, p. 30.
    56Army Regulations No. 170-10, 24 Dec. 1942.
    57(1) See footnotes 9 (2), p. 6; and 39 (1), p. 23. (2) Letter, The Adjutant General to Commanding Generals of all Armies, Army Corps, Divisions, Corps Areas, and Departments; Commanding General, GHQ Air Force; Chief of Staff, GHQ; Chiefs of Arms and Services; Chief of the Armored Force; and Commanding Officers of Exempted Stations, 14 Jan. 1941, subject: Organization, Training and Administration of Medical Units.
    58War Department Circular No. 59, 2 Mar. 1942.


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unit training was concerned, as an agent of the Commanding General, Army Service Forces, and the elevation of the Ground Surgeon and the Air Surgeon to the same level of organizational hierarchy. Under the new system, the Office of The Surgeon General retained as much influence over those units assigned to the Army Service Forces as it had in peacetime when these units were controlled through the War Department or General Headquarters and corps area commanders, but its relationship to the training of medical units assigned to Army Ground Forces or Army Air Forces became more remote. While The Surgeon General still formulated training doctrine and official instructional materials for all medical units, he no longer inspected units assigned to Army Ground Forces and Army Air Forces. The War Department reorganization of 1942 thus reduced the staff level on which The Surgeon General functioned as a training agent, and, in so doing, removed from his control large numbers of medical troops during their unit's training period.

The division of control of unit training among the three major commands did not seriously affect The Surgeon General's control of the basic training of medical troops. Recruits and selectees assigned directly to Medical Department field units between September 1940 and mid-1941, before the opening of replacement training centers, received all the basic training they were likely to receive before the reorganization. Their training was a responsibility of either exempted units under direct command of The Surgeon General or field units under corps area command and General Headquarters. Although the Medical Replacement Training Center at Camp Robinson was under the control of Army Ground Forces for a short period, it too was placed under Army Service Forces for the duration of the war in August 1942. Except for those men assigned directly to units in the initial stages of mobilization, all enlisted members of the Medical Department received basic training from training camps administered as class I installations of Army Service Forces, whether they were ultimately destined for assignment to Army Service Forces or Army Ground Forces.59

Command of schools.-On 1 July 1939, only two Medical Department installations provided academic training: the Medical Field Service School, and the Medical Department Professional Service Schools, including the Medical, Dental, and Veterinary Schools at the Army Medical Center. In the course of the war, the number of schools was expanded heavily to meet requirements for technically trained personnel. Throughout the war, Medical Field Service Schools and the three professional service schools at the Army Medical Center remained under the direct command of The Surgeon General. Mobilization plans called for the establishment of enlisted training schools at exempted installations, which would have remained under direct control, and all but two of the 13 schools established between April 1941 and July 1942 were, at their inception, directly administered by the Medical Department. The exceptions were the Enlisted Technician's School at Station Hospital, Fort Sam Houston, Tex., and the Army School of Roentgenology at the University of Tennessee College of Medicine, Memphis, Tenn., neither of which was located at an exempted station. In July 1942, the newly created service commands, which superseded the older corps area commands under the Army

    59Annual Report, Training Division, Operations Service, Office of The Surgeon General, fiscal year 1943.


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Service Forces, absorbed most of the Medical Department's exempted stations and removed all but the Medical Field Service School and the Army Medical Center from The Surgeon General's direct control. Following the reorganization, the Office of The Surgeon General continued to exercise direct control over training programs and doctrine but was unable to exercise jurisdiction over personnel and administration at schools falling under the authority of the service commands.

Activities of the Training Division, Office of The Surgeon General

Within the Office of The Surgeon General, administrative authority over The Surgeon General's training responsibilities was delegated to the Training Division, which developed all Medical Department training programs; supervised the preparation of technical manuals, training films, and other training aids; formulated plans for Medical Department replacement centers and schools; supervised the activation of training installations; and inspected schools, units, and training centers for which The Surgeon General had supervisory responsibility. On 1 July 1939, the Training Division was actually a subdivision of the Planning and Training Division, staffed by one officer, as it had been since its creation in 1921. In spite of an increasing workload, growth of the subdivision was slow. It was not until January 1940 that the staff was increased to two officers, and when the United States entered World War II, the subdivision was staffed by only three officers. In February 1942, the Training Subdivision achieved division status, but there was no change in personnel until June 1942, when its staff was increased to five officers.

In August 1942, the Training Division was reorganized to parallel the structure of the Army Service Forces Training Division. Originally it had consisted of an Enlisted Branch, an Officer Branch, and a Publication Branch. Thereafter, it contained a Replacement Training Branch, a School Branch, a Training Doctrine Branch, and a Unit Training Branch. The Replacement Training Branch and the School Branch prepared plans for the inauguration of Medical Replacement Training Centers and Medical Department schools, recommended overhead personnel allotments and changes in the staff, wrote appropriate mobilization training programs, and inspected the installations involved. The Unit Training Branch was created to prepare programs for Medical Department communications zone installations, which were an Army Service Forces responsibility, and, in addition, recommended officer personnel for these units and evaluated their proficiency. The Training Doctrine Branch supervised the preparation of technical manuals, field manuals, training films, filmstrips, posters, and graphic training aids. In May 1944, the Replacement Training Branch and the Unit Training Branch were renamed the Regular Training Branch and the Readiness and Requirements Branch to conform with terminology used in the Office of the Director of Military Training, Army Service Forces, but the changes were in name only. The basic structure created by the reorganization of August 1942 remained in effect throughout the war.60

    60(1) See footnote 6 (2), p. 5. (2) Annual Report, Training Division, Operations Service, Office of The Surgeon General, fiscal year 1944.

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