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Chapter II

Contents

CHAPTER II

Medical, Dental, Veterinary, and Sanitary Corps Officers

World War II did not produce radical changes in the pattern of training Medical, Dental, Veterinary, and Sanitary Corps officers. Expanding activities increased specialization and division of labor and intensified the specialization of training. Programs were divided into components that could be expanded into separate courses; other courses were shortened, and the pace of training was accelerated. New courses were added to provide officers with skills that had been traditionally acquired through informal training. Medical specialists required for the treatment of wounds and diseases uncommon in peacetime medical practice also required special training. When the increasing demand for physicians resulted in a transfer of nontechnical duties to MAC (Medical Administrative Corps) officers, some areas of training were deleted from the program. Training facilities were expanded from the Medical Field Service School, Carlisle Barracks, Pa., and the Army Medical Center, Washington, D.C., to include general hospitals, medical depots, civilian institutions, replacement training centers, and officer replacement pools. Despite these changes, however, the division of training into tactical and technical programs continued throughout the war; the addition of new facilities and courses reflected the Medical Department's expansion, and not a change in direction.

PERIOD OF FLUX: 1939-41

Continuing the Peacetime Program: September 1939-September 1940

Regular Army training

Aside from increasing emphasis on field medical service, the first year of the war in Europe produced few substantive changes in Medical Department training. The expansion of the Army that accompanied the limited emergency proclamation, and the conversion to triangular divisions that followed, allowed the Medical Department to organize field medical detachments for four divisions, four medical battalions, and an additional medical regiment. Activation of these units during the winter of 1939-40 was complicated both by the preponderance of recruits and by the relative inexperience of many of the officers who had been detached from hospitals to command them. At best, their performance in the spring maneuvers of 1940 was described as "creditable," and led to the observation: "The inexperience in all echelons of command in the use of these units showed the necessity of having in


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being all of the tactical medical elements of mobile forces in order that all may be trained in respective responsibilities and cooperative action."1

To provide basic field training for newly commissioned officers, and to complete the basic training of Regular Army officers who had not yet attended the Medical Field Service School, the Officers' Basic Course was shortened from 5 to 3 months, and offered twice annually. The change permitted a modest expansion: in contrast to the largest class in the preceding 5 years, 81 officers who graduated in 1935, 111 student-officers completed the basic course in 1940.2

An unusual opportunity to experiment with basic officer training developed in 1940, when the War Department directed the MFSS (Medical Field Service School) students to participate in the spring corps and army maneuvers.3 To prepare the basic officers' class for maneuvers, Lt. Col. (later Brig. Gen.) Charles B. Spruit, MC, recommended altering the course schedule to concentrate formal instruction in the month preceding maneuvers. "I am firmly convinced that the experience these *  *  * officers would obtain by actual participation in the greatest peacetime maneuver the Army has ever had, will be of far greater value to the service and to them than the solution of any number of map problems or participation in the field exercises at Indiantown Gap."4

After an initial period of instruction at Carlisle Barracks, students from the Medical Field Service School participated in both corps and army exercises. During the corps phase, at Fort Benning, Ga., half of the students were assigned to medical battalions, and half to regimental medical detachments. To give students a greater understanding in all echelons of support, assignments were reversed during the army phase of maneuvers, which were held in the Sabine River area of Louisiana. Eight members of the faculty, assigned as special medical observers and control officers, accompanied the class. Although reports on the performance of MFSS students were enthusiastic, particularly when contrasted to that of medical unit officers who had received no formal training, the maneuvers produced conflicting recommendations for future training. The Surgeon General supported Colonel Spruit's opinion that "the sending of these two classes to the Army maneuver was justified."5 The Medical Field Service School, however, took the position that, despite the value of the maneuvers, the time could have been better spent in independent medical exercises at Indiantown Gap, Pa., within a reasonable distance of Carlisle Barracks. Five weeks had been too short to prepare students for field exercises, and the time

    1Annual Report of The Surgeon General, U.S. Army, 1940. Washington: U.S. Government Printing Office, 1941.
    2(1) Annual Report of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1935. (2) See footnote 1.
    3Letter, The Adjutant General, War Department, to The Surgeon General, U.S. Army, 25 Mar. 1940, subject: Courses of Instruction at Special Service Schools, 1940-41.
    4Memorandum, Lt. Col. Charles B. Spruit, MC, Chief, Training Subdivision, Planning and Training Division, Office of The Surgeon General, for Col. Albert G. Love, MC, Chief, Planning and Training Division, Office of The Surgeon General, 5 Jan. 1940, subject: Training at Carlisle as Affected by Coming Course and Army Maneuvers in the South.
    5(1) Letter, Lt. Col. Charles B. Spruit, MC, Chief, Training Subdivision, Planning and Training Division, Office of The Surgeon General, to The Surgeon General, U.S. Army, 14 June 1940, subject: Third U.S. Army Maneuvers, Army Phase. (2) Annual Report of The Surgeon General, U.S. Army, 1941. Washington: U.S. Government Printing Office, 1941.


37

spent on maneuvers was disproportionate.6 The school prevailed, and future maneuvers were confined to facilities adjacent to Carlisle Barracks.

Aside from these experiments with basic field training, few other changes were introduced into the training program for Regular Army officers. The basic graduate courses at the Army Medical Center were shortened by a month, but the number of students remained constant. The advanced course at the Medical Field Service School was lengthened by a month to provide special instruction in training methods for senior officers. In December 1939, advanced graduate courses at the Army Medical Center, scheduled to begin in February 1940, were canceled because officers could not be spared to attend them.7 Revision of the MFSS extension courses, instituted in 1939 as a 4-year plan to concentrate efforts on preparing young Reserve and National Guard officers for service in-grade, eliminated the special extension course for Regular Army officers preparing for promotion to lieutenant colonel or colonel. More elementary courses were still open to them, but only eight Regular Army officers enrolled.

National Guard and Reserve officers

The first year of the limited emergency produced as few changes in the training of Reserve and National Guard officers as it had in the Regular Army program. Until both elements were called to active duty in the fall of 1940, summer training camps and correspondence courses continued to provide the bulk of their training. In common with the Regular Army, Reserve components were trained with an increasing emphasis on field medical service. In addition to the usual basic- and unit-training camps held at the Medical Field Service School in the summer of 1939, summer camp training in field sanitation was conducted for 79 officers at newly constructed demonstration areas at Jefferson Barracks, Mo.; Camp Bullis, Tex.; and Fort Ord, Calif. Previously, sanitary demonstration areas were available only at Carlisle Barracks. To school National Guard units in the problems of cold weather operations, supplemental field training was required between October 1939 and January 1940. Basic- and unit-training camps were again held in the summer of 1940. Field training was supplemented as usual by extension courses, which were still in the process of being revised, and more than 11,000 officers of the Reserve and National Guard enrolled in them between June 1939 and June 1940. During the same period, one National Guard officer enrolled in the Army Veterinary School course in forage inspection.

The program of extension courses for field grade officers, dropped from the Regular Army program, continued to be available to senior officers in Reserve components. The usual fall advanced course, offered between 15 September and 28 October 1939, was attended by 25 officers. The following May, 14 officers in a special course for National Guard officers were unexpectedly given the opportunity to participate in the Third U.S. Army maneuvers in Louisiana, where they were able to gain practical experience as officers in various echelons of medical support.

    6Technical Report of Activities of the Medical Field Service School, Carlisle Barracks, Pa., fiscal year 1940.
    7Letter, Col. James E. Baylis, MC, Executive Officer, Office of The Surgeon General, to The Adjutant General, War Department, 27 Nov. 1939, subject: Advanced Course, Medical Department Professional Service Schools, School Year 1939-40.


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Schools outside the Medical Department

Between September 1939 and September 1940, two Medical Corps officers of the Regular Army attended the Army War College, Washington, D.C.; one attended The Infantry School, Fort Benning, Ga.; three attended the Army Industrial College, Washington, D.C.; and four attended the Command and General Staff School, Fort Leavenworth, Kans. One VC (Veterinary Corps) officer, Regular Army, attended the Chemical Warfare School, Edgewood Arsenal, Md. The number of Regular Army MC (Medical Corps) officers attending the School of Aviation Medicine, Randolph Field, Tex., increased from 10 to 17, reflecting the emphasis at the beginning of the limited emergency on expanding the Air Corps. Eight MC Reserve officers also completed this course, and an additional 51 qualified for entrance by completing a required extension course. Twenty-eight Regular Army officers attended a variety of courses at 15 universities and foundations, and the Reserve officers continued to attend civilian institutions under the Skinner Plan.8

Growth and Transition: September 1940-September 1941

Activation of the Army's Reserve and National Guard components, and passage of the Selective Training and Service Act, accelerated training in the Medical Department as well as throughout the Army. Between September 1940 and the end of the summer of 1941, when the tours of men called to active duty were extended for an additional year, attention focused on providing maximum training within the additional year. Because a high proportion of Medical Department officers called to active duty had previous training, distinctions between programs for Regular Army, Reserve, and National Guard officers were eliminated, and schools concentrated on refresher training designed to prepare them for special duties in the Army of the United States. Existing special service schools were expanded, and new schools were opened to provide specialized training. Officers completing resident courses of instruction in the special service schools of the Medical Department and Medical Corps officers completing courses of instruction at service schools other than Medical Department schools for fiscal year 1941 are shown in the tabulation which follows:

Schools:1

Number

Special schools:

 

    Medical Field Service School, Carlisle Barracks, PA

2,119

    Army Medical Center, Washington, D.C.

247

    Army and Navy General Hospital, Hot Springs, Ark

62

    Letterman General Hospital, San Francisco, Calif

44

    Fitzsimons General Hospital, Denver, Colo

94

    William Beaumont General Hospital, El Paso, Tex

12

    Station Hospital, Fort Sam Houston, Tex

35

    Veterinary Meat Inspection Course, Chicago Ill

114

      Total

2,727

    8See footnote 1, p. 36.


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Schools:1 (Continued)

Number

Other schools:

 

School of Aviation Medicine, Randolph Field, Tex

237

The Infantry School, Fort Benning, GA

0

Army Industrial College, Washington, D.C.

12

Command and General Staff School, Fort Leavenworth, Kans

12

Total

261

    1Annual Report, Training Subdivision, Planning and Training Division, Office of The Surgeon General, fiscal year 1941, p. 16.

The expansion of medical officer strength, from approximately 2,000 to more than 14,000 during the first year of partial mobilization, produced far-reaching changes in Medical Department Special Service Schools. Based on the assumption that previous training equipped officers from Reserve components for general duties, plans formulated by The Surgeon General called for establishment of refresher courses to prepare officers for the assumption of special duties. All officers assigned to tactical units were to receive a 1-month refresher course at Carlisle Barracks. Those assigned for duty at hospitals were to attend schools set up at general hospitals, under The Surgeon General's direct control, and the remainder were to be assigned to special courses offered at the Army Medical Center and other installations.9

To provide basic training for newly commissioned medical officers, the last 3-month basic course was offered at the Medical Field Service School in the fall of 1940, and 73 officers were graduated.10 Beginning in December, a 1-month refresher course for Reserve and National Guard officers was substituted for the regular basic-training program. Because officers were needed to staff enlisted replacement training centers, emphasis had to be shifted from the tactical training planned for this course by The Surgeon General's Protective Mobilization Plan of 1939, to preparing Reserve officers to serve as instructors for the increasing numbers of enlisted men being brought into the Army by selective service. Emphasis on training instructors continued until April 1941, when the program was reoriented to tactical training. During August, a special 1-month course for instructors was again offered, followed by a month-long course given at the replacement training centers, to provide replacements for Reserve officers who wished to be relieved or rotated from training assignments at the end of their year of active duty, and to provide instructors for the expansion of training facilities. By shortening courses and expanding facilities, the Medical Field Service School was able to increase its training capacity

    9(1) Letter, The Surgeon General, U.S. Army, to The Adjutant General, War Department, 6 Sept. 1940, subject: Medical Department in Mobilization, inclosures thereto. (2) Letter, The Adjutant General, War Department, to The Surgeon General, U.S. Army, 15 June 1940, subject: Courses at Special Service Schools. (3) Letter, Col. James E. Baylis, MC, Executive Officer, Office of The Surgeon General, U.S. Army, to The Adjutant General, U.S. Army, 24 June 1940, subject: Courses at Medical Department Special Service Schools, inclosures thereto.
    10Goodman, Samuel M.: History of Medical Department Training, U.S. Army, World War II. Volume III. A Report on the Training of Medical Officers, 1 July 1939-30 June 1944. [Official record.]


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by June 1941, from approximately 100 officers the previous year to more than 500 officers each month.11

In addition to transforming the basic officer training program, activation of the Reserves and the National Guard produced other changes in the MFSS program. Special courses previously offered to officers of Reserve components were dropped from the program, including the advanced course offered for field grade officers. Thereafter, officers of all components were eligible for the same courses. With the exception of the summer camp held for ROTC (Reserve Officers' Training Corps) students in June 1941, all summer camps were eliminated.12

During the first year of mobilization, modifications in the programs of the three Medical Department Professional Service Schools at the Army Medical Center to meet demands for increased training produced a transition to the installation's wartime role as a center for technical training. The Army Medical School basic graduate course, which had been reduced from 3 to 2 months the previous year, was shortened to a single month in the fall of 1940, and subsequently discontinued. The professional specialist courses, which had long provided on-the-job training in clinical and laboratory procedures, were similarly eliminated after the last class of 20 graduated. The advanced graduate course, which had not been offered the previous year, was again suspended. These programs were replaced by a series of refresher courses, ranging in length to a maximum of 3 months, in surgery, clinical medicine, ophthalmology and otorhinolaryngology, roentgenology, and photoroentgenology. The special graduate course at the Army Dental School was again offered. The Army Veterinary School conducted special graduate courses in clinical pathology, and offered the usual courses in forage inspection. Both the Army Medical and Dental Schools participated in the Medical Department's administrative refresher training program. By June 1941, the facilities of the Professional Service Schools at the Army Medical Center had been expanded from a capacity of 100 officers the previous year, to more than 100 officers each month.13

Partial mobilization proved a mixed blessing for the Medical Department, simultaneously providing much needed manpower and increasing the demand for medical services. As graduates of accredited professional schools, MC Reserve officers were considered qualified both by training and by experience to care for the sick and injured, but few of those who entered the Army, after September 1940, had

    11(1) The Surgeon General's Protective Mobilization Plan of 1939, with annexes. (2) Annual Report, Training Subdivision, Planning and Training Division, Office of The Surgeon General, fiscal year 1941. (3) Letter, Maj. E. D. Liston, MC, Acting Executive Officer, Office of The Surgeon General, U.S. Army, to The Adjutant General, War Department, 23 June 1941, subject: Additional Officers at Replacement Training Centers, inclosures thereto. (4) Letter, The Adjutant General, War Department, to Chief of Staff, General Headquarters; Commanding Generals, First, Second, Third, and Fourth U.S. Armies, 12 Dec. 1940, subject: Attendance at the Medical Field Service School, Carlisle, Pa. (5) Letter, Brig. Gen. Albert G. Love, Assistant Chief, Planning and Training Division, Office of The Surgeon General, to The Adjutant General, War Department, 22 Jan. 1941, subject: Training of Officer Cadres for Medical Replacement Centers, Camp Lee, Va. (6) Immediate Action Letter, Maj. E. D. Liston, MC, Acting Executive Officer, Office of The Surgeon General, U.S. Army, to The Adjutant General, War Department, 23 June 1941, subject: Additional Officers at Replacement Training Centers, inclosures thereto.
    12(1) See footnote 5 (2), p. 36. (2) Special Report of the Medical Field Service School: Personnel Trained-Graduates of School Courses, 1921-41.
    13(1) Annual Report of Technical Activities, Medical Department Professional Service Schools, Army Medical Center, Washington, D.C., fiscal year 1940. (2) Letter, The Adjutant General, War Department, to The Surgeon General, U.S. Army, 31 July 1940, subject: Courses at Special Service Schools. (3) Annual Report of the Training Subdivision, Planning and Training Division, Office of The Surgeon General, fiscal year 1941.


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any detailed knowledge of the administration of Army hospitals. Recognizing the need for training Reserve officers in administrative procedures before assigning them to hospitals, The Surgeon General authorized the Army Medical Center (Dental and Medical Schools), each of the named general hospitals, including William Beaumont, El Paso, Tex.; Army and Navy, Hot Springs, Ark.; Fitzsimons, Denver, Colo.; and Letterman, San Francisco, Calif.; and Station Hospital, Fort Sam Houston, Tex., to conduct refresher courses in hospital administration. Under this program, 50 officers could be assigned monthly to each installation to understudy jobs to which they would subsequently be assigned. On-the-job training would thus be available to Reserve officers in positions ranging from forage inspector and mess officer to commanding officer of a general hospital. Maximum capacity reached 300 per month when the program was placed in full operation on 1 April 1941, but sometimes full utilization was not possible because officers could not be spared from their duties to attend these schools.

By the end of June, about 340 officers, or slightly more than 1 month's capacity, had graduated. The following year, facilities were expanded to include 14 named general hospitals, with a capacity of 700 officers per month. Shortly thereafter, when the supply of Reserve officers had been exhausted, the refresher courses became a part of the Officer Pool Program and were offered to newly commissioned officers. Even later, when MAC officers began to replace MC officers in administrative positions, many of them received pool training in administration. Despite its changing title, its function remained the same, and a 30-day period of on-the-job training in hospital administration became a permanent feature of the World War II program.14

Except for this increase in size, other facets of the training program for MC officers remained unchanged. The program for revising extension courses continued, and 12,764 officers enrolled during the fiscal year. This was only a slight increase over the previous year's enrollment of 12,645, but its size is significant in view of the number of Reserve and National Guard officers who had been called to active duty during the year. At the same time, the facilities of civilian institutions continued to be used for the advanced training of selected MC officers. Between July 1940 and July 1941, 25 officers attended courses ranging in length from 5 days to 1 year at 10 civilian institutions. As a result of priority placed on expansion of the Air Corps, attendance at the School of Aviation Medicine increased more than tenfold in 1941. In contrast to the 17 officers who graduated as flight surgeons in 1940, 237 graduated in 1941. Attendance at the Army Industrial College and the Command and General Staff School also expanded, and 12 Medical Department officers graduated from each school.15

    14(1) 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. (2) See footnote 5 (2), p. 36. (3) Annual Report, Training Division, Operations Service, Office of The Surgeon General, fiscal year 1942. (4) Annual Report of Technical Activities, Medical Department Professional Service Schools, Army Medical Center, Washington, D.C., fiscal year 1941. (5) Letter, Col. Larry B. McAfee, MC, Executive Officer, Office of The Surgeon General, U.S. Army, to the Commanding General, Letterman General Hospital, San Francisco, Calif., 7 Nov. 1940, subject: Training of Medical Department Personnel. (6) Letter, Col. Larry B. McAfee, MC, Executive Officer, Office of The Surgeon General, U.S. Army, to The Adjutant General, War Department, 14 Dec. 1940, subject: Allocation of Training Facilities at Special Service Schools.
    15See footnotes 1 and 5 (2), p. 36.


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Additional opportunities for training were provided for VC officers by the inauguration of a course in milk and dairy hygiene at the Chicago Quartermaster Depot, Chicago, Ill. Veterinary officers had traditionally inspected milk and meat purchased locally as part of their regular duties, but late in 1940, Quartermaster plans for the establishment of a market center program to insure a steady flow of perishable foods and cushion the impact of military demand on the market created a need for veterinary officers specializing in meat and dairy inspection. Following discussions between Lt. Col. Will C. Griffin, VC, depot veterinarian at the Chicago Quartermaster Depot, and Lt. Col. (later Brig. Gen.) Raymond A. Kelser, VC, Chief, Veterinary Corps, permission was obtained on 1 November 1940 for the Veterinary Division to conduct classes at the depot.

Under the agreement, staff and equipment for the course were supplied by the Medical Department, while classrooms and laboratory space were provided by the depot. The first class of 17 officers convened on 25 November 1940, and classes continued to be offered through 1946. By the end of 1946, the class had been conducted 52 times, with 1,038 graduates, including more than 100 officers of the Army Air Forces. Originally a 4-week program, it was extended to 5 1/2 weeks in June 1944. After the reorganization of 1942, the school operated as a class IV installation of the Quartermaster Corps.16

THE WAR YEARS: 1941-45

When the United States entered World War II, the program for training medical, dental, and veterinary officers was accelerated. Because of changes made necessary by the near depletion of the pool of officers with previous training, and the decision to retain men called up after September 1940 for an additional year of service, few discontinuities were produced by the transition to war. Basic training was readjusted to prepare officers newly commissioned from civilian practice for military service, and the officer pool program was expanded. Advanced military instruction was provided by the addition of special cadre and medicomilitary courses. On the assumption that civilian physicians were technically competent to perform routine medical duties, the basic and advanced graduate courses at the Army Medical Center, begun during the limited emergency, were suspended. In their stead, the facilities of the Army Medical Center and a number of civilian medical schools were harnessed to retrain physicians with noncritical skills in specialties essential to the war effort or to the rehabilitation of the wounded. Through the ASTP (Army Specialized Training Program), efforts were also made to expand the supply of physicians available for military service by sending eligible enlisted men to medical school.

    16(1) Medical Department, United States Army. United States Army Veterinary Service in World War II. Washington: U.S. Government Printing Office, 1961. (2) Risch, Erna, and Kieffer, Chester L.: The Quartermaster Corps: Organization, Supply, and Services. Volume I. United States Army in World War II. The Technical Services. Washington: U.S. Government Printing Office, 1953.


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Basic Military Training

War brought vast numbers of a new type of officer into the Medical Department. Before the war, Medical, Dental, and Veterinary corps officers were, in most cases, career soldiers with varying lengths of service. Even after September 1940, when the reserve and National Guard were called to active duty, members of these corps had some degree of military training. By late 1941, the Medical Department's pool of trained reserves had been nearly exhausted. Yet between December 1941 and August 1945, the Medical Corps alone expanded from approximately 11,000 to nearly 47,000.17 Those who were not drawn directly from civilian practices were recruited upon the completion of their internships, and few, if any, had previous military experience. As a result, the demand for basic-training facilities mushroomed.

The disproportionate concentration of the Army's wartime strength increases in the first year of hostilities increased pressure on the Medical Department's basic-training facilities, and produced expedient measures that might have been avoided by more uniform growth. Estimates of the troop strength required to defeat the Axis, formulated immediately after Pearl Harbor, projected a need for over 200 divisions, or more that 10 million men, by mid-1944. The troop basis for 1942, approved by the Secretary of War on 15 January as a guide for the organization and activation of units, required by the Army to bring its strength to 71 divisions with a total of 3.6 million men by 1 January 1943. By September, the 1942 troop basis had been increased to an even 5 million men. Since estimates of total troop requirements were later reduced, the troop basis of 1942 required well over half of the soldiers mobilized during World War II to be trained during the first year of the war.18

As its share of the troop basis, the Medical Department was required to raise its strength from 16,219 officers in January 1942 to 39,894 by 1 January 1943.19 By the end of 1942, the Medical Department had narrowly missed meeting the goals set by the War Department. In the process, however, it was necessary to abandon the prewar pattern of sending every newly commissioned officer to the Medical Field Service School and to combine basic training with a variety of military specialty programs at many installations.

Where and how an individual MC, DC, VC, or SnC (Sanitary Corps) officer was given basic training depended, in large measure, upon his ultimate assignment. Because of The Surgeon General's policy that, as far as possible, junior officers who had not acquired a medical specialty would be given basic tactical training and assigned to the field forces, the facilities of the Medical Field Service School were reserved for younger officers. Members of affiliated units, limited-service personnel, and older, more highly specialized officers were usually trained at pools established at installations, ranging from general hospitals and Medical Replacement Training

    17Medical Department, United States Army. Personnel in World War II. Washington: U.S. Government Printing Office, 1963.
    18Kreidberg, 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.)
    19Memorandum, Brig. Gen. Larry B. McAfee, Assistant to the Surgeon General, U.S. Army, Chief, Operations Service, for the Director of Training, Services of Supply, 7 May 1942, subject: A Study in Preactivation Training of Commissioned Officers, inclosure thereto.


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Centers to supply depots, and under the control of headquarters ranging from ASF (Army Service Forces) service commands to AGF (Army Ground Forces) and AAF (Army Air Forces) commanders.

Training facilities at the Medical Field Service School and the Professional Service Schools were allocated by The Surgeon General, through the War Department, to the Army Service, Ground, and Air Forces, which in turn assigned officers within their command.20 As a result, an MC, DC, VC, or SnC officer assigned to the Air, Service, or Ground Forces might receive his basic training at a medical pool within that command or, if he was considered eligible for duty in a tactical unit, at the Medical Field Service School. A medical officer assigned to the Army Air Forces, for example, might receive his initial training at either the Medical Field Service School or the pool established for medical units and installations of the Air Forces at the Gulf Coast Air Corps Training Center, Randolph Field, Tex. Thus, the basic military training given a Medical Department officer included a standard body of military knowledge, but the location and type of installation at which it was received were varied.

Medical Field Service School

Throughout the war, as in the prewar era, the Medical Field Service School provided basic training for the largest single number of officers in the Medical, Dental, Veterinary, and Sanitary Corps. Until the beginning of the limited emergency, the standard period of training in medical field service and in the functions of the combat arms had been 5 months. To provide military training for the large number of officers on active duty, who had previously been unable to attend the course, and to meet the requirement to train a small number of officers added to the Medical Department after the eruption of war in Europe, the course had been compressed to 3 months, and offered twice a year.

Following the activation of the Reserve and National Guard, the course was condensed to a single month of instruction, and facilities were expanded to offer "refresher" training to a large number of officers with previous military training. Because of the exhaustion of reserve pools, refresher training was suspended after the graduation of the Seventh Refresher Course, which was conducted between 4 and 29 August 1941, to train additional officers for duties at replacement training centers. Beginning in September 1941, a 2-month course, designated simply as the "Officers' Course," was introduced to train newly commissioned officers in the principles and methods of medical field service.21

With variations in length, this condensed version of the 5-month, prewar "Basic Course" continued to be offered throughout the war. On 6 July 1942, the course was shortened to a single month, to take advantage of June graduations and double the output of trained officers. The change was not welcomed by authorities at the Medical Field Service School, who felt that a minimum of 8 weeks was required for orientation to field medicine. Under a 4-week program, too much time

    20A Report on the Status of Training in the Medical Department, U.S. Army, 24 Sept. 1942.
    21Technical Report of Activities of the Medical Field Service School, Carlisle Barracks, Pa., fiscal year 1942.


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was spent in teaching subjects required by the War Department to standardize instruction at all special service schools. Six months later, when combined pressure from the Air and Ground Forces for a greater share of the school's output resulted in its being expanded, the course was lengthened to 6 weeks. Beginning with the 19th class, on 3 January 1943, the program was revised and quotas were rearranged to allow a new class of 500 to begin every 2 weeks.

With three basic courses running concurrently, the capacity of the school was increased to allow the graduation of 1,500 officers during every 6-week period. By a series of expedients, which included closing the MAC Officer Candidate School at Carlisle Barracks on 27 February 1943, to provide housing for the expanded basic course, the Medical Department was able to provide basic training for most newly inducted officers, and to reduce the number of those inducted in 1942 without benefit of MFSS training. Even then, one special 6-week class had to be authorized at the ASF Training Center, Camp Barkeley, Tex., in January 1944, when the demand for training exceeded existing facilities. Enrolled were 856 officers. With this exception, the 6-week Officers' Basic Course continued to be offered at Carlisle Barracks until February 1945, when reduced demand for officers allowed the course length to be restored to 8 weeks. Between December 1940 and 2 August 1945, when the 69th course was completed, slightly more than 25,000 officers graduated. Graduates of the Medical Field Service School Officers' Basic Course for fiscal years 1921-45 were as follows:22

 Years

Number

1921-40

1,369

1940-41

2,119

1941-42

1,692

1942-43

7,358

1943-44

9,298

1944-45

4,620


Officer pool training

The inability of Army Special Service Schools to provide basic training for all officers in the event of mass mobilization, and the obvious need to reserve those facilities for officers qualified for tactical duties, had long been a matter of concern to War Department planners. Early in 1941, the Medical Department arrived at a partial solution to the problem by activating refresher courses at general hospitals that allowed Reserve officers, who had the equivalent of basic training when called to active duty, to understudy their counterpart in a hospital's administrative structure for a period of 1 month. Courses were offered at six hospitals, each with a

    22(1) See footnotes 10, p. 39; 12 (2), p. 40; 19, p. 43; and 21, p. 44. (2) Annual Report, Medical Field Service School, Carlisle Barracks, Pa., fiscal year 1943. (3) Memorandum, Lt. Col. F. B. Wakeman, MC, Chief, Training Division, Operations Service, Office of The Surgeon General, for the Personnel Division, Surgeon General's Office, 22 May 1942. (4) Letter, Col. John A. Rogers, MC, Executive Officer, Office of The Surgeon General, to the Commanding General, Services of Supply, 10 Apr. 1942, subject: Special Courses, Medical Field Service School. 1st indorsement thereto, dated 11 Apr. 1942. (5) Annual Report, Medical Field Service School, Carlisle Barracks, Pa., 1945. (6) Annual Report, Army Service Forces Training Center, Camp Barkeley, Tex., fiscal year 1944. (7) Annual Report of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1922. (8) Technical Report of Activities of the Medical Field Service School, Carlisle Barracks, Pa., fiscal year 1944.


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capacity of 50 students per month, but because of the urgent demand for the technical and tactical service of medical officers, the program was never fully utilized.

Within a week after Pearl Harbor, however, the War Department turned its attention to the problem of officer filler and loss replacement training. On 19 December 1941, orders were issued to the chief of each ground arm and service to establish pool training for unassigned officers without delay at special service schools, branch replacement training centers, and War Department overhead installations under the direct control of the chief of the arm or service. These pools were to be designed to provide "suitable preparatory training" to each individual before permanent assignment and to furnish a source of replacements for troop units and training centers.23

Early in 1942, plans were formulated by the Medical Department for the establishment of officer replacement pools within the Zone of Interior at a number of installations and under a variety of commands, including all named general hospitals except Darnall, Danville, Ky., all medical replacement training centers, medical supply depots, medical sections of general depots, and the Gulf Coast Air Corps Training Center. Pools were assigned the threefold mission of providing instruction to qualify officers for their first permanent assignment, of furnishing officers qualified to attend courses training medical specialists at service schools and civilian institutions, and of acting as the primary source of officer filler and loss replacements. Officers destined for Medical Department tactical units (later designated "AGF type" units) were assigned to either pool at one of the medical replacement training centers, each of which had a capacity for 100 officers, or the Medical Field Service School, which was authorized a pool of 150 officers. Officers assigned to the Air Forces were sent to the Gulf Coast Air Corps Training Center, which had a pool of 200 officers; those assigned to professional units of the field forces or fixed Zone of Interior installations (later designated "ASF type" units) were trained in pools of 50 established at named general hospitals, which were the successors to the administrative refresher courses established for Reserve officers in 1940. Pools for training 50 officers in medical supply and procurement were established at medical supply depots and the medical sections of general depots.

Early plans directed that officers would be assigned to pools for a minimum of 3 months, but these were soon changed to allow the period in pools to vary from an extremely short period up to 4 months. Formal course outlines were developed to give newly commissioned officers a basic knowledge of the Army and military subjects, but most of the instruction was provided through on-the-job training. Programs varied with the type of installation at which a pool was located, and commanders were instructed to integrate students in their commands and to train them so that they could furnish either a qualified pool officer or a previously trained

    23(1) Memorandum, Brig. Gen. Wade H. Haislip, Assistant Chief of Staff, War Department General Staff, for the Chief of Staff, 15 Dec. 1941, subject: Pool of Officer Replacements, inclosures thereto. (2) Letter, The Adjutant General, War Department, to Chief of Each Ground Arm or Service; Chief of the Armored Force; and Chief of Staff, General Headquarters, 19 Dec. 1941, subject: Officer Filler and Loss Replacements for Ground Arms and Services. (3) See footnote 5 (2), p. 36.


47

officer whom the student would replace within the command whenever a filler or replacement was requested.24

Full use of officer pools was not possible until after June 1942, when a large number of young officers who had graduated from medical school in 1941, and spent the intervening year in internships, were called to active duty. By the time these officers became available, pools had been established with a total capacity of 1,500 officers. Shortly after June 1942, an additional pool was established at the New York Port of Embarkation.

With varying size and location, pool training continued to be conducted throughout the war. Its importance as a primary source of basic training for medical, dental, and veterinary officers declined late in the war, however, because of the decreasing numbers of such officers available for military service, the expanding capacity of the Medical Field Service School, and the increasing use of MAC officers to perform nonmedical duties. The decentralized agencies that administered pools frequently assigned officers for indefinite and varying periods, sometimes assigned them there only for administrative purposes, and often failed to distinguish between MC and MAC officers in annual reports; for these reasons, it is not possible even to estimate the numbers of MC, DC, VC, and SnC officers who received pool training. It is probable, however, that nearly every junior officer passed through a pool at some time during World War II, and in two areas, supply and administration, it was the only source of training available.

The operation of pools is typified by the Medical Department Replacement Pool which began operations on 8 June 1942 at Camp Barkeley. Between that date and 30 June 1943, the 4-week refresher course was conducted for 528 officers. After completing this course, 359 officers were assigned to temporary duty in Medical Department training battalions at Camp Barkeley, pending permanent assignment.

The program of instruction in the 4-week pool course included a general study of administration, field sanitation, and organization and operation of medical field units. Two officers of the Medical Replacement Training Center cadre at Camp Barkeley were assigned to supervise the pool, prepare schedules, conduct classes, and make necessary reports. Regular classes conducted in the training battalions and in the Officer Candidate School at the center were open to pool officers, whose schedules were arranged to allow them to take advantage of the varied activities available at Camp Barkeley. Special classes were also conducted for pool officers by instructors at the camp. During their period of temporary duty with medical battalions, pool officers were given the opportunity to observe experienced instructors, and were assigned teaching duties. After June 1943, the number of officers passing through the Camp Barkeley pool declined, as the supply of available

    24(1) Memorandum, Maj. F. B. Wakeman, MC, Chief, Training Division, Operations Service, Office of The Surgeon General, for The Surgeon General, 3 Jan. 1942, subject: Training of Officer Filler and Loss Replacements for Ground Arms and Services. (2) Letter, Lt. Col. John A. Rogers, MC, Executive Officer, Office of The Surgeon General, U.S. Army, to The Adjutant General, War Department, 15 Jan. 1942, subject: Officer Filler and Loss Replacements in the Medical Department. 1st indorsernent thereto, dated 7 Feb. 1942. (3) Letter, Lt. Col. John A. Rogers, MC, Executive Officer, Office of The Surgeon General, U.S. Army, to Commanding Generals, All Medical Replacement Training Centers; Commanding Officers, All General Hospitals; and All Medical Supply Depots, 27 Feb. 1942, subject: Officer Filler and Loss Replacements for the Ground and Air, Arms and Services.


48

officers diminished. Only 99 officers received pool training, compared with 528 the previous year.25

An unusual curriculum, typifying the diversity of the officer pool program, was the course in medical supply procedures at the St. Louis Medical Depot, St. Louis, Mo. Between 1922 and 1924, the Medical Department had operated a separate Medical Supply Training School at the New York General Depot, New York, N.Y. Thereafter, medical supply officers were usually assigned to a 2-year tour at the New York General Depot, followed by a year in the Surgeon General's Office, and then completed their training with a 1-year course at the Army Industrial College. During the 1920's, between three and five officers completed this training each year, but during the 1930's, only two medical supply officers were enrolled annually.

In response to wartime demand for an increasing number of medical supply officers, a separate Medical Department school was reestablished in April 1942. Initially, this course consisted of 2 weeks of informal, on-the-job training, organized to give the student officer a few days' practical experience in the supervision of each of the St. Louis Medical Depot's divisions and branches. This drastic reduction in course length was based on the assumption that supply officers would be drawn from the ranks of civilians with medical supply experience, who would require only token orientation to military procedures. Administration of the course was the responsibility of the Officers' Orientation School, established at the St. Louis Medical Depot for that purpose. In August 1942, the course was lengthened to 4 weeks and given permanent status.

As the war assumed global proportions, it became increasingly apparent that officers in charge of supplies needed more thorough orientation to the procedures involved in transferring supplies from the Zone of Interior to combat areas. On 1 March 1943, the course was assimilated into ASF supply training programs reorganized to provide 3 months of training in three phases, and redesignated the "ASF Depot Course." The first phase of this new program was conducted at the Quartermaster School, Camp Lee, Va., where officers received 30 days of orientation to Army supply procedures. The 1-month training program at the St. Louis Medical Depot became phase II of the new program. Phase III consisted of 30 days of practical work at one of several medical supply depots within the Zone of Interior. Course capacity was expanded to 100 officers.

While these developments were taking place, other courses were established at the St. Louis Medical Depot for Medical Department enlisted personnel. On 3 June 1943, the administrative organization at the St. Louis Medical Depot, responsible for supervising all of these courses, was formally designated the "Medical Supply Services School," and the Officers' Orientation School was absorbed as the Officers' Supply Division of the newly created school.26

Following this reorganization, the Medical Supply Services School continued to provide training for the duration of the war without major changes in its curriculum.

    25(1) Annual Report, Army Service Forces Training Center, Camp Barkeley, Tex., fiscal year 1944. (2) Circular Letter No. 48, Office of The Surgeon General, U.S. Army, 23 May 1942.
    26(1) Annual Report, Training Division, Operations Service, Office of The Surgeon General, fiscal year 1943. (2) Annual Report, Army Service Forces, Medical Supply Services School, St. Louis Medical Depot, St. Louis, Mo., fiscal year 1944. (3) Annual Report, Medical Supply Services School, St. Louis Medical Depot, St. Louis, Mo., fiscal year 1943. (4) Medical Department, United States Army. Medical Supply in World War II. Washington: U.S. Government Printing Office, 1968.


49

The first class of officers to enroll in phase II of the new program entered the school on 5 April 1943, and before the end of June, a total of 495 officers had completed this phase. Between June 1943 and June 1944, a total of 412 officers completed this phase of instruction and were sent to the medical sections of ASF depots for phase III of the ASF Depot Course. Thirty-eight officers completed courses in equipment maintenance, and nine completed courses in optical repair, which had been inaugurated at the school. Between June and September 1944, when it was dropped from the program, four officers graduated from the 6-week course for supervisors of optical repair shops. By June 1945, 46 more officers had graduated from the 16-week equipment maintenance course, and an additional 178 had graduated from phase II of the depot course.27 The tabulation which follows shows the total number of male Medical, Dental, Veterinary, and Sanitary Corps officers graduating from service school courses from July 1939 to August 1945.

Training1

Number

Officers Basic Course

25,972

Cadre Course (Special)

526

Medical and Field Sanitary Inspectors

888

Chemical Warefare Medical Dept. Officers Course

1,836

Quartermaster School, ASF Depot Course, Phase I

516

ASF Depot Course, Phase II (Med)

1,195

ASF Depot Course, Phase III

42

Equipment Maintenance

93

Optical Repair

13

Meat and Dairy Hygiene

862

Clinical Pathology, Veterinary Officers (Special)

14

Forage Inspection

67

Tropical Medicine

1,708

Anesthesiology

292

Electroencephalography

48

Maxillofacial Plastic Surgery

233

Roentgenology

802

Military Neuropsychiatry

841

Operation of Red Cross Blood Donor Center

46

Malariology

260

Medical and Surgical Care of Battle Casualties in Forward Areas

179

Adjutant General's School

276

Army Industrial College

15

Army War College

2

Command and General Staff School

246

Engineers School

52

Ordnance School

10

Food and Nutrition

145

    1(1) Training Division, Office of The Surgeon General, 8 Jan. 1948. (2) Goodman, Samuel M.: History of Medical Department, Training U.S. Army World War II. Volume III. A Report of the Training of Medical Officers, 1 July 1939-30 June 1944. [Official record.] A small number of MAC officers may be included in some courses.

    27(1) Annual Report Training Division, Operations Service, Office of The Surgeon General, fiscal year 1944. (2) Annual Report, School Branch, fiscal year 1945. In Annual Report, Training Division, Operations Service, Office of The Surgeon General, fiscal year 1945. (3) Memorandum, Maj. Walter H. Potter, SnC, Chief, Specialties Branch, Supply Planning and Specialties Division, Supply Service, Office of The Surgeon General, for the Chief, Operations Service, Surgeon General's Office, 28 July 1943, subject: Training of Opticians for Optical Repair Sections of Medical Depot Companies. (4) Memorandum, Col. F. B. Wakeman, MC, Director, Training Division, Operations Service, Office of The Surgeon General, to Commandant, Medical Supply Services School, St. Louis Medical Depot, St. Louis, Mo., 13 Aug. 1943, subject: Training of Medical Department Officers in Maintenance of Medical Equipment.


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Pools also provided special instruction for groups which were difficult to fit into the regular program. Women, for example, were not commissioned in the prewar Army, and there were no programs for training female Medical Department officers. After Congress authorized the commissioning of women doctors in April 1943, 76 female physicians were commissioned in the Medical Corps. About one-third of this group was placed on active duty without formal training. Beginning in October 1943, however, all newly commissioned women doctors were sent to the Medical Department Replacement Pool at Lawson General Hospital, Atlanta, Ga., where they received an orientation to military life. Fifty-five women, or approximately two-thirds of all women accepted in the Medical Corps, were trained at this pool. In addition to pool training, three women doctors were sent to the Tropical Medicine Course; four were sent to the School of Military Neuropsychiatry, at Lawson General Hospital; and six, to various courses in anesthesiology.28

A special pool for Negro officers was established at Fort Huachuca, Ariz., on 8 June 1943. This action was taken following publication of a War Department policy, in January 1943, requiring Negro officers to be assigned in groups. Ostensibly, officers assigned to the pool were to continue their technical training "until such time as group assignment to a Medical Department unit or installation" became effective. Since the commandant of the Medical Field Service School, Brig. Gen. Addison D. Davis, refused to allow more than 25 Negro officers to attend the school at one time, the pool also proved useful for holding newly commissioned Negro officers until they could be accepted under the quota.29

Extension courses

Throughout the interwar years, the Special Service School extension program, administered through corps areas, was a major part of the Army's training program for Reserve and National Guard officers. This series of progressive subcourses, designed to expand the officer's grasp of the fundamentals of military knowledge and qualify him for promotion, was participated in by more Reserve and National Guard officers than any other form of training. Even after September 1940, when these officers were called to active duty, enrollment in extension courses offered through the Medical Field Service School continued unabated. Revision of the program to incorporate changes in doctrine and equipment, begun in the late 1930's and scheduled for completion in 1942, continued throughout 1941.

By the time the United States entered World War II, most of these revisions had been completed, and the revised Army Extension Courses were thought to be

    28(1) See footnote 17, p. 43. (2) Goodman, Samuel M.: History of the Training of Medical Department Female Personnel, 1 July 1939 to 31 December 1944. [Official record.]
    29(1) War Department Circular No. 132, 8 June 1943. (2) Annual Report, Office of the Director, Medical Division, Fort Huachuca, Ariz., 1943. (3) Memorandum, Col. Frank B. Wakeman, MC, Director, Training Division, Operations Service, Office of The Surgeon General, to Director of Training, Services of Supply, 10 Mar. 1943, subject: Training Pool for Colored Medical and Dental Officer Personnel. (4) Memorandum, Lt. Col. Durward G. Hall, MC, Assistant to Director, Reserve Division, Personnel Service, Military Personnel Division, Office of The Surgeon General, for Col. Howard T. M. C. Wickert, Chief, Planning Division, Operations Service, Office of The Surgeon General, 20 Mar. 1943. (5) Memorandum, Maj. E. R. Whitehurst, MAC, Assistant to Director, Reserve Division, Personnel Service, Military Personnel Division, Office of The Surgeon General, to the Chief of Military Personnel, Surgeon General's Office, 16 Feb. 1943, subject: Assignment of Colored Medical and Dental Personnel.


51

the most up-to-date source of information on doctrine, tactics, technique, and procedure available. Because most Reserve and National Guard officers were on active duty by the end of 1941, the War Department General Staff, G-3, Operations and Training, recommended, and received approval from the Chief of Staff, that operation of corps area extension courses be suspended and that extension course material be diverted to field force units for use in unit troop schools. Orders for the suspension of corps area extension schools for the duration of the war were issued early in February 1942, and all officers then enrolled in classes were required to complete them by 1 April. Special Service Schools were directed to continue their revisions of course material.

By August, however, reports that unit troop schools were not using the extension courses because they were too cumbersome for the accelerated pace of wartime training were confirmed by training inspections of four newly activated divisions, and G-3 decided to relieve the service commands from the burden of directed use. In the future, G-3 declared, the War Department would handle extension courses as it handled other areas of training, confining itself to announcing policies and outlines of broad objectives, and allowing the commanding generals of the service commands to determine the manner in which the objectives would be achieved. When a poll of the service commands revealed that only the Army Air Forces desired the continued preparation and revision of extension course material, the War Department directed the Special Service Schools to suspend their revision of extension courses for the duration of the war. The service commands were directed to continue their distribution of extension material until stocks were exhausted, and to revise courses that might prove useful in training their respective commands.

By the end of 1942, the prewar extension program was decentralized and, for all practical purposes, suspended for the duration of the war.30

Specialized and Advanced Military Training

The program of basic training provided at the Medical Field Service School and replacement pools was supplemented by a variety of programs, either sponsored by, or available to, the Medical Department for training specialists qualified to protect the health of the Army in the field, or qualified for duties requiring specialized military skills.

    30(1) Letter, Lt. Col. John A. Rogers, MC, Executive Officer, for The Surgeon General, U.S. Army, to the Commandant, Medical Field Service School, Carlisle Barracks, Pa., 8 Oct. 1941, subject: Revision of Army Extension Courses for the 1942-43 School Year. (2) War Department Training Circular No. 6, 2 Feb. 1942. (3) Letter, The Adjutant General, War Department, to All Corps Area Commanders, 3 Feb. 1942, subject: Suspension of Corps Area Extension School. (4) War Department Circular No. 198, 20 June 1942. (5) Letter, Col. C. H. Day, AGD, Assistant Ground Adjutant General, to Assistant Chief of Staff, G-3, 1 Aug. 1942, subject: Suspension of Preparation of Army Extension Courses. (6) Memorandum, Brig. Gen. I. H. Edwards, Assistant Chief of Staff, G-3, for the Commanding Generals: Army Ground Forces; Army Air Forces; and Services of Supply, 27 Aug. 1942, subject: Suspension of the Preparation of Army Extension Courses. (7) Memorandum, Brig. Gen. I. H. Edwards, Assistant Chief of Staff, G-3, for the Commanding Generals: Army Air Forces; Army Ground Forces; and Services of Supply, 29 Oct. 1942, subject: Suspension of the Preparation of Army Extension Courses. (8) Memorandum, Brig. Gen. I. H. Edwards, Assistant Chief of Staff, G-3, for The Adjutant General, 29 Oct. 1942, subject: Suspension of the Preparation of Army Extension Courses, inclosures thereto. (9) War Department Circular No. 361, 31 Oct. 1942.


52

Medical field and sanitary inspectors

Mass mobilization, accompanied by the rapid expansion of existing facilities, the creation of new military installations, and the induction of large numbers of men unfamiliar with techniques for avoiding the potential hazards of garrison and field life, produced threats to the health of the Army. By mid-1942, the problem was serious enough to prompt the War Department to call the attention of commanders of all grades to their responsibility for the enforcement of sanitary regulations, and to observe:31

 * * * The incidence of food poisoning, diarrhea, and dysentery among troops last year, both in camps and on maneuvers, and the recurrence of similar outbreaks this year indicate that training in personal hygiene and sanitation has been neglected and that well established measures for the control of such diseases have not been intelligently enforced. Commanders of all grades, surgeons, and medical inspectors must realize that organizations which have difficulty controlling endemic intestinal diseases during training will have greater difficulty in the field, and it follows that the combat value of such units will be substandard. The recurrence of these diseases is indicative of inefficiency on the part of the responsible commanders and medical officers and lack of discipline in the units.

In response to War Department concern, a conference was held at the Medical Field Service School on 20 August 1942, between the commandant of the school, General Davis, and Lt. Col. (later Col.) Frank B. Wakeman, MC, the director of training at the Office of The Surgeon General, and their assistants, to discuss methods for improving sanitation in the Army. As a result of this conference, recommendations were sent to the War Department calling for the expansion of division cadres and post staffs to include a medical inspector, and the establishment of a special training program for such officers at the Medical Field Service School. The request for a special training program was argued on the grounds that a majority of Medical Corps officers were new to the service and not thoroughly trained in the requirements of military sanitation. The block of instruction included in the basic orientation course could not be expanded to qualify officers for duties as medical inspectors without hampering their training in other military subjects. The course proposed by the committee was to be 1 month in length, with a capacity of 50 officers each month, preferably senior captains of the Medical Corps, to begin in November 1942. In response to these recommendations, the Medical and Field Inspectors' Course was authorized on 9 September 1942, and classes began on 2 November.32

In general, the course established in the fall of 1942 followed the outlines suggested by the Wakeman-Davis Committee. Of 192 hours of course work, 102 were devoted to military sanitation, including such diverse subjects as barracks sanitation, insectborne diseases, food inspection, waste and rubbish disposal, water

    31War Department Circular No. 277, 20 Aug. 1942.
    32(1) Letter, Brig. Gen. Addison D. Davis, Commandant, Medical Field Service School, Carlisle Barracks, Pa., to The Surgeon General, U.S. Army. Attention: Plans and Training Division, 29 Aug. 1942, subject: Medical Inspectors' Course, Medical Field Service School, Carlisle Barracks, Pa. (2) Memorandum, Col. John A. Rogers, MC, Executive Officer to The Surgeon General, U.S. Army, for the Director of Training, Services of Supply, 4 Sept. 1942, subject: Course of Instruction for Medical Inspectors. (3) Memorandum, Brig. Gen. C. R. Huebner, GSC, Director of Training, Services of Supply, for The Surgeon General, U.S. Army, 9 Sept. 1942, subject: Course of Instruction for Medical Inspectors.


53

and sewage treatment, and venereal disease control. The balance was devoted to studying tactics and administration related to the duties of a medical inspector. Quotas were distributed among the service commands, defense commands, and Air and Ground Forces. Courses continued to be offered throughout the war, with few changes in content.

Standards of admission, however, were gradually eroded by the growing shortage of physicians. Originally, only senior captains in the Medical Corps, who had completed the MFSS Officers' Basic Course, were to be admitted, but in time, the regulations were rewritten by authorities outside the Medical Department's control, and lieutenants, newly commissioned captains, SnC officers, and MAC officers were sent to the course. In August 1943, the course was lengthened to 5 weeks to allow a greater amount of basic training and field experience. Reports from the field indicated that SnC and MAC officers were being successfully utilized as medical inspectors. By June 1945, at the completion of the 24th class, 892 officers had graduated.33

Chemical Warfare School

The development of a formal course of instruction in chemical warfare was one of the few radical innovations in the Medical Department officer training program. Before the war, a few officers had been sent to Edgewood Arsenal for training each year, but for most officers, knowledge of defense against chemical agents was confined to a few hours of cursory instruction received in the MFSS Officers' Basic Course.

Early in 1941, The Surgeon General instructed the Medical Research Division at Edgewood Arsenal to prepare tables of organization and equipment for a gas medical battalion that was to be activated to care for gas casualties. Seizing this opportunity, the chief of the Medical Research Division, Lt. Col. (later Col.) William D. Fleming, MC, reported that such a battalion would be of little use unless its medical personnel received more instruction in chemical warfare and chemical warfare medicine than was currently available, and submitted one of the Medical Research Division's periodic recommendations for the establishment of a formal course of instruction.34 Work on a course and text began, and almost a year later, the course outline was submitted to the Office of The Surgeon General. In August 1942, the Medical Corps Officers' Course, to be given at the Chemical Warfare School, was approved by the War Department, and classes began in September.

    33(1) See footnotes 22 (2) and (5), p. 45. (2) Essential Technical Medical Data, U.S. Army Forces, South Atlantic, for April 1944, dated 4 May 1944. (3) War Department Circular No. 99, 9 Mar. 1944. (4) Letter, Col. R. W. Bliss, MC, Assistant to The Surgeon General, U.S. Army, as Chief, Operations Service, to the Director of Military Training, Army Service Forces, 3 Aug. 1943, subject: Training of Medical and Field Sanitary Inspectors. 1st indorsement thereto, dated 8 Aug. 1943. (5) Letter, Brig. Gen. Addison D. Davis, Commanding General, Medical Field Service School, Carlisle Barracks, Pa., to The Surgeon General, U.S. Army. Attention: Col. F. B. Wakeman, MC, Training Division, 28 Apr. 1943, subject: Sixth Medical Inspectors' Course, Medical Field Service School, Carlisle Barracks, Pa., inclosures thereto.
    34(1) Letter, Lt. Col. William D. Fleming, MC, Chief, Medical Research Division, Chemical Warfare Service, Edgewood Arsenal, Md., to The Surgeon General, War Department, 25 Mar. 1942, subject: Special Training in Treatment of Chemical Casualties, inclosure thereto. (2) Letter, Lt. Col. William D. Fleming, MC, Chief, Medical Research Division, Chemical Warfare Service, Edgewood Arsenal, Md., to The Surgeon General, War Department, 31 Mar. 1942, subject: Instruction of Medical Officers in Care of Gas Casualties.


54

This course of instruction to train Medical Department officers in the identification of chemical warfare agents, in decontamination, and in prevention and care of chemical warfare casualties covered a 4-week period. Originally, plans called for five classes of 100 officers each, to begin on 7 September 1942, but before the fifth class had graduated, the course was extended indefinitely. Officers attending the course were selected from the Army Service, Air, and Ground Forces, and from the Office of The Surgeon General.

The teaching staff of the Chemical Warfare School provided technical intruction in agents, materiel, and weather factors, while members of the Medical Research Division presented courses in the physiological effects of agents, pathology, treatment, and medical service. Veterinary Corps officers enrolled in the course were offered an alternate program in the protection, care, and treatment of animal casualties, and the contamination and decontamination of food. A similar adjustment in content was made in May 1943 for SnC officers, who were given special instruction on the decontamination of water. In July 1944, the course was shortened to 3 weeks by the elimination of many hours devoted to basic military subjects. Before the course was discontinued at the end of the 29th class in December 1944, approximately 2,000 officers received instruction at the Chemical Warfare School. A majority were MC officers, but the Sanitary and Veterinary Corps were well represented, and in 1944, the course was even attended by 48 naval officers.35

Special Cadre Course for divisional officers

Providing qualified officers with the ability to organize, activate, and train new divisions was a major problem for all of the arms and services. Prewar planners had counted on being able to strip installations of their Regular Army personnel to provide cadre for the first 8 months of mobilization. At the end of 8 months, it was assumed they would be able to select cadre for future activations from among superior trainees. During the limited mobilization following passage of selective service, unit activations followed this pattern. It was not until after the outbreak of war that formal training was provided for Medical Department officers by the inauguration of the Special Cadre Course for divisional officers at the Medical Field Service School. Under this program, it was planned that, approximately 2 months before the activation of a division, a maximum of 13 medical officers assigned to the medical battalion and medical detachments supporting the division would be enrolled in the Special Cadre Course for 4 weeks of intensive training. The course

    35(1) Cochran, Rexmond C.: History of Research and Development of the Chemical Warfare Service in World War II. Volume 30. Medical Research in Chemical Warfare. Historical Branch, Chemical Corps School, Edgewood Arsenal, Md, 1 Mar. 1947. [Official record. Office of the Chief of Military History.] (2) Annual Report, School Branch, fiscal year 1945. In Annual Report, Training Division, Operations Service, Office of The Surgeon General, fiscal year 1945. (3) Memorandum, Brig. Gen. Alexander Wilson, C.W.S., Chief, Field Service, Chemical Warfare Service, to the Commanding General, Services of Supply, 20 July 1942, subject: Chemical Warfare School, Medical Corps Officers' Course. (4) Letter, The Adjutant General, War Department, to The Surgeon General, U.S. Army, 4 Aug. 1942, subject: Chemical Warfare School, Medical Corps Officers' Course. (5) Annual Report, Training Division, Operations Service, Office of The Surgeon General, fiscal year 1943. (6) Memorandum, Lt. Col. Charles H. Moseley, MC, Deputy Director, Training Division, Office of The Surgeon General, for Lt. Col. John R. Wood, Medical Research Laboratory, Edgewood Arsenal, Md., 10 May 1943. (7) Memorandum, Col. John A. Rogers, MC, Executive Officer to The Surgeon General, U.S. Army, for Director of Training, Services of Supply, 29 Sept. 1942, subject: Chemical Warfare School, Medical Corps Officers' Course.


55

was designed to instruct them in methods of training and administration, and in the principles of first- and second-echelon medical support, to allow them to function efficiently in their newly activated divisions and inform them of duties during unit activation. The first Special Cadre Course began on 26 January 1942, and by the end of June, 138 officers, representing 11 divisions, had graduated.

Included in this total were 22 newly commissioned Negro officers assigned to the 93d (Negro) Infantry Division, and to the Station Hospital, Fort Huachuca, who did not participate in the regular program of instruction. A special outline of instruction was designed for these officers, who attended the Medical Field Service School between 9 March and 4 April 1942.36 The curriculum prepared for these officers contained a greater concentration on basic military subjects than that prepared for regular cadre courses, a procedure which was probably not necessary for the Reserve officers assigned to the 93d (Negro) Infantry Division, but was essential for the training of the cadre of the Negro station hospital, a group of handpicked Negro physicians, which had already become the subject of national controversy.

The controversy arose out of a series of conferences held between representatives of the Office of The Surgeon General and the Negro counterpart of the American Medical Association, the National Medical Association, beginning on 14 October 1940, as a result of pressure by Negro professional and political organizations for integration and greater participation in the war effort. At this time, patients at fixed Army hospitals were completely integrated, but professional service in these installations was the exclusive prerogative of white physicians. Negro physicians were confined to field installations providing first- and second-echelon medical service for Negro units.

Among the demands of the National Medical Association was the complete integration of professional staffs, to relieve a greater number of Negro physicians from duty as regimental surgeons (unflatteringly characterized as "first aid surgeons" by the National Medical Association). Members of the association demanded an equal opportunity to enhance their careers by participating in advanced training programs and to gain the specialized medical and administrative experience available to physicians assigned to station and general hospitals.37 While sympathetic to demands for increased participation in higher echelon medical service, Maj. Gen. James C. Magee opposed any integration of professional services until integration of the Army became a War Department policy, because professional integration of military hospitals would result in white patients being forced to accept treatment by Negro physicians.38

No minutes were kept of the first meeting, but representatives of the Office of The Surgeon General emerged believing that the National Medical Association

    36See footnote 21, p. 44.
    37(1) Press release, National Medical Association Incorporated, "Reply of the National Medical Association to the Purported Press Release of the Honorable Secretary of War, USA, 20 Feb. 1942." (2) Letter, Eleanor Roosevelt to Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, dated 1 Mar. 1943, inclosure thereto. (3) Memorandum, Col. Albert G. Love, MC, Chief, Planning and Training Division, Office of The Surgeon General, to Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, 14 Oct. 1940. 38Minutes, Meeting, Re Use of Negro Doctors, Nurses, and Dentists by Medical Department, 7 Mar. 1941.


56

agreed that the use of Negro physicians in mixed wards was impracticable, and that a satisfactory substitute for professional integration could be provided by establishing segregated Negro wards in hospitals with a large number of Negro patients, or possibly, a hospital devoted exclusively to Negro patients.39 Following the conference, the Office of The Surgeon General began to consider establishing separate Negro hospitals at Fort Huachuca; Savannah Ordnance Depot, Savannah, Ga.; and the Wilmington Anti-Aircraft Firing Center, Wilmington, Del. Separate Negro wards were established at Fort Bragg, N.C., and Fort Livingstone, La. The general plan of segregating Negro patients for the benefit of Negro physicians received War Department approval.40

Late in December 1940, Judge William H. Hastie, the dean of the Howard University Law School, Washington, D.C., who had recently been appointed Civilian Aide to the Secretary of War on Negro Affairs, was given the power to comment or concur before final decision, on all matters of policy pertaining to Negroes.41 Establishment of an all-Negro hospital was postponed until it could be justified by the concentration of sufficient numbers of Negro personnel; in the interim, members of the National Medical Association began to express discontent with plans for Negro medical service.

At a conference in March 1941, attended, among others, by Judge Hastie and Dr. (later Colonel, MC) Midian O. Bousfield, a leading member of the National Medical Association, Judge Hastie took issue with a member of the National Medical Association, who insisted that the association had not accepted the Medical Department's plan. As Judge Hastie explained it, the National Medical Association was willing to concede the necessity of segregated wards in the South, where local customs would be hostile to the integration of a professional staff, but felt it would be unfortunate if the practice were extended to other areas. Dr. Bousfield expressed the opinion that anything short of complete integration would be inconsistent with the concept of democracy.42

When plans for an all-Negro hospital were revived early in 1942, however, and Dr. Bousfield was recommended by the Procurement and Assignment Service, a civilian agency, as the most qualified member of the National Medical Association to recruit a hospital staff, he accepted the responsibility. When his name was urged upon the Medical Department by Judge Hastie's office, he also accepted command of the new hospital.43 In a letter to members of the National Medical Association,

    39(1) See footnote 37(3), p. 55. (2) Letter, Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, to Dr. A. N. Vaughn, President, National Medical Association, 18 Oct. 1940.
    40(1) Letter, Col. Larry B. McAfee, MC, Executive Officer to The Surgeon General, to The Adjutant General, War Department, 25 Oct. 1940, subject: Plan for Utilization of Negro Officers, Nurses, and Enlisted Men in the Medical Department's 1940-41 Military Program. 1st indorsernent thereto, dated 15 Nov. 1940. (2) See footnote 38, p. 55.
    41Letter, The Adjutant General, War Department, to the Chiefs of Arms and Services, and Divisions of War Department General Staff, 18 Dec. 1940, subject: Policies Pertaining to Negroes.
    42(1) See footnote 38, p. 55. (2) Memorandum, William H. Hastie, Civilian Aide to the Secretary of War, to The Surgeon General, U.S. Army, 17 Mar. 1941, inclosure thereto.
    43(1) Memorandum, Lt. Col. Howard T. Wickert, MC, Assistant Chief, Planning Division, Operations Service, Office of The Surgeon General, for General McAfee, Chief, Operations Service, Office of The Surgeon General, 16 Jan. 1942. (2) 2d indorsement, Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General, Chief, Operations Service, Office of The Surgeon General, to The Adjutant General, War Department, 19 Jan. 1942. (3) Informal Action Sheet, Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General, Chief, Operations Service, Office of The Surgeon General, to The Adjutant General, War Department, 1 May 1942.


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Dr. Bousfield announced :44

 * * *  I have just returned from a conference in the Surgeon General's Office in Washington. A station hospital of 672 beds is to be organized immediately at Camp Huachuca, Ariz., with a complete complement of Negro doctors. Except for being a completely segregated unit, it is a victory for the protest against the exclusion of Negro doctors. Much more important, it gives protection to our best physicians in two ways: It prevents them from being drafted into the ranks, and gives great protection by being assigned to a station hospital, which will not be disturbed unless the country is bombed or successfully invaded. The men will likely not see active service with the fighting forces. A complete division is to be trained at Huachuca.

    *  * * * * * *

 An immediate response will indicate the interest of the members of the National Medical Association in the control of an opportunities [sic] of additional training to be obtained in this large hospital, as well as in this successful issue of our protests.

Neither the establishment of an all-Negro hospital nor Dr. Bousfield's letter was long in drawing hostile fire. An announcement by Secretary of War, Henry L. Stimson, that the Fort Huachuca hospital was to be established, purportedly at the request of the National Medical Association, was immediately repudiated by that organization. In its formal reply to the Secretary's press release, the association stated that Dr. A. N. Vaughn, president of the National Medical Association, refused to endorse the plan, and that they would not subscribe to any form of racial segregation.45 The Medical Department responded by informing the Secretary of War, through The Adjutant General:46

 * * *  The point at issue appears to be the purported statement that the Negro association officials specifically requested the present arrangement for the utilization of Negroes in the Medical Service. Actually they have consistently insisted on integration of Negro doctors with white doctors. This had not been done. War Department policy for their use does not contemplate it. However, through patient segregation it has been possible to broaden the Negro doctors' service in the Medical Department, and it has been the impression that the manner in which it was being done, that is, separate departments in these hospitals in which the Negro patient population would justify it and complete Negro staffed hospitals for Negro cantonments, was most satisfactory to the association officials, short of complete integration.

Despite the National Medical Association's protests, it appears that the Medical Department, limited by War Department policy on integration, had acted in good faith to expand the professional activities of Negro physicians, even though it meant changing previous policies of separating patients by disease and substituting segregation by race. Dr. Vaughn had been informed of this policy immediately following the conference of October 1940, and Judge Hastie had endorsed the policy of segregated wards for the benefit of physicians, at least in the South, in March 1940.47

    44Letter, Dr. M. O. Bousfield, Chairman, National Medical Association Procurement and Assignment Service, to All State and Local Societies of the National Medical Association, 12 Mar. 1942.
    45See footnote 37 (1), p. 55.
    46(1) Memorandum, Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General, U.S. Army, Chief, Operations Service, Office of The Surgeon General, to The Adjutant General, War Department, 16 Mar. 1942, subject: Secretary of War's Press Conference on Use of Negro Doctors. (2) 2d indorsement, Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General, U.S. Army, Chief, Operations Division, Office of The Surgeon General, to The Adjutant General, War Department, 9 Mar. 1942.
    47See footnote 39 (2), p. 55.


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Subsequently, both Judge Hastie and Dr. Bousfield, an outspoken opponent of hospital segregation, collaborated with the Medical Department in establishing the Fort Huachuca Station Hospital. Dr. Bousfield was later censured by the National Medical Association for his part in the affair, and his inappropriate recruiting effort also drew expressions of resentment. Others expressed the fear that Dr. Bousfield's geographic origin would result in the choice of too many physicians from the Middle West.48 In any event, the special course for the cadre of the 93d (Negro) Infantry Division and the Fort Huachuca Station Hospital began on a sour note. Preparation of a special outline was justified by the lack of prior experience and training on the part of officers selected for the hospital. Apparently, the course proceeded without incident, and all 22 officers were graduated with satisfactory ratings. No further segregated Special Cadre Courses were held.49

Special Cadre Courses continued to be offered regularly until July 1943, when the program was terminated. In April 1943, the capacity of the program was expanded from 50 to 100, to allow cadres from nondivisional units to attend. During its more than 2 years of operation, 560 officers graduated from the course.50

Schools outside the Medical Department

In addition to courses already discussed at the Chicago Quartermaster Depot and the Edgewood Arsenal Chemical Warfare School, a number of courses were available at Army schools not controlled by the Medical Department. Between July 1941 and July 1942, 46 Medical Department officers were sent to the Command and General Staff School. Twelve MAC officers and three MC officers graduated from the Adjutant General's School, Fort Washington, Md., and a few attended the 2-week Camouflage Course at Fort Belvoir, Va. The following year, 132 completed courses at the Command and General Staff School, 81 completed courses at the Adjutant General's School, 43 completed the Camouflage Course, and four completed the Ordnance Automotive Maintenance Course at the Ordnance School, Atlanta, Ga. Between July 1943 and the end of June 1944, 52 officers graduated from the Command and General Staff School, 180 graduated from the Adjutant General's School, four completed the Camouflage Course, and six completed the Ordnance Automotive Maintenance Course. After June 1944, no officers were reported attending these courses.51

    48(1) Letter, Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General, U.S. Army, Chief, Operations Service, Office of The Surgeon General, to Dr. S. H. Freeman, Secretary, Board of Trustees, National Medical Association, Inc., 7 May 1942. (2) Letter, Dr. W. Harold Branch to The Surgeon General, U.S. Army, 6 Apr. 1942. (3) Letter, Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General, U.S. Army, Chief, Operations Service, Office of The Surgeon General, to Dr. W. Harold Branch, 22 Apr. 1942. (4) Letter, Maj. Gen. J. A. Ulio, The Adjutant General, to Dr. R. M. Hedrick, Chairman, Board of Trustees, National Medical Association, Inc., 9 Mar. 1942.
    49(1) Letter, Maj. E. R. Whitehurst, MAC, Assistant to Director, Reserve Division, Personnel Service, Military Personnel Division, Office of The Surgeon General, to the Commandant, Medical Field Service School, Carlisle Barracks, Pa., 25 Nov. 1942, subject: Training of Negro (sic) Medical Officers. 1st indorsement thereto, dated 30 Nov. 1942. (2) Letter, Brig. Gen. Addison D. Davis, Commandant, Medical Field Service School, to The Adjutant General, U.S. Army, 8 Apr. 1942, subject: Special School Report, Special (93d (Negro) Infantry Division) Course 1942, inclosure thereto.
    50See footnote 22 (2) and (8), p. 45.
    51See footnote 14 (3), p. 41; 26 (1), p. 48; and 27 (1), p. 49.


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Specialized Technical Training

Training officers for tactical and administrative duties was a serious problem, but equally important was the task of providing physicians, dentists, and veterinarians with the specialized technical training required for medical support of an army of 8 million, employed in a global war. The distribution of technical skills in prewar medicine, geared to diseases common to the continental United States and a small number of industrial accidents, was inadequate to provide medical service for an army beset with combat casualties and exotic diseases, and a civilian population whose industrial activities were accelerated.

Within the American medical profession, only a handful of men had any familiarity with tropical medicine, and the number of thoracic surgeons, neurosurgeons, and similar specialists was small compared to the number required for the rehabilitation of war casualties. At the same time, such specialists as general surgeons, obstetricians, and pediatricians were available in numbers greater than the Army could use. To produce the specialists it needed, the Medical Department instituted a series of technical courses designed to retain physicians with redundant skills. Facilities for these courses were provided by expanding existing programs, establishing new service schools, and harnessing civilian institutions. In sum, the redistribution of technical skills to meet wartime requirements was one of the largest and most significant training problems encountered by the Medical Department in World War II.

Civilian institutions

The Medical Department had used the facilities of civilian institutions to provide specialized training for selected officers since 1920. Throughout the interwar years, the Medical Corps officers sent annually for specialized training had proved invaluable in keeping the Medical Department in contact with professional trends. Faced with the problem of training large numbers of officers in professional specialties at the beginning of the war, the Medical Department again turned to civilian institutions for assistance.

On 23 January 1942, the Office of The Surgeon General asked the Division of Medical Sciences of the National Research Council to recommend medical colleges equipped to provide instruction in general surgery, orthopedic surgery, thoracic surgery, maxillofacial plastic surgery, neurosurgery, clinical pathology, roentgenology, and anesthesiology.52 The council was also asked to recommend the length of each course, and to draft outlines of instruction. On 11 April 1942, the Office of The Surgeon General requested that epidemiology, venereal disease control, tropical medicine, and sanitary engineering be added to the list.53

    52(1) Informal Memorandum, Maj. F. B. Wakeman, MC, Assistant to The Surgeon General, Chief, Training Division, Operations Service, Office of The Surgeon General, to Lt. Col. Joseph R. Darnall, MC, Professional Service, Surgeon General's Office, 23 Jan. 1942. (2) Letter, Maj. Robert G. Prentiss, Jr., MC, Director, Technical Division, Operations Service, Office of The Surgeon General, to Dr. Lewis H. Weed, Chairman, Division of Medical Sciences, National Research Council, 23 Jan. 1942. (3) 41 Stat. 786.
    53Letter, Lt. Col. Roger G. Prentiss, Jr., MC, Director, Technical Division, Operations Service, Office of The Surgeon General, to Dr. Lewis H. Weed, Chairman, Division of Medical Sciences, National Research Council, 11 Apr. 1942.


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Working in cooperation with the Office of The Surgeon General, committees of the National Research Council accepted the project and estimated the number of officers required in each specialty. The project was approved by the Army Service Forces in June 1942, and before the end of the month, facilities were available at 22 civilian institutions for courses in eight specialties. Classes could not begin until September 1942, however, because of a shortage of officers available to attend them.54 In the interim, 57 officers were sent to the Mayo Foundation, Rochester, Minn., and to The Johns Hopkins University, Baltimore, Md., for specialized training.55

By September 1942, the supply of officers had increased sufficiently so that it was possible to begin most of the courses planned earlier in the year. On 28 September 1942, courses were opened in 12 specialties at 15 civilian institutions. On 2 January 1943, the program was expanded to include seven additional institutions. By June 1943, 2,067 officers had enrolled, and 2,014 had graduated.56

In the fall of 1943, most of the courses at civilian institutions were canceled. By June 1944, training was confined to a basic course in neurosurgery at the University of Pennsylvania, Philadelphia, Pa., and to courses in anesthesiology, general surgery, internal medicine, physical therapy, and roentgenology at the Mayo Foundation. Between June 1943 and June 1944, the number of officers completing courses in civilian institutions was reduced to 944.57 The following year, enrollment in civilian institutions was reduced even further. In March 1945, the courses in general surgery and internal medicine were canceled. Twelve-week courses in neuropsychiatry at Columbia and New York Universities, located in New York, N.Y., were used to supplement training at the Army School of Military Neuropsychiatry, Mason General Hospital, Long Island, N.Y. A total of 381 officers completed courses between June 1944 and June 1945.58

A variety of factors were responsible for the abrupt reduction of training at civilian institutions in the fall of 1943. Chief among these were a renewed shortage of medical officers and a change in policies governing the use of civilian facilities. In September, The Surgeon General reported that he did not have enough physicians in the Army Service Forces to man hospital units scheduled for overseas movement the following January, and the Medical Department began to study the possibility of a wider use of MAC officers in a semiprofessional capacity.

The movement of hospitals to the overseas theaters dramatically reduced the pool of officers available for advanced technical training. Coupled with this development was a change in policies governing the use of civilian institutions. Early in 1943, the War Department began to insist on the maximum utilization of existing

    54(1) See footnotes 14 (3), p. 41; and 26 (1), p. 48. (2) Memorandum, Brig. Gen. Larry B. McAfee, Acting The Surgeon General, for the Commanding General, Sixth Service Command, 22 Feb. 1943, subject: Medical Department Training Facilities in the Sixth Service Command. (3) Letter, Col. John A. Rogers, MC, Executive Officer to The Surgeon General, U.S. Army, to Dr. Lewis H. Weed, Chairman, Division of Medical Sciences, National Research Council, 18 May 1942. (4) Memorandum, Col. John A. Rogers, MC, Executive Officer to The Surgeon General, U.S. Army, for the Director of Training, Services of Supply, 22 May 1942, subject: Attendance of Military Personnel at Civilian Educational Institutions. 1st indorsement thereto, 3 June 1942.
    55See footnote 14 (3), p. 41.
    56See footnote 26 (1), p. 48.
    57See footnote 27 (1), p. 49.
    58See footnote 35 (2), p. 54.


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schools, and the Medical Department began to emphasize the use of military facilities. Officers in the Training Division were unhappy about this policy, but they began to transfer programs to facilities under military jurisdiction.59 The Army School of Malariology at Fort Clayton, C.Z., is a case in point: one of the purposes of establishing this school was to bring instruction completely under Army control. Similarly, the course in anesthesiology was terminated at all civilian institutions except the Mayo Foundation, and transferred to named general hospitals.60 The only new courses at civilian institutions after September 1943 were added because the urgent requirement for military neuropsychiatrists overtaxed the facilities of the School of Military Neuropsychiatry at Mason General Hospital. Columbia and New York Universities were therefore selected to conduct a 3-month course beginning in April 1944. The course was not repeated.61

General hospitals

To supplement courses developed along National Research Council guidelines at civilian institutions, special courses in anesthesiology and neurosurgery were established at a number of general hospitals. Five general hospitals began to offer a 3-month course in anesthesiology in January 1943. Because these courses were intended merely to increase the total number of specialists being trained, they essentially duplicated those being offered at civilian schools.62 The neurosurgical program, however, was designed to supersede the original civilian course. Dissatisfaction with the programs at civilian institutions, particularly those at the University of Illinois, Chicago, Ill., and the Columbia University Neurological Institute, resulted in the restructuring of the entire program.63

The new two-phase course was established on 26 April 1943. Phase I of the program consisted of 4 weeks of instruction at Columbia University, in the anatomy and physiology of the nervous system, with emphasis on surgical application. During the second phase, students were assigned, singly or in pairs, to neurosurgical centers throughout the country for 60-day periods of practical training. In contrast with the previous program, the practical phase was conducted entirely at military hospitals, where apprentice neurosurgeons saw cases typical of those they would encounter in military practice. On 17 January 1944, the theoretical phase of instruction was shifted to the University of Pennsylvania. It remained there until suspended early in 1945, after the supply of general surgeons available for special training had been

    59See footnotes 14 (1), p. 41; and 17, p. 43.
    60(1) Annual Report, Army School of Malariology, Fort Clayton, C.Z., fiscal year 1944. (2) Letter, Col. F. B. Wakeman, MC, Director, Training Division, Operations Service, Office of The Surgeon General, to the Director of Military Training, Army Service Forces, 26 Nov. 1943, subject: Courses in Anesthesiology.
    61(1) Memorandum, Col. F. B. Wakeman, MC, Director, Training Division, Operations Service, Office of The Surgeon General, for Director of Military Training, Army Service Forces, 9 Mar. 1944, subject: Training of Neuropsychiatrists. (2) Memorandum, Brig. Gen. R. W. Bliss, Chief, Operations Service, Office of The Surgeon General, for Commanding General, Army Service Forces, 21 Mar. 1944, subject: Training of Neuropsychiatrists.
    62(1) Memorandum, Col. F. B. Wakeman, MC, Director, Training Division, Operations Service, Office of The Surgeon General, to Director of Training, Services of Supply, 13 Nov. 1942, subject: Courses in Anesthesiology. (2) Letter, Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, to the Commanding Officer, Tilton General Hospital, Fort Dix, N. J., 20 Nov. 1942, subject: Training in Anesthesiology.
    63Personal Diary, Lt. Col. R. Glen Spurling, MC, Chief, Neurosurgical Section, Walter Reed General Hospital, Washington, D.C., entry dated 15 Mar. 1943.


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exhausted and the needs of the Medical Department had been met. Approximately 245 neurosurgeons were trained during the war, about half through the 3-month program at civilian institutions, and half under the joint military-civilian program.64

Army schools

Tropical and military medicine.-Before World War II, graduates of American medical schools were seldom trained to cope with tropical diseases. Recognizing this deficiency, the Subcommittee on Tropical Diseases of the National Research Council recommended, on 9 May 1941, that the Army and the Navy develop programs in tropical medicine. Specifically, they recommended that the services send officers to the Tropics for special training, and that they utilize the facilities of the Tulane University School of Medicine, New Orleans, La., and the School of Tropical Medicine, San Juan, P.R. The subcommittee stood ready to assist the services in developing facilities, and in preparing programs of instruction.65

Following a meeting between representatives of The Surgeon General and the Subcommittee on Tropical Diseases on 15 May 1941, the Medical Department agreed to draw up an outline for a course to be offered at the Army Medical Center and to explore the possibility of conducting a course at Tulane University, and another in the Tropics.66 Recommendations for the course at the Army Medical Center were approved in June 1941, and classes began in August. The first classes were of 4 weeks' duration, but by the end of the year, course length was extended to 8 weeks to permit the addition of basic subjects in military medicine, including clinical and surgical medicine, preventive medicine, ophthalmology, otolaryngology, roentgenology, dentistry, and veterinary medicine. The title of the course was changed to Tropical and Military Medicine, and the course became, in effect, a substitute for the suspended advanced graduate course, with a heavy emphasis on tropical diseases.67 The Surgeon General justified these changes on the basis of "insistent requests of station, corps, and army surgeons that some basic instruction other than that in tropical medicine be given to the officers who had the opportunity to attend the school."68

Courses were designed to provide both lectures and laboratory instruction in tropical and parasitic diseases. Content was adjusted from time to time to prepare officers for current or future areas of operation. Instructors were Medical Department officers from the Army Medical School, Walter Reed General Hospital, Washington, D.C., and The Surgeon General's office, as well as specialists from other Government and civilian institutions. Lecturers were provided by the

    64Medical Department, United States Army. Surgery in World War II. Neurosurgery. Volume I. Washington: U.S. Government Printing Office, 1958.
    65Minutes, Meeting, Subcommittee on Tropical Diseases, Division of Medical Sciences, National Research Council, 9 May 1941.
    66Minutes, Meeting, Re Special Training in Tropical Diseases, 15 May 1941. [Between representatives of The Surgeon General and the Subcommittee on Tropical Diseases, Division of Medical Sciences, National Research Counsil.]
    67See footnote 10, p. 39.
    68Letter, Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, to Lt. Col. Leon A. Fox, MC, Office of the Division Engineer, Caribbean Division, New York, N.Y., 14 Oct. 1941.


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Department of Agriculture, the U.S. Public Health Service, the U.S. Navy, the Rockefeller Foundation, and several universities.

Beginning with the 11th course, in January 1943, staff members of medical schools in the United States and Canada were enrolled in the course under the sponsorship of the American Association of Medical Colleges and financed by a grant from the John and Mary R. Markle Foundation. Seventy-two faculty members of colleges, graduates of this program, were prepared to present instruction to students who might subsequently enter the armed services.

The course was originally designed for a maximum of 30 students. By July 1942, the demand for officers with a background in tropical medicine was intense, and by November, enrollment had increased to 106 students. Peak enrollment of 222 was reached in January 1943. Courses continued throughout the war, ending with the graduation of the 23d class in September 1945. A final course of 4 weeks was given in October 1945, with special emphasis on tropical diseases in the Far East. During the war, 1,882 students graduated. Of these, 1,741 were Medical Corps officers, 25 were Sanitary Corps officers, and one was a Women's Army Corps officer. Other graduates included 16 from the U.S. Public Health Service, six from other U.S. Government services, and 83 officers from Allied Nations.69

To adjust to the requirements of global war, the course in tropical and military medicine was supplemented by programs emphasizing the control of tropical diseases. During 1942, while the use of civilian institutions for teaching medicomilitary subjects was still in the planning stages, steps were taken to insure a more adequate emphasis on the control of tropical diseases. The course for medical and field sanitary inspectors was inaugurated at the Medical Field Service School, and a course in tropical medicine at Tulane University similar to the one conducted at the Army Medical Center was incorporated into plans for the utilization of civilian institutions. Instruction on tropical diseases was incorporated into the courses in clinical laboratory and in epidemiology that were to be part of the program at civilian medical schools.70

In June 1942, members of the Office of The Surgeon General and its civilian consultants began to discuss the possibility of having the Tennessee Valley Authority conduct a 2-week field course in malaria control at Wilson Dam, Ala.71 Finally, in December 1942, plans were developed for sending small groups of Medical Department officers to hospitals, stations, and dispensaries along the Pan American Highway in Costa Rica, for 1 to 4 months of practical experience in control of tropical diseases.72

Late in 1942, these plans began to be translated into programs. On 10 August

    69Annual Report, Technical Activities, Medical Department Professional Service Schools, Army Medical Center, Washington, D.C., fiscal year 1946.
    70(1) See footnote 26 (1), p. 48. (2) Letter, The Adjutant General, War Department, to Commanding General, Caribbean Defense Command, 19 Aug. 1943, subject: Army School of Malariology, Fort Clayton, C.Z., indorsements thereto.
    71Letter, Lt. Col. Paul F. Russell, MC, Chief, Tropical Diseases and Malaria Control Section, Epidemiology Division, Preventive Medicine Service, Office of The Surgeon General, to Dr. W. A. Sawyer, Director, International Health Division, the Rockefeller Foundation, 9 July 1942.
    72Memorandum, Col. F. B. Wakeman, MC, Director, Training Division, Operations Service, Office of The Surgeon General, to the Director of Training, Services of Supply, 29 Dec. 1942, subject: Applicatory Training in Tropical Diseases.


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1942, the field course in malariology was inaugurated at the Tennessee Valley Authority. This course was conducted until 31 October 1942, when it was replaced by a similar course of 3 weeks' duration, conducted by the Florida State Board of Health, in cooperation with the International Health Service of the Rockefeller Foundation, at Pensacola, Fla. By June 1943, 207 officers had graduated from these field courses. Courses in epidemiology and in clinical laboratory began operation in September 1942. In February 1943, the course in tropical medicine at Tulane University was opened, and by June, it had graduated 42 officers. In March 1943, four officers were sent to Costa Rica for field work in malariology along the Pan American Highway.73

By mid-1943, it had become obvious that field programs in tropical diseases, particularly malariology, were too widely scattered for efficient control and that no site in the United States was completely satisfactory for field work in malariology.74 In September, the Office of The Surgeon General proposed the establishment of a service school to provide instruction in malariology on the Pacific side of the Canal Zone. The site was chosen because all types of malaria control were used in the area

FIGURE 4.-Army School of Malariology, Fort Clayton, C.Z.

    73(1) Report of the Activities of the Epidemiology Branch for 1942. In Annual Report of Activities of Preventive Medicine Division for 1942. (2) Annual Report, Tropical Disease Control Division, Preventive Medicine Division, 1943. (3) See footnote 26 (1), p. 48. (4) Medical Department, United States Army. Preventive Medicine in World War II. Volume VI. Communicable Diseases. Washington: U.S. Government Printing Office, 1963, pp. 22-24.
    74See footnote 73 (4).


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and because it was close to such agencies as the Canal Zone Health Department and the Gorgas Institute.75

The Office of The Surgeon General recommended that the Army School of Malariology be activated on 1 January 1944, but the opening was postponed until late in the month because of construction delays and difficulties in acquiring personnel. The 4-week course conducted by the school included instruction in survey and reconnaissance, epidemiology, parasitology, entomology, engineering principles of malaria control, larvicides and insecticides, malaria discipline and individual protective measures, clinical malaria, and antimalarial drugs. Between January and June 1944, 70 students graduated, and the following year, the course was completed by 172 students. The field course in Florida was terminated when the Army School of Malariology opened (fig. 4).76

The Army School of Roentgenology.-Before the war, the subject of roentgenology was included in several programs at the Army Medical Center. After many of these programs were suspended in 1940 and 1941, roentgenology was elevated to the status of a formal course. The new 4-week course, designed to prepare junior grade MC officers to operate X-ray equipment, began on 5 January 1942. Course capacity was 50 students each month.77

To make room at the Army Medical Center for an expansion of the course in tropical and military medicine, the roentgenology course was transferred to facilities leased in Memphis from the University of Tennessee, and established as the Army School of Roentgenology in December 1942. The first class at the new location enrolled early in January 1943. Class length was extended to 6 weeks, and course capacity was increased to 100. The course continued to be conducted throughout the war. Peak enrollment was reached in 1943, and gradually declined in following years. Course length increased as enrollment fell off, reaching 12 weeks by April 1944, and members of the staff devoted more time to research. Between January 1942 and June 1945, approximately 857 officers graduated.78

The School of Military Neuropsychiatry.-Psychiatry became a permanent part of the practice of military medicine during World War I, but in common with other medical specialties, it fell victim to the attrition of peace and depression. In 1940, only 35 officers of the Regular Army Medical Corps were assigned to psychiatric positions, and only four of these were certified by the American Board of Psychiatry and Neurology.79 Mobilization and war, however, produced a constantly growing demand for specialists to screen inductees and treat the psychiatric casualties of training and combat. It was not until 6 months after the beginning of the war, in the face of mounting patient loads, that the Neuropsychiatry Branch (later the Psychiatry Consultants Division) of the Surgeon General's Office became aware of the national shortage of

    75See footnote 70 (2), p. 63.
    76See footnote 35 (2), p. 54; and 60 (1), p. 61.
    77(1) Medical Department, United States Army. Radiology in World War II. Washington: U.S. Government Printing Office, 1966. (2) See footnote 14 (3), p. 41.
    78(1) Annual Report, Army School of Roentgenology, Memphis, Tenn., fiscal year 1944. (2) Annual Report, Army School of Roentgenology, Memphis, Tenn., fiscal year 1945. (3) See footnote 77 (1).
    79Medical Department, United States Army. Neuropsychiatry in World War II. Volume I. Zone of Interior. Washington: U.S. Government Printing Office, 1966.


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trained psychiatrists, and the need for an intensive training program. Many MC officers assigned to the psychiatric sections of hospitals had had no contact with psychiatric patients since their internship, and even qualified psychiatrists required specialized training to cope with the administrative aspects of military neuropsychiatry. All officers had to be acquainted with Army regulations governing psychiatry, disposition procedures, and testimony before boards and courts-martial. Most had to be prepared for practice under field conditions and the problems of forward areas.80

Early in September 1942, the Neuropsychiatry Branch recommended the establishment of a training program, and on 9 October, the Office of The Surgeon General officially requested the authorization for a 4-week course in military neuropsychiatry. Lawson General Hospital was suggested as the site because of its large psychiatric service. The request was approved on 27 October 1942, and on 2 January 1943, the new service school began operation.81

The School of Military Neuropsychiatry, Lawson General Hospital, began with a staff of four MC officers in existing hospital buildings. The program, consisting of 187 hours of instruction, was designed to orient psychiatrists to the military aspects of their speciality. About two-thirds of the program was devoted to lectures, seminars, and clinical presentations in neurology and psychiatry, and the balance was devoted to administration and military orientation. A total of 308 students graduated from the 11 courses conducted at Lawson General Hospital.82

In October 1943, the school was moved to Mason General Hospital, which had been designated as a specialized treatment hospital for neuropsychiatric casualties. In the spring of 1944, it became apparent that the shortage of trained psychiatrists would continue indefinitely, and the program was redesigned to provide 12 weeks of intensive training for medical officers who had no previous psychiatric experience. With the exception of two "fill in" courses, all subsequent classes were subjected to a total of 600 hours of instruction with a heavy emphasis on orienting physicians to psychiatry. It was at this time that the program temporarily expanded to include courses at Columbia and New York Universities. Both of these universities conducted three such courses, and 227 officers graduated. The School of Military Neuropsychiatry continued to offer classes until 22 December 1945, graduating 692 officers. The total graduates for the military school at both of its locations were exactly 1,000, about two-thirds of whom had no previous background in psychiatry.83

The Professional Service Schools at the Army Medical Center.-Before the war, Medical Department technical training was conducted almost exclusively

    80See footnote 79, p. 65.
    81(1) Menninger, Brig. Gen. William C.: Education and Training in Neuropsychiatry. [Official record.] (2) Memorandum, Col. John A. Rogers, MC, Executive Officer, Office of The Surgeon General, U.S. Army, for Director of Training, Services of Supply, 9 Oct. 1942, subject: Intensive Course of Instruction in Military Neuropsychiatry. (3) Memorandum, Brig. Gen. C. R. Huebner, GSC, Director of Training, Services of Supply, for the Commanding General, Fourth Service Command, 27 Oct. 1942, subject: Establishment of a School for Military Neuropsychiatry.
    82(1) Annual Report, School of Military Neuropsychiatry, Lawson General Hospital, Atlanta, Ga., fiscal year 1943. (2) Annual Report, School of Military Neuropsychiatry, Mason General Hospital, Long Island, N.Y., fiscal year 1944.
    83See footnote 79, p. 65.


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at the Professional Service Schools at the Army Medical Center. Many courses were suspended at the beginning of the war, and others, such as the course in roentgenology, were transferred to make room for expansion of the course in tropical medicine. The few that remained throughout the war were usually conducted by either the Army Dental School or the Army Veterinary School.

In the prewar era, training in plastic and maxillofacial plastic surgery was provided by the Army Medical School through its professional specialists courses. In August 1941, after these courses had been suspended, the Army Medical School and the Army Dental School joined in cooperative efforts to organize a 4-week course to prepare medical and dental officers to serve on maxillofacial surgical teams. The new course opened on 1 September 1941, and continued to be offered until September 1943, graduating 209 officers. Late in 1942, the length of the course was extended to 6 weeks. Between September 1942 and August 1944, training in maxillofacial plastic surgery was also conducted at civilian institutions.84

A new 4-week course in the preparation of blood plasma and the operation of plasma centers was inaugurated at the Army Medical Center in April 1942. The program provided on-the-job training in laboratory techniques and the operation of donor centers. The course continued to be given to a small number of officers throughout the war.85

In 1941, the Army Veterinary School reported that some instruction in meat and dairy hygiene was being given to officers of the Sanitary Corps undergoing training for duty as nutrition officers. The program was designed to orient officers to the production, preparation, and distribution of meat for military use. Instruction was informal, consisting of 6 weeks of conferences and demonstrations. Because of space limitations, the Food and Nutrition Course was transferred to the Army Medical School on 10 June 1942, where it remained until February 1945 when it was transferred to the Medical Nutrition Laboratory in Chicago. The number of officers attending the course was always small and was not consistently reported. By the end of the war, course length had been extended to 9 weeks, and the capacity was six officers.86

The course in forage inspection, described earlier, was one of the few peacetime courses that continued for the duration of the war. The 1-month Refresher Course in Forage Inspection was authorized on 31 July 1940, as a substitute for the National Guard officers' course and a partial substitute for the Basic Graduate Course for VC officers. Temporarily suspended in June 1942, it was reestablished in March 1943 and continued until after V-J Day. It was conducted 21 times, and 66 officers graduated.87

In June 1940, the Veterinary Division of the Surgeon General's Office recommended the establishment of a course in clinical pathology for officers assigned to Medical Department laboratories. A few months later, a 3-month course designated

    84(1) Annual Report, Technical Activities, Medical Department Professional Service School, Army Medical Center, Washington, D.C., fiscal year 1942. (2) See footnotes 26 (1), p. 48; and 27 (1), p. 49. (3) Medical Department, United States Army. United States Army Dental Service in World War II. Washington: U.S. Government Printing Office, 1955.
    85See footnote 10, p. 39.
    86See footnotes 35 (2), p. 54, and 84 (1).
    87See footnote 16 (1), p. 42.


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as the Special Graduate Course in Clinical Pathology was established. The course included 454 hours of instruction and laboratory experience in bacteriology, parasitology, serology, and food chemistry.88

On-the-job training for specialized teams.-Early in 1942, the Medical Department formally recognized the need to prepare specialized teams to operate at medical field installations. Small groups such as surgical teams, composed of an operating surgeon and his assistant, an anesthetist, a nurse, and a surgical technician, required practice to integrate their skills and function efficiently. Other specialties in which the teams were required included treatment of shock, splinting, thoracic surgery, maxillofacial plastic surgery, and neurosurgery. On 27 February 1942, all hospitals with a capacity of 500 or more beds were directed to establish team training programs before 1 April.89 Formal course outlines were not required, and instruction was to be integrated with the routine duties of personnel at the hospitals. Once the program was established, it became a continuous feature of hospital-level training, although statistics were not reported by the Medical Department.90

The School of Aviation Medicine.91-The priority placed on air defense during the initial phases of the limited emergency brought with it an early expansion and acceleration of the training program at the School of Aviation Medicine. In May 1940, Gen. H. H. Arnold, chief of the Army Air Corps, estimated that during the next year 50,000 physical examinations, in addition to routine examinations, would be required to screen the trainees needed for Air Corps expansion. To train physicians to conduct examinations, he recommended, through The Surgeon General, that the training program for the School of Aviation Medicine under the Protective Mobilization Plan be put into effect on 15 July 1940. His recommendation was approved, and in mid-1940, the basic course at the school was shortened from 3 months to 6 weeks.

During the year it remained in effect, the accelerated course had mixed results. Designed to train Army medical officers as aviation medical examiners, the program was confined to theoretical and clinical instruction in medical specialties, and training time was increased from 43 to 50 hours a week. Between 1 July 1940 and 1 July 1941, approximately 240 medical examiners graduated. That number was adequate, but instructors at the school believed that 6 weeks was not enough time to provide thorough training, and reports from the field confirmed this opinion. At the end of the year, class length was restored to 12 weeks, and the capacity of the school was expanded.

Beginning in April 1942, the course was split into two phases of 6 weeks each. During the first phase, students attended conferences, lectures, demonstrations, and

    88(1) See footnote 84 (1), p. 67. (2) Letter, Lt. Col. Ralph B. Stewart, VC, Director, Army Veterinary School, Army Medical Center, Washington, D.C., to the Assistant Commandant, Army Medical Center, Washington, D.C., 3 Aug. 1940, subject: Special Course of Instruction in Veterinary Laboratory Procedure, attachment thereto.
    89Letter, The Adjutant General, War Department, to the Commanding Generals of All Corps Areas, Chief of the Air Force, and the Commanding Officers of All Named General Hospitals, 27 Feb. 1942, subject: Training of Auxiliary Surgical Groups.
    90See footnote 10, p. 39.
    91This section is based on Link, Mae Mills, and Coleman, Hubert A.: Department of the Air Force. Medical Support of the Army Air Forces in World War II.Washington: U.S. Government Printing Office, 1955.


69

clinics at the School of Aviation Medicine. In the second phase, they were sent to special branch schools established at Aviation Cadet Classification Centers for practical training. By assigning students to other stations for half of the course, authorities at the school hoped to double its capacity, and to use students to conduct physical examinations during half of their training. During this period, classes expanded from a capacity of 100 to approximately 320.

Since the classification centers at which the second phase of the medical examiners' course was conducted were initially designed for the examination of cadets, they were not ideally equipped for classes in medical, administrative, and tactical procedures. Training was further complicated by a lack of uniformity in branch school programs. One school, for example, conducted a 3-week course in hospital administration similar to the refresher and pool courses at ASF hospitals. To overcome these difficulties, the Air Surgeon directed a committee to study the training and to recommend a standardized program of instruction, in mid-September 1942. The committee decided that the second phase should be divided into three subcourses of 2 weeks each. During one period, the student was to be assigned to conduct physical examinations on the examining line, and rotated from station to station in the line so that he performed each part of the examination on aircrew applicants. In the second period, he was to conduct psychological studies of aviation cadets, and during the third, he was to be assigned to the station hospital to study medical subjects. The schedule was put into effect in November 1942, but as late as April 1943, branch schools had failed to achieve the desired level of standardization.

On 7 October 1943, the Aviation Medical Examiners' Course was shortened from 12 to 9 weeks, and the branch schools were closed. Between May 1942 and October 1943, 1,020 students had graduated from the San Antonio, Tex., branch school, 666 from the Santa Ana, Calif., branch, and 1,092 from the Nashville, Tenn., branch. After October 1943, all training for aviation medical examiners was conducted at the School of Aviation Medicine. On 31 July 1944, the course was lengthened to 11 weeks to permit the reestablishment of flight training, expand the time devoted to medical studies, and provide students with a free afternoon each week.

During the course of World War II, the School of Aviation Medicine expanded its curriculum to embrace many subjects which had previously been confined to schools under the direct control of The Surgeon General. Traditionally, medical officers assigned to the Army Air Corps had received their training in military medicine, tactics, and administration at the Medical Field Service School, and then attended the School of Aviation Medicine to be trained as aviation medical examiners and eventually become flight surgeons.92 During 1941, when the course was compressed into 6 weeks of intensive training, main emphasis was placed on conducting physical examinations at classification centers and on related subjects, such as cardiology and physical diagnosis. After December 1941, mounting criticism of the officers graduating from the course brought a shift in emphasis

    92Aviation medical examiners became qualified as flight surgeons after a specified period of time, usually 1 year, on duty with the Army Air Forces. The period needed to qualify varied during the war and could be modified by the amount of flight time accumulated by an officer.


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toward military medicine and administration. By March 1942, the commandant of the school was able to report:

 * * *  The course at the School of Aviation Medicine has materially changed since October, as we are stressing the practical aspects of field duty more and more and the physical examination is only of material interest to those who are assigned to classification centers and replacement centers. To be sure 64 examinations are made but they are few and far apart except at the centers mentioned. We have added tropical medicine, field sanitation and hygiene, first aid, shock treatment, low pressure chamber work and other features to our curriculum. Furthermore, some compulsory exercise and drill have been added.93

In November 1942, a Department of Military Medicine was added to the school and made responsible for instruction in the organization and functions of the Army Air Forces, field sanitation and hygiene, chemical warfare, supply and administration, and field exercises. By October 1943, a 6-day bivouac had been added. During the same period, training in medical specialties was increased, and beginning in April 1944, a policy of sending all MC officers assigned to the Army Air Forces to the School of Aviation Medicine was adopted. Finally, after July 1944, officers eligible for service in theaters of operations were assigned to the Tactical Unit Surgeon's Course at the AAF School of Applied Tactics, Orlando, Fla., to be trained in tactics, military aspects of medicine, and administration.

The trend toward incorporating tactical, medicomilitary, and administrative subjects into the curriculum of the School of Aviation Medicine paralleled developments in Special Service Schools and other ASF training programs. The course in tropical medicine, for example, integrated administrative and tactical subjects into the technical curriculum early in the war. Similar developments took place at the Medical Field Service School itself, in the course for medical field and sanitary inspectors, and in pools established at medical installations. The underlying cause of this duplication of efforts lay in the inability of the Medical Field Service School to provide basic training for all Medical Department officers as soon as they reported for duty.

Programs for Negro flight surgeons were also a problem. During the first year of the war, the School of Aviation Medicine was able to keep Negroes from attending by enrolling them in extension courses. Three Negro officers enrolled in the extension course graduated in February 1943. When this policy was brought to the attention of the Secretary of War by Judge Hastie in January 1943, the policy was changed to provide equal standards for admission. The first Negro officers graduated from the course in March 1943.

Mid-War Additions to the Medical Department Program

By late 1943, the pace of unit activations had slowed and training efforts were reduced in the main to providing replacements. At this point, planners began to turn their attention to adjustments in the training process, special courses for special situations, and eventually, to planning for the cessation of hostilities. During the last 2 years of the war, a series of courses was added to the program whose only common denominator was being established to meet special needs.

    93 See footnote 91, p. 68.


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Anesthesiology for portable surgical hospitals.-A special course in anesthesiology for portable surgical hospitals was conducted from 7 August to 4 September 1943. The object of this special course was to provide personnel trained to use the limited anesthetic equipment allotted to portable surgical hospitals. The 7 course was conducted at Halloran General Hospital, Staten Island, N.Y., Nichols General Hospital, Louisville, Ky., and the station hospitals at Fort Bragg and Camp Breckinridge, Morganfield, Ky. A total of 12 officers graduated.94

The Army Ground Forces refresher course.-In December 1943, the commanding general of the Army Ground Forces requested that the Medical Department establish a refresher course in medical and surgical treatment of battle casualties in forward areas for officers assigned to medical detachments and divisional medical battalions. In response, the Office of The Surgeon General developed a 4-week program of on-the-job training at named general hospitals. Forty eight hours' training time was devoted to each of four subject areas: Amputations and fractures, neurosurgery and anesthesiology, neuropsychiatry and medicine, and roentgenology and chest and abdominal surgery. The training consisted of reviewing the case histories of battle casualties, making ward rounds with the chiefs of hospital services, and participating in the weekly clinical conferences of staff sections and the general staff of hospitals.

The first 4-week AGF Refresher Course in First and Second Echelon Medical and Surgical Care was initiated on 29 April 1944 at the following general hospitals: Bushnell, Brigham City, Utah; Percy Jones, Battle Creek, Mich.; Walter Reed; Brooke, San Antonio, Tex.; and McCloskey, Temple, Tex. Courses continued until November 1944, when the program was discontinued.95

Electroencephalography.-In July 1944, a 4-week course was established at Walter Reed and Mason General Hospitals to train officers in the operation and interpretation of electroencephalographs. Each course had a capacity of four students. Subsequently, similar courses were established at Brooke General Hospital and DeWitt General Hospital, Auburn, Calif. By the end of June 1945, a total of 35 students had graduated.96

Orientation for female SnC officers.-In November 1944, a 2-week course was established at Billings General Hospital, Indianapolis, Ind., for newly commissioned members of the Women's Army Corps (detailed to the Sanitary Corps) as bacteriologists, biochemists, or serologists. By the time the course was terminated in March 1945, 31 officers had graduated.

    94(1) Letter, Col. Charles H. Moseley, MC, Deputy Director, Training Division, Operations Service, Office of The Surgeon General, U.S. Army, to the Director of Military Training, Army Service Forces, 21 July 1943, subject: Special Course in Anesthesiology. (2) See footnote 27 (1), p. 49. (3) Letter, The Surgeon General, U.S. Army, to the Commanding Officer, Nichols General Hospital, Louisville, Ky., 28 July 1943, subject: Special Training Course in Anesthesiology.
    95(1) Letter, Commanding General, Army Ground Forces, to Commanding General, Army Service Forces, 4 Dec. 1943, subject: Course of Instruction for Medical Officers, indorsements and inclosure thereto. (2) Memorandum, Col. Floyd L. Wergeland, MC, Director, Training Division, Operations Service, Office of The Surgeon General, U.S. Army, for Director of Military Training, Army Service Forces, 13 Apr. 1944, subject: Refresher Course for Medical Corps Officers of the Army Ground Forces, indorsement and inclosure thereto. (3) See footnote 35 (2), p. 54.
    96Memorandum, Lt. Col. Chas. H. Moseley, MC, Deputy Director, Training Division, Operations Service, Office of The Surgeon General, U.S. Army, to Director of Military Training, Army Service Forces, 26 June 1944, subject: Applicatory Training of Medical Corps Officers in Electroencephalography.


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Refresher courses for Medical Department officers.-At the beginning of World War II, many Regular Army officers had been transferred from professional duties to administrative posts, where their administrative skills and experience could be used to guide the Medical Department's expansion. By late 1944, large numbers of medical, dental, and veterinary officers had already served long periods in administrative or semiprofessional assignments. When peace returned and the Army was demobilized, many would be returned to clinical duties.

Plans for refresher training to bring Medical Department officers up to date with developments in their specialties were approved in the fall of 1944, and on 17 November, a "Guide for the Professional Refresher Training of Medical Corps Officers" was approved. This guide was used as background material for 12 weeks of on-the-job refresher training for MC officers in general medicine and general surgery. By early 1945, 48 general hospitals were participating in the program. By June 1945, 176 MC officers had completed the refresher course. In April and May 1945, guides for refresher training were approved for DC and SnC officers, and courses were established for them at general hospitals.

THE ARMY SPECIALIZED TRAINING PROGRAM97

Between 1943 and 1945, 29,730 enlisted men were assigned to ASTP (Army Specialized Training Program) units at civilian schools to be trained as physicians, dentists, and veterinarians, and approximately 4,900 enlisted men were assigned to ASTP units at colleges and universities for preprofessional training. Before the program was terminated in July 1946, 16,429 enlisted men graduated from professional schools and became available for appointment as officers in the Medical Department.98

World War I Precedents

The World War II Army Specialized Training Program had antecedents in World War I. Following the passage of the Selective Service Act of 1917, medical schools sought to have students exempted from induction on the ground that their value to the Armed Forces would be greater if their education were continued through graduation. A prolonged war might even produce a serious shortage of physicians. Medical students were not exempted, but by the end of August 1917, the Army had made it possible for full-time medical, dental, and veterinary students entering the service to be assigned to the Medical Enlisted Reserve Corps in an inactive status to continue studies at their own expense. Students could retain their inactive status through residency if their academic progress was satisfactory. The program was placed under the supervision of The Surgeon General.99

    97Except as otherwise noted, this section is based on Fitts, Francis M.: Training in Medicine, Dentistry, and Veterinary Medicine, and in Preparation Therefor, Under the Army Specialized Training Program, 1 May 1943 to 31 Dec. 1945. [Official record.]
    98See footnote 17, p. 43.
    99The Medical Department of the United States Army in the World War. Washington: Government Printing Office, 1923, vol. I.


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By March 1918, 60 percent of the medical students in recognized schools of medicine had entered the Enlisted Reserve Corps. Those not under military jurisdiction consisted of aliens, the physically disqualified, registrants deferred because of dependents, overage students, and those who had not reached age 21. Statistics are not available for dental and veterinary students. In August 1918, enlistments and transfers to the Enlisted Reserve Corps were discontinued because SATC (Students' Army Training Corps) was established. That fall, all members of the Enlisted Reserve except those serving hospital internships were called to active duty and transferred to SATC units established at the schools in which they were enrolled. Since these trainees were discharged shortly after the armistice, little information on this experiment is available. Despite provisions for the voluntary continuation of professional studies, the eagerness of that generation to participate in the war effort resulted in a serious reduction of the number entering or continuing their studies.

Neither program made specific provisions for preprofessional students. Those preparing for medical, dental, and veterinary schools had no protection beyond general enrollment in the Students' Army Training Corps. Since the age of induction was not lowered from 21 to 18 until 31 August 1918, failure to assure a continuous flow of students into professional schools created no serious military problems. Had the war continued for several years, however, a shortage of physicians, dentists, and veterinarians might have developed.

National Emergency Programs

Between wars, little thought appears to have been given to providing uninterrupted training for professional and preprofessional students. It was not until after the declaration of a limited national emergency in 1939, when educators became concerned that medical students who had earned Reserve commissions outside the Medical Department as undergraduates might be mobilized as line officers, that the question received formal consideration.100

In April 1940, as a result of a study of medical officer procurement, the War Department made it possible to transfer full-time medical, veterinary, and dental students with Reserve commissions to the MAC Officers' Reserve during mobilization. On 28 August 1940, the day after Congress authorized limited mobilization, the transfer was put into effect by War Department directive.101

Under the Selective Training and Service Act of September 1940, students were exempted from the draft until July 1941, but residents and interns were required to seek occupational deferments from their local boards. While such

    100Letter, The Adjutant General, War Department, to Each Corps Area and Department Commander; Each Chief of Arm or Service, 17 Apr. 1940, subject: Special Mobilization Procedures for Procurement of Medical Department Reserve Officers Who Are Students in Approved Medical Schools.
    101(1) Letter, Col. James E. Baylis, MC, Executive Officer to The Surgeon General, to The Adjutant General, War Department, 9 Aug. 1940, subject: Special Mobililization Procedures for Procurement of Medical Department Reserve Officers Who Are Students in Approved Medical Schools. 1st indorsement thereto, 3 Sept. 1940. (2) Letter, The Adjutant General, War Department, to Each Corps Area and Department Commander; Each Chief of Arm or Service, 28 Aug. 1940, subject: Special Mobilization Procedures for Procurement of Medical Department Reserve Officers Who Are Students in Approved Medical Schools. (3) See footnote 100.


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deferments were usually granted, they could not be guaranteed. In May and June 1941, the War Department authorized the appointment of full-time juniors and seniors in approved schools of medicine to the Medical Administrative Corps, and postponement of their call to active duty. A year later, similar appointments were authorized for students in the two lower classes and for students who had been accepted for the next entering class. After completing their studies, these officers were to be transferred to either the Medical, Dental, or Veterinary Corps.

By February 1943, when the program was discontinued, commissions in the Medical Administrative Corps were held by 13,108 medical, 5,838 dental, and 1,116 veterinary students. The Navy provided a similar program, and by March 1943 when the National Selective Service recommended that local boards defer full-time students in these fields, there were few physically qualified male students who had not enrolled in the wartime Reserve. This change in policy by the Selective Service proved of value, however, for it also extended deferments to preprofessional students who were accepted for approved professional studies and would complete their undergraduate work within 24 months.102

Students in other fields had less extensive opportunities to continue their education. In May 1942, the War Department authorized the voluntary enlistment of college students in the Enlisted Reserve Corps, with the understanding that they were to be exempted from active service as long as the military situation permitted. Medical, dental, and veterinary students could not participate in this program, but preprofessional students who had not yet been accepted by a professional school were able to take full advantage of it.103

The War Department Program104

The decision to initiate the military college training program grew out of the War Department's recognition that lowering the selective service age to 18 would cut off the supply of college-trained men. The armed services could not afford the luxury of allowing a large proportion of the Nation's military manpower to spend 4 years engaged in studies not necessarily vital to the war effort, but neither could they afford to destroy their source of college-trained men who could serve as officers and technicians. Planners also had to consider the impact of reducing the draft age to 18 on the Nation's colleges and universities.

In January 1942, and again in July, representatives of the Nation's colleges met at conferences sponsored by the American Council on Education, to discuss the effect of war on higher education. In both instances, statements were issued urging the Government to make maximum use of college facilities, to grant Federal aid to accelerate training, and to draft plans for using the resources of educational institutions in the war effort. Anticipating that both industry and educators would

    102See footnote 17, p. 43.
    103Letter, The Adjutant General, War Department, to Corps Area and Similar Commanders, 25 May 1942, subject: Preinduction Training in Colleges and Universities, inclosures thereto.
    104This section is based on "History of Military Training, Army Specialized Training Program, Army Service Forces, From Its Beginning to 31 Dec. 1944, With Supplement to 30 June 1945." [Official record.]


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oppose reducing the draft age to 18, the War Department began to make plans for an Army-Navy college training program.

On 25 September 1942, the Commanding General, ASF, was directed to prepare a detailed plan for an Army college training program. On 13 November, the President signed an amendment to the Selective Service Act, reducing the draft age to18, and on 17 December, the Secretaries of the War and Navy Departments announced an Army-Navy college training program. The programs announced by the two secretaries became the Army Specialized Training Program and the Navy College Training Program commonly known as the V-12.

Basic policies guiding ASF planning for the Army Specialized Training Program were developed during a series of conferences between representatives of the War Department and American colleges and universities. Guidelines for the program were incorporated into the memorandum of 25 September 1942, directing the Commanding General, ASF, to develop detailed plans for the Army Specialized Training Program. The number of men to be trained, and their fields of specialization, were to be determined by the Army's needs. Trainees were to be selected from the Army at large, on the basis of previous academic training, the results of scholastic aptitude and achievement tests, and the qualities of leadership demonstrated during military service. Selection was to be preceded by basic military training. During their college training, men assigned to the program were to be on an active-duty status, organized, administered, and disciplined under a cadet system. The curriculum, the duration of training, and the number of men in each course were to be determined by the Army.

In exceptional cases, cadets who were selected for service in nonmilitary activities were to be transferred to the Reserve, for employment in civilian status, subject to recall to active duty. Recommendations were also included for the kinds and levels of instruction, the acceleration of academic training, and the selection of trainees. The detailed plan based on these guidelines was developed by the Personnel Division, ASF, after further conferences.

The final plan for the Army Specialized Training Program, released by the Secretaries of War and Navy on 17 December 1942, modified many of the guidelines in the memorandum of 25 September. Medical and dental students, and members of the Enlisted Reserve Corps, were exempted from basic military training. Selection was placed under the control of the War Department and was to follow the general guidelines for selecting officer candidates. Enlisted men over the age of 22 were eligible only for advanced training. Trainees were to be privates, seventh grade, and given military training under a cadet system, concurrent with their academic training. Academic standards were to be formulated after consultation with the U.S. Office of Education and the American Council on Education. Men in training were to undergo continuous screening, and failing trainees were to be promptly relieved and reassigned.

Graduates of the program were to be selected for further training at an officer candidate school, recommended for ratings as technical noncommissioned officers, or returned to troops. Responsibility for the operation of the program was assigned to the Army Service Forces. A memorandum from the Secretaries, submitting the


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plan for the President's approval on 3 December 1942, stipulated that not more than 150,000 men would be trained by the Army at any one time, of whom 40,000 would be medical, dental, veterinary, premedical, and predental students.

Special provisions were included for members of the Enlisted Reserve Corps and the Reserve Officers' Training Corps, and medical, dental, and veterinary students who held Reserve commissions in the Medical Administrative Corps, to insure that their previous training would be utilized, and that there would be no discrimination against them. It was considered discriminatory to deprive them of opportunities for further training, or to require them to continue at their own expense. Premedical and predental students in the Enlisted Reserve Corps were to be called to active duty at the end of the first full term beginning in 1943, and detailed to continue their studies. Medical, veterinary, or dental students commissioned in the Medical Administrative Corps were given the opportunity to resign their commissions and enlist as privates to continue their studies at Government expense. Premedical students not in the Enlisted Reserve Corps, if inducted through selective service, were to be placed on inactive duty until the end of the first full term beginning in 1943, and were then to be called to active duty. Thereafter, they could be assigned to the Army Specialized Training Program for further medical or premedical training, or to other military duties.

Between its establishment late in 1942, and its termination in 1946, the Army Specialized Training Program underwent continuous change. Of major importance were fluctuations in the program's size. At the beginning, ceiling strength was set at 150,000. By September 1943, the Army Specialized Training Program had reached a strength of approximately 124,000 trainees and was still growing. On 16 September, however, the War Department let it be known that the program would probably be reduced, and on 1 November 1943, the Secretary of War directed that total enrollment be reduced to 95,000 by 30 June 1944, and to 40,000 by the end of December. The program reached a peak strength of 140,000 in January 1944, when plans for reduction to prescribed ceilings were put into effect. On 10 February 1944, the Chief of Staff, War Department General Staff, sent a strongly worded memorandum to the Secretary of War, recommending a drastic reduction of ceilings to a maximum of 30,000. On 16 February, the War Department General Staff, G-1, Personnel, informed the Commanding General, ASF, that a ceiling of 30,000 ASTP trainees would become effective on 1 April. Those remaining in the program would consist entirely of advanced technical, preprofessional, and professional trainees.

In response to this directive, a plan, submitted on 25 February 1944, recommended that 25,000 professional and preprofessional medical, dental, and veterinary trainees be retained in the program, and that an additional 1,000 vacancies be reserved for soldiers who held acceptances from professional schools but were not yet enrolled in the Army Specialized Training Program. It also recommended that the Army Specialized Training Program include 2,000 foreign area and language trainees, 3,000 advanced engineering trainees, and a small group of men in other programs. Under this plan, total enrollment would have been reduced to 34,100. With revisions that reduced it to 30,000 trainees, the Secretary of War approved the plan on 28 February 1944. As a result of these decisions, medical, dental, and


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TABLE 2.-Summary of Army Specialized Training Program demands, by arms and services, January 1943-July 1944

    Arms and Services

    1943

    1944

    January

    April

    July

    October

    January

    April

    July

    Army Air Forces

    -----

    -----

    43,997

    10,197

    12,790

    100

    100

    Army Ground Forces

    -----

    46,995

    55,985

    40,520

    40,520

    2,350

    2,350

    Classified

    -----

    -----

    3,156

    3,156

    3,156

    955

    955

    Corps of Engineers

    6,633

    6,633

    3,000

    3,000

    4,500

    1,700

    1,700

    Chemical Warfare Service

    1,683

    1,683

    500

    500

    500

    50

    50

    Ordnance

    1,650

    1,650

    -----

    900

    900

    645

    645

    Signal Corps

    4,925

    4,925

    13,707

    13,707

    13,234

    3,001

    3,001

    Transportation Corps

    -----

    -----

    50

    50

    -----

    -----

    -----

    Surgeon General

    5,630

    5,630

    5,630

    5,630

    5,630

    5,665

    5,665

    Adjutant General's Office

    1,170

    1,170

    1,100

    1,100

    -----

    -----

    -----

    Provost Marshal General

    1,595

    1,595

    1,600

    -----

    -----

    -----

    -----

    Total

    23,286

    70,281

    128,725

    78,760

    81,230

    14,466

    14,466


    Source: History of Military Training, Army Specialized Training Program, Army Service Forces, From Its Beginning to 31 December 1944, With Supplement to June 1945. [Official record.]

veterinary students were the largest single group of Army Specialized Training Program trainees after April 1944 as reflected in table 2.

Medical, Dental, and Veterinary Training

Army specialized training in medicine, dentistry, and veterinary medicine differed from other Army specialized training in a variety of ways.105 Because study in these fields led to professional degrees, the program was longer and followed the regular curriculum of professional schools. Instead of adopting the standard 12-week ASTP cycle, many schools remained on the quarter or the semester. Provisions for physical and military training were different, and because most medical, dental, and veterinary students were on commutation of quarters and rations, there were differences in local administrative problems. Since most students in these fields had begun their professional or preprofessional training before the establishment of the Army Specialized Training Program, most of them were selected under other than ASTP procedures; and, while Medical Department officers connected with the program were fond of repeatedly saying that trainees were not "students in uniform" but "soldiers in college," the differences between standard Army specialized training and the Army Specialized Training Program in medical specialties was so marked that, in May 1943, a representative of the Army Specialized Training Division told participants at an ASF conference that contracts with medical schools fell into a separate category from standard ASTP contracts because
"*  *  *  we are putting professional students into uniform, we are not

    105 See footnote 97, p. 72.


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putting soldiers into medical colleges. *  *  *  most of these boys have had no military training at all; we are merely going to put a uniform on them and let them keep right on doing what they have been doing all the time."106

The program in operation.-During the spring and summer of 1943, all members of the Enlisted Reserve Corps, who had reached age 18, were called for active duty. Upon completion of basic military training, they, and all other enlisted men in the Zone of Interior (except loss replacements and those in alerted units), were eligible for selection for the Army Specialized Training Program. Medical, dental, and veterinary students in approved schools, who were called to active duty as members of the Enlisted Reserve Corps or inducted through the Selective Service System, were not required to receive basic military training before assignment, but were processed through reception centers and immediately returned to the schools in which they were enrolled as members of the school's ASTU (Army Specialized Training Unit). Members of the Enlisted Reserve Corps who had been accepted for admission to a 1943 or 1944 professional school freshman class were also exempted from basic training and were granted the option of remaining on inactive status to complete prerequisites for admission. Those who did not elect to remain on inactive status were processed at reception centers and sent to a STAR (Specialized Training and Reassignment) unit for verification of their admission to professional schools, and for evaluation of their progress toward completing entrance requirements.

This information was forwarded to the Army Service Forces, which ordered the trainee to an Army Specialized Training Unit to complete his preprofessional training. Enlisted men with 1943 and 1944 acceptances, who had finished basic military training without completing their preprofessional training, were also sent to STAR units for classification and assignment. In short, the War Department did everything possible not to interrupt the professional and preprofessional training of potential physicians, dentists, and veterinarians.

Enlisted men who had completed their preprofessional training and been accepted by a professional school were assigned interim duties until they could be enrolled in a freshmen class. Such duties were performed on an "attached-unassigned" status at Medical Department installations within the service command in which the professional school was located, or in which the trainee was then stationed. The period of interim duties varied from 1 to 8 months.

By honoring the commitments of individual schools during 1943 and 1944, the War Department, in effect, delegated responsibility for selecting trainees to accredited medical, dental, and veterinary colleges. A major factor in this decision was the presence in the Army of a large number of enlisted men with premedical or predental training who had either failed to apply for acceptance at a professional school, or failed to gain admission. To avoid selecting these men at the expense of those already admitted, the Army agreed to accept the admissions of individual schools for freshman classes beginning in 1943 and 1944.

    106Remarks of Lt. Col. Blake R. Van Leer, MC, at Army Service Forces Conference on Negotiation and Renegotiation Procedure for Training Unit Contracts for Securing Services and Facilities of Non-Federal Education Institutions, Omaha, Neb., 28 May 1943.


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The number of men accepted by individual schools for classes beginning in 1943 and 1944 was estimated to be adequate to meet the Medical Department's 1946 and 1947 demand schedules. However, demand schedules for subsequent years could be met only by selecting and assigning enlisted men for training in medicine and dentistry. Satisfaction of the Medical Department's annual demand schedule for 4,200 physicians, 1,100 dentists, and 150 veterinarians required the reservation of 3,600 freshman medical school and 825 dental school vacancies in each 9-month cycle. Because of the disproportionately large number of enlisted men in veterinary training, additional training in this field was not required. To guarantee these vacancies, the War Department entered contracts with medical and dental schools to reserve 55 percent of the freshman medical capacity and 35 percent of the freshman dental capacity in each class beginning after 1 January 1945. The schools were advised that vacancies in 1945 freshman classes would no longer be filled by honoring the selections of individual institutions. Instead, representatives of medical and dental education would participate in the selection of enlisted men to fill Army-reserved freshman vacancies.

To fill its reserved vacancies, the Army was required to provide an average of 400 medical and 100 dental trainees each month. This level of enrollment could be maintained only by selecting trainees from those who had demonstrated their academic competence by completing two or three terms of the basic ASTP curriculum. Courses required for admission to medical or dental school could then be completed in three additional terms-a total period of 60 weeks. Assuming a loss in these three terms of only 15 percent, a monthly input of 625 trainees into term 3 of the preprofessional curriculum was necessary to meet the contract obligations for the utilization of freshman vacancies. While it was assumed that a number of potential candidates might be discovered in the Army at large, their numbers and qualifications were so uncertain that they could not be counted upon to furnish a continuous flow of trainees. Thus, plans for professional training after 1944 required continuation of the basic phase of the Army Specialized Training Program at a level sufficient to provide a choice of candidates for preprofessional training.

The basic phase of the Army Specialized Training Program was discontinued on 1 April 1944, and approximately 42,000 trainees enrolled in the basic program were assigned other military duties. Only those who had been selected from basic ASTP cycles ending in December, January, and February were transferred to the preprofessional program. On 18 April, ASF headquarters announced that the Army's share of classes entering medical schools during 1945 would be cut from 55 percent to 28 percent, and for dental schools, from 25 percent to 18 percent; no commitments were to be made for classes starting in 1946.107

Meanwhile, the question of reducing the dental Army Specialized Training Program became involved with that of discharging dentists already in the service. In March 1944, the Dental Corps had reached its ceiling strength and was faced with the prospect of having more graduates than it needed. On 18 July, the War

    107Memorandum, Brig. Gen. W. L. Weible, GSC, Director of Military Training, Army Service Forces, for The Surgeon General, 18 Apr. 1944, subject: War Department Policy Governing Training in Medicine and Dentistry under Army Specialized Training Program.


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Department announced that training would be terminated. Only those who were seniors in July were able to continue, and the dental Army Specialized Training Program came to an end when they graduated in April 1945.

In May 1944, The Surgeon General approved the termination of the veterinary phase of the Army Specialized Training Program. Apparently, the Veterinary Division considered the program no longer necessary, since the Veterinary Corps was near its authorized strength, and having little difficulty in recruiting veterinarians from civilian practice.108

The future of the medical phase of the Army Specialized Training Program was a matter of more concern to The Surgeon General. The collapse of Japan raised the problem of whether the Army should continue the program to meet civilian needs for doctors. Some War Department authorities feared the Army would be criticized for the lack of medical training during the war, while others believed that training should be confined to meeting the future needs of the Army. Maj. Gen. (later Gen.) Brehon B. Somervell, Commanding General, ASF, believed that the Army could not justify continuing expenditures and recommended that medical courses be terminated during the academic year 1945-46. The Surgeon General believed that young medical officers who had received their education at Government expense should be ordered to active duty as replacements for older medical officers with long periods of service.109

Two months after the defeat of Japan, the Medical Department recommended that the program be continued as a source of replacements. In light of past difficulties in recruiting physicians for the Regular Army, it took a dim view of the loss of 5,000 medical officers that would result from terminating the program in June 1946. The Chief of Staff did not agree, and in November 1945, the War Department announced that the program would be terminated on 1 July 1946. With specified exceptions, those scheduled to graduate before 1 July 1946 were to be retained for service. Those scheduled for graduation after that date were to be separated from the program in March 1946. Upon separation, they were transferred to the Enlisted Reserve Corps in an inactive status and subject to recall if they failed to complete their studies. Those who were unable to continue their studies were transferred to other duties and discharged when they became eligible. The medical phase of Army Specialized Training Program came to an end a year after the dental and veterinary phases and permitted the Army to solve many of its postwar personnel problems. Total enrollment in professional courses, and their output, as a result of the Army Specialized Training Program, are summarized in table 3.

Peak enrollment was reached in March 1944, when 21,581 enlisted men were in training: 14,042 in medicine, 6,143 in dentistry, and 1,396 in veterinary medicine. Peak enrollment in preprofessional training was reached in April of the same year, when 4,093 enlisted men were enrolled. Precise figures for total enrollment in

    108See footnote 17, p. 43.
    109(1) Letter, Maj. Gen. I. H. Edwards, GSC Assistant Chief of Staff, G-3, to Prof. Philip Lawrence Harrison, Bucknell University, Lewisburg, Pa., 23 Aug. 1945. (2) Memorandum, Gen. Brehon B. Somervell, Commanding General, Army Service Forces, for Chief of Staff, U.S. Army, 4 Sept. 1945, subject: Future of Army Specialized Training Program. (3) Letter, Maj. Gen. Norman T. Kirk, The Surgeon General, U.S. Army, to the Honorable L. Mendel Rivers, House of Representatives, 16 Oct. 1945.


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    TABLE 3.-The Army Specialized Training Program: Students of medicine, dentistry, and veterinary medicine assigned, separated, discharged, and transferred through curtailment of the program

    Student Status

    Medicine

    Dentistry

    Veterinary medicine

    Assigned

    20,336

    7,734

    1,660

    Separated

    15,216

    3,031

    679

      By graduation

    (13,373)

    (2,458)

    (598)

      By failure

    (1,045)

    (472)

    (41)

      For other reasons

    (798)

    (101)

    (40)

    Curtailment

    5,120

    4,703

    981

      Discharged

    (5,120)

    (4,651)

    (940)

      Transferred

    -----

    (52)

    (41)

    NOTE.-Figures in parentheses are subtotals.

    Source: (1) Fitts, Francis M.: Training in Medicine, Dentistry, and Veterinary Medicine, and in Preparation Therefor, Under the Army Specialized Training Program, 1 May 1943 to 31 December 1945. [Official record.] (2) Letter, Col. Francis M. Fitts, MC (Ret.), to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 15 Nov. 1955.

preprofessional courses throughout the life of the program are not available, but approximately 3,500 were assigned to premedical, about 1,400 to predental, and an unknown number to preveterinary studies.110

Curriculum.-The curriculum adopted for enlisted men in engineering and in area language studies was designed to meet specific requirements of the arms and services. Many traditional college courses, oriented toward scientific or liberal arts degrees, were modified in content, duration, or emphasis to provide soldiers with special skills in the shortest possible time. College credits and academic degrees were secondary and had little military value. ASTP curriculums for medical, dental, and veterinary students were the exception because graduation from a professional school approved by the War Department was a prerequisite for commissioning. Since these schools had accelerated their programs by eliminating long vacations and holidays before the establishment of the Army Specialized Training Program, it was not even necessary to shorten the length of their programs. Contracts, therefore, merely stipulated that the ASTP trainees at these institutions would follow the contractor's standard curriculum under the accelerated program recommended by the national professional association of which it was a member. Schools were unofficially requested to remain in session 48 weeks of each calendar year, since no more than 30 days annual leave could be routinely granted to Army trainees.

Since the Army had accepted the standards of professional schools for graduation, it had little choice but to accept their standards for admission. Success of the preprofessional program, and in the long run, the professional program, depended upon graduates being acceptable for advanced training. Despite these limitations, the Army was able to make significant changes through standardization and acceleration. Standards for admission to accredited medical, dental, and veterinary

    110See footnote 17, p. 43.


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schools had been formulated by professional associations, college accrediting associations, and the schools themselves, long before the establishment of the Army Specialized Training Program. The requirement for admission to medical schools was a minimum of 2 years of college work that included courses in English, physics, biology, and general and organic chemistry. Three years of college were recommended, and a number of medical schools required 4 years. A few required the degree of bachelor of arts or science. Schools were free to expand these requirements, and beyond meeting minimum standards, professional school admission requirements varied widely. Requirements for admission to schools of dentistry and of veterinary medicine were lower, but since only one preparatory curriculum could be adopted for the Army Specialized Training Program, the program had to meet medical school standards.

By the time the Army Specialized Training Program was established, college associations had already paved the way for standardization and acceleration by recommending that professional schools contribute to the war effort by accepting applicants who satisfied minimum requirements for admission. At the request of the Director, Army Specialized Training Division, The Surgeon General invited selected representatives of medical, dental, and veterinary education to a conference in January 1943. This committee recommended that the professional program consist of 30 term hours of required basic courses, and 60 term hours of electives. Required courses were to include 8 term hours of general chemistry, 4 term hours of organic chemistry, and 6 term hours each in English, physics, and biology. Electives were to be restricted to courses in qualitative and quantitative analysis, physical chemistry, comparative anatomy and embryology, psychology, economics, public administration, and a modern foreign language. Completion of the program required six ASTP terms, or a total of 72 weeks.111 The recommendations of this committee were accepted by The Surgeon General and were adopted by the Army Specialized Training Division with only minor changes. The length of the program was reduced to five terms, and basic course requirements were increased to 8 hours in each subject.112

The War Department's decision to compress premedical training into a period of 60 weeks (five ASTP terms) was controversial. The Association of American Colleges contended that the curriculum was overaccelerated; it would result in physical and mental exhaustion, and enter trainees in professional programs before they had matured. Since the program could be completed in five terms if preprofessional students followed schedules comparable to those adopted for other ASTP trainees however, the War Department did not feel that it could justify adding a sixth term. Sixty weeks of ASTP instruction was considered to be the equivalent of at least 64 weeks (2 academic years) of peacetime college work.

The sequence of courses under the Army Specialized Training Program was a marked departure from traditional patterns of training. Customarily, students in

    111In Letter, Brig. Gen. Larry B. McAfee, Acting The Surgeon General, to Officer in Charge of Army Specialized Training Program, 2 Jan. 1943, subject: Pre-Medical and Medical Education, inclosure thereto. Report of Advisory Committee on Medical Sciences Part of the Army Specialized Training Program.
    112Army Service Forces Manual M 108, Catalog of Curricula and Courses, Army Specialized Training Program, March 1945.


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preprofessional programs began specializing as early as their freshman year, with no assurance that they would eventually be admitted to a school of medicine or dentistry. There was no way to coordinate the number of preprofessional students with the number of vacancies in professional schools, and as a result, large numbers of students who had completed premedical programs annually competed for a limited number of medical school vacancies. The training of unsuccessful candidates was either wasted or adapted to other fields.

The Army attempted to avoid wasting talent and manpower by assigning all trainees to a common curriculum in which they studied English, physics, and general chemistry. Candidates for preprofessional training were then selected from among those who had proved their academic competence by completing the first two or three terms of the ASTP basic curriculum, or a year of college before entering the service.113 The number of trainees selected to complete the remaining course in the preprofessional curriculum was limited by the number of professional school vacancies reserved for the Army, with an allowance for dropouts and failures. Those who were not selected for preprofessional training were allowed to continue in other phases of the Army Specialized Training Program.

Selection of schools.-Selecting schools to participate in the medical phases of the Army Specialized Training Program was never a major problem, because the choice was limited to those accredited by the American Medical Association.114 By the time the Army Specialized Training Program was established, members of the Officers' Reserve Corps, the Medical Administrative Corps Reserve, and the Enlisted Reserve Corps were attending all of these schools except the Woman's Medical College of Pennsylvania, Philadelphia, Pa. Since the problems involved in transferring the academic credits of these men to a few select institutions were considered insurmountable, the Army chose to make arrangements for contract instruction at all approved medical, dental, and veterinary schools.

Race and religion presented special problems. Because of its policy of honoring the admissions of schools which had accepted students for classes beginning in 1943 and 1944, the Army was unable to reject Negroes who had been accepted by predominately white schools. This could be done only when the Army had full control of freshman vacancies. At the same time, many schools were worried that Army control of vacancies, and the Army procedure of assigning students by number instead of by name, would lead to unwanted integration. Col. Francis M. Fitts, MC, Director of Military Training, ASF, explained these problems and their solution at The Surgeon General's conference with chiefs of the medical branches of the service commands in mid-1943:115

 ** * Negro trainees now accepted by Chicago or Harvard will be sent to those schools by which they had been accepted. When Chicago and Harvard reserve for the Army a certain percentage of vacancies we will not send Negro trainees there. That has been the point which has given some concern to some schools and is one which you cannot decide absolutely or say that an order will not be made; but if it is made, it will be rectified.

    113War Department Memorandum No. W350-112-43, Army Specialized Training Program Professional and Preprofessional Training General Information and Procedures for Selection of Personnel, 29 Apr. 1943.
    114See footnote 17, p. 43.
    115Report of The Surgeon General's Conference with Chiefs, Medical Branch of Service Commands, Washington, D.C., 14-17 June 1943.


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As a result of these policies, enrollment in medicine and dentistry at Howard University and Meharry College, Nashville, Tenn., was limited exclusively to Negroes, and Negroes were not selected for other colleges unless they had already been admitted by the individual school. In any case, enrollment of Negroes was to be limited, because the Medical Department did not plan to expand its use of these officers, and needed only about 40 replacements a year for those already on active duty. With about 380 Negro medical students already enrolled in the Medical Administrative Corps, the Medical Department had a 10-year supply of replacements and believed it could not justify extensive training of this racial group. A small group of trainees were sent to Negro colleges late in 1944, but reservations for 1945 were canceled. Enrollment at the College of Medical Evangelists, Loma Linda, Calif., a Seventh-Day Adventist School, was similarly limited to members of that faith.116

The selection of colleges for preprofessional programs was more complicated. Reports compiled by the Association of American Medical Colleges, on the performance of freshman medical students admitted from more than 500 colleges and universities between 1931 and 1941, served as a basis for evaluation. The names of schools whose past performance and capacity indicated that they were capable of acceptably training a class of at least 50 preprofessional. students were then submitted for clearance to the Joint Army-Navy Manpower Commission Committee for the Selection of Non-Federal Institutions. Final selection for participation in the preprofessional program required that total ASTP enrollment at the school, in all programs, be sufficient to allow the formation of an Army specialized training unit with a strength of 200 to 250 trainees.

The number of schools at which preprofessional programs could be established was limited by the number of students assigned to the program. Initial estimates called for the enrollment of 8,000 students, and the selection of 90 institutions for possible contracts. This estimate, however, was based on the assumption that enlisted men would be enrolled for preprofessional studies during their first term. The decision to enroll all ASTP trainees in a common program until the end of their second term reduced the number of men to be classified as preprofessional trainees to 5,400. This level of enrollment, which would have been reached in September 1944, allowed the establishment of preprofessional programs at 52 institutions.

Contracts.-Government contracts with colleges and universities for ASTP professional and preprofessional programs were negotiated through the service commands. In contracts with medical and dental colleges, the Government agreed to allow schools to continue training ASTP and Reserve students who were already enrolled, or who had been accepted for enrollment in classes beginning before 1945. In each class beginning in 1945 and subsequent years, the schools agreed to reserve a specified number of vacancies for Army trainees. By an agreement with the War Manpower Commission, the combined enrollment of ASTP and V-12 trainees after 1944 was limited to 80 percent of incoming freshman classes: 55 percent to the Army and 25 percent to the Navy. The remaining 20 percent was reserved for

    116See footnote 115, p. 83.


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women and men who were not eligible for military service. Thirty-five percent of the capacity of dental schools was allocated to the Army, and 25 percent to the Navy. No contracts were made for the reservation of freshman vacancies in veterinary schools. The Army was required to give 60 days' notice if it was unable to fill reserved vacancies.

In April 1944, when the basic phase of the Army Specialized Training Program was discontinued, it became apparent that the Army would be unable to fill the freshman vacancies it had reserved. The number of men selected for professional training was only adequate to fill half of the vacancies reserved for 1945, and there would be no new trainees in subsequent years. Contracts were therefore revised to reserve only 28 percent of the capacity of medical schools, and 18 percent of the freshman dental capacity. The number of institutions under contract remained unchanged.

To compensate the school for the staff, facilities, equipment, and supplies it provided, the Government agreed to pay the equivalent of nonresident tuition for each trainee enrolled. Special provisions were made for a small group of schools whose normal tuition was significantly below the national nonresident average. The Army also agreed to pay incidental fees normally paid by students. No payment was made for registration fees, enrollment fees, and "good-faith" deposits. The textbooks, instruments, and supplies required by trainees were purchased by the Government and issued, or reissued, to trainees on receipt. Textbooks issued to freshman trainees remained in their possession until the completion of training. Instruments which could be obtained on a rental basis, such as microscopes, were not purchased. Instructional supplies and equipment which were not standard throughout the program were purchased for the Government through the contracting school, which was allowed a small handling charge.

The average monthly cost of professional training per trainee is shown in table 4.

Contracts for preprofessional training were similar to those for other ASTP programs. Payment was made on a cost basis computed for the rental and maintenance of facilities (classrooms, laboratories, dormitories, and messhalls) and for proportional salaries of faculty members actually engaged in the instruction of Army trainees. All contracts were subject to renegotiation each term.

The average monthly cost per trainee for instruction under the preprofessional curriculum was $52.31.

    TABLE 4.-Average monthly cost of professional training per trainee

Item

Medical

Dental

Veterinary medicine

Tuition and instructional fees

$51.00

$38.00

$26.70

Textbooks and instruments

$7.15

$4.84

$4.40

Instrument rental

$4.32

$18.26

$2.40

    Total

$62.47

$61.10

$33.50


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Preprofessional trainees were housed and messed by the contracting institution. In most medical, dental, and veterinary medicine schools, however, group housing and messing facilities could not be provided. Many medical and dental schools had no university housing and were located in densely populated metropolitan areas where common housing and messing were impractical. At other schools, the wide dispersion of trainees for clinical training during their junior and senior years made it undesirable. As a result, most ASTP medical, dental, and veterinary trainees were paid commutation allowances for quarters and rations. At schools in which group housing and facilities were available, many regulations, including restrictions on late study, had to be relaxed.117

Academic standards.-When the program was established, the Army accepted all enlisted men then enrolled in approved professional schools. It similarly accepted enlisted men who had been admitted to freshman classes entering approved schools in 1943 and 1944. Thus, for the first 2 years of the program, standards for selection were set by individual schools. Many of these students could not have been accepted under Army standards. The AGCT (Army General Classification Test) was given to all enlisted men when they came on active duty. A minimum AGCT score of 115, plus graduation from high school, were the prerequisites for assignment to the Army Specialized Training Program. When members of the Enlisted Reserve Corps and Medical Administrative Corps Reserve enrolled or accepted by medical, dental, and veterinary schools were called to active duty in mid-1943, nearly 9 percent of the Army trainees in medical schools, 22 percent in dental schools, and 18 percent in veterinary schools failed to achieve the AGCT score of 115. These percentages did not include students accepted by the two accredited Negro schools, where 35 percent of the medical students and over 60 percent of the dental students failed to achieve a qualifying score.118 Because of the Army's commitments, students accepted by individual schools for classes beginning in 1943 and 1944 had to be exempted from basic ASTP standards. Enlisted men assigned for preprofessional or for professional training by the Army, however, were required to meet minimum standards.

To remain in the professional program, trainees were required to meet the individual school's standards for continuation and graduation. Students were permitted to repeat courses only if failure was explained by illness, injury, or official Army orders. Failure in any subject, not satisfactorily explained by extenuating circumstances, resulted in separation from the program. Trainees so separated were ineligible for reassignment to the Army Specialized Training Program. The majority of the medical, dental, and veterinary trainees separated from the program, other than by graduation, were assigned to the Medical Department for further training and for service as medical soldiers.119 In setting standards for the preprofessional program, the Army accepted the policy established at a majority of the accredited professional schools and required an overall "C" average.

    117Army Service Forces Manual M 105, Army Specialized Training Programs, 3 Apr. 1944.
    118Compilation of the number of ASTP students at various universities who fell below the Army General Classification Test passing score of 115 by Medical Section, Curricula and Standards Branch, Army Specialized Training Division, 3 Sept. 1943.
    119See footnote 117.


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The selection of the enlisted men for assignment to vacancies reserved by the War Department in classes beginning after 1944 required more elaborate procedures. In general, candidates were chosen from trainees completing term 2 and term 3 of the basic ASTP curriculum (B-1), who were then transferred to the preprofessional curriculum for the completion of their premedical training. Applicants for admission to the preprofessional program were required to pass a preliminary screening test known as the Aptitude Test for Medical Professions before they could be sent to unit classification boards for interviews.120

The Aptitude Test for Medical Professions was prepared for the War Department by Drs. Fred A. Moss and Thelma Hunt under the direction of a committee of the Association of American Medical Colleges. Dr. Moss and this committee had previously designed and administered the Scholastic Aptitude Test for Medical Colleges (Medical Aptitude Test) which was used by the admissions committees of a majority of medical schools. The applicant's score on the Medical Aptitude Test had served as a basis for admission in conjunction with academic records, letters from professors, and personal interviews. The test had not been used extensively in the selection of dental students.

In the Army Specialized Training Program, the Aptitude Test for Medical Professions was used primarily to limit the number of candidates who would be presented to unit classification boards for interviews. Usually, minimum scores were set at a point that required boards to interview three times the number of candidates they would ultimately select. Representatives of contracting medical and dental schools within each service command served as consultants, and conducted ASTP classification board interviews to determine whether candidates were qualified and acceptable. After being interviewed, candidates were assigned to one of four categories: fully qualified and acceptable; acceptable, but not of the highest qualifications; acceptable; or not satisfactory and not acceptable. As far as possible, units were assigned from candidates classified as fully acceptable. Reports of qualified candidates in excess of unit quotas were forwarded to the Army Specialized Training Division.

Since preprofessional trainees were selected before they had taken courses in biology and in organic chemistry, a second screening was required in the final term (term 5) of the preprofessional curriculum. This second screening resulted in an elimination from the program of 173 enlisted men, or 7.2 percent of the 2,401 previously selected for training in medicine.

Because of the abrupt termination of all but a few special purpose programs in early 1944, only four groups of candidates were able to take the Aptitude Test for Medical Professions. Trainees in the first three groups tested were screened and selected for professional training by routine procedures. Since it was impossible to interview members of the group tested on 16 February 1944, before the basic program was brought to a conclusion, the 500 candidates with the highest scores were arbitrarily transferred and interviewed during their first term in the preprofessional program. Those found unacceptable for medical or dental training were offered the opportunity to study Japanese.

    120 Herge, Henry C.: Wartime College Training Programs of the Armed Services. Washington: American Council on Education, 1948.


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Trainees who graduated in medicine and were commissioned in the Medical Corps, AUS, or the Medical Corps Reserve, were not called to active duty until they had completed their civilian hospital training. This training, in an inactive-duty status, consisted of 9 months of hospital internship for all, an additional 9 months as assistant residents for a maximum of one-third, and a further period of 9 months as residents for one-sixth of the original group. When called to active duty, they were assigned for 6 weeks' intensive field training at the Medical Field Service School, Carlisle Barracks, and 6 weeks of training in Army hospital procedures and administration in general hospitals in the Zone of Interior.

In 1945, The Surgeon General recommended that, effective on 1 April 1946, all medical officers still in an inactive status be called to active duty from previously authorized civilian hospital residencies and assistant residencies, and that those serving hospital internships be activated upon the completion of 12 months of intern training. This change in existing procedures was adopted, with the concurrence of the War Manpower Commission, to allow these positions to be filled by veterans whose hospital training had been interrupted.

Military and physical training.-All ASTP trainees, except those in medicine, dentistry, and veterinary medicine, were required to participate in 6 hours of military training and 5 hours of physical training. For men in the professional program, the military training requirement was reduced to 3 hours, and physical training was eliminated. These exemptions were granted because it was difficult to crowd an extra 9 hours of training into the accelerated programs of professional schools without using time needed by trainees for their studies. Moreover, almost every medical, dental, and veterinary school lacked the gymnasiums and athletic fields required for a physical training program. In units where such facilities were available, trainees were encouraged to engage in physical exercise. Military instruction outside the classroom was usually conducted in streets, vacant lots, and parks.

At first, military instruction was based on the program previously used by medical units of the Reserve Officers' Training Corps. Later, it was modified to be used both for enlisted men who had completed basic training and by those who had been assigned directly to the Army Specialized Training Program. In July 1944, a program of branch immaterial training was established to allow students to be trained by nonmedical officers.121 Under this program, branch training was given to students in a 6-week course at the Medical Field Service School, followed by 6 weeks of training at a Zone of Interior hospital after they had been commissioned and served their hospital internship.

EDUCATIONAL TECHNIQUES AND PROBLEMS

Despite their number and variety, Medical Department training programs shared many common techniques and problems. Facilities and equipment had to be

    121(1) Army Service Forces Manual M 107, Military Training Program for ASTP Trainees and ASTRP Students, 2 June 1944. Change No. 1, dated 17 July 1944. (2) See footnote 117, p. 86.


89

provided, instructors had to be selected and trained, and educational techniques had to be geared to an accelerated program.

Facilities and Equipment

The expansion and acceleration of officer training programs created a corresponding need for an expansion of training facilities. At Carlisle Barracks, extensive construction was required to prepare the Medical Field Service School for its role in training commissioned and noncommissioned officers. During the first half of 1940, barracks were built to house 125 men, and the school received an appropriation of $375,000 for the construction of a new permanent school building.122 The training area was expanded to include 220 tent platforms, 14 lavatories, a 400-man messhall, and buildings for storage and administration. The following year, construction began on 18 barracks (63-man), two temporary classroom buildings, and a variety of overhead buildings. Most of these were intended for use by officer candidates, but were eventually used for student officers as well.123 At the Army Medical Center, construction was limited to two new officers' barracks.124

While helpful, this construction in no way prepared the service schools for the expansion that lay ahead. By mid-1941, the Medical Field Service School had been required to increase its capacity from approximately 100 officers to 6,000, and that of the Army Medical Center increased from approximately 100 to 1,200.125 Construction did not expand space. To increase the output of schools, courses were shortened, classes were staggered at intervals of as little as 2 weeks, and year-round use was made of existing facilities. During 1941, for example, classes at the Medical Field Service School were conducted in the gymnasium while the new school was under construction.126 Both schools found it difficult to house their expanded enrollment, and students were encouraged or required to live off-post.127

Construction undertaken in 1940 and 1941 solved many of these problems, but others persisted throughout the war. By mid-1942, the Medical Field Service School was able to report that existing facilities were adequate for its program,128 but continued, even after 1942, to resort to expedients. The new classroom building, for example, was designed to hold only 200 students at a time, and it was necessary to continue using the gymnasium as a classroom and auditorium.129 Both the Army Medical Center and the Medical Field Service School had to terminate programs to allow the expansion of others.130 In some instances, it was necessary to establish new special service schools, which usually encountered difficulties similar to those experienced by the parent schools.

    122See footnote 1, p. 36.
    123See footnotes 6, p. 37; and 21, p. 44.
    124Annual Report, Headquarters, Army Medical Center, Washington, D.C., calendar year 1940.
    125See footnote 5 (2), p. 36.
    126See footnote 21, p. 44.
    127(1) See footnote 10, p. 39. (2) Annual Report, Commanding General, Headquarters, Army Medical Center, Washington, D.C., 1942.
    128See footnote 22 (2), p. 45.
    129See footnote 50 (2), p, 58.
    130(1) See footnote 77 (1), p. 65. (2) Annual Report of The Surgeon General of the Army for the Commanding General, Army Service Forces, fiscal year 1943.


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Instructional Staff131

Instructors in the Medical Department officer training program can be divided into two categories: those concerned with the military aspects of medicine, and those concerned with the technical phases of medicine, dentistry, veterinary medicine, and related sciences. Instructors in the first category were necessarily graduates of the courses they taught, while those in the second were usually men who had become specialists through extensive study at civilian institutions. Each was selected by different procedures.

Instructors in military subjects.-With minor variations, the pattern of selecting and training instructors for military subjects at the Medical Field Service School was typical of all military programs. Until a supply of officers returning from overseas became available, instructors were selected from among candidates who had demonstrated leadership ability during their own training. Responsibility for recognizing potential instructors among trainees at the school rested upon individual department heads, who interviewed promising candidates and selected those who would remain at the school for further training. As overseas returnees became available, fewer students were retained for teaching assignments, and officers with combat experience were selected for faculty assignments.

Until 1944, the training of new instructors was almost exclusively a departmental responsibility. Candidates were oriented through conferences with veteran members of their department, by studying materials used by the department, and by observing other instructors in the classroom and in the field. New teachers were required to present lectures in front of experienced instructors before being allowed in the classroom. When it was considered necessary to give them experience in handling troops, they were temporarily attached to the demonstration battalion at Carlisle Barracks.

In 1944, departmental indoctrination of new teachers was supplemented by an instructor guidance course conducted by the Training Department. This course, established at all ASF training centers, was designed to familiarize new or potential instructors with approved teaching techniques, and with procedures for selecting materials and making lesson plans. At the Medical Field Service School, the establishment of an instructor guidance program did little more than elevate existing procedures to the status of formal requirements.

At the Medical Field Service School, as at other military training facilities, the major staff problem was not selection and training, but retention. Between June 1942 and June 1944, for example, the annual rate of replacement at the school exceeded 40 percent. This lack of stability in instructor assignments created a need for constant selection and training of new personnel.132

Instructors in technical subjects.-Vacancies in technical teaching positions could not be filled through on-the-job training, or intensive short courses. The specialized skills required for these positions could be acquired only through extensive study or experience. Neurosurgery, for example, could be taught only by

    131See footnote 10, p. 39.
    132See footnotes 22 (2) and (8), p. 45.


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a qualified neurosurgeon, and the parasitology of tropical diseases could be taught only by an expert in the field. Instructors in technical subjects had to be selected in much the same manner as instructors at civilian colleges. Instructors were selected by the Military Personnel Division of the Office of The Surgeon General according to the specific requirements for each position. In some instances, the commandants of schools were able to request specific individuals who had gained reputations in a field as civilians, and preference was given to men who had been college instructors before being commissioned. Once hired or assigned to a position, instructors were indoctrinated through conferences with veteran members of the staff at each school.

Each technical course or school had different requirements, and filled its staff from different sources. At the Medical Supply Services School, for example, key instructors in the Officers' Supply Division were staff officers at the St. Louis Medical Supply Depot. Instructors in the Maintenance and Repair Division were civilians who had been sent to the depot by large manufacturing firms and were later commissioned and formally assigned to the staff. Instructors in the Optical Division were opticians. Most of the instructors at the Army Medical Center were staff officers who were assigned additional duties as teachers. As a result, the Army Medical Center also experienced difficulties in staff retention.133

Educational Techniques

In training officers to perform the varied duties of the Medical Department, a wide variety of techniques were employed. Courses designed to provide trainees with military skills usually employed standard military techniques. Those designed to impart technical skills varied as widely as the skills themselves.

Class organization.-Class organization varied according to the number of trainees enrolled, and the degree to which drill, road marches, and field problems were part of the curriculum. In a course such as the Officers' Basic Course at the Medical Field Service School, drill and field problems played a large role, and classes were organized into battalions, companies, and platoons. Faculty members selected for their military ability were assigned as platoon leaders, class directors, and battalion commanders. These officers usually supplemented the technical instruction given by the school's academic departments with training in military subjects and were responsible for details such as messing, housing, and supplying units under their command.134

In courses involving purely technical subjects, class organization differed little from that of typical civilian colleges. At the Army Medical Center, for example, selected students were appointed as "monitors" and made responsible for details such as keeping attendance records. Because of the relatively small numbers attending such courses, formal organization into companies and battalions was not considered practical.135

    133(1) Annual Report, Technical Activities, Medical Department Professional Service Schools, Army Medical Center, Washington, D.C., fiscal year 1941. (2) See footnotes 21, p. 44, and 22 (2), p. 45.
    134See footnote 21, p. 44.
    135See footnote 10, p. 39.


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Teaching methods.-Service schools conducting courses for Medical Department officers followed approved military teaching techniques as closely as possible. In general, these consisted of the lecture, the conference, the demonstration, and the practical exercise. The frequency with which any one method of presentation was utilized varied with the content of the course.

Courses such as the Officers' Basic Course, the Special Cadre Course, and the National Guard and Reserve Officers' Course used much the same techniques as those employed by the MAC Officer Candidate School, and a report by one of these schools best illustrates their application. Courses emphasizing principles of command, organization, and administration relied heavily upon conferences, demonstrations, and practical exercises. Conferences and lectures were used solely to introduce and develop subject matter, but practical exercises which emphasized learning by doing rather than by listening were the preferred technique. Whenever possible, demonstrations and practical exercises were used exclusively. The Medical Field Service School, for example, had utilized demonstration troops since 1921.136 The 1st Medical Regiment was assigned to Carlisle Barracks as a demonstration unit until 1940, when it was replaced by the 32d Medical Battalion. The battalion was used to demonstrate the operation of medical field installations and the employment of specialized equipment used in emergency medical treatment and field sanitation.137

In highly technical courses, lectures and conferences were used in conjunction with practical exercises; such as, working in laboratories, participating in hospital rounds, and assisting in operations. In neurosurgery, for example, academic reviews of the anatomy of the nervous system were followed by neurological examination of patients. In thoracic surgery, lectures and demonstrations on the fundamentals of surgery were balanced by experience in assisting at operations and anatomical dissections of the thorax. In surgery of the extremities, cadaver surgery was practiced, with special emphasis on the surgical approaches to the treatment of fractures. The course in anesthesiology consisted almost entirely of applied work138

The courses at the Medical Supply Services School, although different in content, were conducted along similar lines. In the Officers' Supply Division, lectures and conferences on Medical Department supply functions were followed by practical exercises on the methods of handling supplies. Instruction in the Maintenance and Repair Division of the school consisted largely of on-the-job experience with X-ray equipment, sterilizers, gas anesthesia apparatus, oxygen therapy appliances, and other technical equipment. In the Optical Division, courses were essentially designed to provide experience in the operation of optical repair equipment.139

In sum, courses for Medical Department officers were designed to provide them with skills that had immediate application in the operation of field medical

    136See footnote 22 (7), p. 45.
    137Hume, E. E.: Training of Medical Officers for War Duty. War Med. 1: 642-643, September 1941.
    138Memorandum, Lt. Col. Sanford V. Larkey, MC, Chief, School Branch, Training Division, Office of The Surgeon General, U.S. Army, to Col. Frank B. Wakeman, MC, Director, Training Division, Office of The Surgeon General, U.S. Army, 12 Mar. 1943, subject: Report of Inspection of Training Courses for Medical Department Officers at Civilian Institutions.
    139See footnote 26 (2), p. 48.


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installations. Courses stressed application, rather than theory, and were designed to provide a maximum of practical work.140

Training aids.-Training aids played a major role in converting theory into applicable knowledge. Items classified as training aids ranged from pictures, films, and demonstration units to areas set aside for demonstrating field sanitary equipment, and infiltration courses. Drill fields, obstacle courses, and bivouac areas fell into this category, as well as rubber moulages of wounds, scale model compasses, and other devices used to provide visual assistance.141

In military courses, audiovisual aids were used extensively. These included War Department filmstrips, film bulletins, and training films. Most service schools operated auxiliary film libraries, to make them continuously available.142 Charts, diagrams, and posters were prepared for use in lectures and conferences. Some, such as graphic portfolios on first aid and map reading, were prepared at higher echelons for distribution to all schools. Others were prepared at the schools for use in specific lessons. The Medical Field Service School maintained an art department, and the operations officer was made responsible for scheduling the use of aids, for having aids on display, and for training and supplying projectionists.143 Field manuals, training manuals, and other War Department publications were used almost exclusively as texts in military subjects.

Since technical courses covered a broad range of subjects, the training aids and equipment used in each course were different. Just as sanitary areas and obstacle courses were considered training aids in military courses, the laboratories, operating rooms, and medical and surgical wards used to enhance training were considered training aids for technical courses. The same definition was frequently applied to cadavers used in surgical courses, and patients treated in medical courses. In the Maintenance and Repair Course at the Medical Supply Services School, the equipment used and items repaired fell into the same category. Visual aids used in technical courses included anatomical charts and diagrams and pictures projected on photographic screens.144

Standard medical textbooks were assigned in most technical courses, but in a few a combination of War Department publications and special texts was used. The Maintenance and Repair Division and the Optical Division of the Medical Supply Services School used special texts prepared by the instructors in these divisions to supplement material in War Department publications. The special textbook issued for the Maintenance and Repair Course was issued in three volumes totaling 2,200 pages, and the textbook for the Optical Course was a volume of approximately 300 pages.145 These special textbooks were used for enlisted men, as well as for officers, and were similar to those prepared in schools for enlisted technicians.

Tests and critiques.-Written examinations were used as measures of student achievement, as instructional devices, and as a means of checking the effec-

    140See footnote 138, p. 92.
    141See footnote 22 (8), p. 45.
    142See footnote 26 (2), p. 48.
    143See footnote 10, p. 39.
    144See footnote 138, p. 92.
    145See footnote 26 (2), p. 48.


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tiveness of instruction. At most schools, the construction of tests was a departmental responsibility. At the Medical Field Service School, test questions, prepared by the instructors who presented the material in a given class, were submitted to department directors for approval or modification before being incorporated into an examination. Schools relied almost exclusively on objective examinations, consisting of true-false, multiple choice, and completion questions. The same tests were often used for succeeding classes and, therefore, were not returned to the student for study and analysis. Instead, tests were reviewed in class, and doubtful points were clarified. Students who failed were scheduled for conferences on their individual problems. When an unusually high number of students failed, the test was reevaluated.

Supervision and inspection of instruction.-To insure a continuing quality of instruction, department heads or officers corresponding to department heads were charged with responsibility for supervising the performance of instructors on their staff.146 The most widely used technique of supervision and evaluation was a personal visit to the classroom. There was no set schedule for observing instructors, and periodic reports were not required on instructors doing satisfactory work. New instructors were frequently visited, and reports on those whose performance was inadequate were forwarded to the assistant commandant of the school. When necessary, instructors were relieved. From time to time, officers senior to the department head visited classes to check on his evaluations.

Representatives of higher echelons periodically inspected special service schools and civilian schools employed by the Medical Department. Inspection reports included comments on the school's facilities, teaching staff, methods of instruction, training aids, and trainees, and enabled higher echelons to compare schools and maintain an Army-wide standard of training.147

Trainee Quality

Schools conducting courses for medical, dental, and veterinary officers had the good fortune of receiving trainees of consistently high quality. While marked differences in background and ability existed between trainees, all were graduates of approved professional colleges. Schools for such officers had to cope with few of the problems confronting training centers established for other categories of personnel.

Among medical, dental, and veterinary officers, attrition rates were low. Samples taken during the first 2 years of the war revealed a gross attrition rate of 5.6 percent in professional courses and 4.9 percent in military courses. Studies of these rates are incomplete, but available data indicate that at least half of the trainees who failed in technical courses, and approximately 25 percent of those who failed military courses, failed because they were recalled to their units before they could complete enough work to be credited with passing the course.

    146See footnote 10, p. 39.
    147Army Service Forces Manual M 4, Military Training, 20 Sept. 1944.


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In most other instances, age and inadequate background seem to account for failure. A study conducted in the Tropical Medicine Course revealed that students over 40 years of age, who represented only 14 percent of the trainees enrolled, accounted for 64 percent of the failures in the course. Older students, long removed from intensive study, seemed to have found it more difficult to assimilate the material presented in accelerated programs. A second study of this program uncovered a high incidence of failures among graduates of less prestigious medical schools.148 Graduates of these schools frequently lacked skill in laboratory techniques and the background to absorb highly technical subjects. Studies of failures in military courses are less complete and do not isolate groups with a high incidence of failure.

Although the principles of medicine and surgery are the same in military and civilian life, the conditions under which they are practiced are radically different. The military physician and surgeon must be able to deal with mass casualties, often under combat conditions. To perform on the field of battle, the surgeon requires an understanding of evacuation procedures, the medical equipment and treatment available at each stage in the chain of evacuation, and the limitations of field medicine and surgery. He must also understand the relationship of field medical service to the combat arm it serves, the tactical employment of medical units, and the principles of medical supply. Administrative and tactical courses conducted at the Medical Field Service School, and other service schools, were designed to provide the Army physician with the basic knowledge required for field service. Other more technical courses were designed to provide him with the skills needed to engage in restorative treatment of battle casualties in rear echelons, or to combat the diseases which have traditionally ravaged armies in garrison and in the field.

Three facts testify to the caliber of service provided by the Medical Department in World War II: The recovery of 97 percent of all hospitalized battle casualties, the control of a number of diseases which had caused high rates of noneffectiveness in past wars, and the absence of major epidemics.149

An important factor in the improvement of surgical care was the development of new facilities and procedures for evacuation of casualties, and a knowledge of how to use them. Similarly, improved approaches to the treatment of neuropsychiatric breakdowns and increased attention to reconditioning casualties returned many men to duty who would have been lost to the Army in earlier wars. Improved immunizing agents, and techniques for controlling disease-bearing insects, were applied with marked effect against such diseases as dengue fever, typhus, typhoid fever, and malaria. These successes cannot be attributed solely to training; advances in medical science and education played a major role. But it was training in military procedures that allowed members of the Medical, Dental, Veterinary, and Sanitary Corps to apply their knowledge to military problems.

    148See footnote 10, p. 39.
    149Medical Department, United States Army. Surgery in World War II. Thoracic Surgery. Volume I. Washington: U.S. Government Printing Office, 1963.

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