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Chapter X

Contents

CHAPTER X

Utilization of Personnel

ASSIGNMENT OF MEDICAL DEPARTMENT PERSONNEL

The accuracy of classification in large measure determined the adequacy of assignment, which was in turn the key to maximum utilization of the tremendous reservoir of skills and experience that made up the Army Medical Department in wartime. Only because the classification of both officers and enlisted men-but particularly that of medical officers, including proficiency ratings-was by and large an outstanding accomplishment, was it possible to place a very high percentage where each individual's greatest potential could be realized.

The Surgeon General actually had assignment jurisdiction over only that small percentage of Reserve officers who belonged to the Army and Service Assignment Group. During the emergency period and until the creation of the Services of Supply in 1942, he assigned officers to all named general hospitals (of which there were 15 by the end of 1941, 10 of them having been established since the beginning of the emergency), medical supply depots, and the Medical Field Service School. Most Reserve officers, however, were in the Corps Area Assignment Group, under the assignment authority of the commanding generals of the corps area, who acted on the advice of their staff surgeons. This division of authority did not ordinarily prevent a proper distribution of assignments. The Surgeon General could communicate with the corps area surgeon through the latter's commander and tell him what types of personnel could be made available to him. If the corps area had vacancies for such personnel, the surgeon could then take steps to obtain them from outside the corps area.

The Problem of Proper Assignment, 1939-41

An officer's assignment was not always, or entirely, based on his classification, nor was he always kept fully occupied in the position for which he was best fitted. This gave rise to complaints of misassignment.

Letters from officers, and from civilians as well, told not only of the misuse of skills-they told, too, of the waste of physicians' time in idleness. Medical associations showed their concern by forwarding copies of these letters to the Surgeon General's Office.1 That Office's reply to such criticisms was that there

1(1) Letter, Mrs. Margaret Black Warres, Harrington, Del., to Brig. Gen. Frederick Osborn, USA, Washington, D.C., 26 Nov. 1941. (2) Letter, Thomas A. Hendricks, Executive Secretary, Indiana State Medical Association, Indianapolis, Ind., to Olin West, M.D., Secretary, American Medical Association (and others), 12 Feb. 1941, with enclosure thereto.


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would be small demand for some specialties during the training program; the soldiers were of an age at which very little surgery, for example, was necessary. The picture, however, would change entirely if we became engaged in war.2

There was little the Medical Department could do to keep many of these specialists constantly engaged in their own fields. A higher proportion of certain types of specialists existed in civilian life than the Army required (obstetricians, for example); consequently, some specialists had to perform duties outside their specialty. Attempts were made to assign them so that they could do some work in their special field, and they were assigned to hospitals whenever possible. For a time, the position of specialists within the National Guard was particularly hard. They were inducted with the regimental medical detachments of which they were members and restrictions on their reassignment prevented their transfer, even if outstanding specialists, from these units into hospitals giving the type of treatment where full use of their professional skill could be made. This restriction was not removed until September 1941.3

The problem of proper assignment was further complicated by the necessity of finding a place for certain officers of the Reserve and the National Guard who had been promoted to a rank higher than their professional capabilities. Finally, the shortage of medical administrative officers until well after Pearl Harbor compelled the employment of doctors, dentists, and veterinarians in administrative duties to a greater extent than was the case later on. However, the professional groups in the Army, as in civilian life, could at no time completely escape certain administrative functions.

Sometimes the cause of inappropriate utilization lay with the Medical Department, sometimes it was outside its control. Especially in the days of building camps, recruiting personnel, and obtaining equipment, the matching of need with supply was an intricate and at times impossible task. No doubt, the Medical Department sometimes erred on the side of safety. If, for example, medical officers arrived at a camp before other men and equipment, it was probably because the Department judged it better to have physicians present beforehand than to risk being without them when men needed treatment.

To prevent medical officers serving in field units from losing their skill, a plan of rotation was promulgated in February 1941; it provided that after an officer had spent 6 months in a fixed installation he could take a refresher course and be assigned to a tactical unit, or vice versa.4 The plan affected few officers, however. It was voluntary, and although the Office of The Surgeon General was swamped with requests for transfers from field units to fixed installations, almost no one requested transfer in the opposite direction; hence, the system proved unworkable.

2Letter, Col. George F. Lull, Office of The Surgeon General, to Dr. Edwin F. Lehman, Department of Surgery, University of Virginia, Charlottesville, Va., 25 Nov. 1941.
3Letter, The Adjutant General, to Commanding Generals of all Armies, Army Corps, Divisions, (and others), 19 Sept. 1941, subject: Transfer and Reassignments-Officers of National Guard of United States.
4
Letter, The Adjutant General, to Commanding Generals, all Armies and Corps Areas, 4 Feb. 1941, subject: Rotation of National Guard and Reserve Medical Department Officers.


291

Misassignment

Officers

Some of the same factors that hindered proper classification-rapid procurement during the summer of 1942, insufficient information concerning the professional qualifications of the doctors procured, and lack of experience, with the established procedure-doubtless interfered with proper assignment; that is, the placement of officers in jobs that called for their best talents and that they were physically qualified to fill. In the fall of 1942, the Committee to Study the Medical Department as one of its "major findings" stated that it had heard numerous complaints of misassignment of professional personnel by the Medical Department, involving for one thing "the assignment of doctors, either part or full time, to clerical or other administrative duties." Under established practice, however, most of these duties were the direct responsibility of Army medical officers.

Although the committee heard complaints about "the assignment of specialists to the practice of general medicine or of other specialties not their own,'' the specialty boards themselves were on the whole well pleased and were of great assistance to the Personnel Service. The Chief of The Surgeon General's Personnel Service received conclusive evidence of this in replies to queries he had directed to them late in 1942-the great majority of officials replying for the boards expressed satisfaction with the classification and assignment performed by the Surgeon General's Office.5 Spokesmen for the Army neuropsychiatrists asserted that, in spite of constant effort to keep neuropsychiatrists in jobs devoted to their specialty, the younger graduates were often assigned as general practitioners to ground force units or organizations alerted for oversea movement. The critics attributed this to The Surgeon General's lack of power to reassign medical personnel within certain commands, which made it impossible for him to compel proper use of these specialists. They compared the Surgeon General's Office to a fire department that procured and pumped water through a hose but was denied the right to direct the nozzle at the fire.6

It is true that The Surgeon General lacked authority for some time to order the reassignment of personnel within any service command, the Air Forces, the Ground Forces, or the oversea theaters. So far as reassignment within the service commands was concerned, however, the trouble was perhaps not entirely the want of authority on the part of the Surgeon General's Office but to some extent the situation within the service commands themselves, where the working of the assignment system seems to have been hampered by lack of personnel with training adequate to perform the task most efficiently.7

5Letters, American Specialty Boards, to Col. George F. Lull, Chief, Personnel Service, Office of The Surgeon General, September-October 1942.
6Farrell, Malcolm J., and Berlien, Ivan C.: Neuropsychiatry, Personnel. [Official record.]
7
Letter, Robert W. W. Evans, M.D., to Col. C. H. Goddard, Office of The Surgeon General, 8 Dec. 1952, with enclosure thereto. (Dr. Evans was assigned to the Classification Branch, Military Personnel Division, Office of The Surgeon General, from 1942 to 1945, and served as its chief during the later war years.)


292

In spite of certain drawbacks, it is possible that the decentralization of the power to assign officers was the best system during the early war years. At that time, The Surgeon General was so largely occupied with adapting his Department to meet the demands of a two-front war and with procuring officers that he no doubt needed the assistance of others in making assignments. In the later war years, however, when he had improved classification procedures and acquired more thoroughgoing statistical information on the distribution of Medical Department officers, he certainly knew more about the relative needs for them, both as between the theaters of operations and the United States and within the United States itself. As this became increasingly apparent to War Department authorities in the higher echelons, he regained more control of the personnel of the Medical Department.

Some of the causes of misassignment that had raised difficulties during the period 1939-41 still operated during the war. Among those which became more obvious as time went on was one stemming from the Army's system of promotion. Men who had entered the service before or in the early part of the war had filled the higher ranking posts in many units and installations. Those who joined later were therefore sometimes placed in subordinate positions regardless of professional ability.

There were plenty of reasons why misassignments should occur, but some of the complaints on that score were unjustified. Apparently, some doctors not only believed they would practice medicine in the Army in much the same manner as they had in civilian life but understood little of the need for any time spent in training. When they were assigned first for training and later to a job that did not duplicate their civilian practice, many objected that the Army was wasting their professional skills. Others raised the same objection simply because they overrated their own capacity.

An assignment feature was the use of officer replacement pools, established by the Army just after the outbreak of war.8 The existence of pools facilitated the task of meeting promptly the need for officers; they contained unassigned personnel who could be withdrawn for assignment to other units or installations as the occasion demanded. Many newly commissioned officers were sent to pools pending their initial assignments. As a matter of convenience, unassigned officers not available for jobs-for example, persons awaiting discharge or sick in hospital-might also be placed in the pools. Medical Department officer pools were located at replacement training centers, certain general hospitals, and-for the Veterinary Corps-at Quartermaster depots and ports of embarkation. When pools were first created, the Medical Department was allotted a maximum strength of 1,500 for them. This figure was changed from time to time as conditions required.

8Letter, The Adjutant General, to Chief of each Ground Arm and Service (and others), 19 Dec. 1941, subject: Officer Filler and Loss Replacements for Ground Arms and Services.


293

Enlisted men

Errors also occurred in the assignment of enlisted men. For example, men sent to technicians schools to receive specialized training sometimes received assignments on which such training was unnecessary. In August 1942, The Surgeon General asserted that this mistake was being made in numerous instances, due, he believed, partly to the errors of medical units in making requisitions on The Adjutant General and partly to the errors of The Adjutant General in filling them. Although he himself lacked personnel who understood the situation, The Adjutant General nevertheless failed to follow the recommendations of The Surgeon General, who had allocated certain numbers of technicians to these units. The Adjutant General had even assigned some graduates to Zone of Interior installations that possessed technicians schools as their own sources of supply. According to The Surgeon General, 56 percent of the technicians graduating in July 1942 had been assigned to units and installations other than those he recommended. He therefore proposed that Zone of Interior hospitals receive personnel direct from reception centers, that commanders of theater of operations units submit requisitions for Medical Department technicians in the numbers authorized by their tables of organization (that is, only for those shown as "rated" in the tables), that the Adjutant General's Office follow the recommendations of The Surgeon General in allotting technicians, and that a Medical Department officer be assigned to the Replacement Section of the Adjutant General's Office "who has a knowledge of permissible substitutions in technical specialties and who will maintain close liaison with the Office of The Surgeon General in the disposition of trained technicians." The response was generally favorable. Headquarters, Services of Supply, believed it unnecessary to assign a Medical Department officer to full-time duty with the Adjutant General's Office but suggested that a representative of The Surgeon General be designated to assist The Adjutant General "when occasion demands." That headquarters also instructed the Adjutant General's Office to follow The Surgeon General's recommendations as to the disposition of technically trained personnel "so far as possible subject to the priorities imposed by higher authority." It approved the remainder of The Surgeon General's recommendations and ordered directives to be issued putting them into effect.9

These measures did not settle the question of misassigned personnel, if only because they covered something less than the whole field. Various efforts were made to cope with the problem, including the occasional reclassification and reassignment of individual enlisted men.10

9(1) Memorandum, The Surgeon General, for Director of Training, Services of Supply, 28 Aug. 1942, subject: Dissipation of Trained Enlisted Personnel. (2) Memorandum, Director, Military Personnel, Services of Supply, for The Surgeon General, 14 Sept. 1942, subject: Request for Filler and Loss Replacements.
10Memorandum, The Surgeon General, for The Adjutant General, 14 Dec. 1942, subject: Reclassifications of Enlisted Men.


294

It would be difficult to estimate the precise extent of misassignment so far as Medical Department enlisted personnel were concerned, for one reason because proper assignment was a matter of degree and circumstances. An enlisted man was in a sense properly assigned to the Medical Department if his civilian experience or his training in the Army made him useful there, and his removal from the Department would constitute a misassignment. On the other hand, even if he remained in the Medical Department, he might be improperly assigned, either because he was actually needed more somewhere else or because the Department was not making the best possible use of his abilities.

The problem of transfers of qualified personnel was a serious one to the Medical Department. For example, in September 1943, The Surgeon General's Personnel Director cited the cases of 18 noncommissioned officers who had been transferred to other branches after 3 to 25 years of service with the Medical Department. The Surgeon General's Office, he said, heard of only a small percentage of such transfers. Taken together they meant that "a serious situation has arisen * * *. It seems uneconomical and foolish to train men for certain duties and then transfer them to other branches where they know nothing of the technical work and have to be retrained. To replace them, we have to train new men."11 He pointed out that the transfers were made by the service commands, and it was their interposition which The Surgeon General's Personnel Office at the end of the war singled out as being responsible for transfers of this kind as well as for other personnel practices to which it objected. That office stated in September 1945:

Distribution of enlisted personnel to installations was satisfactory until branch allotments [that is, bulk authorizations of certain numbers of enlisted men according to their branch of service] were discontinued during the summer of 1943, and authority was delegated to local commanders to make suballotments and assign personnel according to their own policies * * *. Operating policies were never uniform throughout the commands at such a low level, and the pride, loyalty, and efficiency of medical enlisted men serving under these conditions was greatly impaired. Perhaps the most demoralizing act was the transfer of many high ranking noncommissioned officers of long training to other branches and the transfer of noncommissioned officers of other branches into the Medical Department. Competent though these men undoubtedly were in their previous assignments, they were so inept, untrained and unskilled in the duties encountered in the Medical Department that some were reduced.12

In the middle of 1943, at any rate, the Director of Military Personnel, Army Service Forces, felt that the assignment of medical technicians was satisfactory. His office had investigated the "alleged misassignment" of technically trained personnel, particularly medical, and found itself in agreement with the Commanding General, Army Ground Forces, who had stated

11Letter, The Surgeon General, to Director, Military Personnel, Army Service Forces, 13 Sept. 1943, subject: Transfer of Medical Department Enlisted Men to Other Branches.
12Report, Military Personnel Division, Office of The Surgeon General, to Historical Division, summer 1945, subject: Medical Department Personnel. (The statement goes on to say that the Surgeon General's Office made a vigorous effort to recover the men so transferred and that the situation had improved "during the last eighteen weeks [that is, at the very end of the war] but only a return to the branch allotment system will fully correct the situation.")


295

that every effort was being made to prevent misassignments, and that when they did occur it was generally because of temporary surpluses of technicians, who were appropriately assigned later. This condition, the Director added, existed "in the Services as well as in the Ground Troops."13

The problem of proper assignment was involved with that of the procurement and retention of personnel. The number of men with medical backgrounds who were assigned by the reception centers to the Medical Department or who were reassigned to it by other branches of the service constituted an important part of the Department's procurement. Regulations against the reassignment of Medical Department personnel to other branches or to jobs outside the United States might have helped to reduce the amount of procurement that had to be done for the Department, at least in the Zone of Interior. From the early part of 1944 onward, the increased effort to channel critically needed medical technicians into the Medical Department both from the reception centers and from nonmedical branches of the Army probably helped to reduce misassignment not only in the Medical Department but elsewhere.

Assignment Problems in the War Years

Toward the end of 1943, Army Service Forces headquarters, prompted by a report submitted by The Inspector General "and other reports," ordered a survey of the classification and assignment of all military personnel in its command. Two examples of the findings with regard to Medical Department officers appear in the surveys conducted at the Army Medical Center, Washington, D.C., and in the Fourth Service Command. These surveys give some idea of how suitably officers were assigned and perhaps also how appropriately they were classified in the Medical Department as a whole up to this time. At the Army Medical Center, the survey of 427 officers showed that 366 (or 85.7 percent) had good assignments, 44 (10.3 percent) had fair assignments, and 17 (4 percent) had misassignments. The report on this installation pointed out that there were three kinds of misassignments: (1) An officer might have substantially more skill and experience or substantially more rank than was required for his assignment; (2) he might have substantially less skill and experience than were required for his assignment; or (3) he might be assigned to the wrong occupational field when his skill was needed elsewhere.14 In the Fourth Service Command, a preliminary report covering somewhat more than half the Medical Department officers showed that about 86 percent had good assignments, over 13 percent fair assignments, and less than 1 percent misassignments. The surgeon of the command stated that it was difficult to transfer

13Memorandum, Director, Military Personnel Division, Army Service Forces, to Director of Military Training, Army Service Forces, 15 July 1943, subject: Transfer of Medical Department Enlisted Men.
14Letter, Maj. Fred J. Fielding, Office of The Surgeon General, to Army Medical Center, 13 Jan. 1944, subject: Officer Assignment Survey.


296

men discovered to have fair assignments or misassignments as no replacements were available.15

The Surgeon General's Office and the various service command headquarters of Army Service Forces placed considerable reliance on their professional consultants for assistance in assignment. Consultants in the Surgeon General's Office advised personnel officers there on the staffing of units, and in August 1944, this function became mandatory when The Surgeon General ordered that "assignments of key personnel will be made only with the concurrence of the appropriate service or division particularly concerned with, or possessing special knowledge as to the qualifications of the officers and the requirements of the specialty assignments."16 While the order did not specifically mention consultants, the "appropriate service or division" would be, in many cases, one of the sections of the office headed by the consultant (or his equivalent) in a professional branch of medicine. At that time, those sections were the Medical Consultants Division, the Surgical Consultants Division, the Neuropsychiatry Consultants Division, the Reconditioning Consultants Division, the Preventive Medicine Service, the Dental Division, the Veterinary Division, and the Nursing Division.

In the later war years, it continued to be more difficult to assign than to classify doctors according to their capabilities, if only because the needs of the Army did not always match the material it had at its disposal. An example of doctors assigned outside their specialty for unavoidable reasons was the case of gynecologists and obstetricians. In November 1943, "considerably less than half" the 650 Army doctors so classified were engaged in that type of work. Those who were employed in their specialties attended female members of the Medical Department and the dependents of Army personnel. The use of a larger percentage in their specialty had to await the entrance of large numbers of Women's Army Corps members into the Army. Even in assignments requiring their professional skill, Army doctors were not able to devote all their time to their specialty. Administrative duties took a higher proportion of their time than it had done in civilian practice. In addition, some doctors found the Army system of evacuation unsatisfactory because it required passing many patients through a number of medical units before definitive treatment was given, and thus prevented the individual physician from following certain cases through to the end.

There were cases of assignment which not only did not take qualifications fully into account but which can hardly be excused on the score of Army necessity-as, for example, that of the war surgeon who was classified as a neurosurgeon although he had done nothing of the sort in his life.17 Despite continuing vigilance on the part of The Surgeon General, there were instances of misassignment as long as the war lasted. These were sometimes brought

15Annual Report, Surgeon, Fourth Service Command, 1943.
16Office Order No. 175, Office of The Surgeon General, U.S. Army, 25 Aug. 1944.
17Memorandum, Director, Resources Analysis Division, Office of The Surgeon General, for Chief, Operations Service, Office of The Surgeon General, 10 June 1945, subject: Visit to England General Hospital.


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to light through the complaints of doctors or members of their families addressed to the American Medical Association or to the White House. Whenever The Surgeon General learned of an actual case of misassignment he endeavored to rectify it.18 This, of course, was more difficult during the early years of the war prior to establishment of firm classification criteria and when his authority in connection with assignment and reassignment of Medical Corps officers in the United States was considerably curtailed.

There is ample testimony that the assignment of doctors who were specialists was on the whole well done. In April 1945, the surgical consultant in the Surgeon General's Office reported that, of 922 surgical specialists certified by specialty boards or having equivalent qualifications who were serving in Army installations in this country, 96 percent (or 885) were doing surgery in their own specialty. The other 4 percent (or 37) who were not doing surgery, he reported, were serving as consultants either in the Surgeon General's Office or in the nine service commands.19 Referring to surgical personnel, the Chief of the General Surgical Branch of the Surgical Consultant's Division, Office of The Surgeon General, wrote: "The competent performance of the surgical personnel who participated in World War II undoubtedly had more to do with the surgical results achieved than any other single factor. That performance was made possible, in turn, by the increased availability of such personnel, in comparison with World War I, and by proper assignment."20 Likewise, the consultant in neuropsychiatry estimated that at the end of the war only 3 percent of the specialists in his field were misassigned.21

When in 1946 the Procurement and Assignment Service was summing up its wartime experience with the organization and administration of the medical branches of the Armed Forces, it wrote as follows:

In spite of many difficulties the Office of The Surgeon General has accomplished a notable feat in the general assignment of medical personnel to work for which they have been especially trained. Much credit is deserved for overcoming an attitude formerly prevalent, "that any medical officer was a medical officer and could do anything equally well." The great improvement in results of medical care in this war is due more to the effective use of highly trained men than to any other single factor.22

THE REPLACEMENT SYSTEM

Vacancies overseas could be filled by direct transfer of personnel from other units, which in turn created vacancies in those units; from table-of-organization units having an overstrength; and from the Zone of Interior. The replacement system functioned with regard to enlisted men in the same man-

18Letter, Maj. Gen. George F. Lull, Deputy Surgeon General, to Dr. Morris Fishbein, Secretary, American Medical Association, 5 Nov. 1944.
19Rankin, F. W.: The Mission of Surgical Specialists in the U.S. Army. Surg. Gynec. & Obst. 80: 441-444, April 1945.
20
DeBakey, M. E.: Military Surgery in World War II; Backward Glance and Forward Look. New England J. Med. 236: 341-350, 6 Mar. 1947.
21
Information from Brig. Gen. William C. Menninger, Office of The Surgeon General, 11 June 1946.
22
Memorandum, Dr. Frank H. Lahey, Chairman, Directing Board, Procurement and Assignment Service, for Watson B. Miller, Administrator, Federal Security Agency, 26 June 1946.


298

ner as it did for officer personnel-the theater commander was responsible for requisitioning the necessary replacements and the War Department for filling the requisitions as best it could. Medical Department authorities in the various theaters had the responsibility for finding suitable positions for such replacements or casuals as were allocated to them; for correcting any errors in assignment made initially by the responsible authorities in the Zone of Interior; and for transferring personnel, even when satisfactorily located, to assignments in which they could be of greatest service.23

Sources of Oversea Replacements

Replacement personnel for the Medical Department came from three main sources: (1) Personnel released from hospitals; (2) personnel made available by administrative actions; and (3) casuals from the Zone of Interior.

Personnel released from hospitals

Probably, the chief source of replacement personnel for the Medical Department consisted of individuals who had been hospitalized and dropped from assignment to their former units. In the European theater, 46 percent of the officers of the Medical Department entering the Ground Forces Reinforcement Command during the period of ground combat came from detachments of patients in hospitals. This was higher than the corresponding percentage of all officers, that is, 38. It was also higher than that of Medical Department enlisted men, that is, 44, which, in turn, exceeded the percentage of all enlisted personnel by three points (table 24).

In the case of both enlisted men and officers, the percentage of men from detachments of patients who returned to their old units was greater in the Army as a whole than it was in the Medical Department. For Medical Department enlisted men, the percentage was 53, while that of the Army in general was 60. Corresponding percentages for officers were, respectively, 51 and 63.

Among the replacements supplied to the Medical Department by the Ground Forces Reinforcement Command in the European theater, a smaller proportion of the officers than of the enlisted men appear to have been limited assignment personnel. The proportion of such officers seems to have been larger than that which the Command provided the Army as a whole.

Because of the lengthy professional education required for medical, dental, and veterinary officers, it is probable that very few officers, other than Medical Administrative Corps officers, whether suited for limited assignment or otherwise, were transferred to the Medical Department from any source outside itself.

23(1) War Department Field Manual, 100-10, Field Service Regulations, 9 Dec. 1940 and 15 Nov. 1943. (2) Annual Report, Surgeon, North African Theater of Operations, U.S. Army, 1943.


299-300

TABLE 24.-Movement of Medical Department personnel in and out of Ground Forces Reinforcement Command, European Theater of Operations, D-day to V-E Day
(6 June 1944-8 May 1945)

Groups

Total officers

Medical Department officers

Total enlisted men

Medical Department enlisted men

Input

Total

55,966

2,484

1,259,046

45,002

On hand, 6 June 1944

4,520

122

71,506

2,749

Arrivals:

Total

51,446

2,362

1,187,540

42,253

From ZI:

Number

24,428

801

511,620

6,318

Percent of total arrivals

47.48

33.91

43.08

14.95

From theater sources:

Detachments of patients:1

Number

19,766

1,079

484,873

18,547

Percent of total arrivals

38.42

45.68

40.83

43.90

OCS graduates:2

Number

792

---

---

---

Percent of total arrivals

1.54

0

0

0

Other sources:

Number

6,460

482

191,047

17,388

Percent of total arrivals

12.56

20.41

16.09

41.15

Output

Total

49,633

3,120

1,073,378

38,331

Shrinkage:3

Number

3,686

404

48,873

6,238

Percent of total output

6.59

16.26

3.88

13.86

Shipped for service in theater:

Total

45,947

2,716

1,024,505

32,093

Percent of total output

92.57

87.05

95.45

83.73

Returnees to units:4

Number

12,495

550

291,870

9,839

Percent of total shipped

27.19

20.25

28.49

30.66

White:

General assignment

11,934

485

266,647

8,843

Limited assignment

248

24

11,920

711

Negro:

General assignment

39

1

9,146

86

Limited assignment

---

---

519

9

Category unknown5

274

40

3,638

190

Others:6

Number

33,452

2,166

732,635

22,254

Percent of total shipped

72.81

79.75

71.51

69.34

White:

General assignment

25,465

1,233

564,002

16,039

Limited assignment

2,984

211

111,491

3,432

Negro:

General assignment

165

11

13,090

488

Limited assignment

6

---

1,474

67

Category unknown5

4,832

711

42,578

2,228

Percent of general assignment in number shipped

18.84

63.70

83.25

79.32

Percent of limited assignment in number shipped

7.05

8.65

12.24

13.15

On hand, 8 May 1945

6,157

152

188,669

8,425

Excess of output on hand (8 May 1945) over input7

-176

788

3,001

1,754


1Arrivals from the detachment of patients who are scheduled for return to units (but also includes those limited assignment men not eligible for return to combat units and who subsequently were assigned to other units).
2Enlisted men who became officers during the period of the report.
3
Losses through absent without leave, transfer to detachment of patients, evacuation to Zone of Interior, and like reasons; also 4,056 Medical Department enlisted men retrained under infantry retraining program and 16 Medical Department enlisted men sent to officer candidate school.
4Individuals from detachments of patients who were returned to the units in which they served prior to hospitalization. They are designated as "casuals" in the source.
5
Unreported as to race or ability to fill general or limited assignment. Represents shipments only from 10th Depot in United Kingdom for period from 6 June to 31 December 1944.
6Designated as "reinforcements" in the source.
7
The following explanation of the discrepancies between output and input occurs in the source:
"4. The violent flow of stockage through the Command precluded any attempt to account for all assignments outside of the originally reported branch to another branch * * *. A further factor * * * lies in the fact that the opening inventory (D-day) included approximately 35,600 men in packages prepared for Invasion Operations. Approximately 15,000 were returned to stockage after estimated requirements were found to be too high. A good portion of these men who were carried in packages as infantry, were members of branches other than infantry who subsequently shipped out in their original branches. Exact accounting of these transactions is not available. FA [Field Artillery] and TD [Tank Destroyer] were the branches principally affected * * *."
The above quotation probably helps to explain the discrepancy in the case of Medical Department enlisted men and, perhaps, officers. In the case of the Medical Department officers it is also possible that a certain number entered the replacement system as members of nonmedical services or arms and then were assigned to administrative duties with the Medical Department. It is doubtful, however, whether these would account for the entire discrepancy.

Source: Headquarters, Ground Forces Reinforcement Command, European Theater of Operations, "Flow of Enlisted and Officers Stockage for Period D-Day to V-E Day (6 June 1944 to 8 May 1945)." in History of the Ground Force Reinforcement Command, European Theater of Operations, U.S. Army, pt. II, ch. VI.


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In the Southwest Pacific, theater headquarters in late 1944 and the early part of 1945 attempted to make arrangements under which limited service officers no longer fit for duty in their original branches would be made available for service in the Medical Administrative Corps. The scheme was carried into effect to some extent but it not only aroused opposition on the part of the services losing the officers but also failed, because of inexperience of the officers transferred in matters pertinent to the jobs to be filled, to arouse much enthusiasm in the Medical Department.24

Personnel made available by administrative actions

Units developed an overstrength in given types of personnel as a consequence of table-of-organization changes. This overstrength might be used by other units. In the European theater, for example, the reorganization of general hospitals under T/O 8-550, 3 July 1944, made available for other assignments particularly in units arriving from the Zone of Interior short of Medical Corps officers or specialist personnel, 450 Medical Corps officers. Indeed, it was with a view to meeting the needs of such units that the War Department directed this reorganization.25

By a directive of 30 November 1944, Headquarters, Communications Zone, European Theater of Operations, ordered 92 general hospitals in that theater to be reorganized with substantial decreases in the authorized nursing and enlisted personnel permitted for each and with minor reductions in male officer strength. The personnel thus made available was to be reported by the hospital commanders to the Commanding General, Ground Forces Replacement System, through base or section headquarters, for transfer to an appropriate replacement depot.26 As of 30 November 1944, the reorganization of station hospitals under T/O 8-560, 28 October 1944, had made surplus, according to an estimate prepared in December of that year, a total of 477 medical officers in all theaters.27

In certain cases, units were abolished in order to supply personnel for others. Deactivation of six station hospitals in the North African theater made it possible to provide specialized personnel for the enlargement of general hospitals in that theater in 1944.28

In particularly pressing circumstances, certain medical units gave up personnel, without abolishing the pertinent positions, to units considered to be in greater need of the personnel than themselves. In 1942, units in the

24Memorandum, Deputy Chief Surgeon, U.S. Army Forces, Far East, to Chief Surgeon, 12 Apr. 1945.
25Administrative and Logistical History of the Medical Service, Communications Zone, European Theater of Operations. [Official record.]
26Organization Order 68, Headquarters, Communications Zone, European Theater of Operations, 30 Nov. 1944.
27Letter, Office of The Surgeon General (R. J. Carpenter, MC), to War Department, Assistant Chief of Staff, G-1, through Commanding General, Army Service Forces (attention: Director, Military Personnel Division), 8 Dec. 1944, subject: Memorandum of Transmittal.
28Logistical History of NATOUSA-MTOUSA, 11 August 1942-30 November 1945. [Printed in Naples, Italy, by G. Montanino, 1945.]


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European theater designated to participate in the invasion of North Africa were brought up to strength by drawing upon other medical establishments which were to remain behind in the United Kingdom.29 Subsequently, in 1944, when the cross-channel invasion of France was undertaken, personnel assigned to communications zone installations in the theater was sent forward into the combat zone in order to provide medical care in field units. When, on 22 June 1944, the First U.S. Army, spearheading the invasion of France, found it necessary to requisition 46 Medical Corps officer replacements, they were obtained not only from replacement depots located in the United Kingdom but also by transfer from general and station hospitals situated therein. Forty-eight hours after the requisition had been submitted, the replacements began to arrive and continued to do so until 30 June.30

At the time of the Battle of the Bulge in December 1944 and January 1945, there again was a heavy demand for both officer and enlisted replacements, and communications zone units were found to be virtually the only source of such personnel. Despite the fact that conditions at the front were doubling and tripling their patient loads, these installations were called upon for and did supply more than 300 medical officers for frontline units.31

Within a month and a half, more than 3,100 enlisted men also were sent forward to help provide the combat zone medical service. On several occasions, the Ground Forces Reinforcement Command, despite its responsibility to provide medical service to the personnel passing through the replacement system, supplied Medical Department officers to satisfy the more urgent needs of combat units.32

Some time in 1945, apparently, the Personnel Division of the Chief Surgeon's Office, European theater, stated that a base section might be rendered understrength by as much as 2 percent of its total medical strength in order to fill requisitions from an army.33

Shifts also took place within the combat zone. Not long after D-day, the First U.S. Army found that it had a shortage of 28 medical officers within its corps and divisions. Consequently, each 400-bed evacuation hospital in the army was asked to designate two medical officers and each 750-bed evacuation hospital was requested to designate four to aid in filling the vacancies. In this way, the needed replacements were obtained with great rapidity.34

Personnel obtained through transfers, overstrength, and deactivations of units constituted 20 percent of the whole number of Medical Department officers entering the European theater Ground Forces Reinforcement Command between D-day and V-E Day, but only 13 percent of the whole number

29Information from Col. James B. Mason, 1 Feb. 1952.
30First United States Army: Report of Operations, 20 October 1943-1 August 1944, Book VII, pp. 106-107.
31See footnote 25, p. 301.
32Annual Report, Surgeon, Ground Forces Reinforcement Command, European Theater of Operations, U.S. Army, 23 Oct. 1943-30 June 1945.
33Memorandum, Col. A. Vickoren, MC, for Colonel Liston, 2 Mar. 1945, subject: Reference Cable UK 27386.
34See footnote 30, p. 302.


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of Army officers entering this command. The proportion of Medical Department enlisted men thus entering the Reinforcement Command was very much greater than that of Medical Department officers and vastly in excess of the corresponding proportion of enlisted men in general.

In the case of medical officers at least, the personnel made surplus by these procedures were not always satisfactory replacements. As a rule, the reorganizations which produced the surpluses were designated to relieve such officers of administrative duties which could be performed by members of the Medical Administrative Corps and thus permit the former to practice medicine. Yet, in many cases, the men thus relieved were precisely those least fitted to take up professional duties, for in the course of holding administrative posts, they had lost skills and acquired rank which greatly reduced their eligibility to fill vacancies for men of professional competence. The change in the table of organization of general hospitals by War Department Circular No. 99 of 1944 provided for the substitution of a lieutenant colonel of the Medical Corps by a lieutenant colonel of the Medical Administrative Corps in the position of executive officer. In the European theater, however, it was noted in June 1944 that, while this reorganization would render 79 medical officers surplus, only about 14 of these would be qualified to fill professional assignments suitable to their rank, since the great majority of them had been promoted strictly on the basis of their administrative ability.35

Even when officers made surplus through reorganization of hospitals were fully qualified to do professional work, there was difficulty in placing them where the need for them was greatest. In the European theater, for example, "the acute shortages that most needed to be filled and filled quickly," were positions of company grade in ground force combat units. The revision of the tables of organization, however, created overstrengths which consisted largely of field grade officers who had served in positions "totally foreign to combat medical assignments." The result was that the "needs were just as acute after reorganization of hospitals as they had been before."36 Such difficulties account at least partly for the fact that some of the officers made surplus by table-of-organization changes were returned to the United States.

Casuals from the Zone of Interior

Comprehensive data on the number of Medical Department replacements that actually were provided by the Zone of Interior for oversea areas are lacking for most of the war period, completely so for the year 1942. We know, however, that because of the buildup of strength for the North African invasion, it was not until the end of that year that any significant number of non-table-of-organization personnel arrived in the European theater.37 Statistics are available for the period March-November 1943 when a total of 2,737

35Memorandum, Col. C. D. Liston, for G-1, European Theater of Operations, 17 June 1944.
36
Annual Report, Personnel Division, Officer of the Chief Surgeon, European Theater of Operations, U.S. Army, 1944.
37See footnote 25, p. 36.


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Medical Department officers and 14,820 Medical Department enlisted men were dispatched overseas as replacements. During the year 1944, 2,906 male Medical Department officers were shipped overseas to all theaters, a decline from 1943.

In March to November of the latter year, the monthly shipments of such officers averaged 0.46 percent of the male Medical Department officer strength throughout the world and 1.89 percent of the same strength overseas. In the European theater, the monthly rate of shipments of Medical Department officer replacements in March-November 1943 was 1.26 percent of the mean strength of such officers in the theater. From the beginning of 1944 to the end of June 1945, a total of 1,096 officers arrived from the Zone of Interior as Medical Department replacements or casuals for use in other than units of the Army Air Forces.38 This amounted, on a monthly basis, to 0.204 percent of the mean strength serving in Ground Forces and Services of Supply units in the theater within the dates mentioned. For the period from the beginning of the invasion of the Continent to V-E Day, the average monthly shipment was equal to 0.214 percent. Not only was the rate of shipment lower than it had been in 1943, but it was vastly lower than that of the service and ground forces as a whole; this, however, should occasion no surprise since these forces taken together had far greater combat losses, proportionally, than did the Medical Department.

Scattered information from other theaters also indicates the existence of meager replacement shipments in a stage of the war when they were needed most. Replacements for the Mediterranean Theater of Operations were scarce through nearly all of the campaign in Italy.39

The China-Burma-India theater in the summer of 1944 complained to the War Department of a shortage of 91 Medical Corps officers. Not only was that theater then told that under revised tables of organization this shortage amounted only to 12, but it also was informed that no more than 9 men would be shipped from the Zone of Interior to meet this shortage. The shipment was to take place during October; when the rest of the deficit would be wiped out as not stated. The theater was urged to report to the War Department shortages of other types of medical personnel although it was told that nurses, physical therapy aides, and dietitians might not be available until after January 1945.40

38(1) Memorandum, Army Service Forces, for Assistant Chief of Staff, G-3, War Department General Staff (attention: Colonel Stevenson), subject: Report of Overseas Replacements for the Period 16 September 1942 through 28 February 1944. (2) See footnote 32, p. 302.
39Statement of Maj. Gen. Joseph I. Martin to the author, 19 Feb. 1952.
40Smith, Robert G.: History of the Attempt of the United States Army Medical Department to Improve the Efficiency of the Chinese Army Medical Service, 1941-1945, vol. II, pp. 159-160. [Official record.] (The theater complaint was based on the fact that nearly all hospitals were operating far above rated capacities * * *. In the largest hospitals patients of the Chinese Army comprised from one-third to one-half of their totals. The shortage of medical officers (and units) at that time was so serious that the Theater Surgeon was sent by the Theater Commander to Washington for these conferences. Letter, Brig. Gen. Robert P. Williams, to Col. J. B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 22 Dec. 1955.)


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Aside from the difficulties occasioned by lack of personnel, the provision of replacements by the Zone of Interior was complicated by delays in the requisitioning process. Requisitions went through channels to the theater G-1, or the replacement command, before being forwarded to the Zone of Interior.41 Thus, although the surgeon of the Southwest Pacific theater submitted a requisition for 50 dental officers during December 1944, he was informed by a letter from the Office of The Surgeon General, dated 9 April 1945, that that Office had not yet received the requisition although it would be filled upon receipt.

The average waiting period for the arrival of a replacement in the Mediterranean theater was 3 months.42 In that theater, at least, it was not possible to reduce the delay in filling requisitions by anticipating needs and calling for personnel from the Zone of Interior before vacancies actually existed for such personnel. A requisition for seven Dental Corps officers submitted in November 1944 by the Twelfth Air Force in anticipation of the establishment of new service groups and expectation of losses occasioned by hospitalization and other factors of attrition was disapproved on the ground that the theater would not requisition replacements unless a table-of-organization vacancy actually existed.43

Lack of replacements from the Zone of Interior and difficulties in obtaining such as were available forced the theaters increasingly to resort to local sources of supply to fill vacancies in units or to establish new organizations. Obviously, the closer the source of supply the less was the likelihood of delay in obtaining what was needed. Thus, in the course of the war, the importance of a careful check of personnel requisitions by representatives of the Medical Department on each level of an oversea command in order to make certain that all available personnel was utilized before resorting to a higher echelon or the Zone of Interior became manifest. It appears, however, that even in late stages of the war, this was not always done.44

Nevertheless, there is good reason to believe that a greater proportion of oversea replacements came from theater sources than from the Zone of Interior, and that the proportion was larger than in the case of Army replacements in general. There can be little question of this as regards the European theater, particularly during the period of ground combat.

41(1) Letter, Col. Homan E. Leech, to Department of Army General Staff, Personnel and Administrative Division, 23 Oct. 1947, subject: Replacement System Study. (2) Semiannual Report, Surgeon, Twelfth Air Force, June-December 1944. (3) Semiannual Report, Personnel Division, Office of The Chief Surgeon, European Theater of Operations, U.S. Army, January-June 1945, with enclosure 5 thereto.
42Munden, Kenneth W.: Administration of the Medical Department in the Mediterranean Theater of Operations, U.S. Army. [Official record.]
43See footnote 41(2), p. 305.
44(1) See footnote 25, p. 301. (2) Letter, Lieutenant General Devers to all concerned, 8 Aug. 1944, subject: Unit Personnel Requisitions for Medical Department Officers. (3) Pacific Conference, Panel III, Personnel, 31 July 1945.


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Temporary Personnel

Personnel temporarily attached to a unit for training or in order to be provided with administrative services might be used as a source of manpower above the assigned strength. In May 1943, for example, the percentage of the total Services of Supply Medical Department strength in the European theater that was classified as "attached" exceeded 13 percent, dropping sharply as the time for the cross-channel invasion approached. The corresponding percentages for the Army as a whole were always higher than those of the Medical Department (table 25). A similar situation prevailed in the Southwest Pacific Area, where the 118th General Hospital, which complained of shortages of personnel in all categories, found, during the second quarter of 1943, that it was able to tide over several difficult periods as a result of temporary attachment of personnel of other organizations. The staff of the 9th Portable Surgical Hospital, consisting of 4 officers and 25 enlisted men, was attached to the general hospital for purposes of training for a period of about 1½ months. Both the officers and men were utilized in operating the general hospital.

Another method of obtaining additional personnel above assigned unit strength was to "borrow," on temporary duty from other organizations. This was particularly the case when it was desired to meet the requirements of frontline units. Thus, during periods of severe combat, personnel from corps and army medical units in the European theater were attached for temporary duty to divisional organizations. Litter bearers, company aidmen, and medical and surgical technicians were prominent among those attached.45 On occasion, general or station hospitals in the Mediterranean theater were drawn upon for dental officers to serve temporarily in units lacking such personnel.46 In general, it was the practice in that theater to fill vacancies temporarily with individuals from units that were not operating at full capacity.

ORGANIZATIONAL AND PROCEDURAL CHANGES

During the emergency and war periods, various methods were developed which led to a more efficient utilization of medical personnel. Primary among these were measures permitting freer use to be made of personnel, such as the extensive use of Medical Administrative Corps officers to relieve medical, dental, and other professional personnel of nontechnical duties; the use of trained medical technicians; and the shifting of minor nursing functions from Army nurses to nurses' aides and to some extent to members of the Women's Army Corps. The use of stenographers at certain hospitals to aid the doctors in preparing clinical records relieved the latter of much routine

45(1) Annual Report, Surgeon, Ninth U.S. Army, 1944. (2) Annual Report, Surgeon, Third U.S. Army, 1944.
46Report, Col. Lynn H. Tingay, of Dental Activities in North African Theater of Operations, 29 Dec. 1944.


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clerical work, although such assistance was never widely furnished. Other expedients to meet the growing demands of the Army without lowering the standard of medical service or unduly increasing the number of medical personnel employed included undermanning of theater of operations units in training; changes in the Zone of Interior hospital system and its procedures; readjustment of personnel allowances to theater of operations units and Zone of Interior installations; redistribution of Medical Department officers among major commands in the Zone of Interior; and shipment of hospitals overseas with less than full complements.

Undermanning Theater of Operations Units in Training

A policy of deferring the assignment of part of the officer complement of newly activated theater of operations medical units and detachments which was gradually put into effect in 1942-43 doubtless resulted in some saving of personnel. Before this, it had been the practice to assign a full complement of officers to these units immediately upon activating them. This meant that while the unit or detachment was taking unit training and waiting to go into operation, the officers were not fully occupied, since there was little professional work for them to do unless they could be used to assist the station complement of the hospital at that post. This constitued a waste of professional personnel, and the complaints of officers so assigned was one reason for the change of policy.

The new policy was applied first to affiliated hospitals when in May 1942 The Adjutant General issued a directive providing for the assignment of only a small percentage of the authorized officer strength to these hospitals while in training.47 Similar steps were taken to conserve the supply of medical officers in nonaffiliated hospitals-officers were to be assigned to these units only in the numbers needed and as they were needed.48 The heavy demand for medical officers dictated the application of this policy to nonmedical units having assigned medical personnel.

In March 1943, a War Department directive announced that each table of organization calling for attached medical and dental officers would be revised to include a notation that this personnel was to be furnished only as required and available within the continental limits of the United States, but would be furnished in full prior to departure for oversea duty.49

47Letter, The Adjutant General, to Commanding Generals, Army Ground Forces, Army Air Forces, Services of Supply, and others, 29 May 1942, subject: Allotment of Officer Personnel to Medical Units of the Field Forces, Continental United States.
48(1) Memorandum, The Surgeon General, for Officers Branch, Office of The Adjutant General, 19 Dec. 1942. (2) Memorandum, Col. Francis M. Fitts, Office of The Surgeon General, 3 Jan. 1943, subject: Plans for Bringing Theater Hospital Units and Named General Hospitals to T/O or to Authorized Allotted Strength.
49
Memorandum, Deputy Chief of Staff, for Commanding General, Services of Supply, 10 Mar. 1943, subject: Availability of Physicians.


308-311

TABLE 25.-Monthly Medical Department strength in Services of Supply or Communications Zone, European Theater of Operations (exclusive of Iceland), 30 September 1942-31 October 19441


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Changes in the Zone of Interior Hospital System

Use of specialty centers

As the Army and therefore the number of patients increased, a greater diversity of specialty centers in the general hospitals was established for the treatment of particular diseases, wounds, and injuries. In such a center, patients requiring a highly specialized type of care were concentrated in order to make the best use of the available specialists. Several centers of this sort had been in operation before the war; others were added in 1942, and the number was further increased in 1943, when the practice was announced as a settled policy. The system, which continued throughout the war, permitted the Army to place its limited number of specialists to the best advantage.50

Creation of convalescent hospitals

In April 1944, the War Department authorized convalescent hospitals, as distinct from convalescent centers, annexes, and facilities, which had been in operation since the preceding June. It was felt that the convalescent patient did not need the highly specialized care he was receiving in a general hospital and that the removal of patients from general to convalescent hospitals would permit fuller use of the former's highly specialized staff. A guide for the utilization of personnel in convalescent hospitals in the Zone of Interior was recommended by The Surgeon General and approved by the War Department (see table 7).51 Comparison of this table with the guides for named general hospitals (table 6) will indicate the saving in Medical Corps officers that could be made by placing convalescents in the new type of hospital instead of keeping them in general hospitals.

Closure of station hospitals

Early in 1944, as the military population in the Zone of Interior was shrinking due to oversea movement of troops, The Surgeon General effected the closure or reduction in size of station hospitals. As this was done, doctors assigned to these hospitals could be reassigned either to hospitals scheduled for oversea service or to general hospitals in the Zone of Interior. Although in 1944, the General Staff sanctioned the establishment of so-called regional hospitals in the Zone of Interior by both the Army Air Forces and the Army Service Forces, general hospitals remained under the jurisdiction of the Army

50Memorandum, Director, Resources Analysis Division, Office of The Surgeon General, for Deputy Surgeon General, 19 Aug. 1945.
51(1) Memorandum, Brig. Gen. R. W. Bliss, Assistant Surgeon General, for Commanding General, Army Service Forces, attention: Director, Personnel Division, 18 Apr. 1945, subject: Personnel Guides for Convalescent Hospitals. (2) War Department Circular No. 170, 8 June 1945.


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Service Forces, more exclusively for the care of highly specialized cases and of patients brought home from overseas.52

Reduction of time of hospitalization

During the war, the Medical Department initiated a number of measures designed to reduce the period of hospitalization to the absolute minimum. This released not only beds for incoming patients, but the personnel to care for them. In addition, The Surgeon General succeeded in having convalescent furloughs granted for periods not to exceed 90 days. On 1 June 1945, there were approximately 70,000 patients on furlough from the general and convalescent hospitals for whom otherwise beds would have had to be provided.53

Readjustment of Personnel Allowances

Oversea units

The overall personnel requirements of the Army are set forth in published tables of organization by type of unit. Revisions of the medical tables for oversea theaters during 1940-41 were made on the basis of World War I experience and partly as a means of adjusting medical units to the new triangular organization of the combat divisions.54 The 1942-43 revisions reflected the difficulty in procuring Medical Corps officers and therefore authorized a smaller percentage of such personnel in proportion to the rapidly expanding Army as a whole (tables 9 and 10).

When the number of personnel available in certain categories proved insufficient to meet the requirements of all units that were being activated under these revised tables, further revisions were made during the later war years. For example, after it became permissible to substitute a Medical Administrative Corps officer for one of the two Medical Corps officers who served as surgeons in every infantry battalion, the tables of organization of the infantry regiment were revised to that effect (table 9).55 Table 8 shows personnel changes in the tables of organization for selected hospitals. In all but two cases, the number of Medical Corps officers, nurses, and enlisted men was reduced while the number of Medical Administrative Corps officers was increased.

52Smith, 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.
53(1) War Department Circular No. 111, 7 Apr. 1945. (2) Memorandum, Director, Hospital Division, Office of The Surgeon General (Col. A. H. Schwichtenberg), for Director, Historical Division, Office of The Surgeon General, through Chief, Operations Service, Office of The Surgeon General, 18 June 1945, subject: Additional Material for Annual Report Fiscal Year 1945, with Tab A thereto.
54(1) Letter, Maj. Gen. Alvin L. Gorby, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 3 Apr. 1956. (2) See footnote 56, p. 314.
55(1) TOE 7-11, 1 June 1945, Infantry Regiment. (2) TOE 7-95, 12 July 1944, Infantry Battalion (Separate).


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The tables issued in 1943 and 1944 also show for the first time small numbers of dietitians and physical therapists as military personnel.

Another device for making the most efficient use of the limited personnel available was the development of the "team" or "cellular" concept, which grew out of the auxiliary surgical groups and attained its most general usefulness in the 8-500 series of tables of organization. The basic principle was to so balance specialists and technicians in teams for specific purposes that each man's skills were extended by the complementary skills of those who worked with him. Such groups as malaria control units, dental operating detachments, and food inspection detachments were refined under the new concept of specialized group effort. Carried over into civilian medicine, the team concept has spread throughout the profession.56

Zone of Interior installations

In 1943, the War Department Manpower Board, in investigating all Army installations in the Zone of Interior to determine where savings in personnel could be made, developed "yardsticks" or criteria for manning various types of installations.

The General Staff used the yardsticks in making its bulk authorizations of personnel for the Army Service Forces and, to provide a guide for subordinate commanders, developed manning tables for hospitals of various sizes which were promulgated as War Department Circular No. 209, 26 May 1944. In general, these manning tables, or guides, agreed with the Manpower Board's yardsticks and the recommendations of the Inspector General's Office. They were not, however, meant to be followed as rigorously as tables of organization, and if in any particular case they failed to provide enough personnel for adequate medical care, a written request for increases could be submitted. The guides were announced as subject to correction by any future surveys made by the Manpower Board (tables 6 and 7). In general, these guides indicate that the greater the extent to which beds could be concentrated in large hospitals, the greater would be the saving in medical officers and in certain other categories of personnel.

The issuance of manning tables seems to have achieved considerable success in conserving medical personnel so far as general hospitals in the Zone of Interior were concerned. In July 1943, the number of personnel (military and civilian) assigned to these hospitals per 100 authorized beds was 94. By June 1944, the number had fallen to 68.6 and by July 1945, it had risen to 71.1; in the former month, however, less than half the beds were occupied, while in the latter month the general hospitals were operating at 122 percent of their rated capacity.57

56Statement of Durward G. Hall, M.D., to the editor, 27 May 1961.
57
See footnote 52, p. 313.


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Redistribution of Medical Department Officers

As has been noted, when in 1942 the Army Air Forces were authorized to procure their own doctors, their recruiting program was more successful than that of Army Service Forces. As a result, The Surgeon General felt that some of these medical officers should be transferred to understrength Army Service Forces installations in this country or to units scheduled for overseas.58 However, there was no single authority to distribute doctors to the Army Service Forces, Army Ground Forces, and Army Air Forces according to need, and the Deputy Chief of Staff at first refused to take any action leading to the transfer of doctors from the Air to the Service Forces. He was said to believe that some general hospitals (all of which were under the jurisdiction of the Army Service Forces) were overstaffed and that the Service Forces should "make a thorough canvass of the situation" to utilize to the best advantage all its own doctors before calling on either the Ground or Air Forces for any of theirs. Army Service Forces headquarters thereupon urged The Surgeon General to continue his survey of medical personnel with a view to releasing the number necessary for oversea duty and at the same time retaining the minimum required to operate U.S. establishments.59

In the fall of 1943, when The Surgeon General declared that he did not have in Army Service Forces enough doctors to man all the hospital units scheduled for oversea movement the following January, he recommended that the Air Forces be directed to supply the doctors needed for nine such hospitals.60 Approximately 10 days after these recommendations, the Air Forces having lost certain of their hospital functions, voluntarily transferred 200 Medical Corps officers to the Army Service Forces.61

Shortly after this the Personnel Planning and Placement Branch, Office of The Surgeon General, submitted a report on the numbers of medical specialists available and required in the Army Ground, Air, and Service Forces in this country; it showed that the Air Forces had 3,271 available against 1,271 required, whereas the Service Forces required 8,014 and had available only 6,571. The report showed no excess in Army Ground Forces. Based on this study, the General Staff ordered the Air Forces to transfer 500 Medical Corps officers to the Service Forces.62 Of the 700 transferred altogether, a large

58Memorandum, Lt. Col. Francis M. Fitts, Office of The Surgeon General, for Colonel Lull, Office of The Surgeon General, 11 Jan. 1943, subject: Availability of Physicians.
59Memorandum, Maj. Gen. W. D. Styer, Services of Supply, for The Surgeon General, 3 Oct. 1943.
60Memorandum, Military Personnel Division, Army Service Forces, for The Surgeon General, 17 Nov. 1943, subject: Filling Officer Shortages in Medical Units Committed, with 1st endorsement thereto, 26 Nov. 1943.
61Memorandum, Headquarters, Army Service Forces, for Commanding General, Army Service Forces, attention: Military Personnel Division, 30 Nov. 1943.
62(1) Memorandum, Office of The Surgeon General (Maj. Fred M. Fielding), for G-1, 28 Dec. 1943. (2) Memorandum, G-1, for Chief of Staff, 4 Jan. 1944, subject: Requirements for Medical Corps Officers. (3) Letter, Brig. Gen. J. M. Bevans, Assistant Chief of Air Staff, to Commanding General, Army Service Forces, 26 Jan. 1944, subject: Reassignment of Medical Corps Officers to Army Service Forces, with endorsements thereto.


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proportion were specialists, whom the Service Forces most needed to staff units destined for overseas. Other transfers of doctors occurred throughout the war period.63 In addition to its relinquishment of doctors, the Air Forces during the year ending on 30 June 1945 transferred approximately 1,500 Army nurses, 72 Medical Administrative Corps officers, and 17 Medical Department dietitians to the Army Service Forces.64

Shipment of Hospitals With Less Than Full Complements

When, in 1944, The Surgeon General concluded that, despite all efforts to make the personnel supply meet the demand, the Army would not have enough medical specialists and nurses to staff both Army Service Forces hospitals in this country and units yet to be shipped abroad, he used the expedient of shipping some hospitals without their full table-of-organization complement of specialists and nurses. While no theater chief surgeon ever agreed that he possessed an excess of specialists, The Surgeon General considered this expedient feasible because the theaters in his judgment did possess a relative excess of specialists who could be used to balance the staffs of these hospitals. Accordingly, in early 1944, The Surgeon General received permission to ship general hospitals overseas with a full complement of doctors but with general practitioners in place of seven of the specialists authorized by the tables of organization; that is, the chiefs of medicine, surgery, orthopedic surgery, neurosurgery, psychiatry, radiology, and laboratory service. This policy was followed for several months; eventually, certain units were sent overseas with even fewer specialists.65

By July 1944, with an accelerated shipment of approximately 53 general hospitals requested by the European theater, it was considered impossible to staff all these units at full table-of-organization strength even by substituting nonspecialists. Consequently in that month, The Surgeon General recommended to the Commanding General, Army Service Forces, that general hospitals be shipped to the European theater with only 16 instead of the authorized 32 Medical Corps officers, until the excess of such personnel in the theater should be absorbed. This recommendation was returned informally without action. Later, however, units were shipped with only 16 doctors, but with attempts to balance the staffs. Proper classification and accurate accounting procedures enabled The Surgeon General to make such adjustments.

63Letter, The Adjutant General, to Commanding General, Army Air Forces, 23 Sept. 1944, subject: Medical Officer Requirements. (2) Weekly Diary, Operations Branch, Military Personnel Division, Office of The Surgeon General, for week ending 5 Mar. 1945. (3) Letter, Military Personnel Division, Army Air Forces, to Commanding General, Army Service Forces, 17 July 1944, subject: Transfer of Medical Corps Officers.
64(1) Letter, The Surgeon General, to The Adjutant General, 11 Feb. 1944, subject: Army Nurse Corps. (2) Letter, The Surgeon General, to The Adjutant General, 18 May 1944, subject: Designation of Medical Corps Personnel for 124th and 125th General Hospitals. (3) Annual Report, Personnel Division, Air Surgeon's Office, 1944-45.
65Memorandum, Military Personnel Division, Office of The Surgeon General, for Colonel Love, Historical Division, Office of The Surgeon General, 19 Oct. 1944.


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The procedure of shipping hospitals without all of their Medical Corps officers was continued until practically the end of hostilities against Germany. In March 1945, The Surgeon General informed the Operations Division, General Staff, that orthopedic surgeons of grade C or better were not available to the European theater in April of that year and added that they would not be available for shipment from the United States at any future date.66 The next month, April 1945, he recommended that 5 general hospitals, short 16 Medical Corps officers each, be shipped to the Pacific Ocean Areas. He based this recommendation on his knowledge that that theater had more doctors per 100 hospital beds occupied than either the Southwest Pacific Area or the Zone of Interior; and stated that in August or September he would ship sufficient Medical Corps officers to staff the hospitals fully.67

The Surgeon General also felt compelled to ship certain hospitals without nurses, thereby permitting the assignment of nurses to these hospitals from excess numbers resulting from cuts in tables of organization. In 1944, he received approval to ship several general hospitals without nurses to the European theater. (At that time, a 1,000-bed general hospital carried a complement of 83 nurses.) At least two general hospitals lacking nurses were shipped to the Southwest Pacific Area.68

UTILIZATION OF NEGRO PERSONNEL

In late 1940, when Selective Service was about to bring large numbers of Negroes into the Army, the Medical Department contained only a few Negro enlisted men and no Negro officers or nurses on active duty. Negro patients in Army hospitals were therefore attended by white doctors and nurses, and there was no segregation of Negro from white patients. In September 1940, the Medical Department Officers Reserve contained a small number of Negro officers eligible for service (that is, physically qualified and not overage): 60 Medical, 8 Dental, and 3 Veterinary Corps officers. About the same time, 40 nurses were in the Reserve maintained for the Army by the Red Cross.69

When, in 1940, it became likely that the Army would take in many more Negroes, the Surgeon General's Office made plans to place its share of the new personnel in the Medical Department. The Surgeon General recognized his responsibility in a memorandum to the General Staff in October 1940: "It ap-

66Memorandum, The Surgeon General, for Assistant Chief of Staff, Operations Division, through Commanding General, Army Service Forces, 9 Mar. 1945, subject: Inclusion of Orthopedic Surgeons for Staffs of General Hospitals.
67Memorandum, The Surgeon General, for Commanding General, Army Service Forces, attention: Director of Plans and Operations, 20 Apr. 1945, subject: Staffing of the 303d, 304th, 308th, 309th, and 310th General Hospitals.
68
Letter, Office of The Surgeon General (Brig. Gen. Bliss, Chief, Operations Service), to Commanding General, Army Service Forces, 6 May 1944, subject: Staffing of Medical Units of July, with endorsement thereto, 31 May 1944.
69
(1) Memorandum, Assistant Chief of Staff, G-1, for Chief of Staff, 28 Sept. 1940, subject: Use of Negro Reserve Officers Under 1940-41 Military Program, Tab C. (2) Blanchfield, Florence A. and Standlee, Mary W.: The Army Nurse Corps in World War II. [Official record.]


318

pears that * * * the Medical Department will have to utilize * * * around 4,000 Negro enlisted men and several hundred officers."70 Six months later, The Surgeon General and his advisers had agreed among themselves that the Medical Department would be prepared to go as far in the use of Negro troops as any other service and could conform to any Army-wide policy of employing Negroes segregated from or in combination with whites. The Department, however, would "not willingly accord to a policy whereby any detachment will be part White and part Black unless this policy is adopted not only by the services but by the line." The Medical Department did, in fact, go further than any other service in the use of Negro officers.71

During the course of the war, the Medical Department used Negro enlisted men and male Negro officers in the medical detachments of all-Negro combat divisions, in a number of all-Negro theater of operations hospitals, in sanitary companies, in the Negro wards of certain Zone of Interior hospitals, and in at least two all-Negro hospitals in the United States. The Department used Negro members of the Nurse Corps in a number of hospitals at home and overseas and Negro members of the Women's Army Corps in some Zone of Interior hospitals. Negro Medical Department personnel constituted, at its wartime peak, about 4.2 percent of the Medical Department's overall strength. In the Medical Corps, the highest proportion was about 0.76 percent; in the Dental Corps, 0.78 percent; in the Veterinary Corps, 0.39 percent; in the Sanitary Corps, 0.34 percent; in the Medical Administrative Corps, 1.1 percent; in the Nurse Corps, 0.88 percent; and among enlisted men, 5 percent (tables 1 and 26). In the assignment of Negro medical personnel, Dean John W. Lawlah of the Howard University Medical School was of inestimable assistance to The Surgeon General.72

Hospital Personnel

As early as October 1940, the Surgeon General's Office proposed the establishment of Negro wards in certain hospitals in the United States.73 When such wards were organized in the hospitals at Fort Bragg, N.C., and Camp Livingston, La., in May 1941, twice as many medical officers were at first allotted to them as were customarily assigned to ward duty. The commanders of both hospitals, however, later found that one Negro doctor instead of two per ward was sufficient, and the Surgeon General's Office revised its estimates accord-

70Memorandum, The Surgeon General, for The Adjutant General, 25 Oct. 1940, subject: Plan for Utilization of Negro Officers, Nurses, and Enlisted Men in the Medical Department, 1940-41 Military Program.
71(1) Memorandum, Lt. Col. C. B. Spruit, Office of The Surgeon General, for Colonel Love, Office of the Surgeon General, 10 Apr. 1940, subject: Use of Negroes in the Medical Department Under the PMP. (2) Letter, Maj. Ulysses G. Lee, Jr., Office of the Chief of Military History, to Col. C. H. Goddard, Office of The Surgeon General, 22 Aug. 1952.
72Statement of Durward G. Hall, M.D., to the editor, 27 May 1961.
73Memorandum, Office of The Surgeon General (General Love), for The Adjutant General, 22 Oct. 1940, subject: Assignment of Negro Medical Officers.


319

TABLE 26.-Negroes in the Medical Department , 1943-45

Date, end of month

Male officers

Female officers

Enlisted men

Medical Corps

Dental Corps

Veterinary Corps

Medical Administrative Corps

Sanitary Corps

Pharmacy Corps

Total

Army Nurse Corps

Hospital Dietitian

Physical Therapist

Total

1943

October

276

73

4

115

4

---

472

198

9

1

208

25,296

December

284

76

2

126

6

---

494

198

9

1

208

25,431

1944

March

297

70

2

117

5

---

491

219

10

2

231

23,720

June

340

102

6

146

6

---

600

213

8

2

223

23,347

September

327

101

2

118

5

---

553

247

9

2

258

20,544

December

342

104

8

178

5

---

637

256

9

6

271

19,587

1945

March

326

95

2

189

6

---

618

336

7

9

352

19,352

June

325

114

1

210

6

---

656

464

9

11

484

18,534

September

307

101

2

213

8

---

631

466

8

10

484

18,213

December

208

79

6

116

1

---

410

318

8

7

333

7,440


Source: "Strength of the Army" for corresponding dates.

ingly.74 This separation into white and Negro wards was abandoned before the end of the war.

At the same time, The Surgeon General recommended establishing all-Negro hospitals in the Zone of Interior and commissioning Negroes as Medical Administrative and Sanitary Corps officers. The General Staff informed him that no all-Negro hospital was planned and that commissioning Negroes in the two corps named was "not favorably considered."75 Later on, however, Negroes were commissioned in the Medical Administrative Corps, and two all-Negro hospitals were eventually established.

The Air Forces Station Hospital at Tuskegee, Ala., activated in 1941, was the first of these two hospitals to receive its personnel, and played an important part in utilizing Negro doctors and nurses. It also supplied some of the first personnel to report to the Negro Station Hospital at Fort Huachuca, Ariz., which began operations in 1942.76

74Letter, Secretary, General Staff, to Judge William H. Hastie, Civilian Aide to Secretary of War, 1941, subject: Redistribution of Negro Medical Department Personnel.
753d endorsement, The Adjutant General, to The Surgeon General, 31 Jan. 1941, to memorandum cited in footnote 70, p. 318.
76(1) See footnote 52, p. 313. (2) See footnote 71(2), p. 318.


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Fort Huachuca was the training center for the 93d (Negro) Infantry Division. The National Medical Association (the Negro counterpart of the American Medical Association) was requested to assist in procuring medical officers for its hospital, which by the end of 1942 had 676 beds and a staff of 37 Medical Corps officers, 1 Sanitary Corps officer, 2 Medical Administrative Corps officers, 100 nurses, and 243 enlisted men. At that time, also four Negro Dental Corps officers had been assigned to the hospital dental clinic, which functioned under the post dental surgeon. Two Veterinary Corps officers were assigned to the post surgeon's office at that time. The commanding officer of this hospital from June 1942 until his return to civilian life in October 1945 was Lt. Col. Midian O. Bousfield. Chief of the medical service until March 1943 was Maj. Harold W. Thatcher. Both of these men, as well as many others on the Fort Huachuca hospital staff, made outstanding records under particularly difficult circumstances.

Sanitary Companies

In October 1940, also, The Surgeon General recommended a new type of unit which was to absorb most of the Negro enlisted increment and some Negro officers as well.77 This was the "sanitary company" authorized in November 1940 for the purpose of performing "such general duties as the commanding officer [of the theater of operations general hospital to which a company was assigned] may prescribe."78 The Surgeon General's Office insisted that activation of these companies should not reduce the medical department's overall requirements for enlisted men.79

The sanitary companies, established under T/O 8-117 (November 1940), found difficulty in obtaining useful work. In July 1942, after several had completed their training, The Surgeon General adopted the policy of assigning one to each named general hospital and Medical Department Replacement Training Center in this country. Large numbers of these companies remained unemployed, however, because the theaters and defense commands refused to requisition them when informed by The Surgeon General that they were ready for shipment.80

In January 1943, the Commanding General, Services of Supply, directed The Surgeon General to consider widening the scope of the work to be performed by the companies in order to obtain more useful employment for them. The Director of The Surgeon General's Sanitary Engineering Division voiced a belief that these companies could do valuable work in environmental sanitation at larger War Department installations, particularly in the South. He

77(1) Memorandum, Office of The Surgeon General (Col. A. G. Love), for Executive Officer, Office of The Surgeon General, 1 Oct. 1940, subject: Policy of The Surgeon General re Colored Troops (9%). (2) See footnote 75, p. 319.
78T/O 8-117, 1 Nov. 1940.
79
Memorandum, The Surgeon General, for Assistant Chief of Staff, G-1, 5 May 1941, subject: Plan for the Use of Colored Personnel in the Medical Department.
80Letter, The Surgeon General, to all Surgeons, Defense Commands, and U.S. Army Forces in Oversea Bases, 18 Nov. 1942, subject: Sanitary Companies.


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suggested that such work might consist, among other things, of mosquito and other insect control; constructing, maintaining, and operating the sanitary demonstration areas; and maintaining proper conditions at the incinerator, the dump, and the sewage disposal plant.81 This recommendation led to a revision (June 1943) of the table of organization which would appear to have these companies used largely on mosquito control. In the new table, each of the two platoons now had two drainage, two oiling, and two spraying teams. None of the other suggested functions were ever incorporated in a table of organization.

Medical Administrative Corps Officers

In the Medical Administrative Corps, Negro officers almost without exception obtained their commissions on graduating from officer candidate school instead of by direct commissioning either from civil life or from the enlisted ranks of the Medical Department. By 1 April 1945, the school located at Camp Barkeley, had graduated 158 Negroes. At that time, a total of 189 had been admitted to the Medical Administrative Corps, some of whom had undoubtedly been commissioned by the school at Carlisle Barracks.82

The Surgeon General experienced difficulty in placing Negro members of the Medical Administrative Corps. In early 1943, the War Department, at his suggestion, established a pool of 100 Negro Medical Department officers at Fort Huachuca. The Surgeon General controlled the assignment, relief, and transfer of officers assigned to the pool. Those in it were used in the local station hospital, the 93d Infantry Division, and in other duties at that station while awaiting transfer to other posts.83 But The Surgeon General had trouble in finding assignments elsewhere for many Medical Administrative Corps officers in the pool. His Office finally arranged with the Army Ground Forces to have certain numbers attend the special basic course for infantry officers. The understanding was that those who completed the course satisfactorily would be detailed to the infantry; at least 16 and possibly more were so detailed; the remainder were returned to the pool at Fort Huachuca.84

81(1) Memorandum, Services of Supply (Assistant Chief of Staff for Operations), for The Surgeon General, 16 Jan. 1943, subject: Sanitary Companies. (2) Memorandum, Col. W. A. Hardenbergh, Office of The Surgeon General, for Brig. Gen. L. B. McAfee, Office of The Surgeon General, 25 Jan. 1943, subject: Use of Medical Sanitary Companies.
82
(1) Annual Reports, Army Service Forces Training Center, Camp Barkeley, Tex., 1944-45. (2) Strength of the Army, 1 Apr. 1945. Prepared for War Department General Staff by Machine Records Branch, Office of The Adjutant General, under direction of Statistical Branch.
83(1) Memorandum, Office of The Surgeon General (Col. F. B. Wakeman, Director of Training), for Director of Training, Services of Supply, 10 Mar. 1943, subject: Training Pool for Colored Medical and Dental Officer Personnel, with endorsement thereto, 8 June 1943. (2) Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Colonel Wickert, Office of The Surgeon General, 20 Mar. 1943. (3) War Department Circular No. 132, 8 June 1943.
84(1) Weekly diary, Sanitary Corps and Medical Administrative Corps Section, Classification Branch, Military Personnel Division, Office of The Surgeon General, for weeks ending 3 Mar. and 11 May 1945. (2) Semiannual History of Medical Administrative Corps and Sanitary Corps, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 Jan.-31 May 1945. (3) Semiannual Report, Records and Statistics Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 July-31 Dec. 1944.


322 

When hostilities came to an end in August 1945 and there appeared to be little likelihood of any demand for these Medical Administrative Corps officers, the Surgeon General's Office took steps to release them as being surplus to the needs of the Army.85

Army Nurse Corps

As to Negro members of the Army Nurse Corps, the Secretary of War in late 1943 committed himself to enlarging this group, which then consisted of about 200 individuals. The Surgeon General's Office, however, argued that there was no apparent demand for more on the part of commanders and suggested that, before additional Negro nurses were commissioned the service commands and oversea theaters should be asked how many more they could use.86 Whether or not this suggestion was followed, more Negro nurses were actually brought in, especially during the recruiting drive at the beginning of 1945.

During the early years of the war, Negro nurses had been restricted to the care of Negro patients and had therefore served with white nurses only in the two hospitals that for a time possessed wards devoted exclusively to the care of Negroes. Later, however, Negro nurses were assigned to work alongside white nurses in at least 16 hospitals in the United States, where they attended not only Negro but white patients. According to the report of one of these hospitals, "no case was found where a white patient objected to a colored nurse taking care of him."87

Women's Army Corps

The early campaigns to recruit Women's Army Corps members for the Medical Department seem to have resulted in the acceptance of few Negro women but there was a Women's Army Corps detachment composed of Negroes stationed in at least one general hospital (Halloran) in 1943.88 Six and possibly more Women's Army Corps hospital companies were formed of Negroes in 1945 after the War Department General Staff had authorized this type of unit. They functioned at the following general hospitals: Lovell, Fort Devens, Mass.; Tilton, Fort Dix, N.J.; Halloran, Staten Island, N.Y.; Wakeman, Camp Atterbury, Ind.; Thomas M. England, Atlantic City, N.J.; and Gardiner, Chicago, Ill.89

85Memorandum, Chief, Classification Branch, Military Personnel Division, Office of The Surgeon General, to Chief, Personnel Service, Office of The Surgeon General (attention: Procurement, Separation, and Reserve Branch, Office of The Surgeon General), 3 Sept. 1945, with endorsement thereto, 8 Oct. 1945. (2) War Department Circular No. 290, 22 Sept. 1945.
86(1) Memorandum, Maj. Gen. W. D. Styer, Army Service Forces, for The Surgeon General, 14 Dec. 1943, subject: Utilization of Negro Nurses. (2) Memorandum, Brig. Gen. R. W. Bliss, Chief, Operations Service, Office of The Surgeon General, for Commanding General, Army Service Forces (attention: Planning Division), 27 Dec. 1943, subject: Utilization of Negro Nurses.
87(1) See footnote 52, p. 313. (2) Annual Report, Station Hospital, Camp Livingston, La., 1944. 
88Annual Report, Halloran General Hospital, N.Y., 1943.
89Directory of the Army of the United States (Exclusive of Army Air Forces and Attached Services), 1 Sept. 1945.


323

This did not represent any great demand for Negro enlisted women on the part of Medical Department commanders. The Enlisted Branch of the Surgeon General's Military Personnel Division reported in the fall of 1944 that with one exception there had been practically no demand for these women and "it has been found almost impossible to find suitable assignments for the few that had been enlisted. Many of the few installations that do have colored WAC's seem desirous of releasing them."90 On the other hand, the surgeon of one service command reporting for 1943 declared: "Especial mention should be made of the success had in this service command with colored enlisted women."91

Demands for Use of More Negro Medical Officers

During the emergency period and the war, Negro leaders and others urged that more Negro members of the medical profession, especially doctors and nurses, should be brought into the Medical Department.92 The Surgeon General's Office gave a number of reasons why the use of Negroes was limited as to numbers and range of jobs. One was the substandard ratings of the Negro professional schools.93 Another was the results of the Army General Classification Tests, which were unfavorable to Negroes. These and the proposed demobilization of certain Negro combat units for lack of intelligence were cited as reasons for assigning most of the Medical Department's quota of enlisted Negroes to the sanitary companies.94

Moreover, with reference to Negro doctors, the Office of The Surgeon General had pointed out even earlier that the Army's requirements would have to be considered in relation to civilian needs and that the ratio of physicians to population was smaller in the case of Negroes than in that of whites.95

In the course of the war, it became plain that, despite the insistence by Negro doctors and their professional organization that the Army accept them, the country's total supply of Negro doctors was not great enough to spare many from civilian life. Estimates of the number of Negro physicians in the country ranged from about 3,300 to about 5,000. As late as October 1942, using a figure of 3,800, the Assistant Civilian Aide to the Secretary of War, Truman Gibson, stated that about 25 percent of the 1,900 who were practicing in the North "could be rather easily spared for Army service" and that about 5 percent of the 1,900 practicing in the South could be spared. This would give a total of 570, in addition to those already in service, although it is almost

90History, Enlisted Personnel, Military Personnel Division, Office of The Surgeon General, U.S. Army, July-September 1944.
91Annual Report, Surgeon, Fifth Service Command, 1943.
92Memorandum, Maj. Gen. James C. Magee, The Surgeon General, for Assistant Chief of Staff, G-1, 17 Mar. 1941, subject: Synopsis of Meeting Held Between The Surgeon General and Representatives of Negro Medical Association, 7 Mar. 1941.
93Letter, Brig. Gen. Albert G. Love, USA (Ret.), to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 29 Nov. 1955.
94See footnote 79, p. 320.
95Memorandum, The Surgeon General (Col. G. F. Lull), for Colonel Wharton, G-1, 28 Dec. 1940.


324

certain that not all of these could have qualified physically for Army service or would have volunteered for it, even though the Procurement and Assignment Service had classified them as available. The Chief of The Surgeon General's Personnel Service confirmed the 25-percent estimate of availables in June 1943 when he stated that 75 percent of the names of applicants which he submitted to a member of the Subcommittee on Negro Health of the Procurement and Assignment Service were turned down as being needed in their respective communities.96

UTILIZATION OF PRISONERS OF WAR AND NATIVE LABOR TROOPS

Zone of Interior

In accordance with the provisions of the Geneva Convention of 1929, the Medical Department as well as other branches of the Army used captured enemy personnel as they became available in this country. The two categories of such personnel assisted the Medical Department in different ways. "Protected" personnel, which included enemy nationals who had been employed in medical work, took over to an increasing extent the care of the sick and wounded of their own nationality, under the administration and supervision of members of the U.S. Army Medical Department. Except in cases of emergency, protected personnel were not to treat U.S. Army personnel who might be patients in the same hospital.97 "Nonprotected" prisoners of war were used for other types of work according to their capabilities, the Medical Department's need, and the stipulations of the Geneva Convention as to the kind of duties they might perform.

In 1945, the War Department directed that protected personnel should be assigned to each service command in the ratio of 2 doctors, 2 dentists, and 6 enlisted men for each 1,000 prisoners. This quota did not include protected personnel in general hospitals that cared for sick and wounded prisoners of war.98 As early as November 1943, the Secretary of War had directed that maximum use be made of enemy personnel in the care and treatment of prisoners of war of their own nationality and that so far as possible U.S. medical personnel should be relieved from duty in prisoner-of-war hospitals, wards and dispensaries.99 In 1945, the question arose as to whether this injunction was being followed to the letter.

The two general hospitals devoted exclusively to the care of prisoners of war (Prisoner of War General Hospital No. 2 at Camp Forrest, Tenn., and

96Report of the Surgeon General's Conference With Chiefs, Medical Branch, Service Commands, 14-17 June 1943.
97
War Department Technical Manual 19-500, "Enemy Prisoners of War," 5 Oct. 1944, with changes thereto.
98Annual Report, Prisoner-of-War Liaison Unit, Office of Provost Marshal General, 1945. 
99
War Department Prisoner-of-War Circular No. 6, 6 Nov. 1943.


325

Glennan General Hospital, Okmulgee, Okla.) for a time possessed duplicate staffs of American and German personnel.100 Liberal use of American personnel along with protected personnel also seems to have characterized other hospitals receiving prisoner-of-war patients, for in February 1945 The Surgeon General sent a message on the subject to four service commands. Data in his Office, he stated, showed continued assignment of considerably more Americans to prisoner-of-war hospitals than appeared to be necessary if protected personnel were fully utilized; the needs of American patients made it essential that all American personnel at these hospitals beyond the minimum required for supervision be assigned elsewhere. The Surgeon General seems to have found it necessary to repeat this admonition five months later, in July 1945. At that time, a total of 345 officers and 3,300 enlisted men had been certified as protected personnel in the nine service commands.101

"Nonprotected" prisoners of war as distinct from protected personnel performed a variety of tasks in hospitals and other Medical Department installations. One service command reported that it was using them to the number of 191 officers and 2,875 enlisted men for cleanup work, care of grounds, landscaping, and mess duties. Hospital authorities seem to have found the work of prisoners of war generally satisfactory. The Director of Personnel at Valley Forge General Hospital, Pa., Capt. Francis E. Baker, MAC, went so far as to say: "As the prisoners of war learned their assigned jobs and became accustomed to the required standards, their services became invaluable and in almost every instance supervisors preferred them to any other type of personnel."102

Oversea Theaters

As in the Zone of Interior, the Medical Department overseas availed itself of the services of prisoners of war, using them in construction as well as in the operation and maintenance of medical installations. Prisoners of war used in these ways were in addition to those protected personnel who were generally assigned only to prisoner-of-war hospitals or to prisoner-of-war wards in Army hospitals. Prisoner-of-war labor, as long as hostilities endured, was important only in the European and North African theaters, since few or no Japanese captives were used by the Medical Department until after V-J Day, except to care for Japanese prisoner-of-war patients.103

100See footnote 52, p. 313. 
101See footnote 98, p. 324.
102(1) Annual Report, Eighth Service Command, 1945. (2) Annual Report, Valley Forge General Hospital, Pa., 1945. (3) See footnote 52, p. 313.
103(1) Letter, Col. I. A. Wiles, to Col. C. H. Goddard, Office of The Surgeon General, 17 Sept. 1952, and letter. Col. Paul O. Wells, to Col. C. H. Goddard, 26 Sept. 1952. (2) The sections which follow, dealing with prisoners of war and native labor troops, are based largely on a manuscript account of "Medical Department Utilization of Civilian and POW Labor Overseas in World War II," prepared under the supervision of the authors of this volume by Cpt. Alan M. White.


326

Italian service troops

After the Italian armistice on 8 September 1943, Italian prisoners of war were organized into "Italian service units" under tables of organization and equipment established by the War Department. Some of these organizations, including "Italian sanitary companies" set up under TOE 8-117 (the only Medical Department table of organization utilized to establish Italian service units), were assigned to Army hospitals and other medical units throughout the communications zone, largely to supply common labor; although, occasionally, these units contained medical technicians or skilled artisans whose services were especially valuable.

Normally, at least one Italian sanitary company, consisting of approximately 3 officers and 115 enlisted men, would be assigned per general hospital, and frequently this company would be augmented by a platoon or more of a second. Such assignments usually meant the discharge of at least an equal number of Arab, French, or Italian civilians since it was more advantageous for the Medical Department to use personnel under military control who could be given longer and more thorough training in their duties. The fact that they could be required to work longer hours than civilian employees and could be moved with units to new locations probably reinforced their acceptability. Many commanders felt that Italian troops exhibited superior efficiency and a more cooperative attitude than civilians. Few, if any, disciplinary problems were encountered in the use of these troops, and they were described as "honest, industrious, and faithful," "willing and cooperative," and having "rendered inestimable service."

In addition to the Italian troops, Yugoslav service troops, who had been brought by the Germans to Sardinia as forced labor, "because," by all accounts, "the most effective and dependable source of labor available in the theater," when their "detested" Italian officers were replaced by Americans and they were given proper nourishment and medical care.

On 1 May 1945, medical service-type units in the Mediterranean theater employed more than 400 civilians and approximately 5,000 prisoners of war (table 21).

The invasion of southern France in August 1944, which was based on the North African theater, brought some Italian service troops into the European theater. However, they played a comparatively insignificant role in the latter area. In June 1945, they accounted for but 1.8 percent of the entire Medical Department communications zone personnel (exclusive of headquarters installations), the corresponding figure for the Army as a whole being 3.5 percent (table 23).

German prisoners of war

During the Normandy campaign (June and July 1944), German prisoners of war were used as litter bearers, sanitary details, and other "general work" at the evacuation hospitals of the First U.S. Army. Usually, 40 of these


327

men were assigned to each evacuation hospital. In August and September 1944, the Third U.S. Army used 40 prisoners of war per 400-bed evacuation hospital, 50 prisoners of war per 750-bed evacuation hospital, and about twice that number in each medical depot company. The general policy of the theater was that prisoners of war in the evacuation hospitals could be retained 7 days only, at the end of which period they had to be exchanged for a new group of prisoners. However, after October 1944, evacuation hospitals and medical depots in the Third U.S. Army were permitted to retain prisoners "after proper screening" for an indefinite length of time. The successful use of prisoners of war in the First U.S. Army evacuation hospitals during the early stage of continental operations suggested their further use in communications zone medical installations, and they were used extensively at general hospitals and depots on the Continent.

Probably, the average number of German prisoners used per general hospital was 250-300, although there are many instances where more were assigned. The 813th Hospital Center at Mourmelon, France, in 1945 had 7,321 German prisoners of war working in its 10 general hospitals. In April 1945, German prisoners of war working for the Medical Department in nonheadquarters installations of the communications zone of the European Theater totaled nearly 40,000. In May, this number increased considerably, perhaps because of redeployment of Medical Department troops. At the end of August, it amounted to 29 percent of the entire Medical Department personnel of the zone. Nevertheless, this proportion was smaller than the equivalent ratio for all branches of the Army, the same being true of all other months between June and October. The actual number used also began to decline after May, and whereas in the months April-June, inclusive, the Medical Department was utilizing in the vicinity of 13-15 percent of all nonheadquarters communications zone prisoner-of-war labor, this percentage fell well below 10 percent in subsequent months (table 23).

In the United Kingdom Base Section, the original plan was for 10 hospitals to use 250 German prisoners each and 30 hospitals to use 50 each; it was later decided that 100 was the minimum number that could be profitably utilized in a single hospital. In this base section, however, the Medical Department made little use of such labor until March 1945, but, thereafter, its importance increased greatly.104 Even in May 1945, however, when more than 40 percent of nonheadquarters Medical Department communications zone troops were stationed in the United Kingdom, only slightly more than 15 percent of the German prisoners used in nonheadquarters communications zone medical installations were located there (table 23).

German prisoners of war performed the same general duties for the Medical Department as did civilian employees; that is, primarily manual labor (fig. 39). Sometimes this included ward duties although, generally, they were not employed in such duties. Enlisted prisoners with experience

104For the first half of 1945 the hospital employment figures were as follows: January, 317; February, 415; March, 2,525; April, 5,726; May, 8,228; and June, 7,236.


328

FIGURE 39.-German prisoners of war assist in unloading a hospital train. Liége, Belgium, 18 March 1945, 
Hospital Train No. 8.

in repair and maintenance of medical equipment were assigned to many of the medical depot companies in the theater.

In 1944 on the Continent, medical units drew their prisoner labor from the nearest prisoner-of-war stockade. In the communications zone, such enclosures were constructed at or near most general hospitals. As the need for prisoner labor increased, the European theater organized it in a more formal manner than previously. A directive of 2 October 1944 assigned to the base section commanders of the communications zone the responsibility for "formation of POW's into labor companies of approximately 250 each," and "military labor service companies" were organized accordingly. U.S. officer and enlisted personnel were attached to the prisoner-of-war labor companies for administration and supervision.105 Displaced persons were recruited to replace American units on guard duty with the prisoners-of-war labor companies. In 1945, the 10 general hospitals of the 813th Hospital Center employed 935 Dutch guards and 788 Polish women.

105Lewis, George G., and Mewha, John: History of Prisoner of War Utilization by the U.S. Army, 1776-1945. Washington: U.S. Government Printing Office, 1955. [DA Pamphlet 20-213.]


329

In Italy, German prisoners of war were available only in isolated cases for Medical Department work before the end of the fighting in that country (2 May 1945) but many were used to replace civilians and Italian troops in Army hospitals in the summer of 1945. Indeed, German prisoners of war were regarded as the most skillful, efficient, and cooperative of all local labor groups at least in Europe.

Native labor troops

In addition to displaced persons and prisoners of war the Medical Department was able to obtain the services of native labor troops in certain areas. During the latter part of the war, such troops were sent into Assam from southern India and used by a medical supply depot.106

After the capitulation of Italy and the assumption by the Italian Government of a quasi-Allied status, that government supplied troops to the Medical Department who, unlike the Italian service unit personnel, were not technically prisoners of war. These were used in the combat zone of the Mediterranean theater; as has been stated, the service units were not expected to serve in that zone. Most evacuation hospitals in that theater had from 30 to 60 Italian soldiers working for them. Some Italian soldiers were reluctant to serve as litter bearers in forward areas but others performed this function with skill and courage. The attachment of the so-called military companies to Army malaria control detachments, where "they were organized as labor crews for ditching, larviciding and house spraying," was said to be "very satisfactory" and to have "enabled the control units to increase their work schedules many fold.''

MORALE FACTORS IN EFFICIENT UTILIZATION OF PERSONNEL

Living and working conditions in the Army were sufficiently different from those in civilian life as to require considerable adjustment on the part of the new officer or soldier, whatever his branch of service. Conditions overseas might make the problem of adjustment a good deal more difficult. Very frequently prolonged service in unfamiliar surroundings was in itself a depressing factor. Even a year overseas was long enough for some Medical Department officers to reveal a distinctly "fed-up" attitude toward their environment, although the dissatisfaction appeared more often after a period of 18 months. The extent to which the condition manifested itself differed among individuals and probably many escaped it altogether. Others showed loss of interest in routine duties, irritability, and general inefficiency. Nurses found the first year of their service overseas both interesting and stimulating despite the attendant hardships and discomforts. At the end of 18 months of service,

106Letter, Lt. Col. Irvine H. Marshall, to Col. C. H. Goddard, Office of The Surgeon General, 1 Aug. 1952.


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however, nurses serving in forward hospitals began to display signs of restlessness and homesickness. Enlisted men of the Medical Department displayed similar signs of discomfort, but when these most frequently appeared has not been ascertained.

Methods of Combating Morale Problems Overseas

Value of continued professional activity

Despite war weariness, the effect of long stays overseas was mitigated in the case of nurses if they had a sufficient amount of satisfactory work to keep them busy. Morale remained at a high level when the patient load and demands for the services of these women were heaviest. When there was little to do, it dropped drastically even after hostilities had ceased, as in the European theater in July 1945. Nurses were also anxious to care for battle casualties. Those who found themselves on protracted duty in Panama, for example, were unhappy because they had no opportunity to do so. Thus, although nurses could expect to withstand the conditions in rear areas for as long as 2 years without suffering harm, they were eager for forward duty, and their morale sagged when it was denied them. Many combat unit nurses were reluctant to move into rear areas, although they were unable to escape the wearing effects of the service they were performing.107

The value in terms of morale of keeping personnel busy in the professional tasks to which they were primarily suited was not confined to nurses. It was of demonstrated weight in the case of medical officers and others. When the immediate professional duties were not sufficient for the purpose, as well as at other times, library facilities, the circulation of professional journals, clubs for the discussion of such periodicals, and professional conferences and meetings all served to bolster morale. In the European theater, before D-day, a number of opportunities for professional refreshment were afforded: A theater medical society and several area medical societies meeting at short intervals; an Inter-Allied medical society which met in London every month and to which the Chief Surgeon could order 200 medical officers, thus affording them transportation; and weekly visits to the great teaching hospitals in London for 10 officers at a time. After V-E Day, groups from the European theater were sent to medical centers all over western Europe.108

In 1943, the Twelfth Air Force reported from the North African theater that among its medical personnel flight surgeons, being intensely interested in aviation medicine and flying, had shown the least staleness and loss of morale.

107(1) History of Medical Department Activities in the Caribbean Defense Command in World War II. [Official record.] (2) See footnote 45(2), p. 306. (3) Parsons, Anne F.: History of the Army Nurse Corps in the Mediterranean Theater of Operations, 1942-45. [Official record.] (4) Annual Report, 814th Hospital Center, European Theater of Operations, U.S. Army, 1945. (5) Report, Lt. Col. Alan P. Parker, MC, Executive Officer, 38th General Hospital, on Medical Department Activities in the Middle East, 23 Dec. 1943.
108Letter, Maj. Gen. Paul R. Hawley, USA (Ret.), to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12 Mar. 1956.


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On the other hand, dental officers in the Air Forces, although they were engaged in work quite similar to that which had occupied them in civilian life, still developed mental depressions of varying degree. Even the interest of flight surgeons in their work began to wane after they had been overseas in excess of 20 months.109 It was in respect to nurses that the value of continued professional activities as a means of maintaining morale was considered greatest; nevertheless, even in their case, these activities served only to retard the cumulative effects of prolonged oversea service.110

Recreation

Personnel of the Medical Department, under other than combat conditions and just as in other branches of the Army, usually had access to various types of recreational facilities, including officers' and enlisted men's clubs, which were provided as a means of maintaining morale and alleviating the adverse conditions under which troops had to live in oversea theaters. Indeed, because of their proximity to the facilities provided for patients, Medical Department troops were perhaps better off in regard to spectator activities than those of most other arms and services. Recreational facilities of course were not always available. This was true particularly on some of the small islands in the Pacific. On Guam, for example, there were few recreational facilities and no club.111

Leaves, furloughs, and reassignments

Besides steady occupation and proper recreation, another means of restoring morale and efficiency was temporary or permanent relief from assigned duties. This could be accomplished without discharging a man from the service, by various administrative means which were used by the Medical Department as by other branches of the Army. Only scattered data are available as to the extent to which these devices were used overseas. Among them were leaves of absence for officers and their equivalent, furloughs, for enlisted men, both of which however were probably of much shorter duration, as a rule, than the standard 7 days in 4 months suggested by the field service regulations. Several medical officers who saw service in the Pacific and Mediterranean theaters believe that medical personnel in those areas fared about the same as others with respect to leaves and furloughs, although distances in the Pacific sometimes made return from leave areas unpredictable.112

109(1) Report, Col. Abram J. Abeloff, MC, on Medical Department Activities in the Persian Gulf Command, 29 May 1945. (2) Flick, John B.: Activities of Surgical Consultants, Pacific Theater, In History of Pacific Ocean Areas and Middle Pacific. [Official record.] (3) Annual Report, Surgeon, Twelfth Air Force, 1943. (4) Letter, Col. W. F. Cook, Surgeon, to Maj. Gen. D. N. W. Grant, Air Surgeon, Army Air Forces, 8 Aug. 1944.
110(1) Stone, James H.: History of the Army Nurses, Physical Therapists, and Hospital Dietitians in India and Burma. [Official record.] (2) Annual Report, 36th General Hospital, 1944.
111(1) See footnote 109. (2) The annual reports of hospitals during the war mentioned the sharing of facilities with patients.
112(1) Letter, L. K. Pohl, MC, USAF, to Col. C. H. Goddard, Office of The Surgeon General, 1 Aug. 1952. (2) Letter, G. H. Yeager, to C. H. Goddard, Office of The Surgeon General, 29 Sept. 1952. (3) Letter, T. C. Keramides, to Col. C. H. Goddard, Office of The Surgeon General, 12 Sept. 1952.


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Reassignment in or outside an individual's organization and detached service or temporary duty away from it were other means of relief from assignments involving heavy strain, although, unlike leaves and furloughs, they served various additional purposes. Reassignment was practiced extensively within the Medical Department overseas as well as in the United States and between the United States and oversea areas.

Rotation

In popular parlance within the Army, some of the forms of transfer or reassignment-such as placing oversea personnel on temporary duty in the United States when that practice was instituted as a policy toward the end of the war-were loosely comprehended in the term "rotation." As defined by War Department Circular No. 58, 9 February 1944, rotation was "the exchange of personnel in theaters for replacements furnished from the United States as substitutes therefor in accordance with advance requisitions submitted periodically by theater commanders." Rotation within the theaters, to which the directive also referred, was presumably to be understood as also requiring the provision of substitutes for persons being sent elsewhere, in accordance with advance requisitions submitted by the units from which the transfers were to be made. An earlier directive (28 June 1943) was the beginning of an Army-wide rotation policy. Among the persons it specified as eligible for transfer to the United States were (1) those "whose morale or health has been adversely affected by prolonged periods of duty under unusually severe conditions, even though not requiring hospitalization," and (2) those whose experience and training would make them useful "in the training and formation of new units, or for other purposes." The directive of February 1944 added a third category-"personnel considered by the theater commander as deserving of such return." Both circulars provided that persons in the first category be returned to the United States only when their effectiveness could not be restored by rotation within the theater. In general, theater commanders were directed to rotate personnel within their jurisdiction in order to maintain the efficiency of their commands.

The Medical Department had practiced intratheater rotation to some extent even before the Army-wide policy was instituted. In the European theater, a program involving temporary exchanges of medical officers of company grade between the 5th General Hospital and tactical units training in Northern Ireland was carried on as early as 1942. Although the advantages of the scheme were generally acclaimed, a wider application of it did not follow for a long time.113

On 30 September 1943, 3 months after the first War Department directive favoring intratheater rotation appeared, instructions to apply it to medical

113Middleton, W. S.: Medicine in the European Theater of Operations. Ann. Int. Med. 26: 191-200, February 1947.


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officers in the China-Burma-India theater were issued by the theater commander. Under these regulations, officers of the Medical Corps who had served with troops in the field for more than 12 months might apply for transfer to hospital duty, and officers with at least the same amount of service in hospitals might request transfer to a combat unit. In general, however, such rotation was not to be applied to specialists and flight surgeons, nor were applications for transfer to be approved if the transfer would lower the efficiency of a unit engaged in combat or one about to become so engaged. Each commander was directed to effect transfers within his own command if it was possible to do so, and if applications were not forthcoming, he was instructed to initiate such transfers as he believed good for the service.114

It was not until a year later that this policy was formally adopted by the Medical Department in the European theater. Two types of intratheater rotation were formulated by the theater surgeon. Permanent rotation from ground force units to communications zone installations was provided for officers and men who had served with line units for extended periods and whose value to the medical service in the opinion of the respective army surgeons would be enhanced by such reassignment. At the same time, rotation of specialists was introduced. Specialists were to be transferred for a 3 months' tour of duty from general and station hospitals to field and evacuation hospitals and auxiliary surgical groups operating in the army area, or vice versa. This program was adopted primarily for professional purposes, being designed to enable medical officers to follow the progress of their patients through various echelons of treatment.115

Precisely how much advantage was taken of these programs is not known, but it is certain that they were curtailed as a result of the German counteroffensive of December 1944. At that time, as has been stated the communications zone was called upon to supply large numbers of officers and men to army units without receiving replacements in return. The permanent type of rotation was especially affected by this development.116 Nevertheless, on 5 January 1945, theater headquarters again authorized rotation of Medical Department officers and enlisted men between army area and communications zone units. The minimum period of service in a field army unit required to establish eligibility for such rotation was 1 year, of which 3 months had to be subsequent to D-day. The age limit for men transferred to an army was fixed at 35, except in special cases, and they were to possess grades and professional or technical qualifications similar to those of the men they were replacing. Before a man could be transferred from an army to the communications zone, his replacement had to be immediately available. The monthly quota of trans-

114Circular No. 75, Headquarters, Rear Echelon, U.S. Army Forces, China-Burma-India, 30 Sept. 1943, subject: Rotation of Officers.
115(1) See footnote 36, p. 303. (2) Annual Report, Professional Service Division, Office of The Chief Surgeon, European Theater of Operations, U.S. Army, 1944.
116See footnote 36, p. 303.


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fers for each army was fixed at 5 Medical Corps officers, 5 other Medical Department officers, and 25 enlisted men.117

Intratheater rotation of medical officers was practiced in the North African-Mediterranean theater as early as 1943. Company grade officers in combat units who were more than 35 years of age were moved to communications zone units and replaced, insofar as possible, by general service officers under 30. In most cases personnel wounded in combat or otherwise hospitalized also were reassigned to the communications zone if they so desired. Two or more years of constant field service, especially if a part of this was rendered in combat, gave an individual a strong claim to rotation from a field unit to a communications zone hospital.118

In the Mediterranean theater, it was reported that, up to 1 March 1945, 365 Medical Corps officers had been rotated between field units and communications zone hospitals. The impression of a former consultant in the theater was that more officers moved from field units to hospitals than in the opposite direction and that the losses of the former were made up by requisitioning replacements from the Zone of Interior.119 In view of the charge that Zone of Interior replacements in the theater were scarce during the Italian campaign, there is some doubt as to how well the process of replacement was accomplished.

In the European theater, the exchange of personnel within the theater was not without its morale problems. Difficulties arose when men with relatively high rank who had served in forward units were rotated to establishments further in the rear where they outranked personnel with greater experience and talent in specialized work.120 This situation has been attributed at least in part to the fact that interchangeability of personnel, as regards rank, was less possible in table-of-organization general hospitals than in evacuation hospitals.121

Not much information is available about the amount of rotation of Medical Department personnel between the theaters and the Zone of Interior. In early 1945, The Surgeon General asserted that the rate of rotation of medical officers from oversea theaters had been much higher than that of any other arm or service.122 Yet there were complaints that the rotation of both medical officers

117Letter, Brig. Gen., R. B. Lovett, Adjutant General, European Theater of Operations, to Commanding General, each Army Group, and Commanding General, each Army, 4 Jan. 1945, subject: Rotation of Medical Personnel Between Communications Zone and Armies.
118Letter, Stewart F. Alexander, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 3 Dec. 1955.
119Letter, E. D. Churchill, to Col. C. H. Goddard, Office of The Surgeon General, 4 Sept. 1952, with extract from Lt. Col. M. E. DeBakey, for The Surgeon General, 5 Mar. 1945, subject: Report of Visit to the Mediterranean Theater of Operations.
120
(1) Letters, to Col. C. H. Goddard, Office of The Surgeon General, from J. S. Skobba, M.D., 10 Oct. 1952; T. L. Badger, M.D., 3 Sept. 1952; M. E. DeBakey, M.D., 7 Aug. 1952; and C. S. Drayer, 3 Sept. 1952. (2) Annual Report, Professional Service Division, Office of The Chief Surgeon, European Theater of Operations, U.S. Army, 1945.
121Letters, to Col. C. H. Goddard, Office of The Surgeon General, from W. S. Middleton, M.D., 26 Aug. 1952; Alan Challman, M.D., 11 Sept. 1952; J. M. Flumerfelt, M.D., 8 Sept. 1952; and C. H. Bramlitt, M.D., 24 July 1952.
122Letter, The Surgeon General, to Dr. Olin West, Secretary and General Manager, American Medical Association, 31 Mar. 1945.


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and other medical personnel was insufficient. About March 1944, the Surgeon of the Twelfth Air Force (Mediterranean theater), expressing his belief that "the rotation policy has not been adequate," called attention to the fact that since the inception of that Force only one dental officer in it had been returned to the United States for any reason except medical.123

In answer to criticism of the low rate of rotation of nurses, the Deputy Surgeon General pointed out that the rotation policy for these women was the same as that for other personnel.124 He stated that although the Surgeon General's Office had concurred in a special policy proposed by the Mediterranean theater whereby 30 nurses would be returned to the United States each month, sufficient replacements for these women could not be supplied. As there were approximately 2,500 nurses in the Mediterranean theater in November 1944, it is readily seen that 30 rotations a month would have benefited only a small percentage of the nurses in the theater.

Despite widespread agreement on the physical and professional benefits of rotation, various medical commanders in the theaters saw drawbacks in the practice. They were disturbed by the prospect of losing an experienced member of a team and having to spend time training an inexperienced replacement. Such a task would, of course, be more difficult if the hospital or other type of unit was operating with a heavy patient load. The theaters, as already noted, had to wait until a replacement arrived before permitting a mall to leave for the United States. Although authorities in the United States endeavored to send men with the same qualifications as those they were to replace, instances occurred in which the replacement lacked the attainments of the man being relieved.125

The North African theater refused to rotate within the theater a man of particular value in either a combat zone or communications zone assignment.126 With reference to oversea rotation, the theater surgeon in a statement issued in early 1944, declared that "only under unusual circumstances should key professional personnel be recommended for rotation. Chiefs of professional services, psychiatrists, surgeons, medical or surgical specialists should be considered as key professional personnel."127 There was a feeling in the theater that the policy of rotation had resulted in the loss during 1943 of many well-trained, experienced medical officers, and that replacements frequently had been relatively inexperienced men.128 As a result of this feeling, and of the theater surgeon's directive, the more competent officers ceased to be nominated for rotation, which thus became a reward to the less deserving.l29 Indeed, in the European theater, the Chief Surgeon's Office, while not actively discouraging intratheater rotation, long looked upon it with suspicion because it might lend itself to efforts of

123See footnote 109(3), p. 331.
124Letter, Maj. Gen. George F. Lull, Deputy Surgeon General, to Hon. Edith Nourse Rogers, 16 Feb. 1945.
125Annual Report, 15th Field Hospital, 1944. 
126See footnote 118, p. 334.
127Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944, vol. I.
128Annual Report, Surgeon, Mediterranean Theater of Operations, 1944, vol. II.
129Annual Report, 70th General Hospital, 1944.


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commanders to rid themselves of undesirable officers or to create promotion opportunities for personnel within an establishment by requisitioning a replacement in a grade lower than that of the individual to be rotated out of the unit.130

Toward the end of the war, the War Department adopted an alternative to rotation in the form of temporary duty in the United States. This gave the persons so assigned a break in oversea service without ending it for them entirely. One method by which this was accomplished, particularly in the case of nurses, was to assign the officers as medical attendants of patients being evacuated to the Zone of Interior and upon their arrival in the United States to grant them emergency leave.131

Many officers in the Mediterranean theater preferred temporary duty in the United States to rotation, for they wished to continue as members of their units rather than be separated from them and risk being sent to another theater.132 Commanding officers recognized certain advantages to this temporary-duty assignment, for it not only permitted them to give their subordinates a leave at home without the necessity of obtaining a replacement beforehand, but also assured them of the return of experienced personnel after a time.133 In the very merits of the system, however, lay its disadvantages, for the same commander might be deprived of a valuable officer's service for a period of 60 to 90 days without any kind of substitute.134

Thus, in the Mediterranean theater at least, commanding officers became increasingly favorable to rotation as a method which was more likely than temporary duty to provide them with replacements.135 Perhaps they also felt that it was better to have fresh personnel than war-weary veterans of oversea service, even after a period of leave at home, particularly since the approaching termination of the war made it less necessary than formerly to depend on experienced officers.

Although rotation was of limited scope, its influence, according to Col. Stewart F. Alexander, a former chief personnel officer in the medical service of the North African theater and the Seventh U.S. Army, "was a vital factor in maintenance of morale * * *. The benefits * * * extended far beyond the actual number of men rotated. The men in forward or unfavorable areas often were dominated by the thought that they were doomed in perpetuity to their assignments. Rotation was a very concrete expression that higher echelons were interested in their problems, and was a potent influence for good. This was particularly true in that rather small but very important groups were de-

130Memorandum, Col. D. E. Liston, Office of the Chief Surgeon, European Theater of Operations, for Adjutant General, Personnel, European Theater of Operations, 11 Mar. 1944.
131(1) Annual Report, Chief Surgeon, U.S. Army Services of Supply, Southwest Pacific Area, 1944. (2) Annual Report, Surgeon, United Kingdom Base, Communications Zone, European Theater of Operations, U.S. Army, 1944.
132(1) Annual Report, 43d General Hospital, 1944. (2) Annual Report, Surgeon, Fifth U.S. Army, 1944.
133See footnote 131(2), above.
134(1) Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944, vol. II. (2) See footnote 132(2), above.
135(1) See footnote 132(2). (2) Annual Report, Surgeon, Fifth U.S. Army, 1945.


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tailed overseas early in the war, when neither the physical aids nor the incentives of imminent victory were present."136

Authorization of a medical badge

Promotion was not the only reward for exceptional service. In 1945, the Medical Department's enlisted men and lower ranking officers who were serving with troops in combat received something approaching the recognition that had already been accorded infantrymen. For the latter, the War Department in October 1943 had authorized an Expert Infantryman Badge and a Combat Infantryman Badge, and in June 1944, Congress had awarded $5 a month extra pay to holders of the first and $10 a month to holders of the second.137 In late 1944, a Medical Department observer returning to the Surgeon General's Office after a visit to the European theater proposed serious consideration of increased pay for medical troops in the infantry. He added that many infantry companies made special arrangements by which medical aidmen were paid out of company funds, and said it was generally felt that such men did daily what, if the infantryman did it, would have brought him a Bronze Star award.

As it happened, a special badge had already been proposed for the medical aidmen. On 1 March 1945, the General Staff authorized a Medical Badge to be worn by Medical Department officers of company grade, warrant officers, and enlisted men who were "daily sharing with the infantry the hazards and hardships of combat." The badge could be temporarily withdrawn when the bearer was transferred or assigned outside the Medical Department to duties in which he might come into contact with the enemy. This, it was explained, was ordered so as not to impair the protected status of regularly assigned Medical Department personnel. In such cases, the right to wear the badge was restored on relief from combat duties or on reassignment to the Medical Department. The badge was of oxidized silver and showed a stretcher placed horizontally behind a caduceus with a cross of the Geneva Convention at the junction of the wings, the whole enclosed by an elliptical wreath 1 inch in height and 1½ inches in length. Like all ground badges, it was worn on the left breast of the service coat, jacket, or shirt.138 At first, these badges were not awarded posthumously; later, the badge might be awarded to any individual eligible to receive it who had been killed in action or died as a result of wounds received in action on or after 7 December 1941. In 1945, Congress authorized pay of $10 per month to enlisted men (but not officers) entitled to wear the badge.139

For bravery in action, in World War II, as well as for meritorious service, many personnel of the Medical Department received citations ranging from the highest award conferred by the U.S. Government, the Congressional Medal of Honor, to the Bronze Star medal-as well as decorations from foreign governments. At least nine of these unarmed soldiers received the Congressional Medal of Honor (fig. 40).

136See footnote 118, p. 334.
137(1) War Department Circular No. 269, 27 Oct. 1943. (2) 58 Stat. 648. 
138Army Regulations No. 600-70, 18 Apr. 1948.
139(1) War Department Circulars No. 66, 1 Mar. 1945, and 151, 23 May 1945. (2) 59 Stat. 462.


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Figure 40.-Medical Department enlisted men awarded the Congressional Medal of Honor, in World War II. Upper row, left to right: Pfc. Desmond T. Doss, Okinawa; Pvt. Harold A. Garman, France; Pfc. Lloyd C. Hawks, Italy. Center row, left to right: Cpl. Thomas J. Kelly, Germany; Pvt. William B. McGee (died of wounds), Germany; Pfc. Frederick C. Murphy (killed in action), Germany. Lower row, from left to right: T4g. Laverne Parrish (died of wounds), Luzon, Philippine Islands; Pfc. Frank J. Petrarca (died of wounds), New Georgia, Solomon Islands; T5g. Alfred L. Wilson (died of wounds), France.

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