U.S. Army Medical Department, Office of Medical History
Skip Navigation, go to content

HISTORY OF THE OFFICE OF MEDICAL HISTORY

AMEDD BIOGRAPHIES

AMEDD CORPS HISTORY

BOOKS AND DOCUMENTS

HISTORICAL ART WORK & IMAGES

MEDICAL MEMOIRS

AMEDD MEDAL OF HONOR RECIPIENTS External Link, Opens in New Window

ORGANIZATIONAL HISTORIES

THE SURGEONS GENERAL

ANNUAL REPORTS OF THE SURGEON GENERAL

AMEDD UNIT PATCHES AND LINEAGE

THE AMEDD HISTORIAN NEWSLETTER

Chapter 12

Contents

CHAPTER XII

Rank, Promotion, and Pay

The Surgeon General was keenly aware of the morale factors involved in problems of rank, promotion, and pay. He understood, also, that in such matters he could not hope to win the approval of everybody in the Medical Department. Policies concerning rank and promotion necessarily varied somewhat from corps to corps. The way in which these policies were applied or took effect might also vary to a certain extent from one command to another. Personnel in oversea areas, for example, did not always fare the same in matters of promotion as did their opposite numbers in the Zone of Interior. Pay increased with length of service, and extra compensation came to be given for service overseas. But for the most part, pay followed rank, and promotion therefore was of vital interest to Army personnel not only because of the added prestige but because of the higher pay that went with it.

ZONE OF INTERIOR

Emergency Period

Officers

In the early part of the emergency period, when selective service had not yet been introduced, and even reservists could not be compelled to accept active duty, many physicians resigned from the Reserve, the reason given being the disparity between civilian income and Army pay. It must be assumed, too, that some resigned for other reasons, notably an unwillingness to accept active duty, but gave the insufficiency of pay and allowances as an excuse. Whatever their real reasons, in the year ending on 30 June 1941, 1,937 Medical Corps Reserve officers resigned.1 No raise in base pay was granted until 1942, and even then only second lieutenants and enlisted personnel received an increase. Since doctors entered the Army as first lieutenants or higher, the increase did not affect them.

The commissioning of men in the Reserve directly from civilian life in the same grade or even higher than that held by members who had belonged to the Reserve for a period of time did not sit very well with the Reserve officers, particularly those on active duty. Men had spent time and effort in the Reserve during peacetime expecting that in an emergency or war they would receive higher recognition than those who were newcomers. The Gen-

1Annual Report of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1941.


452

eral Staff resisted any change in the existing system on the ground that it was protecting the interest of reservists. The Medical Department, therefore, had to point out that there was then a need for more professional specialists than were available from the Reserve or National Guard and as most of those in civilian life had advanced themselves professionally by postgraduate study, in order to obtain their services, it was necessary to offer the inducement of higher rank. The General Staff acquiesced in this line of reasoning so far as to permit a certain number of appointments of the kind desired, but it was not until after Pearl Harbor that a sizable group of civilians was brought in with advanced rank.2 That these new men were specialists (most of them members of affiliated units) did not lessen the dissatisfaction of other reservists.3

It would also appear that promotions came more readily to National Guard officers in Federal service than to medical officers in the Regular Army. Objections to this policy were expressed by Reserve officers, who were being called to active duty without a comparable promotion policy.

Meanwhile, a promotion had been authorized in 1940 for Reserve officers who had been on active duty for a year, but only the relatively small number who had been placed on active duty in 1939 were affected. In August 1941, the Secretary of War listed certain temporary promotions, but again, as with the promotion of 1940, relatively few benefited from this action. The authority covered Reserve officers with at least a year's service ending not later than 1 August 1941, and on the date nearest the beginning of that period for which figures are available (30 August 1940), only 646 Reserve officers of the Medical Department were either on active duty or had had orders requested for them by The Surgeon General. Of these, 450 were in the Medical, 121 in the Dental, 52 in the Veterinary, 17 in the Medical Administrative, and 6 in the Sanitary Corps. By 30 June 1941, however, a month before the authority became effective, 11,477 were on active duty,4 and undoubtedly, the number was larger by 1 August 1941.

After careful consideration, the Secretary of War on 26 December 1941 directed The Surgeon General to submit a list of not to exceed 360 captains and 1,620 first lieutenants of the Medical Corps, without regard to component, whom The Surgeon General recommended for a temporary, one-grade promotion.5 On this basis, The Surgeon General recommended and the General Staff approved the promotion of 351 captains and 1,277 first lieutenants.6

2(1) Committee to Study the Medical Department, 1942. (2) Letter, The Surgeon General, to The Adjutant General, 24 Aug. 1940, subject: Appointment in Medical Department Reserve, with 1st endorsement thereto, 9 Sept. 1940.
3Letter, Lt. Col. Laurence Mickel, to Executive Officer, Ohio Military Area, 25 Mar. 1941, subject: Medical Reserve Officers.
4See footnote 1, p. 451.
5Disposition Slip, G-1, to The Surgeon General, 26 Dec. 1941, subject: Promotion of Captains and First Lieutenants of Medical Corps.
6Memorandum, Lt. Col. Paul A. Paden, Military Personnel Division, Office of The Surgeon General, for Col. A. G. Love, Director, Historical Division, Office of The Surgeon General, 14 Mar. 1944.


453

Since by that time new regulations had been issued, conferring on local commanders the right to promote, The Surgeon General suggested that these authorities handle further promotions.

The Surgeon General had not recommended, nor did the Secretary of War grant, the authority to promote officers other than those of the Medical Corps. The advent of war somewhat dulled the edge of the question, but the War Department's new policies after Pearl Harbor did not change the feeling of many physicians, that they were not receiving their due. Nevertheless, this action began a process of removing restrictions on promotion that had had the effect of lowering morale among Medical Corps officers.

Nurses

During the emergency period, Army pay was no greater inducement for Reserve nurses to go on active duty than it was for many doctors. At this time, those in the grade of "nurse," which included the great majority of reservists, were paid only $840 a year plus maintenance. Although nurses who had served 3 or more years on active duty received more, few of those brought on duty beginning in 1940 could have qualified for the higher rates, as there had been little or no opportunity for active duty in the preceding years. The low pay of nurses was emphasized by a War Department plan to use male nurses with noncommissioned rank in theater of operations hospitals during wartime. These men were to be paid substantially more than female nurses were receiving in 1941. The Surgeon General called attention to this inequality, even though no action on the plan was taken.7

On 13 June 1941, in answer to a letter of complaint from a nurse on active duty, The Surgeon General stated that he had recommended to the War Department an increase in nurses' pay "on several occasions."8 The following day, he repeated the recommendation.9 A representative of the Surgeon General's Office reported that in many Army hospitals "third-rate civilian ward employees" were receiving $85 a month as against the Army nurse's $70.10 The Superintendent of the Army Nurse Corps believed that personnel requirements could not be met without an increase in pay.11 But efforts to secure an increase did not succeed until June 1942 when Congress approved an upward revision for all members of the Armed Forces.12

7Letter, The Surgeon General, to Hon. Charles A. Clason, U.S. House of Representatives (Mass.), 23 June 1941.
8Letter, The Surgeon General, to 2d Lt. Birdie B. Daigle, ANC, 13 June 1941.
9Memorandum, The Surgeon General, for The Adjutant General, 14 June 1941.
10Report, Perrin Long, M.D., of Visit to Station Hospital No. 3, Fort Bragg, N.C., 30 Aug. 1941.
11Memorandum, Maj. Julia O. Flikke, Superintendent, Army Nurse Corps, for The Surgeon General, 2 Dec. 1941. Cited by Blanchfield, Florence A., and Standlee, Mary W.: Organized Nursing and the Army in Three Wars. [Official record.]
1256 Stat. 359.


454

Early War Years, 1941-43

Officers

The outbreak of war brought with it a need for temporary promotions in the Army of the United States for all officers, medical and otherwise. Hence, an Army regulation, dated 1 January 1942, one of the basic orders affecting promotion that were issued during the war, suspended most peacetime promotion regulations; advancement was thereafter based on (1) completion of a minimum of 6 months in grade except for second lieutenants, who could be promoted sooner; (2) recommendations from superiors, attesting to the officer's qualifications; and (3) existence of a vacancy in the desired grade. The regulation stipulated that "normally" no officer except a second lieutenant would be recommended for promotion until he had been assigned to a position calling for the higher grade and had actually performed the duties of the higher grade for a period of at least 6 months. This regulation, applying to officers of the Army of the United States, governed temporary promotions only; Regular Army Medical Department officers continued throughout the war to receive their permanent promotions in the Regular Army under conditions laid down in peacetime. As promotion in the Army of the United States was more rapid than in its Regular component, the vast majority of Regular officers held two different grades throughout the war and for some time afterward-a temporary one in the Army of the United States (the higher one) and a permanent one in the Regular Army. They wore the insignia, had the command powers and duties, and drew the pay of the higher grade. National Guard and Reserve officers did not receive permanent promotions in those components during the war.

This January 1942 regulation gave the power to recommend promotions for personnel under their command to the commanding generals of armies, defense commands, corps areas, chiefs of services, and similar major elements of the Army. The Surgeon General thereby lost the power to control promotions of all Medical Department officers except those (relatively few) who were serving in one of the installations under his command.13 At that time, these included the named general hospitals, the Army Medical Center, the Medical Field Service School, and medical replacement training centers. He later lost command of the medical replacement training centers and the general hospitals, except Walter Reed, which was part of the Army Medical Center. This order was one of the first if not the very first of many that decentralized the control of personnel, taking much of it from The Surgeon General and giving it to the corps area, army, and defense command commanders.14

13A similar measure affecting the promotion of enlisted men deprived The Surgeon General of all power to make such promotions, vesting it in local medical authorities (War Department Circular No. 17, 22 Jan. 1942). A year earlier, his power in that respect had already been limited to promotions in the two highest noncommissioned grades (War Department Circular No. 5, 7 Jan. 1941).
14(1) War Department Circular No. 1, 1942. (2) See footnote 6, p. 452.


455

Meanwhile, in July 1942, Congress raised the limit of rank in the Medical Administrative Corps from that of captain to temporary ranks as high as colonel.15 During the war, at least one officer of this corps-Edward Reynolds, chief of The Surgeon General's Supply Service-was appointed a brigadier general. Before the law was passed, a few Medical Administrative Corps officers had received temporary promotions to the grade of major, although they were not permitted to draw a major's pay until the passage of the act, which made this pay retroactive to 9 September 1940.

In March 1943, at the suggestion of The Surgeon General, the Deputy Chief of Staff issued an order revising the tables of organization which increased the possibility of promoting members of the Medical and Dental Corps from first lieutenant to captain.16 This provided an opportunity to promote approximately 8,082 medical and dental lieutenants then authorized; the troop basis for the remainder of 1943 called for an additional 4,065 first lieutenant positions in the two corps which were thereupon changed to captain or first lieutenant positions. The Surgeon General meanwhile had proposed extending the policy to all medical units and detachments. At the same time, he recommended that all first lieutenants of the Medical and Dental Corps be promoted to the rank of captain upon the completion of 6 months' satisfactory service. The Army Service Forces, without rejecting these ideas entirely, postponed consideration of them until promotions had been made under the policy already adopted.17

An extension of this policy to all table-of-allotment units18 took place 2 months later (July 1943).19 First lieutenants of the Veterinary Corps in table-of-organization units or in table-of-allotment or manning-table organizations were given the same opportunity for promotion later in the war.20

The effect of this new policy on table-of-organization units was immediate, but some difficulty seems to have been encountered in installations working under manning tables or tables of allotment since service commands were restricted to certain numbers of officers in each grade, and they hesitated to advance Medical Department officers when such action would prevent promotions desired for qualified officers of other branches of service.21

The new policy gave members of the Medical and Dental (and later the Veterinary) Corps a better chance of promotion to the grade of captain than

1556 Stat. 663.
16Memorandum, Deputy Chief of Staff, for Commanding General, Services of Supply, 10 Mar. 1943, subject: Availability of Physicians.
17(1) Memorandum, The Surgeon General, for General Somervell, 22 Apr. 1943. (2) Memorandum, Army Service Forces, for The Surgeon General, 10 May 1943, subject: Promotion for Medical Corps and Dental Corps Officers.
18Since all or nearly all units and activities were operating under either a table of organization, a table of allotment, or a manning table, these two orders made all but a negligible percentage of Medical and Dental Corps lieutenants eligible for promotion.
19War Department Circular No. 169, 24 July 1943.
20Army Regulations No. 605-12, 3 Feb. 1944.
21Medical Department, United States Army. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955.


456

that possessed by officers of other corps. But officers in the grade of captain or higher in many table-of-organization units still found themselves blocked from promotion. Whenever the table of organization was filled and all officers had the maximum grade allowed by it, there could be no further promotion without transfer to a new unit in which an opportunity for promotion existed. Transfer could and did solve the problem for some officers. For example, the Chief of Personnel in the Surgeon General's Office was able to arrange a number of promotions for Medical Corps officers, particularly in the grades of lieutenant colonel and colonel by permitting the Surgeon, Army Ground Forces, to suggest commanding officers for new units being activated. By selecting competent and deserving officers whose rank was lower than that called for by the new position, a promotion could be effected. Thus, many able men who came to the Army Ground Forces as division surgeons and organic medical battalion commanders, and were frozen in the grade of lieutenant colonel in consequence, achieved their colonelcies by being named hospital commanders.

Aside from inequalities in the promotion policy so far as it affected individuals, there was a lack of uniformity, if not of equity, in the distribution of rank among the several Medical Department corps (table 61).

The percentage distribution of field grades in the Medical and Veterinary Corps differed markedly from that in the Dental Corps. In each of these three grades (colonel, lieutenant colonel, and major), the Medical and Veterinary Corps had a much higher percentage of officers than the Dental Corps. Possibly, the high percentage of Veterinary Corps officers in field grades is accounted for by their holding a staff position in numerous headquarters. At each headquarters, as one might expect, a Medical Corps officer served as the senior Medical Department representative in that headquarters. Commanders of most Medical Department units and installations were also Medical Corps officers.

The distribution of general officers in the expanding Medical Department was also heavily weighted in favor of the Medical Corps. As of 30 June 1942, The Surgeon General was the only major general in the Department, and the three brigadier generals included the chiefs of the Dental and Veterinary Corps. A year later, there was still only 1 major general, and only the 2 nonmedical brigadier generals, but the number of Medical Corps brigadiers had jumped from 1 to 33. The chief of the Dental Corps won an additional star in September 1943, but by 30 June 1944, there were eight additional Medical Corps major generals and three more brigadier generals, including in the latter category an Assistant Surgeon General of the U.S. Public Health Service. There were thus altogether 47 general officers in the Medical Department as of 30 June 1944, an increase of 43, or more than 1,000 percent in 2 years.22

22(1) Annual Report, Commissioned and Enlisted Division, Personnel Service, Office of The Surgeon General, U.S. Army, 1942. (2) Annual Report, Military Personnel Division, Personnel Service, Office of The Surgeon General, U.S. Army, 1944.


457-461

TABLE 61.-Rank of Medical Department officers, 1939-451

Date

Colonel

Lieutenant colonel

Major

Captain


First lieutenant

Second lieutenant

Number

Percentage of component

Number

Percentage of component

Number

Percentage of component

Number

Percentage of component

Number

Percentage of component

Number

Percentage of component


30 June 1939
2

Total Army:

    

Male

793

6.12

1,605

12.38

2,858

22.04

4,094

31.57

2,146

16.55

1,471

11.34

    

Female

---

---

---

---

---

---

---

---

---

---

---

---

Medical Department:

    

Male

126

8.38

556

36.97

91

6.05

502

33.38

205

13.63

24

1.60

         

Medical Corps

109

9.96

384

35.10

68

6.22

402

36.75

131

11.97

---

---

         

Dental Corps

13

5.91

99

45.00

14

6.36

42

19.09

52

23.64

---

---

         

Veterinary Corps

4

3.17

73

57.94

9

7.14

35

27.78

5

3.97

---

---

         

Medical Administrative Corps

---

---

---

---

---

---

23

35.94

17

26.56

24

37.50

    

Female

---

---

---

---

---

---

---

---

---

---

---

---

         

Army Nurse Corps

---

---

---

---

---

---

---

---

---

---

---

---


30 November 1941
3

Total Army:

    

Male

2,380

1.98

5,712

4.75

9,680

8.04

21,194

17.61

40,033

33.26

41,373

34.37

    

Female

---

---

---

---

1

.01

35

.50

365

5.18

6,642

94.31

Medical Department:

    

Male

234

1.41

712

4.29

1,214

7.31

4,341

26.14

9,611

57.87

495

2.98

         

Medical Corps

183

1.62

536

4.73

897

7.92

2,910

25.69

6,801

60.04

---

---

         

Dental Corps

30

.97

106

3.42

226

7.29

872

28.12

1,867

60.21

---

---

         

Veterinary Corps

20

2.89

62

8.95

52

7.50

153

22.08

406

58.59

---

---

         

Sanitary Corps

1

.44

8

3.54

21

9.29

70

30.97

126

55.75

---

---

         

Medical Administrative Corps

---

---

---

---

18

1.43

336

26.67

411

32.62

495

39.29

    

Female

---

---

---

---

1

.01

35

.50

365

5.18

6,642

94.31

         

Army Nurse Corps

---

---

---

---

1

.01

35

.50

365

5.18

6,642

94.31


28 February 1943

Total Army:

    

Male

6,553

1.55

13,895

3.29

31,628

7.49

78,629

18.62

117,068

27.73

174,417

41.31

    

Female4

2

.007

1

.004

9

.03

182

.64

1,528

5.35

26,833

93.97

Medical Department:

    

Male

765

1.38

1,803

3.24

6,796

12.22

18,059

32.48

22,765

40.95

5,408

9.73

         

Medical Corps

603

1.73

1,459

4.18

5,325

15.27

13,903

39.87

13,557

38.94

---

---

         

Dental Corps

112

1.14

234

2.39

920

9.40

2,442

24.94

6,082

62.12

---

---

         

Veterinary Corps

48

3.27

59

4.02

223

15.18

414

28.18

725

49.35

---

---

         

Sanitary Corps

2

.17

26

2.20

116

9.82

357

30.23

680

57.58

---

---

         

Medical Administrative Corps

0

0

25

.30

212

2.56

943

11.38

1,701

20.52

5,408

65.24

    

Female

1

.004

1

.004

9

.035

90

.35

1,048

4.02

24,905

95.59

         

Army Nurse Corps4

1

.004

1

.004

7

.027

90

.35

1,048

4.13

24,250

95.48

         

Physical Therapists4

0

0

0

0

1

.48

0

0

0

0

208

99.52

         

Hospital Dietitians4

0

0

0

0

1

.22

0

0

0

0

447

99.78


30 September 1943

Total Army:

    

Male

7,681

1.31

17,569

3.00

42,086

7.20

110,925

18.97

161,625

27.64

244,784

41.87

    

Female

2

.005

18

.047

75

.2

567

1.48

2,734

7.12

34,997

91.15

Medical Department:

    

Male

900

1.28

2,374

3.38

8,648

12.30

26,785

38.09

23,268

33.09

8,350

11.87

         

Medical Corps

734

1.84

1,967

4.94

6,811

17.11

19,171

48.15

11,130

27.96

---

---

         

Dental Corps

102

.78

262

2.00

1,049

8.02

4,910

37.56

6,750

51.63

---

---

         

Veterinary Corps

59

3.18

66

3.56

288

15.53

566

30.53

875

47.20

---

---

         

Sanitary Corps

4

.20

37

1.84

163

8.09

657

32.62

794

39.42

359

17.82

         

Pharmacy Corps

1

2.94

12

35.29

18

52.94

3

8.82

---

---

---

---

         

Medical Administrative Corps

---

---

30

.22

319

2.36

1,478

10.92

3,719

27.47

7,991

59.03

    

Female

1

.003

18

05

48

.14

202

.58

1,736

4.95

33,069

94.28

         

Army Nurse Corps5

1

.003

18

.05

46

.14

195

.58

1,551

4.59

31,945

94.64

         

Physical Therapists6

---

---

---

---

1

.23

4

.92

73

16.74

358

82.11

         

Hospital Dietitians6

---

---

---

---

1

.11

3

.34

112

12.70

766

86.85


31 December 1943

Total Army:

    

Male

7,861

1.27

19,076

3.08

46,752

7.54

124,963

20.16

175,069

28.24

246,148

39.71

    

Female

2

.005

22

.05

101

.23

712

1.65

3,670

8.52

38,555

89.53

Medical Department:

    

Male

951

1.30

2,566

3.50

9,511

12.98

30,842

42.08

21,076

28.76

8,340

11.38

         

Medical Corps

770

1.91

2,129

5.28

7,405

18.38

21,310

52.90

8,673

21.53

---

---

         

Dental Corps

113

.80

290

2.06

1,215

8.63

6,338

45.03

6,118

43.47

---

---

         

Veterinary Corps

61

3.15

61

3.15

305

15.77

652

33.71

855

44.21

---

---

         

Sanitary Corps

5

.23

38

1.73

191

8.70

763

34.76

738

33.62

460

20.96

         

Pharmacy Corps

2

3.08

21

32.31

33

50.77

4

6.15

2

3.08

3

4.62

         

Medical Administrative Corps

---

---

27

.18

362

2.46

1,775

12.05

4,690

31.84

7,877

53.47

    

Female

1

.003

22

.06

56

.15

222

.60

2,320

6.24

34,585

92.96

         

Army Nurse Corps

1

.003

22

.06

54

.15

215

.60

2,056

5.76

33,363

93.42

         

Physical Therapists

---

---

---

---

1

.20

4

.80

109

21.80

386

77.20

         

Hospital Dietitians

---

---

---

---

1

.10

3

.30

155

15.58

836

84.02


31 May 1944

Total Army:

    

Male

8,405

1.25

21,952

3.26

54,273

8.06

147,925

21.97

193,529

28.74

247,368

36.73

    

Female

2

.004

46

.10

176

.37

1,223

2.59

7,499

15.88

38,286

81.06

Medical Department:

    

Male

1,066

1.37

3,188

4.09

10,938

14.02

36,814

47.18

18,958

24.30

7,041

9.03

         

Medical Corps

876

2.01

2,673

6.12

8,609

19.70

24,270

55.55

7,262

16.62

---

---

         

Dental Corps

114

.76

346

2.31

1,305

8.72

8,479

56.64

4,727

31.57

---

---

         

Veterinary Corps

66

3.31

69

3.46

333

16.71

786

39.44

739

37.08

---

---

         

Sanitary Corps

7

.31

45

1.97

212

9.27

879

38.42

643

28.10

502

21.94

         

Pharmacy Corps

2

3.77

19

35.85

28

52.83

3

5.66

---

---

1

1.89

         

Medical Administrative Corps

1

.01

36

.24

451

3.00

2,397

15.97

5,587

37.22

6,538

43.56

    

Female

1

.003

38

.09

117

.28

607

1.47

5,573

13.47

35,045

84.69

         

Army Nurse Corps

1

.003

38

.10

115

.29

596

1.51

5,133

12.98

33,659

85.12

         

Physical Therapists

---

---

---

---

1

.16

5

.78

171

26.64

465

72.43

         

Hospital Dietitians

---

---

---

---

1

.08

6

.50

269

22.47

921

76.93


31 December 1944

Total Army:

    

Male

9,690

1.32

25,534

3.47

63,947

8.69

174,327

23.69

238,172

32.37

224,158

30.46

    

Female

2

.003

68

.13

281

.56

1,899

3.76

13,128

25.97

35,178

69.58

Medical Department:

    

Male

1,224

1.47

3,647

4.37

12,209

14.64

40,924

49.06

18,633

22.34

6,781

8.13

         

Medical Corps

1,017

2.18

3,058

6.54

9,501

20.32

25,703

54.98

7,468

15.98

---

---

         

Dental Corps

124

.82

372

2.46

1,439

9.52

9,815

64.96

3,360

22.24

---

---

         

Veterinary Corps

73

3.58

73

3.58

355

17.42

1,018

49.95

519

25.47

---

---

         

Sanitary Corps

5

.21

43

1.80

198

8.30

919

38.52

591

24.77

630

26.40

         

Pharmacy Corps

2

3.03

22

33.33

26

39.40

4

6.06

2

3.03

10

15.15

         

Medical Administrative Corps

3

.02

79

.46

690

4.04

3,465

20.30

6,693

39.21

6,141

35.97

    

Female

1

.002

58

.13

168

.38

1,045

2.34

10,449

23.49

32,928

73.67

         

Army Nurse Corps

1

.002

58

.14

166

.39

1,014

2.40

9,871

23.37

31,138

73.70

         

Physical Therapists

---

---

---

---

1

.10

11

1.11

245

24.75

733

74.04

         

Hospital Dietitians

---

---

---

---

1

.07

20

1.37

383

26.21

1,057

72.35

31 August 1945

Total Army:

    

Male

11,027

1.42

29,356

3.79

70,958

9.16

197,495

25.49

305,989

39.49

159,958

20.64

    

Female

3

.005

116

.18

463

.73

2,933

4.63

33,884

53.46

25,980

40.99

Medical Department:

    

Male

1,404

1.62

4,256

4.90

13,818

15.92

43,483

50.09

18,002

20.74

5,842

6.73

         

Medical Corps

1,186

2.48

3,547

7.41

10,662

22.21

26,597

55.60

5,882

12.30

---

---

         

Dental Corps

131

.91

426

2.97

1,618

11.26

10,167

70.75

2,028

14.11

---

---

         

Veterinary Corps

69

3.26

84

3.97

397

18.76

1,169

55.25

397

18.76

---

---

         

Sanitary Corps

9

.37

52

2.12

269

10.95

1,010

41.12

708

28.83

408

16.61

         

Pharmacy Corps

4

5.88

22

32.35

24

35.30

4

5.88

3

4.41

11

16.18

         

Medical Administrative Corps

5

.02

125

.63

888

4.45

4,536

22.72

8,984

45.01

5,423

27.17

    

Female

1

.002

96

.17

301

.52

1,803

3.13

30,175

52.36

25,251

43.82

         

Army Nurse Corps

1

.002

96

.18

299

.55

1,704

3.11

28,695

52.38

23,984

43.78

         

Physical Therapists

---

---

---

---

1

.08

41

3.23

550

43.38

676

53.31

         

Hospital Dietitians

---

---

---

---

1

.06

58

3.67

930

58.86

591

37.41


1Unless otherwise specified, basic data are from issues of "Strength of the Army" corresponding to the dates shown. Percentage distributions by rank therefore are based on The Adjutant General's figures rather than those of The Surgeon General (table 1). In accordance with the principles governing the preparation of these tables, general officers are not covered by any of the figures presented here. Figures for male officers include the female members of the Medical Corps, whose distribution by rank was:

Date

Colonel

Lieutenant colonel

Major

Captain


First lieutenant

Number of women

Percent of doctors 

Number of women

Percent of doctors 

Number of women

Percent of doctors 

Number of women

Percent of doctors 

Number of women

Percent of doctors 

31 December 1943

0

0

0

0

3

7.14

18

42.86

21

50.00

31 May 1944

0

0

0

0

3

5.88

26

50.98

22

43.14

31 December 1944

0

0

0

0

5

6.67

38

50.67

32

42.67

31 August 1945

0

0

1

1.39

4

5.56

51

70.83

16

22.22


2Basic data on Medical Department ranks from Annual Report of The Surgeon General, U.S. Army, 1939. Basic data on rank of male officers in general are from Annual Report of the Secretary of War, 1939. Only Regular Army personnel are covered in either figure.
3Approximate date. Basic data for the entire Army and for nurses are for 31 December 1941 and were provided by Statistics and Accounting Branch, Statistics Section, Office of The Adjutant General, on 21 February 1958. Basic data on Medical Department male officers cover Regular Army and Reserve personnel on active duty as of 5 December 1941 and Army of the United States and National Guard personnel as of 1 November 1941. Memorandum, F. M. Fitts, for Colonel Lull, 29 Oct. 1942, subject: Status of Medical Department Officers as of 7 Dec. 1941, addendum to History of Military Personnel Division, Personnel Service, 1939-April 1944.
4Figures for 31 March 1943, from "Strength of the Army," 1 Feb. 1947.
5Basic data from Annual Report, Nursing Branch, Military Personnel Division, Office of The Surgeon General, 1944.
6"Strength of the Army," 1 Feb. 1947.


462

Nurses

In the Nurse Corps, the percentage of personnel in the grade of second lieutenant was far higher than in either of the male officer corps having members in that grade-the Medical Administrative Corps and the Sanitary Corps; of these three corps, the percentage was lowest in the Sanitary Corps (table 61). Up to December 1942, the grades of colonel, lieutenant colonel, and major in the Nurse Corps were not authorized as a general rule, although exception had been made in the cases of the superintendent and her chief assistant, who had been granted the grade of colonel and lieutenant colonel, respectively. In December 1942, Public Law 828 authorized appointments in the grades of lieutenant colonel and major. During the remainder of the war, however, no appreciable percentage reached a higher rank than that of captain.

After Congress had granted the dietitians and physical therapists relative rank (December 1942), the War Department on the recommendation of The Surgeon General established the following table of grade distribution for each group: In addition to one major, the number of captains was not to exceed 1 percent; the number of first lieutenants not to exceed 15 percent; the remainder were to be second lieutenants.23 During the rest of the war, each group possessed an actual percentage in the grade of first lieutenant much larger than that authorized; during most of the period, the percentage in the grade of captain was also larger (table 61).

In the early war years, Congress increased the pay of most members of the Armed Forces, and male personnel of the Medical Department received the same increases, rank for rank, that were simultaneously accorded to those in other branches of the Army. In March 1942, Congress passed a law which included, among other provisions, extra compensation for oversea or sea duty amounting to 10 percent of base pay for commissioned officers and 20 percent for warrant officers, enlisted men, and female nurses.24 Another law, enacted in June 1942, raised the pay of all enlisted men; privates, for example, whose base pay had been increased from $21 to $30 a month by the Selective Training and Service Act of 1940,25 received a further increase to $50. The base pay of warrant officers was also raised.

The new scale for commissioned officers involved partly a readjustment of base pay and partly added compensation for subsistence and rental of quarters. In the case of most Medical, Dental, and Veterinary Corps officers, the increase took the form of higher allowances for subsistence and quarters. In no case did the increase accorded Army officers amount to more than a few hundred dollars a year,26 an addition which, so far as doctors in particu-

23Letter, Col. Emma E. Vogel, USA (Ret.), to Col. C. H. Goddard, Office of The Surgeon General, 5 June 1952.
2456 Stat. 143.
2554 Stat. 885.
2656 Stat. 359.


463

lar were concerned, did little or nothing to close the gap between Army pay and income from civilian practice.

Members of the Army Nurse Corps, although their compensation was gradually increased, did not achieve the full pay and allowances of Army officers until they attained full commissioned rank. Nevertheless, their compensation was high enough so that the majority of nurses were not reluctant to accept it until the establishment of the more highly paid Women's Auxiliary Army Corps in May 1942.27

As nurses entered the Army or were induced by higher wages to take nonnursing jobs in industry, fewer remained in civilian practice, so that wages rose there too (until they were frozen in 1942). A slight rise in pay for Army nurses came from the Pay Readjustment Act of 1942, effective on 1 June 1942. Nurses also received monthly quarters and subsistence allowances equal to those of a second lieutenant, but unlike male officers, they did not receive increased allowances as their rank increased.28 In spite of improvements, the pay still seemed inequitable, for the same act set enlisted men's pay rates at such levels that an intelligent soldier with little or no civilian training might in the course of a year be earning as much as a nurse who had spent 3 years in nursing school.29

The increase in pay did not satisfy all Army nurses or civilian nurses who considered entering the service. To add to their belief that the Army was not only underpaying but actually discriminating against nurses were the provisions in the act creating the Women's Auxiliary Army Corps in May 1942 which fixed a generally more liberal pay scale.30 When questioned by members of the Committee to Study the Medical Department in the fall of 1952, the Superintendent of Nurses answered that the nurses were not properly paid, and mentioned the salary of the Women's Auxiliary Army Corps as a "hindrance," presumably to the procurement of nurses.

The dissatisfaction of the nurses, coupled with support by their friends outside the corps, was partly responsible for further improvements in the position of Army nurses. These31 included a pay increase in December 1942, which gave nurses a remuneration substantially equal to that of commissioned officers.32 By its terms, nurses received the same military base- and longevity-pay and allowances for subsistence, rental of quarters, mileage and other travel allowances as commissioned officers were receiving. Subsistence and quarters allowances increased according to rank, and they henceforth received only a 10-percent increase in base pay (not 20 as previously) for oversea or sea duty, the same increase as that given to commissioned officers. Thus, although

27Memorandum, Colonel Blanchfield (Ret.), for Col. C. H. Goddard, Office of The Surgeon General, 14 July 1952, subject: Medical Department History in World War II.
28See footnote 26, p. 462.
29Memorandum, Chief, Military Personnel Division, Office of The Surgeon General, for Colonel Nugent, G-1, 6 Oct. 1942.
3056 Stat. 278.
31For other concessions to the nurses at this time, see chapter VIII, pp. 247-266.
3256 Stat. 1072.


464

they held only relative rank, Army nurses had now attained the same pay schedule as commissioned officers, except for the allowance for dependents. They received that allowance and other privileges when in June 1944 they were accorded full commissioned rank in the Army of the United States.

Dietitians and physical therapists

The act of December 1942 raising the pay of Army nurses, "militarized" two other groups of women, the hospital dietitians and the physical therapists, giving them, along with "relative rank," the same pay as nurses. Before they were given military status, women in these two groups received a salary of $1,800 to $2,300 a year, while the two superintendents each received $3,200.33

As before the war, the pay of civilian employees of the Medical Department conformed to the wage scales of all employees of the Federal Government, except that for a time certain Medical Department civilian personnel did not receive the higher pay for overtime work which, after 1940, some of those scales had allowed.34 The reason was that, since not all classes of civilian workers were entitled to such a rate, the commanders of hospitals, in order to avoid a morale problem and also because only a few members of their civilian staffs were entitled to it, did not request this rate for them. In May 1943, however, Congress granted almost all Federal employees higher pay in lieu of specific pay for overtime work.35

Later War Years, 1943-45

Officers

Inequalities (or inequities) in the system of promotion and in the distribution of rank among Medical Department officers caused concern and criticism during the later war years. At the same time, some progress was made toward removing the basis for complaint.

As regards promotion, there was a tendency to restrict it at this period, both by lengthening the time an officer must spend in his current rank and by preventing his promotion above the rank authorized for his job. The War Department in 1942 made officers' promotions to each grade possible after 6 months had been spent in the lower grade; the only exception was in favor of second lieutenants, who could be promoted in less than 6 months. This regulation applied throughout the Army, as did succeeding regulations during 1943-46 which increased the waiting time in all grades. It will be observed that the increases in waiting time struck the higher grades first and were greater in them than in the lower grades. In July 1944, however, the

33Memorandum, Maj. Helen B. Gearin, for Col. C. H. Goddard, Office of The Surgeon General, 23 June 1952, subject: Draft of Material To Be Included in History of World War II.
34(1) 54 Stat. 1205. (2) 55 Stat. 241.
3557 Stat. 75.


465

War Department granted extra credit to all officers overseas; it stipulated that for time-in-grade purposes, service outside the United States would be counted as time and a half.36

Working within the confines of these Army-wide policies, Army Service Forces likewise tended to restrict promotions, particularly in the higher grades, within its own domain. On 26 February 1944, Army Service Forces headquarters, under whose jurisdiction fell a large percentage of Medical Department officers stationed in the United States, published Circular No. 59 which showed its desire to prevent indiscriminate promotions of officers. It stated at that time that the two principal considerations in promoting an officer were the importance of the position and the merits of the individual. The promotion of any group or individual at a rate faster than was prevalent throughout the Army, especially in combat units, could be justified only in the most exceptional circumstances. Medical Department authorities believed that existing regulations did not give medical and dental officers enough opportunities for promotion, and during the later war years, they succeeded in having special instructions issued to favor members of those corps.37

In June 1945, the General Staff declared its desire and intent to be that all first lieutenants of the Medical, Dental, Veterinary (and Chaplains) Corps occupying positions established for an officer of these services in the grade of captain or first lieutenant should be promoted to captain-providing, of course, that the officer was qualified for and deserving of promotion and had served the required time in grade and position. For this purpose, the order authorized each command concerned a larger number of captains' ratings in each of the corps just mentioned-a number equal to the combined total of hitherto authorized captains' and first lieutenants' ratings in the corps. The order applied to ratings established both by tables of organization and from bulk allotment sources.38

Surgeon General Kirk had already complained that the promotion of medical officers of higher as well as lower rank had not kept pace with their responsibilities, as indicated by the growing patient load. Many outstanding specialists from civilian life who were chiefs of services in general hospitals, he declared, were only majors or lieutenant colonels. Many officers had been in company grade for 2 or 3 years without promotion. Pointing out the amount of time that medical, dental, and veterinary officers had spent in getting their education, he said that many of these men after 3 years of Army service were still in the grade of lieutenant, despite the provisions of Army regulations. Actually, although changes in regulations had made lieutenants

36Army Regulations No. 605-12, 3 Feb. 1944, with Changes No. 1, 24 July 1944.
37(1) Memorandum, Surgeon General Kirk, for General Styer, Army Service Forces, 24 Nov. 1943, subject: Failure to Promote 1st Lieutenants of the Medical and Dental Corps. (2) The Surgeon General's Conference With Service Command Surgeons, commencing 10 Dec. 1943. (3) Army Regulations No. 695-12, 17 Aug. 1944.
38Letter, The Adjutant General, to Commanding General, Army Service Forces, 30 June 1945, subject: Temporary Promotions in the Army of the United States of 1st Lieutenants, Medical, Dental, Veterinary, and Chaplains Corps.


466

eligible for promotion to captain, they had not made such promotions mandatory, and presumably not all commanding officers had recommended their Medical and Dental Corps lieutenants for these promotions.39

Shortly afterward, The Surgeon General initiated a move to have the chiefs of services and sections of Zone of Interior general hospitals promoted. Stating that these officers had a big workload and grave responsibilities, he pointed out that if the chiefs of services in hospitals having a capacity of 1,500 beds or more had been so assigned in table-of-organization hospitals of the same size they would, without exception, have been authorized to hold the rank of colonel. He showed that only 29 chiefs of medical and surgical services in these Zone of Interior hospitals were colonels, whereas 87 were lieutenant colonels, and 16 were only majors. (At the end of April 1945, a few months before The Surgeon General furnished this information, only about 6 of the 65 general hospitals in this country had capacities of less than 1,500 beds.) Moreover, a table showing the grade of chiefs of sections in such hospitals listed 3 colonels, 66 lieutenant colonels, 114 majors, 35 captains, and 5 first lieutenants. The chiefs of the larger sections, such as laboratory, neuropsychiatry, X-ray, and eye, ear, nose, and throat would rank, he asserted (presumably referring again to table-of-organization general hospitals), either as majors or lieutenant colonels, depending upon the workload of the hospital. Somewhat later, he submitted a list of officers who were chiefs of services in Zone of Interior general hospitals and urged that they be promoted as rapidly as possible to a grade commensurate with their professional assignments.40

In this effort, The Surgeon General, besides invoking justice for these highly trained officers, was endeavoring to correct a situation which, he stated, would inevitably result in hard feelings toward the Army in the future on the part of individuals whose work was not rewarded. Undoubtedly, many of those concerned wielded considerable influence in the medical profession, and he may have feared the effects of their criticism based on the Medical Department's failure to obtain promotions for them. The War Department finally granted his request. General Kirk was then able to recommend a one-grade promotion for many of the medical officers who were serving as chiefs of services and sections in Zone of Interior hospitals.41 He did not secure this authorization, however, until after the end of hostilities, and by that time,

39Army Service Forces Seventh Semiannual Service Command Conference, 28-30 June 1945.
40(1) Memorandum, Surgeon General Kirk, for General Somervell, Commanding General, Army Service Forces, 4 July 1945. (2) Memorandum, Chief, Personnel Service, Office of The Surgeon General, for Commanding General, Army Service Forces (attention: Director, Military Personnel Division), 10 July 1945, subject: Promotions of Chiefs of Services in Zone of Interior Hospitals. (3) Memorandum, Deputy Surgeon General, for Director, Military Personnel Division, Army Service Forces, 16 Oct. 1945, subject: Promotion of Chiefs of Services in Zone of Interior General Hospitals.
41(1) Memorandum, Surgeon General Kirk, for G-1, 28 Feb. 1946, subject: Promotion of Selected Officers. (2) Letter, Office of The Surgeon General (Col. H. W. Doan), to Commanding General, Army Service Forces (attention: Military Personnel Division), 19 Apr. 1946, subject: Promotion of Certain Medical Officers.


467

undoubtedly, some of the officers for whose promotion he had worked so diligently had returned to civilian life.

In November 1945, The Surgeon General recommended that about 100 specialists needed in hospitals in this country be retained on active duty regardless of their eligibility for separation from the Army and that all of them who were not already colonels be given a one-grade promotion. These men were promoted.42

Nurses

Some complaints were made about the delay or lack of promotion not only for male Medical Department officers but also for nurses-in the case of the latter, promotions from second to first lieutenant in particular. Pressure originated from nurses' families, from nursing and allied organizations, and from the press. The critics alleged that nurses were dispirited at their own lack of promotion in comparison to the rise of at least some members of the Women's Army Corps, of whom less formal training was required than of nurses; that some nurses served long periods overseas in the same grades as recent graduates or remained second lieutenants while others at home were promoted.

Partly, no doubt, in order to placate so many critics, the Medical Department increased its exertion, in the later war years, to get higher grades for its nurses. In November 1943, revisions of many tables of organization for various kinds of hospitals and for certain other types of medical units raised the number of nurse first lieutenants in those units while lowering the number of second lieutenants.43 As with other regulations concerning rank or promotion, this one did not make the new proportions of grades mandatory, and it is possible that for one reason or another many of the first lieutenant vacancies created by it were filled slowly, if at all. In any case, as late as November 1944, 31,116 nurses-75 percent of the total Nurse Corps strength-were still in the grade of second lieutenant.44

A move to increase the opportunity for promotion of second lieutenants, not only of the Army Nurse Corps but of all other components of the Army, took shape at the end of 1944. In December of that year, the War Department announced that any second lieutenant who had completed 18 months of service in that grade might be promoted to the grade of first lieutenant without table-of-organization or table-of-allotment vacancies in that grade, provided he (or she) was qualified for and worthy of promotion. This authorization was not to be used for the automatic promotion of all second lieutenants who had served 18 months in that grade, but was reserved for those denied

42(1) Information from Military Personnel Division, Office of The Surgeon General, 17 Mar. 1947. (2) Letter, Acting Chief, Personnel Service, Office of The Surgeon General (Col. Francis F. Mintz), to Commanding Officer, Valley Forge General Hospital, Pa., 11 Dec. 1945, subject: Promotion of Officers.
43War Department Circular No. 306, 22 Nov. 1943.
44Strength of the Army, 1 Dec. 1944. Prepared for War Department General Staff by Machine Records Branch, Office of The Adjutant General, under direction of Statistical Branch.


468

TABLE 62.-Army Nurse Corps first lieutenants and second lieutenants: Numbers in grade and numbers of promotions, September 1944-August 1945

Date

Second lieutenants1

First lieutenents1

Promotions to grade of first lieutenant2

1944

September

31,468

7,753

213

October

31,653

8,565

636

November

31,116

9,276

622

December

31,138

9,871

632

1945

January

30,810

10,790

973

February

29,601

13,752

2,350

March

30,871

16,528

3,126

April

30,870

19,490

3,670

May

29,497

22,826

3,723

June

26,013

26,330

4,369

July

25,629

28,028

1,914

August

23,984

28,695

1,388


1"Strength of the Army" for dates approximate to those shown.
2"Strength of the Army," 1 Sept. 1945.

merited advance solely because they were not in positions established for the higher grade.45 In the Medical Department, the directive applied to all officer components except the three which contained no second lieutenants-that is, the Medical, Dental, and Veterinary Corps. It meant ultimate promotion for large numbers of nurses, dietitians, physical therapists, and Medical Administrative Corps officers, and for smaller numbers of the Sanitary and Pharmacy Corps. By the early part of 1945, the change of policy was beginning to stimulate the promotion of sizable numbers of Army-nurse second lieutenants (table 62).

Dental Corps

At the urgent recommendation of the American Dental Association, and of the dental profession generally, The Surgeon General agreed in September 1943 to promote the chief of his Dental Division from brigadier general

45(1) Army Regulations 605-12, 17 Aug. 1944, with Changes No. 1, 9 Dec. 1944. The same regulations also permitted a promotion without regard to position vacancies for officers returned to the United States from a status of missing in action, evading capture in enemy controlled territory, internee, or prisoner of war, provided the officer's case presented unusually meritorious or exceptional circumstances justifying waiver of the normal requirements for promotion. This permitted one-grade promotion of the 66 nurses, 3 dietitians, and 1 physical therapist who had been prisoners of the Japanese in the Philippine Islands and who were returned to this country in early 1945 after their recovery by the forces under General MacArthur. (2) History of Nursing Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 Jan.-31 May 1945. (3) Quarterly History of Medical Department Dietitians, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 Mar.-3l Mar. 1945. (4) Quarterly History of Physical Therapy Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 Apr.-31 May 1945.


469

to major general, and to consider recommending the appointment of one or more brigadier generals in the Dental Corps. Only one was actually appointed, in February 1945; and he was reduced to the rank of colonel some months after the end of the war. There was also some improvement in rank so far as the mass of dental officers was concerned, as a comparison of the situation in late 1943 with that in 1945 (table 61) will show. Nevertheless, their position continued to lag behind that of Medical Corps officers.46

Medical Corps

In the Medical Corps, a problem of rank was sometimes involved when an officer had as his subordinate a man of lower rank but of higher proficiency rating, and therefore presumably of greater professional ability, in the specialty to which both were assigned. By virtue of his rank, the man of higher grade could give orders in technical as well as administrative matters to his subordinate and could either accept or refuse his advice. In cases such as these, it would have been better from the professional standpoint if the positions had been reversed, but under existing Army practices, there was no way this could be accomplished. Sometimes the purpose was achieved, however, in the case of specialists when the ranking officer accepted his subordinate's advice or permitted him virtually to issue the orders. If this was not done voluntarily, informal means were occasionally used to overcome the difficulty; ranking officers were asked to accept orders and advice from subordinates of superior competence. The Surgeon General's Military Personnel Division reported at the end of the war that success had occurred only in cases where the ranking officers recognized that the ability of those under them completely surpassed their own.47 The problem might also have been solved by relieving certain ranking officers from active duty, but since the procurement of medical officers was still going on, the War Department did not permit such action.

Sanitary Corps

During the war, members of the sanitary engineering profession exerted great pressure on The Surgeon General to promote members of the corps to rank commensurate with their experience. In June 1943, a bill was introduced in Congress providing for an Assistant to The Surgeon General in the person of a Sanitary Corps officer with the rank of brigadier general. The Secretary of War, however, contended that such a promotion should be made only when the War Department considered the duties and responsibilities of a Sanitary Corps officer justified it. He furthermore stated that permanent

46For a detailed discussion of the reasons for this discrepancy, see publication cited in footnote 21, p. 455.
47Report, Military Personnel Division, Office of The Surgeon General, to Historical Division, autumn 1945, subject: Medical Department Personnel.


470

legislation affecting the peacetime Army should not be enacted in time of war.48 The bill did not pass.

Enlisted personnel

Late in the war, the War Department took steps to promote privates-Medical Department as well as others-who through no fault of their own had not received a promotion-just as it did second lieutenants. In May 1945, regulations provided that commanding officers who were authorized to appoint privates, first class, might waive the requirement of an authorized vacancy to appoint enlisted men or women to that grade if they had completed one year of satisfactory service or had served outside the United States (a few exceptions were listed in the latter case). The War Department admonished that this authority was not to be used for the automatic promotion of all privates in those categories but was to be reserved for those who were qualified for promotion but were denied it because of lack of position vacancies. At the same time, oversea commanders and the commanding generals of the Army Air Forces, Army Ground Forces, and Army Service Forces were authorized to waive the requirements of an authorized vacancy to appoint to the next higher grade any persons below the grade of first or master sergeant who was returned to U.S. military control after having evaded capture by the enemy or after having been missing in action, interned, or taken prisoner. Such promotions were limited, however, to those who presumably would have been promoted except for their absence from the Army.49

PROMOTION OVERSEAS

Officers

During the early part of the war, the rank held by Medical Department officers50 overseas was the rank they had acquired before leaving the Zone of Interior. For one thing, the oversea theaters were limited as to the number of high-ranking positions they could set up. The theaters throughout the war lacked the function of supervising the worldwide medical service

48(1) Letter, Arthur D. Weston, Chief Sanitary Engineer, Department of Public Health, Boston, Mass., to Abel Wolman, Professor of Sanitary Engineering, The Johns Hopkins University, 22 Apr. 1943. (2) Letter, Deputy Surgeon General, to Abel Wolman, 30 June 1943. (3) Letter, Secretary of War, to Robert R. Reynolds, Chairman, Committee on Military Affairs, U.S. Senate, 31 May 1944.
49Army Regulations No. 615-5, Changes No. 6, 23 May 1945.
50In the section which follows, the term "Medical Department officers," unless qualified, includes nurses. On the other hand, officers above the rank of colonel are not included in the term. Probably not more than 20 general officers of the Medical Department were overseas at any time. Sixteen (3 major generals and 13 brigadier generals) are listed in "The Surgeon General's Notebook," vol. I, under date of 28 July 1945.


471

that characterized the Surgeon General's Office, nor did they have the responsibility to the same degree of definitiveness, of providing specialized treatment, as did medical facilities in the continental United States. Both of these functions formed the basis for positions with the highest ranks. Thus, it was only on rare occasions that any Medical Department corps had a percentage of its oversea strength in the rank of colonel equal to or greater than that which it possessed in the Zone of Interior (table 63). In the Dental Corps, this inherent advantage of the Zone of Interior extended down into ranks as low as that of major, for the concentrations of dental officers necessitated by a large amount of remedial work on new recruits was lacking in oversea areas.51

However, even had the higher positions existed, the possibilities of promotion into them would have been few and far between in the earlier years. Promotions at the time were greatly dependent upon the existence of vacancies. Conditions overseas, however, were not such as to give rise to a great many vacancies that could be filled by promotion. In the Zone of Interior, until the middle of the war, units were constantly activated with personnel recently drawn from civilian life; fresh jobs were continuously established, and many of the new posts could be filled by promotion. In the theaters, on the other hand, such organizations as were activated generally were staffed with the personnel of units that had been disbanded or reorganized, and the total number of jobs remained substantially unchanged. Nor did the establishment of non-table-of-organization units provide many vacancies to be filled by promotion since many casuals arrived from the Zone of Interior with grades appropriate to the positions which arose in this fashion. Casuals also could be used to replace losses which, moreover, were fairly low particularly because the U.S. Forces were not yet fully committed to combat. Finally, transfers between units often were carried out on a grade-for-grade basis. Though promotions as a rule depended on the existence of vacancies, a possibility of advancement also existed when a man held a position for which the table of organization of his unit authorized a higher rank than the one he possessed. Overseas, as in the Zone of Interior, however, some commanders both in the line as well as in the Medical Department, who had spent many years in the military service without advancement in grade, frequently were unwilling to accord their juniors rapid promotion.52

51(1) Letter, Brig. Gen. L. H. Tingay, DC, Brooke Army Medical Center, to Col. C. H. Goddard, Office of The Surgeon General, 20 Sept. 1952. (2) As late as 31 May 1944, no hospital dietitian or physical therapist was serving abroad in any grade above that of first lieutenant (table 63).
52(1) Report, Maj. John B. West, 14 Apr. 1944, on Medical Department Activities in Liberia. (2) King, Arthur G.: Medical History of Espiritu Santo (New Hebrides) Service Command, pp. 55-56. [Official record.] (3) Letter, Brig. Gen. Robert P. Williams, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 22 Dec. 1955. (4) Information from Col. Florence A. Blanchfield, USA (Ret.), 13 Mar. 1952.


472-475

TABLE 63.-Rank of Medical Department officers overseas (excluding general officers), 31 July 1941-31 May 19441


476

It is true that Regular Army promotions continued, and it can be assumed that in this respect the oversea areas had an advantage owing to the fact that they had a greater proportion of regulars in their officer strength than did the Zone of Interior (table 41). When special regulations to permit promotions in the Army of the United States were issued, the oversea areas also had an advantage in view of the greater seniority of their officers. Such regulations, however, were of extremely limited scope in the emergency and especially in the early war period.

Thus it is that the arrival of large numbers of second lieutenants from the Zone of Interior in 1942 caused the first significant wartime alteration in the distribution of rank among Medical Department officers overseas; that is, a general lowering of the level of grades. Most of the second lieutenants who came were members of the Army Nurse Corps, whose numbers overseas increased tenfold between Pearl Harbor and 30 September 1942, while those of male Medical Department officers grew less than seven times. A considerable increment of Medical Administrative Corps officers also helped to account for the increase in the proportion of second lieutenants (tables 32 and 64). Whereas the proportion of the oversea membership of this corps in the lowest rank had been less than 20 percent in November 1941, it was 43.55 percent in September 1942. The change was of such proportions that it reversed the relationship with regard to the grade of second lieutenant that had prevailed prior to Pearl Harbor between Medical Department officers and officers in general. The Medical Department overseas now had, and continued to have until at least May 1944, a ratio of second lieutenants that was larger than that possessed by the entire Army abroad. Among male Medical Department officers alone, the proportion of second lieutenants also increased, but it is clear that overseas as at home the proportion continued to be smaller than was the case among the other male officers until the end of the war. The fact that the Medical Corps, Dental Corps, and Veterinary Corps had no members in the grade of second lieutenant accounts for this situation.

A similar process was taking place in the Zone of Interior. Intensive commissioning of Medical Administrative Corps officers beginning in 1942 and heavy recruiting of the professional corps during the same period accounts for the substantially greater proportions of worldwide strength in second and first lieutenants as compared with oversea strength.

The latter part of the war witnessed a very marked improvement in promotion rates among oversea Medical Department officers. This development began to manifest itself among the male components of the group toward the middle of 1943. During 1944, the pace slackened, but in 1945 rates were attained which surpassed the levels reached in 1943 (table 65). Although


477

pressure by Surgeon General Kirk upon oversea authorities in mid-1944 gave some impetus to promotions of members of the Army Nurse Corps, the monthly rate of these promotions abroad even during the third quarter of that year was 0.1 per 1,000, whereas the worldwide rate was 3.4 (table 65).53

In 1945, however, great promotion activity was manifested among the members of the female components in the Medical Department overseas. The most important factors in the improvement of the promotion rates of Medical Department officers were the special regulations making possible advancements in grade regardless of the existence of vacancies. However, a directive of October 1943 authorizing promotion of second lieutenants of the Nurse Corps to the rank of first lieutenant irrespective of openings in the higher grade was of little influence at least until the invasion of Normandy since they were applicable only to personnel serving with combat forces engaged in foreign areas.54

Promotions through the creation of vacancies also increased in the later war period. Higher attrition rates, rotations, arrival of units from the Zone of Interior without qualified incumbents in highly specialized jobs, and changes in tables of organization to permit replacement of medical officer's by members of the Medical Administrative Corps all swelled the number of vacancies in oversea areas, although in many cases obstacles were raised to filling these vacancies by promotion. Among such obstacles was the requirement that an officer rotated to the Zone of Interior be replaced by an officer from that area holding the same rank. In the North African theater, regulations issued in August 1944 provided that a replacement for a Medical Department officer be requisitioned in the same grade as the individual to be replaced and that when a vacancy was to be filled by promotion no action to that effect be taken until a replacement was obtained for the officer to be promoted. In the Southwest Pacific, medical officers transferred to headquarters in order to serve as consultants, remained on the rolls of their parent units, thus blocking promotion opportunities in such units.55

53(1) Letter, Maj. Gen. Kirk, to Maj. Gen. M.C. Stayer, Chief Surgeon, North African Theater of Operations, U.S. Army, 30 Nov. 1944. (2) Letter, Maj. Gen. Kirk, to Maj. Gen. P. R. Hawley, Chief Surgeon, European Theater of Operations, U.S. Army, 30 May 1944.
54Promotions under the regulation were subject to demonstration of the fitness of the subject for advancement. She must also have served at least 6 months as a second lieutenant, no less than 3 months of this being in a theater of operations. Moreover, the number of first lieutenants in a table-of-organization unit might not exceed 50 percent of all lieutenants in the unit. Finally, the authorization applied only to specified theaters. Memorandum, The Adjutant General, to Commanding General, Army Ground Forces, 2 Oct. 1943, subject: Promotions of Second Lieutenants, Army Nurse Corps, in Active Theaters. Also Annual Report, Surgeon, U.S. Army Services of Supply, 1943.
55(1) Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944. (2) Memorandum, Brig. Gen. G. B. Denit, Chief Surgeon, Headquarters, U.S. Army Forces, Far East, for Colonel Pincoffs, 22 May 1945.


478-479

TABLE 64.-Temporary promotions of Medical Department officers, worldwide and overseas, January 1943-September 1945


480-481

TABLE 65.-Temporary promotions of Medical Department officers by rank,1 by corps, and by other components, worldwide and overseas, November 1944 to June 1945, inclusive


482

Some commanders also retained their prejudice against rapid promotions. On the other hand, in Espíritu Santo and probably in many other places there were commanders who, upon hearing reports of high initial ranks being granted to men entering the medical service in the United States, went to the opposite extreme and tried, although perhaps with not much success, to fill all vacancies by promotion even before they had an opportunity to observe the beneficiaries in action. For similar reasons, commanders were more willing than formerly to permit individuals to attain the rank authorized for their jobs by tables of organization.

In spite of obstacles, at least 19.4 percent of all Medical Department promotions during the period from November 1944 to June 1945, inclusive, resulted from assignments to vacancies or from advancement to authorized rank. In each of the Medical Department's male officer corps, the percentage was much higher (table 65).

In the latter part of the war, promotion rates of Medical Department officers overseas at times exceeded the corresponding worldwide rates. There were several reasons for this. The special regulations favoring promotion had their initial application in the Zone of Interior and attained their peak effect overseas when their influence at home was waning. Certain regulations, such as the time-and-a-half credit for service abroad, quite rightly favored oversea personnel. Promotion requirements in the continental United States became more stringent. Finally, few new units were being activated in the Zone of Interior, and in those that were activated, the new jobs were given more and more to the former members of disbanded or reorganized establishments or to men who had been rotated home from overseas who already had ranks appropriate to the vacancies created.

Although the rate of promotion of oversea Medical Department officers increased, it exceeded the rate of all officers in the theaters only during the second quarter of 1945. The reason for this generally lower rate was the fact that attrition was a much greater influence in the Army in general than it was in the Medical Department. The contrast is better illustrated when male officers alone are compared. At no time did the promotion rate of male Medical Department officers overseas even closely approach that of the corresponding group in the Army as a whole despite the increased medical losses experienced in 1945 and all the other aids to promotion activity. Indeed, promotion rates of the two groups were closer together in 1943 than they were at later dates.

Even though promotions overseas increased during the latter part of the war, it can be assumed that only about half of all Medical Corps officers who served overseas prior to the end of hostilities received promotions there. Many officers, of course, received promotions before going abroad, but the fact nevertheless remains that considerable numbers of medical officers who


483

saw service overseas never were promoted at all or not until late in their Army careers.56

Decentralization of promotions

Decentralization of promotion in wartime had many advantages. It obviated heaping upon a central headquarters the vast amount of paperwork necessary to the promotion of officers, both of high and of low rank. In removing the necessity of sending all recommendations for promotions through military channels to a central headquarters (for the Medical Department this was the Surgeon General's Office), decentralization speeded promotions greatly. This acceleration tended to foster officers' morale. Undoubtedly, The Surgeon General was content to have others promote officers in the lower grades. Lack of attention in certain instances to qualifications when promoting officers to the grade of colonel overseas, however, posed serious problems for him when men who lacked either the professional or the military experience to justify that rank for assignment to any type of job were returned to the Zone of Interior. Often, particularly in the later war years, he had difficulty in persuading commanding generals of service commands and others to accept young, inexperienced or ineffectual men who held that rank. A centralized control over promotions to the rank of colonel, in the hands of The Surgeon General, might possibly have tended to eliminate such difficulties.57 But this procedure was unthinkable. Theater commanders had the authority to promote up to and including the rank of colonel. This was based on the recommendations of major commanders and availability of TOE vacancies and the proved competence of the individual concerned.

Enlisted Personnel

Between 31 July 1941 and the end of May 1944, the percentage of Medical Department enlisted men who were in grades above that of private increased from 49 to 68, and above the grade of private, first class, from 19 to 45 percent. Even in ranks above that of corporal, the increase was substantial, being from 15 to 21 percent (table 66). In terms of pay, however, these improvements were less significant than they seem to be. Prior to June 1942, certain Medical Department enlisted men in the grades of private and private, first class, had specialist ratings which made their pay equal to that of soldiers in higher ranks. What proportion of the number in each of these grades they constituted is unknown, but it seems probable that they comprised more than 31 percent of all Medical Department enlisted men

56Letters, to Col. C. H. Goddard, Office of The Surgeon General, from (1) T. L. Badger, M.D., 3 Sept. 1952; (2) Col. E. G. Billings, 23 Sept. 1952; (3) Col. H. L. Blumgart, 7 Aug. 1952; (4) Col. G. G. Duncan, 19 Aug. 1952; (5) C. S. Drayer, M.D., 3 Sept. 1952; (6) G. H. Gowen, M.D., 10 Sept. 1952; and (7) Col. George G. Finney, 2 Sept. 1952.
57Letter, Col. Paul A. Paden, Percy Jones Army Hospital, to Col. C. H. Goddard, Office of The Surgeon General, 9 June 1952.


484

TABLE 66.-Rank of Medical Department enlisted men overseas, 31 July 1941-31 May 19441

Date


Master sergeant

First sergeant

Technical sergeant

Staff sergeant2

Sergeant3

Corporal4

Private, first class

Private

Number

Percent of strength in rank

Number

Percent of strength in rank

Number

Percent of strength in rank

Number

Percent of strength in rank

Number

Percent of strength in rank

Number

Percent of strength in rank

Number

Percent of strength in rank

Number

Percent of strength in rank

31 July 1941

Total Army

961

0.77

874

0.70

1,762

1.40

4,220

3.36

9,665

7.71

11,554

9.21

33,399

26.63

62,999

50.22

Medical Department

26

.60

9

.21

75

1.74

188

4.37

328

7.63

202

4.70

1,271

29.56

2,201

51.19

30 November 1941

Total Army

1,136

.74

1,098

.71

1,969

1.28

5,415

3.52

12,637

8.21

14,777

9.60

40,858

26.56

75,962

49.37

Medical Department

45

.68

25

.38

97

1.47

248

3.77

494

7.51

386

5.87

1,888

28.69

3,397

51.63

30 September 1942

Total Army

4,990

.65

4,115

.54

10,195

1.33

34,261

4.46

82,638

10.76

124,311

16.19

171,803

22.37

335,738

43.71

Medical Department

168

.35

216

.44

533

1.10

2,480

5.11

4,213

8.68

7,391

15.22

11,880

24.47

21,666

44.63

31 January 1943

Total Army

7,252

.70

5,527

.53

16,175

1.56

55,478

5.35

120,156

11.59

193,408

18.66

236,881

22.86

401,452

38.74

Medical Department

244

.34

319

.44

797

1.10

3,105

4.30

7,409

10.25

13,647

18.89

17,733

24.54

29,005

40.11

31 December 1943

Total Army

19,536

.81

13,200

.55

48,100

2.00

55,747

6.49

320,695

13.37

517,470

21.57

551,328

22.98

773,383

32.23

Medical Department

673

.37

725

.40

2,174

1.20

10,178

5.60

22,515

12.39

41,440

22.80

43,893

24.15

60,164

33.10

31 May 1944

Total Army

29,549

.87

18,731

.55

80,443

2.36

246,654

7.22

466,609

13.67

721,718

21.14

796,861

23.34

1,053,584

30.86

Medical Department

1,033

.40

1,065

.41

3,105

1.20

16,565

6.43

33,584

13.03

60,976

23.65

59,852

23.22

81,625

31.66


1Basic data from sources shown in table 31, footnote 3.
2After 1941 includes technicians, 3d grade.
3After 1941 includes technicians, 4th grade.
4After 1941 includes technicians, 5th grade.


485

in oversea areas. After June 1942, the specialist ratings were abolished, and although a minority of the men who had held them remained in the ranks of private and private, first class, the bulk of the specialists were automatically placed in the newly created ranks of technician, 5th grade, and technician, 4th grade. Their rank was thus brought up to the level of their pay rather than vice versa. Despite this immediate monetary limitation, the level of pay of Medical Department troops nevertheless increased considerably over a period of time through gains in the level of grades. Between 30 September 1942, by which time the conversion of the grades of enlisted specialists had been completed, and 31 May 1944, the proportion in grades above that of private increased by nearly one-fourth; above that of private, first class, by about one-half; and above that of corporal by a somewhat smaller ratio.

What proportion of this relative rise in rank of Medical Department enlisted men took place overseas cannot be precisely determined. As in the case of officers, attrition and special regulations favoring oversea personnel undoubtedly had some effect on promotion rates in the late stages of the war, but not enough to put the Medical Department on a par with the Army as a whole in this respect. The medical soldier continued to have less chance of promotion to higher rank, with accompanying increase in pay, than had his enlisted counterpart elsewhere in the Army.

RETURN TO TABLE OF CONTENTS