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Chapter IV

Contents

CHAPTER IV

Requirements: 1941-45

In May 1941, the War Plans Division of the General Staff was given the task of preparing a study on the ultimate munitions that the United States would have to produce to defeat the Axis Powers. At the request of President Roosevelt in July and again in August, the study was expanded to include an estimate of troop strength and total units necessary for the various theaters. This Victory Program submitted to the President on 25 September 1941 placed total strength at 8,795,658.1 The production goals for munitions were immediately established on the basis of the Victory Program, but no action was taken on a troop basis until after the Japanese attack on Pearl Harbor. The Victory Program became the War Munitions Program at that time, and the preparation of intermediate troop bases became necessary. The 1943 troop basis was set at 8,208,000 (7,533,000 enlisted men, 675,000 officers); the 1944 troop basis reduced overall strength to 7,700,000.2 In the spring of 1942, The Surgeon General estimated his requirements for the various corps of the Medical Department based on the strength estimates of the Victory Program and the 1943 troop basis, as yet unapproved.

MEDICAL CORPS

In April 1942, in compliance with a request from the Assistant Chief of Staff, G-1, War Department, General Magee estimated that the United States had a total of 176,000 physicians, and remarked that "while many are overage or have retired from practice * * * it will be assumed that the entire number is available for the period of national emergency." He doubted that the Federal services, including the Military Establishment, could obtain more than a third of these and declared that, if no more than 50,000 were available for the Army, the existing allotments and tables of organization would have to be reduced by one-third. He estimated that under these existing allotments and tables 75,000 physicians would be needed for a 7,500,000-man Army, or one for every 100 men. Initially, however, the ratio would be

1Watson, Mark Skinner: Chief of Staff: Prewar Plans and Preparations. United States Army in World War II. The War Department: Washington: U.S. Government Printing Office, 1950, pp. 338-349.
2
Kreidberg, Marvin A., and Henry, Merton G.: History of Military Mobilization in the U.S. Army, 1775-1945. Washington: U.S. Government Printing Office, 1955, pp. 628-629. (DA Pamphlet 20-212.)


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greater, decreasing as the troop basis rose.3 In suggesting that he might be allowed 50,000, The Surgeon General at this early date had arrived at a figure very close to the 45,000 ultimately granted him.

In the course of the next few months, the question of the ratios of physicians to troops in foreign armies was injected into the discussion of the desirable strength of the Medical Corps. This point may have been raised at this time by the fact that in July plans for the first Allied assault landing (Operation TORCH) were being formulated. It was the President himself who raised the question by telling the Chief of Staff and the Chairman of the War Manpower Commission that he could not reconcile the British ratio of 3 physicians per 1,000 troops with the United States ratio of 8 per 1,000. At about the same time, a subcommittee of the Senate Committee on Labor and Education dealing with war manpower issued a preliminary report in which it stated, after noting that the ratio of doctors to military strength in the American Army appeared to be more than twice that maintained by the Allies of the United States, that British experience should be studied in order to work out a balanced plan for use of this scarce national resource.

Shortly after this recommendation was published, The Surgeon General took note of the President's comment in a communication to the General Staff. After stating a belief that the British ratio was 4.5 per 1,000 instead of 3, he said that the ratio of physicians to population in Great Britain was considerably lower than in the United States and that because of proximity to active operations "a large percentage" of British casualties were cared for in civilian hospitals. Moreover, not only were standards of medical care much higher in the United States than in Great Britain but the British themselves had recognized the inadequacy of their medical service by requesting "large numbers" of medical officers from the United States before we entered the war. Then, The Surgeon General, after reviewing the history of congressional action on ratios, pointed out that the act of 3 April 1939 in authorizing 1,424 Medical Corps officers had established a ratio of 6.33 per 1,000 of enlisted strength. He contended, however, that this figure provided Medical Corps officers only for administrative overhead and hospital care, not for combat units or for the organization and training of tactical medical units. He asserted that it had been demonstrated "through all the lean years prior to the present emergency" that this ratio would provide only for the necessary care of the sick "in accordance with the accepted standards of American medicine."4 But during a war, he continued, it was necessary to man tactical units and to provide a relatively higher proportion of Medical Corps officers for the increased hospitalization incident to the care of battle casualties and troops living under adverse cli-

3Memorandum, The Surgeon General (Col. John A. Rogers, MC, Executive Officer), for Personnel Division, Services of Supply, 27 Apr. 1942.
4Memorandum, The Surgeon General (General Magee), for Chief of Staff, 23 Oct. 1942.


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matic and general health conditions in various parts of the world. Small garrisons and task forces scattered throughout the world increased medical personnel requirements, although The Surgeon General said it was difficult to evaluate that factor accurately. He pointed out that he had reduced tables of organization and service command allotments sufficiently to save more than 8,600 doctors.

General Magee declared that he would be remiss in his duty if he "failed to emphatically protest any reduction of medical officers which would lower the standards of medical service * * * below that confidently expected by the American public. Should these standards be dangerously lowered future criticism would be mainly directed against the Army." "Any further material reduction," he said, "will lower medical efficiency to a dangerous level." He believed that 50,000 physicians for an army of 7.5 million men would enable his Department to perform its mission.

In concluding this strong statement of his position, The Surgeon General expressed his conviction that from the national point of view the problem was not so much one of reducing the number of physicians in the Army as it was one of redistributing available physicians to meet civil requirements.

The question of foreign ratios and also the proper ratio of doctors for the U.S. Army came before the Committee to Study the Medical Department of the Army. Those who testified on personnel matters included not only officers from the Surgeon General's Office and the Services of Supply, but also individuals from the Directing Board of the Procurement and Assignment Service, the Director of the War Manpower Commission, which in April 1942 had incorporated the Procurement and Assignment Service into its organization, officials of the American National Red Cross, and other civilians.

Shortly after General Magee's reply to President Roosevelt concerning the ratios of foreign and American doctors in army medical services throughout the world, the committee made its report. Among other comments, the committee stated, on what authority is unknown, that the ratios of Medical Corps officers to military personnel adopted by the Army was 6.5 per 1,000 troops in the United States and 10.5 per 1,000 in theaters of operations, but this ratio in foreign armies was not obtainable. Furthermore, the committee stated that it did not feel competent to express an opinion as to the adequacy of the American ratios."5

Meanwhile, the Deputy Chief of Staff in October 1942 asked The Surgeon General to submit a plan for the medical service of a fully expanded army (fig. 18). The plan, concurred in by the Air and Ground Surgeons and presented in December 1942, proposed 49,100 doctors for an army of 7,500,000-a ratio of about 6.5 per 1,000-and recommended a reduction of allotments to Zone of

5Report, Committee to Study the Medical Department, 1942.


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FIGURE 18.-Representative Army surgeons. Upper left: Brig. Gen. John A. Rogers, MC, First U.S. Army. Upper right: Brig. Gen. Thomas D. Hurley, MC, Third U.S. Army Lower left: Brig. Gen. Joseph I. Martin, MC, Fifth U.S. Army. Lower right: Col. (later Brig. Gen.) William A. Hagins, MC, Sixth U.S. Army.


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FIGURE 18.-Continued. Upper left: Col. Myron P. Rudolph, MC, Seventh U.S. Army. Upper right: Brig. Gen. George W. Rice, MC, Eighth U.S. Army. Lower left: Brig. Gen. William E. Shambora, MC, was colonel when Surgeon, Ninth U.S. Army. Lower right: Col. Frederic B. Westervelt, MC, Tenth U.S. Army.


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Interior installations based on new personnel guides to be promulgated.6 The proposed allotment to the three major forces were as follows:

 

Allotment

Army Ground Forces:

 

Units in the 1943 troop basis

113,222

Army Air Forces:

Units in the 1943 troop basis

4,553

Zone of Interior (including station hospital staffs, schools, and so forth)

27,358

Services of Supply:

Units in the 1943 troop basis for medical service (3 million overseas)

314,254

Zone of Interior (including station and general hospitals, technician schools, Medical Replacement Training Centers, laboratories, overhead and procurement and supply activities, except those provided by Army Air Forces)

48,809

Total

549,100


1After a reduction of 827.
2After a reduction of 262. 
3
After a reduction of 361. 
4After a reduction of 2,805.
5
Includes 904 allotted to War Department filler and loss replacement pool.

After discussion about the number of doctors, the Deputy Chief of Staff in March 1943 set the permissible number at 48,000 for an Army strength of 8,248,000 (the 1943 troop basis plus 40,000 Army nurses). Six months later, however, G-1 stated that in view of a reduction of the troop basis to 7,686,000 the War Department could not support the previous figure and ordered a restudy to reduce it, indicating that 45,000 would be about the right number. Shortly afterward, Army Service Forces headquarters directed The Surgeon General to modify his plan for the utilization of Medical Corps officers, using a basis of approximately 45,000 officers for an army of 7,686,000 as of 31 December 1943.7

At the end of September 1943, Medical Corps strength stood at 39,951 and total Army strength at 7,273,784, or a ratio of 5.49 doctors per 1,000 strength. Forty-five thousand doctors for an Army of 7,686,000 would have provided a ratio of slightly less than 6 per 1,000. In protesting against this reduction, The Surgeon General declared that 48,000 was an irreducible minimum. Although no action seems to have been taken on this rejoinder, The Surgeon General later noted that the reduction to 45,000 had been made while a draft of doctors was under discussion, and claimed that it was without prejudice to additional requirements after 1 January 1944.8 At this time, there was no question of

6Memorandum, Acting Surgeon General, for Deputy Chief of Staff (through Military Personnel Division, Services of Supply), 14 Dec. 1942, subject: Availability of Physicians.
7(1) Memorandum, Deputy Chief of Staff, for Commanding General, Army Service Forces, 10 Mar. 1943, subject: Availability of Physicians. (2) Memorandum, G-1, for Commanding General, Army Service Forces, attention: Military Personnel Division, 18 Sept. 1943, subject: Officer Requirements. (3) Memorandum, Military Personnel Division, Army Service Forces, for The Surgeon General, 22 Sept. 1943, subject: Officer Requirements, Medical Corps.
8(1) Memorandum, Military Personnel Division, Army Service Forces, for The Surgeon General, 22 Sept. 1943, subject: Officer Requirements, Medical Corps, with 1st endorsement thereto, 2 Oct. 1943. (2) Memorandum, The Surgeon General, for Assistant Chief of Staff, G-1, 11 Sept. 1944, subject: Conference With Chairman, Procurement and Assignment Service.


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exceeding an actual strength of 48,000 or even 45,000, since the total number of Medical Corps officers on duty was only about 40,000 as late as the end of December 1943 (table 1).

By the end of September 1944, however, the number on duty was approximately 45,000, and on 7 October, the War Department again established that figure as a ceiling; any excess was to be disposed of either by transferring officers to the Veterans' Administration or by separating them from the service. Two days later, The Surgeon General stated that 47,000 as of 31 December 1944 was a "firm requirement" and that further reduction of tables of organization was "out of the question."9 On 7 November 1944, his appeal was rejected, but the War Department acknowledged that it was "impracticable to maintain an exact ceiling of 45,000" and that "some tolerance or leeway appears desirable on the long side."10 In any event, the strength of the Medical Corps was permitted to exceed the ceiling; at the end of November 1944, it stood at 46,747 and reached its maximum-about 48,000-in July 1945 (table 1).

Procurement and Assignment Service

The Procurement and Assignment Service, which had been established shortly before Pearl Harbor as a coordinating agency for all Federal services for medical, dental, and veterinary personnel, in April 1942 created a Committee on Allocation of Medical Personnel, which was charged with determining a safe minimum standard of medical care for civilians. The minutes of the first meeting of this committee (26 April 1942) show that it entered on its task with the idea not only of allocating personnel to civilian and military service, but of trying to constrain the Army into what it considered an efficient use of physicians. Dr. Harold S. Diehl, Dean of Medical Sciences, University of Minnesota, the chairman, said that the committee had to plan to prevent medical personnel from being put into positions where their special qualifications were not utilized. Dr. Roscoe G. Leland, Director of the Bureau of Medical Economics of the American Medical Association, a member, expressed the opinion that it would be the committee's job to get the Army to change its position on requirements by reducing the ratio of physicians to Army strength and by replacing certain physicians with medical administrative personnel. Dr. Diehl then said that "if we have a case and can get the figures to prove it, we can get the Army to revise their demands."

This is one of the first indications that the members of the Procurement and Assignment Service actually meant to put a limit on the number of physicians the Army could have so as to keep civilian communities from being stripped of doctors. The sequel was that for the duration of World War II

9Memorandum, The Surgeon General, for the Assistant Chief of Staff, G-1, 9 Oct. 1944, subject: Medical Officer Requirements and Availabilities.
10Letter, The Adjutant General, to The Surgeon General, 7 Nov. 1944, subject: Medical Corps Officers-Procurement, Assignment, and Ceiling.


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the Medical Department was governed in many aspects of its personnel procurement program by the wishes of a civilian agency.

On 7 November 1942, at a meeting attended among others by Surgeon General James C. Magee; Vice Adm. Ross T. McIntire, his Navy counterpart; and Paul V. McNutt, Chairman of the War Manpower Commission, the Procurement and Assignment Service recommended a ratio of 1 physician to 1,500 of population as a minimum for civilian medical service in each State. This of course would indirectly set a limit on the procurement of doctors for the armed services. Admiral McIntire agreed that every possible effort should be made to maintain the proposed ratio and stated that the Navy could operate with "anywhere from 6 to 6.5 in this war." General Magee accepted the 1:1,500 ratio for civilian medical service, but objected to committing himself as to the precise number of doctors the Army would need. The Medical Department, he said, was reducing its figures "as far as our conscience and intelligence will let us," but "if it comes to a point of making immediate decisions, I am not in a position to do so at the present time." Mr. McNutt was obviously dissatisfied with The Surgeon General's position. He said that the Procurement and Assignment Service would give the Armed Forces all it possibly could, but that he knew "full well" that tables of organization had been too high. "If you want my candid appraisal of the situation," he said, "we cannot be dealing with any 8.2 or 8.3 per 1,000. We had better be talking about 6.4 or 6.5." The latter ratios would have given the Army about 48,000 doctors figured on a strength of 7.5 million, or in fact very nearly the 50,000 which The Surgeon General had earlier suggested. That suggestion had probably been made, however, with a view to giving the Army not as many doctors as would be considered ideal but simply enough to enable the Medical Department to fulfill its function.

The Procurement and Assignment Service adhered to the 1:1,500 ratio for civilian medical service throughout the war as a basis for authorizing the military services to procure doctors in the several States. Many States did not possess so high a ratio; some had higher. The Procurement and Assignment Service had small power to improve their positions by reallocating civilian doctors, and in fact, it achieved little in that respect.

In discussing the Procurement and Assignment Service's lack of power to relocate doctors, the vice chairman of that organization had stated:

Our position would have been much easier, and some of our obvious failures might have been avoided, if we had possessed the same "power" over the relocation of civilian doctors to needy communities that we had to limit the commissioning of medical officers to those men considered "available." The fact that New York and Chicago, throughout the war, had an excess of doctors and dentists that we could not relocate, weakened our position and prevented the accomplishment of our obligations to the civilians. If another great war should break out, I personally think that a body with power over all professional people should be set up.11

11Letter, Harvey B. Stone, M.D., to Col. C. H. Goddard, MC, Office of The Surgeon General, 3 June 1952.


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FIGURE 19.-Brig. Gen. Robert Mills, DC, wartime director of the Dental Division, Office of The Surgeon General.

DENTAL CORPS

By the start of World War II, experience had shown that any ratio of less than 1 dental officer for each 750 men would be grossly inadequate. Although formal requests for procurement objectives were generally brief, containing no discussion of the method of calculation, it is clear that the ultimate goal of the Surgeon General's Office was an overall ratio of 1 dentist for each 500 men. This ratio was agreed upon informally between the director of the Dental Division (fig. 19) and the chief of the Personnel Service, both in the Office of The Surgeon General.12 Even though it was not "officially recognized," the July request for a procurement objective stated that it was based on a ratio of 2 dentists per 1,000, and permission was asked to appoint up to 9,000 Dental Corps officers for an Army of 4.5 million.13 In November 1942, The Surgeon General estimated that in view of the planned increase in the size of the Army

12Medical Department, United States Army. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955.
13
Letter, Office of The Surgeon General, to Commanding General, Services of Supply, 3 July 1942, subject: Procurement Objective, Dental Corps, Army of the United States.


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he would need 17,248 dentists. This estimate was accepted by the War Department General Staff.14

The overall ratio of dental officers (1 to 500) which the Dental Service considered necessary was never reached during the entire war period except in September and October 1942. The problem of meeting the needs of new recruits for dental rehabilitation, which was particularly serious during the early part of the war, seems to have been partially met by deferring all but work of an emergency nature.

Early in 1943, the Procurement and Assignment Service determined that 1 dentist was required for each 2,500 civilians and that a total of 22,620 could be spared for the Army and Navy, thereby leaving 50,250 in civilian practice.15 This standard and its application could be criticized on several grounds. In the first place, the standard was arbitrary, being based more on opinion than knowledge. Moreover, not all communities had as many as 1 dentist per 2,500 civilians-many had not above half that ratio-and there was no machinery to give them more or even to restrict recruiting to other areas. Finally, if the number of dentists that could be spared for the Armed Forces had been arrived at simply by counting as available all dentists in excess of the 1:2,500 ratio in communities possessing a higher ratio, the number would have been considerably larger than 22,620. The military authorities, however, did not raise these or other objections to the calculations of the Procurement and Assignment Service; they could hardly have effectively challenged a formula which gave them the right to solicit one-third of the Nation's dentists for 12 million men while two-thirds were reserved for 120 million civilians.

In late 1943, Army Service Forces set a ceiling of 15,200 for the Dental Corps. According to Col. George F. Jeffcott, DC:

The manner in which the ceiling for the Dental Corps was established, and the exact date, are not entirely clear. In a memorandum to the Deputy Surgeon General, of 7 Sep 43, Lt Col D. G. Hall of the Personnel Service, SGO, stated that his office had "that day" been notified of a revised requirement based on changed plans in ASF * * *. Other incidental references [however] indicate that representatives of the Dental Division [SGO], the Military Personnel Division, SGO, and of G-1 attended conferences on the matter before a decision was reached. It is also probable that PAS [Procurement and Assignment Service] had a hand in the matter, but the extent to which its influence affected ASF is not known.16

VETERINARY CORPS

Unlike the Medical, Dental, and Army Nurse Corps, the size of the Veterinary Corps could not be calculated by a simple ratio of veterinarians to the overall strength of the Army. One factor that complicated the process of calculation was present to some degree before the United States entered

14 Letter, The Adjutant General, to The Surgeon General, 27 Nov. 1942, subject: Increase in Procurement Objective for The Surgeon General (Dental Corps).
15Minutes, Committee on Dentistry, Procurement and Assignment Service, 20 Feb. 1943. 
16See footnote 12, p. 75.


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the war-the inspection of food by the Army Veterinary Service for other branches of the Military Establishment and even for certain nonmilitary agencies of Government. During the war, one of the most important tasks of Veterinary Corps officers was the procurement-inspection of food for the Navy and the Marine Corps; by the end of the war, Army veterinarians were inspecting about 90 percent of the Navy's food at the time of procurement.17

New and increased requests for veterinary officers throughout the war period therefore perplexed the General Staff, for no fixed basis, such as troop strength, could be used as a guide in making their decisions.18 Army Regulations No. 40-2035, 18 December 1942, governing veterinarians, listed the number of assistants a station veterinarian could have (depending on animal strength) and stated further:

A station having a human strength of approximately 1,000 will be allowed one or more veterinary officers, as circumstances warrant, for duty in connection with meat and dairy hygiene, the maintenance of instruction courses, or other duties pertaining to the veterinary service. At depots, ports of embarkation and debarkation, purchasing points, and other places where foods of animal origin are purchased, stored, or handled by the Army, the assignment of veterinary officers will be based on actual need as determined by The Surgeon General.

In practice, The Surgeon General from time to time requested new procurement objectives which would authorize the Medical Department to obtain additional veterinary officers as the occasion seemed to demand. Although the objectives granted were not as large as those he requested, they enabled the corps to be moderately enlarged. No ceiling appears to have been set for the Veterinary Corps until January 1945 and even this was more in the nature of a procurement objective, since the War Department General Staff not only set a figure (2,150) somewhat above the actual strength but authorized procurement of the necessary officers from certain specified, though restricted, sources.19

SANITARY CORPS

Throughout the war, no personnel ceiling was established for the Sanitary Corps, and no ratio was adopted as a means of computing the numbers required. The Surgeon General merely requested and justified successive procurement objectives which, if approved by the War Department General Staff, permitted him to add certain numbers to the corps. In February 1945, further commissioning in the corps was ordered stopped, the membership being considered large enough for the Army's needs.

17Annual Reports, Veterinary Division, Office of The Surgeon General, U.S. Army, 1942-46.
18Information from Maj. E. B. Miller, VC, U.S. Army Medical Service historian, 1950.
19Semiannual Report, Procurement Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 Jan.-31 May 1945.


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FIGURE 20.-Brig. Gen. Edward Reynolds, MAC, Chief, Medical Administrative Corps.

PHARMACY CORPS

The number of personnel required by the Pharmacy Corps was determined by The Surgeon General. Since most of the pharmaceutical work in the Army could be done by pharmacy technicians working under supervision, the 72 Pharmacy Corps officers permitted by the act of 1943 which created the corps proved to be more than sufficient throughout the war from The Surgeon General's point of view.

MEDICAL ADMINISTRATIVE CORPS

On 30 June 1940, the ratio of Medical Administrative Corps (fig. 20) officers on active duty to Medical Corps officers was a little more than 1:25; 5 years later, the ratio had risen to l:2.4. This was due not to the establishment of a formal requirement for Medical Administrative Corps officers but rather to the transfer of administrative duties from Medical Corps officers to qualified nonprofessional personnel, thereby freeing the physicians for strictly professional work.


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In April 1942 when, in reply to questions from G-1, The Surgeon General was discussing the substitution of Medical Administrative Corps for Medical Corps officers, he said that whereas 75,000 physicians would be needed according to existing tables of organization and allotments, probably 10 percent of that number, or 7,500, could be supplanted by Medical Administrative Corps officers. "It is doubtful that all of these or additional substitutions would prove of economic value," he explained.20

Apparently not until the Medical Department found itself limited by the ceiling on doctors did it envisage the great number and variety of assignments that members of the Medical Administrative Corps were qualified to fill. Nevertheless, in a report on the procurement and supply of Medical Corps officers, the Control Division, Services of Supply, stated in June 1942 that as a result of the serious shortage of Medical Corps officers the Medical Department had an obligation to release them from "all administrative procurement, and similar duties which can be assigned to nonmedical personnel." This report did not limit those to be substituted to members of the Medical Administrative Corps, but suggested the use of Sanitary Corps, branch immaterial, and Army Specialist Corps officers as well.21 In July 1942, The Adjutant General issued a letter requiring the relief of Medical Corps officers from duties that did not demand professional training.

The Committee to Study the Medical Department reviewed the problem of replacement of Medical Corps officers and made the following recommendations:

l. The practice of assigning Medical Corps officers, even temporarily, to any type of work that could be performed by nonprofessional personnel should be discontinued.

2. Medical and dental officers should be utilized to the fullest extent in their professional fields.

3. All professional personnel engaged in administrative tasks except those who had lost the skills necessary for professional work should be replaced by Medical Administrative Corps personnel.

4. More nonmedical men who had proved competent in managing establishments providing medical care should be used in positions of greater responsibility in Army hospitals and even in the higher echelons of the Medical Department.

5. The Medical Department should take steps, "even at this late date," [1942] to increase greatly the number of Medical Administrative Corps trainees per month.

The committee believed that statements made by The Surgeon General's representatives that the supply of such officers would equal demand by 1 Jan-

20Memorandum, The Surgeon General (Col. John A. Rogers, MC, Executive Officer), for Personnel Division, Services of Supply, 27 Apr. 1942.
21The Army Specialist Corps was composed of administrative, professional, scientific, and technical specialists who were "civilians in uniform" functioning under civil service. The corps existed less than a year, being abolished in late 1942.


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uary 1943 were far too optimistic.22 As by that date only about 5,900 were on duty in contrast to the later peak strength of nearly 20,000, the committee's belief seems justified (table 1). Actually, the Department did not have enough Medical Administrative Corps officers until nearly a year after the committee met; even then, the sufficiency lasted but a few months.

Not all high ranking Medical Department officers agreed on the extent to which Medical Administrative Corps officers should replace those of the Medical Corps. The commanding officer of the Medical Replacement Training Center at Camp Pickett, Va., was reported in 1942 as insisting that he "could not possibly" run his center "on a sound basis" with fewer than two and one-half or three Medical Corps officers per training company; this would have required either 10 or 12 for each battalion. At the same time, it was reported that the training center at Camp Barkeley, Tex., was operating with only three Medical Corps officers per battalion.23

In 1943, the training center at Camp Grant, Ill., noted that young Medical Administrative Corps officers were rapidly replacing doctors and dentists, and that in most cases the replacement had proved very satisfactory. Whereas, on 30 June 1942, 37 percent of the 383 officers at the center had been Medical Corps, 25 percent Dental Corps, and 19 percent Medical Administrative Corps officers, a year later the percentage of medical and dental officers had fallen to 10 and 2, respectively, while that of Medical Administrative Corps officers had risen to 73 in a total officer group of 423.

In the fall of 1943-at a time when difficulties were foreseen in furnishing doctors to all the units and installations which The Surgeon General believed to be in need of them-General Kirk determined to effect a more widespread replacement. He decided to replace one of the two battalion surgeons with a specially trained Medical Administrative Corps officer to be known as battalion surgeon's assistant and to make other substitutions of a similar nature.24 Although fear was expressed that such substitution in the battalion was a real source of danger since it was "unquestionable that many such untrained officers will assume unwarranted diagnostic powers and seriously endanger the health of the soldier under treatment," The Surgeon General disagreed with this belief, declaring flatly that the battalion surgeon's assistant was not given that assignment to make diagnoses or to treat the seriously injured. "He is put in there to do the administration of the detachment, command the litter bearers and assist the battalion surgeon * * *." General Kirk reasoned that since there had been no trouble in the hospitals with Medical Administrative Corps officers attempting to assume professional duties there was no reason to anticipate

22Report, Committee to Study the Medical Department, pp. 11, 38-39.
23Letter, 1st Lt. T. C. M. Robinson, Training Division, Office of The Surgeon General, to Col. Frank Wakeman, c/o Col. George M. Edwards, William Beaumont General Hospital, El Paso, Tex., 13 Dec. 1942.
24Annual Report, Operations Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1943-44.


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trouble in the units.25 Actually, although there may have been complaints against individual officers, the Office of the Surgeon, Army Ground Forces, was reported as stating that the work of the assistants had been very satisfactory.26

Fortunately, there were about 1,500 Medical Administrative Corps officers in replacement pools in the United States at the time The Surgeon General decided to use them in this way,27 and beginning in January 1944, they were ordered to school in successive groups at Camp Barkeley to be trained as battalion surgeon's assistants. Ultimately (by May 1945), about 2,100 were graduated;28  in the later stages of the training program, recently commissioned Medical Administrative Corps officers were sent to the school.

In addition to serving as battalion surgeon's assistants, Medical Administrative Corps officers came to be assigned to other positions formerly reserved for doctors. In November 1943, The Surgeon General proposed using them as registrars in hospitals. Some months later, the General Staff announced that they were to be preferred for assignment not only as registrars but as executive officers in station and general hospitals both at home and overseas.29 The Surgeon General objected to making them executive officers of general hospitals on the ground that these officers must act for and in the absence of the commanding officer and must have a professional appreciation of the proposals presented in order that the personnel of the hospital might be properly utilized. As a consequence, the General Staff omitted reference to the use of Medical Administrative Corps (also Pharmacy and Sanitary Corps) officers as executive officers of general hospitals in the restatement of its policy in August 1944.30

There were other places in hospitals, however, where Medical Administrative Corps officers could relieve doctors. For example, in the later war years when the bed census in Army hospitals in the United States was running high, they were made ward property officers. In some hospitals, too, they came to serve as administrative assistants to the chiefs of the medical and surgical services.31

The extent to which Medical Administrative Corps officers were used in conjunction with Medical Corps officers in general hospitals of the Zone of Interior during the later war years is indicated by the table of suggested allotments published by the War Department in May 1944 (table 3). A similar situation came to prevail in other Medical Department installations as well; for example, in the replacement training centers, which late in the war were using large percentages of Medical Administrative Corps officers.

25Letter, Surgeon General Kirk, to Maj. Gen. Morrison C. Stayer, Surgeon, North African Theater of Operations, U.S. Army, 11 Sept. 1944, in reply to General Stayer's letter of 3 Sept. 1944, in which General Stayer had reported the comments of one of his subordinate officers.
26Semiannual History of Medical Administrative Corps and Sanitary Corps, 1 Jan.-31 May 1945. 
27See footnote 24, p. 80.
28See footnote 26.
29War Department Circular No. 99, 9 Mar. 1944. 
30War Department Circular No. 327, 8 Aug. 1944.
31Annual Reports, William Beaumont General Hospital, 1944; Ashburn General Hospital, 1944; and Fifth Service Command, 1945.


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FIGURE 21.-Col. David E. Liston, MC, Deputy Chief Surgeon, European Theater of Operations, U.S. Army.

As late as 10 years after the, war, there were differences of opinion among Medical Corps officers as to how completely Medical Administrative Corps officers had been able to perform certain duties previously performed by Medical Corps officers and noncommissioned officers. General Kirk stated that regardless of the number of Medical Administrative Corps officers employed "there were never enough doctors to do the job properly" until V-E Day. Several other medical officers also expressed opinions based on their wartime

TABLE 3.-Numbers of Medical and Medical Administrative Corps officers suggested (1944) for Zone of Interior general hospitals of various sizes

Number of beds

Medical Corps officers (number)

Medical Administrative Corps officers (number)

Number of beds

Medical Corps officers (number)

Medical Administrative Corps officers (number)

1,000

35

24

2,500

60

39

1,500

46

30

3,000

64

44

1,750

50

33

3,500

70

47

2,000

55

36

4,000

80

56


Source: War Department Circular No. 209, 26 May 1944.


83

FIGURE 22.-Col. Fred J. Fielding, MC, Office of The Surgeon General, U.S. Army.

experiences. Col. David E. Liston, MC (fig. 21), Deputy Chief Surgeon, European Theater of Operations, U.S. Army, stated his belief that "the increased number of Medical Administrative Corps officers did not materially affect the requirement for doctors and did affect [that is, reduce] the requirement for senior noncommissioned officers. Often the Medical Corps officer had to exercise an equal degree of supervision over the Medical Administrative officer to that exercised over his NCO previously." On the other hand, Col. Fred J. Fielding, MC (fig. 22), stated that in the later war years tables of organization and equipment "were culled to eliminate MC positions of administrative nature except for CO [commanding officer]." He went on to state that when in 1944 Medical Administrative Corps officers were trained as battalion surgeon's assistants "* * * this produced a direct replacement of many MC officers formerly required in a position not of administrative nature but related to the professional duty field. "Lt. Col. Paul A. Paden, MC, also favored using Medical Administrative Corps Officers where possible to relieve Medical Corps officers. He went so far as to state: "Except for training, there was no reason why other than a few Medical Department officers should have been assigned to any type of unit until just before its actual employment in a theater of operations." He felt that even in combat the treatment should


84

have been minimal and that therefore a Medical Administrative Corps officer could easily have been a battalion surgeon's assistant.32

ARMY NURSE CORPS

During the first months of the war, the Surgeon General's Office made its estimates for nurse requirements and submitted them to the General Staff, which customarily accepted them. The ratio was approximately 6 nurses for 1,000 overall strength. In September 1942, when the troop basis was raised to 8,200,000, the Surgeon General's Office transmitted to the General Staff a figure of 51,177 as its estimate of the nurses required to serve a force of that size.33 On this occasion, the General Staff did not approve the estimate. Some time during the first 2 months of 1943, G-3 notified the Surgeon General's Office that 51,177 was too high a figure and that the number was being held at 40,000 (including physical therapists and dietitians), which had been previously authorized for the fiscal year ending on 30 June 1944. The nurse requirement was verbally agreed to by the Assistant Chief, Operations Service, Office of The Surgeon General, but neither the Nursing Division nor the Personnel Division, Office of The Surgeon General, nor the nursing authorities of the War Manpower Commission, were informed that the authorized figure was to be retained.34

As a result, the Superintendent of the Army Nurse Corps (fig. 23) and various nursing organizations engaged in recruiting continued to assume for months that the War Department had authorized a quota of 51,000 nurses. Therefore, when the Superintendent heard that the budget contained provision for only 40,000 she refused to believe that the budget directive constituted a limitation and insisted that it would be impossible to operate with such a number. The nursing organizations also continued to use the goal of 51,000 to impress the nursing profession with the critical need for recruits.35

In a memorandum to the Commanding General, Army Service Forces, on 18 December 1943, General Kirk argued that the ceiling figure of 40,000, which actually included not only nurses but physical therapists and dietitians, was far too small to meet the requirements of the 1944 troop basis. In reaching

32(1) Letter, Maj. Gen. Norman T. Kirk (Ret.), to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12 Dec. 1955. (2) Col. David E. Liston, MC, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 5 Jan. 1956. (3) Letter, Col. Fred J. Fielding, MC, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12 Dec. 1955. (4) Lt. Col. Paul A. Paden, MC, to Col. C. H. Goddard, MC, Office of The Surgeon General, 9 June 1952.
33At 6 per 1,000 of troop strength, the estimate would have been 49,200. The higher figure may have been set in order to provide for losses.
34Blanchfield, Florence A., and Standlee, Mary W.: The Army Nurse Corps in World War II. [Official record.]
35(1) Haupt, A. C.: National War Nursing Program. Hospitals 17: 26-30, April 1943. (2) "Have You Thought It Through, Private Duty Nurse?" Am. J. Nursing 43: 522-523, June 1943. (Moreover, the Subcommittee on Nursing of the National Defense Council's Health and Medical Committee, unaware of the true situation, used the prospective depletion of civilian resources as a lever to secure an authoritative place for the Nursing Supply and Distribution Service in the Procurement and Assignment Service.)


85

FIGURE 23.-Col. Florence A. Blanchfield, ANC, Superintendent of the Army Nurse Corps.

this conclusion, he relied largely on the use of a ratio of 1 nurse to 10 fixed beds, the approximate ratio established for Zone of Interior hospitals and theater of operations fixed hospitals.36

G-1 of the War Department General Staff answered The Surgeon General's protest, but before doing so, it assembled further data on the subject. From the Inspector General, G-1 obtained a report by Maj. Gen. Howard McC. Snyder, MC, the medical representative on the Inspector General's staff. General Snyder cited a recent survey of 95 Zone of Interior hospitals which showed that they averaged 19 beds and 12.4 patients per nurse without consistently overworking the nurses; this was bolstered by a consideration of the facts which the War Department Manpower Board used to justify its estimate of Army nurse requirements for hospitals in the Zone of Interior; namely, 1 nurse per 12 beds in general hospitals and 1 nurse per 12 to 17 beds in station hospitals. General Snyder pointed out that only 30.6 percent of the patients in the 95 hospitals surveyed were bed patients, which reduced the amount of nursing care required. Taking this into consideration, and allowing for the dispersion of beds necessitated in part by the care of patients having communi-

36War Department Circular No. 306, 22 Nov. 1943.


86

cable diseases, he estimated that a 750-bed "cantonment hospital" would require 40 nurses, or 1 nurse per 18 beds. His general conclusion was that The Surgeon General's estimate of 1 nurse per 10 beds was excessive and that the allotment of nurses for Zone of Interior hospitals should be reduced to 1 nurse per 17 beds and for fixed-bed theater of operations hospitals to 1 nurse per 15 beds.

G-1 added some observations of its own, chiefly on the subject of how many fixed beds actually were required, and announced on 8 January 1944 that the ratio for Zone of Interior hospitals would be 1 nurse to 15 beds and for theater of operations fixed hospitals 1 nurse to 12 beds. The Surgeon General was to recommend reductions in allowances for Zone of Interior hospitals and in tables of organization to meet these ratios for the purpose of keeping within the 40,000 ceiling. G-1 concluded that "the present ceiling of 40,000 nurses will amply meet the overall requirements provided the ratio of nurses to beds is decreased, convalescent hospitals established, and maximum use made of semi-skilled aides, civilians, and corpsmen to replace nurses." The only concession The Surgeon General's Personnel Service was able to secure was that physical therapists and dietitians, of which the combined total at that time was approximately 1,700, would not be lumped with the nurses but would be in addition to the 40,000 limit.37

In response to this directive, The Surgeon General again entered a plea for the 1 to 10 ratio. He proposed, however, to retain the 40,000 ceiling "for the present" by filling all units in the troop basis with Army nurses at the existing table-of-organization figures-which would require 38,818 of the 40,000-and supplementing those who remained in the Zone of Interior by civilian nurses so as to provide a ratio of 1 nurse to 10 beds. G-1 rejected this proposal of 25 February 1944, "in view of the critical shortage of military and civilian nurses," and a few days later, the Deputy Chief of Staff enjoined compliance with the original directive of 8 January.38

In a little more than a month, on 5 April 1944, General Somervell was able to report that this directive was being carried out-in part. The Surgeon General had modified the tables of organization and also the allotments for Zone of Interior installations to provide the required ratios of nurses to fixed beds-1 to 12 and 1 to 15, respectively. As to maintaining the 40,000 ceiling, General Somervell referred to a study by The Surgeon General which showed that a total strength of 47,677 nurses was necessary to meet requirements for 1944, taking into account the new ratios but not allowing for potential requirements of 3,646 nurses "that can be foreseen at this time." The figure of 47,677 nurses required was arrived at as follows:

37(1) Memorandum, G-1, for Chief of Staff, 4 Jan. 1944, subject: Nurse Personnel Requirements. (2) Letter, G-1, to Military Personnel Division, Army Service Forces, to The Surgeon General, and to The Adjutant General, 8 Jan. 1944, subject: Nurse Personnel Requirements.
38(1) Disposition Form, G-1, to The Surgeon General, 25 Feb. 1944, subject: Nurse Personnel Requirements. (2) Memorandum, Deputy Chief of Staff, for Commanding General, Army Service Forces, 1 Mar. 1944, subject: Nurse Personnel Requirements.


87

Number
required

For general and station hospitals in Zone of Interior

113,867

For fixed-bed theater of operations hospitals

226,031

For other units, provided for in the 1944 troop basis:

Hospital ships

1,309

Hospital trains

228

Auxiliary surgical groups

420

Composite units

390

Air evacuation squadrons

498

Evacuation hospitals

988

Evacuation hospitals, semimobile

2,200

Field hospitals

1,746

Total

47,677


1This number was calculated by applying the 1:15 ratio to 108,000 beds in station hospitals and 100,000 beds in general hospitals; total, 208,000 beds. Bed strength of station hospitals was arrived at by counting it as 4 percent of a 2,700,000 troop strength.
2This number was calculated by applying the 1:12 ratio to 312,375 beds, which were provided for in the War Department Operations Division troop unit basis.

General Somervell added that at his instance The Surgeon General was continuing his studies to produce the greatest possible economies in the use of nurses, but it seemed clear to General Somervell that the existing ceiling of 40,000 should be increased by at least 5,000. He therefore asked for a further authorization of 5,000 "to avoid interruption of the Nurse recruitment program."39

On 28 April 1944, G-1 more than met General Somervell's request by raising the authorization for nurses to 50,000 where it remained until almost the end of January 1945. Meanwhile, The Surgeon General's estimates of requirements ran considerably above that figure. In October 1944, his Strategic and Logistics Planning Unit forecast that by 31 December 1944 the need would rise to 45,869 and would remain at approximately that point until September 1945.40 Early in January 1945, The Surgeon General raised the forecast to 59,401 for June 1945 (table 4).

The Surgeon General's estimate was considerably higher than a forecast made about 2 weeks later by the Military Personnel Division, Army Service Forces, which placed the requirement at 55,722 nurses by 30 June 1945. On 28 January 1945, the War Department General Staff virtually met this requirement by raising the ceiling to 55,000. A week afterward, it added 5,000 to make the total 60,000. These increases came in the midst of public agitation concerning the adequacy of the nursing force and the necessity of a draft of nurses. As many as 60,000 nurses might have been needed if Germany had continued in the war beyond May 1945. With her defeat in that month, however, the requirement for nurses rapidly diminished, and the problem became one of reduction rather than increase of the nursing force.

39Memorandum, Commanding General, Army Service Forces, for Deputy Chief of Staff, 5 Apr. 1944, subject: Nurse Personnel Requirements.
40Memorandum, Director, Strategic and Logistics Planning Unit, for The Surgeon General, 24 Oct. 1944, subject: Army Nurse Corps Requirements, Medical Department, U.S. Army.


88

TABLE 4.-Proposed distribution of nurses, June 1945

Units and installations

Authorized beds 
(number)

Bases for computation of requirements

Nurse 
requirements (number)

Table-of-organization units in troop basis:

Overseas1

437,500

table of organization

34,657

Zone of Interior

6,325

...do...

570

Non-table-of-organization in Zone of Interior:

General hospitals

165,000

1 nurse per 15 beds

11,000

Convalescent hospitals

50,000

1 nurse per 30 beds

1,667

Regional and station hospitals

2130,000

1 nurse per 15 beds

8,667

Miscellaneous

575

Miscellaneous:

Theater of operations overhead

265

Pipeline; pools; sick

2,000

Total

59,401


1Includes fixed and mobile beds actually overseas. 
2
Estimated strength V-E Day+90.
Source: Memorandum, The Surgeon General, for G-1, 4 Jan. 1945.

DIETITIANS AND PHYSICAL THERAPISTS

Early in 1943, after the dietitians and physical therapists had attained military status, Maj. Emma E. Vogel, WMSC, Superintendent of Physical Therapists (fig. 24), recommended a ratio of 1 physical therapist to 100 beds in Zone of Interior hospitals. She later was forced to lower the ratio when procurement failed to meet it.41 The number of physical therapists specified in the manning guide for 10 April 194342 reflected this lowered ratio. Seven months later, on 22 November, a further reduction, for the same reason, was put into effect.43 The November reduction was drastic: for a 500-bed hospital, the number of physical therapists was cut from 4 to 2; for a 700-bed hospital, from 6 to 3; and for a 1,000-bed hospital, from 10 to 5. Dietitians, on the other hand, did not undergo comparable reductions. The guide issued in April 1943 allotted them to Zone of Interior hospitals at a considerably lower rate than physical therapists; for example, the 500-bed hospital was to have 3 dietitians, the 700-bed hospital 4, and the 1,000-bed hospital 5. The November guide, however reduced the allotment in only the larger sized hospitals-those of 2,000- to 3,000-bed capacity-which were to have 1 to 3 fewer dietitians than formerly. The result was that from November 1943 onward the guide for general, station, and eventually regional hospitals provided for the same, or nearly the same, number of physical therapists and dietitians in proportion to a hospital's bed capacity. This proportion was not changed, except for minor reductions in the largest hospitals,44 during the remainder of the war. The

41Vogel, Emma E.: Physical Therapists of the Medical Department, United States Army. [Official record.]
42War Department Circular No. 99, 10 Apr. 1943. 
43
See footnotes 36, p. 85, and 41.
44War Department Circular No. 209, 26 May 1944.


89

FIGURE 24.-Maj. Emma E. Vogel, WMSC, Superintendent of Physical Therapists.

new Zone of Interior convalescent hospitals, however, were to have from two to six times as many physical therapists as dietitians, according to the guide issued in June 1945,45 but the proportion of both was much smaller in relation to bed capacity than that allotted to other Zone of Interior hospitals.

The general and station hospitals for service overseas were provided by their tables of organization with fewer physical therapists and dietitians than were allotted to similar hospitals of like capacity in the Zone of Interior, and in 1943, even these few were reduced. Thus, in November 1943, the number of physical therapists in a 1,000-bed general hospital was cut from 5 to 3; in 750- to 900-bed station hospitals, from 4 to 2; and in 500- to 700-bed station hospitals, from 3 to 1. The numbers and reductions of dietitians were the same as for physical therapists. In July 1944, dietitians in the 1,000-bed general hospitals were reduced from 3 to 2, and 5 months later, physical therapists in 750- to 900-bed station hospitals were reduced from 2 to 1. Evacuation hospitals (750-bed) retained one physical therapist from April 1943 to the end of the war.46

45War Department Circular No. 170, 8 June 1945.
46(1) See footnotes 36, p. 85, and 42, p. 88. (2) T/O 8-550, General Hospital, 3 July 1944, and T/O 8-560, Station Hospital, 28 Oct. 1944.


90

Requests for authorizations of both physical therapists and dietitians were based mainly on the manning guides and tables of organization, but the authorizations granted by the War Department usually fell below those requested by the Surgeon General's Office. In September 1944, the latter asked for an increase in the ceiling for physical therapists from 1,000 to 1,464 and for dietitians from 1,500 to 2,000. In October, the War Department went no farther than 1,250 for physical therapists and 1,750 for dietitians. Next month, the Surgeon General's Office responded by asking for an increase from 1,250 to 1,700 in the authorization for physical therapists. This was disapproved in December, but at the end of January 1945, the War Department raised the ceiling for physical therapists to 1,500 and for dietitians to 2,000.47

A further increase was sought in April 1945. Based chiefly on manning guides and tables of organization, the total requirement for physical therapists was 1,779 and for dietitians, 2,303, made up as follows:48

Dietitians

Physical 
therapists

Zone of Interior general hospitals

597

668

Zone of Interior regional hospitals:

Army Service Forces

153

124

Army Air Forces

133

90

Zone of Interior station hospitals:

Army Service Forces

233

121

Army Air Forces

185

19

Zone of Interior convalescent hospitals:

Army Service Forces

40

101

Army Air Forces

20

20

Instructors

34

24

Surgeon General's Office

4

4

Table-of-organization units

862

557

U.S. Army Military Academy

2

1

Nonavailables:

In transit and in personnel centers

25

18

Patients and personnel on terminal leave

15

12

Total

2,303

1,779


The Surgeon General requested ceilings a trifle lower than this computation called for; namely, 1,750 for physical therapists and 2,250 for dietitians. Six weeks later (30 May 1945), the War Department raised its total authorization for physical therapists to 1,700 and for dietitians to 2,150.49 By that time, Germany was out of the war. Moreover, during the following months, recruit-

47(1) Letter, Chief, Personnel Service, Office of The Surgeon General, to Assistant Chief of Staff, G-1, War Department, 14 Sept. 1944, subject: Request for an Increase in the Procurement Objective for Dietitians and Physical Therapists, AUS. (2) Letter, The Adjutant General, to Commanding General, Army Service Forces, 30 Oct. 1944, subject: Procurement Objective for Appointment of Nurses, Physical Therapists, and Dietitians in the AUS. (3) Quarterly Report, Physical Therapy Branch, Office of The Surgeon General, U.S. Army, 1 Jan.-31 Mar. 1945. (4) Diary of Personnel Service, Office of The Surgeon General, for week ending 3 Feb. 1945.
48Memorandum, The Surgeon General, for Assistant Chief of Staff, G-1, 16 Apr. 1945, subject: Requirements for Dietitians and Physical Therapists.
49
Letter, The Adjutant General, to Commanding General, Army Service Forces, 30 May 1945, subject: Requirements for Dietitians and Physical Therapists.


91

ment did not succeed in increasing actual strength above 1,580 for the dietitians and 1,300 for the physical therapists (table 1).

ENLISTED MEN

In 1940, the quota for the enlisted strength of the Medical Department was raised from the 5 percent of total Army strength, established by the National Defense Act of 1920, to 7 percent or more, at the discretion of the War Department, in case of emergency. This quota remained throughout the war. The lowest percentage in the period 1942-43 was 6.8; the highest, 7.5. After August 1944, it never rose above 7 percent; and between October 1944 and August 1945, it fell steadily from 6.9 to 6.1 (table 1).

At the end of December 1944, the Enlisted Branch of the Surgeon General's Office observed that for some time it "had acknowledged that there was sufficient enlisted personnel, such as it was." At this time, total Medical Department enlisted strength was 541,650 (table 1). By the end of March 1945, strength had decreased to 533,044, but the decline was not considered dangerous since it was caused "mainly by the deactivation of a number of T/O units." Two months afterward (31 May 1945), although Medical Department enlisted strength had fallen still further-to 524,332, of which 377,231 was overseas (table 5)-the enlisted personnel situation was described as "the best it has been for some time."50 

Manning guides and tables of organization provided a basis for estimating the enlisted requirements, as they did in the case of other personnel. Guides for station hospitals in the Zone of Interior were issued in April 1941, December 1942, and May 1944. A comparison between the first and last of these will show the extent to which enlisted personnel were reduced in all except the 1,500- and 2,000-bed units:51

Enlisted requirement

Table-of-organization bed capacity:

April 1941

May 1944

250

150

131

300

175

157

350

200

180

400

225

198

450

250

222

500

275

239

600

325

292

700

370

341

750

390

368

800

410

383

900

455

422

1,000

500

458

1,500

700

706

2,000

900

912


50Quarterly Reports, Enlisted Personnel Branch, Personnel Service, Office of The Surgeon General, U.S. Army, for periods ending 31 Dec. 1944, and 31 Mar. 1945, and for 2 months ending 31 May 1945. 
51(1) Mobilization Regulations No. 4-2, Change No. 1, 9 Apr. 1941. (2) See footnote 44, p. 88. (3) Smith, Clarence McKittrick: The Medical Department: Hospitalization and Evacuation, Zone of Interior. United States Army in World War II. The Technical Services. Washington: U.S. Government Printing Office, 1956.


92-93

TABLE 5.-Medical Department enlisted strength, worldwide and overseas, 31 July 1941-30 September 1945

Date and area

Army enlisted strength

Medical Department enlisted strength

Number1

Percentage of total Army strength2

Number3

Percentage of worldwide Medical Department enlisted strength

Rate per 1,000 troops4

Percentage of Army enlisted strength

Percentage of total Medical Department strength5

31 July 1941:

             

Worldwide

1,422,158

92.9

106,662

100.0

---

7.5

83.8

Overseas

128,476

94.7

4,301

4.0

31.7

3.3

81.5

30 Nov. 1941:

             

Worldwide

1,523,116

92.6

108,674

100.0

---

7.1

81.6

Overseas

154,938

93.8

6,580

6.1

39.8

4.2

82.3

31 Mar. 1942:

             

Worldwide

2,235,113

93.7

169,627

100.0

---

7.6

84.3

Overseas

306,638

93.5

15,512

9.1

47.3

5.1

77.9

30 June 1942:

             

Worldwide

2,867,762

93.3

209,952

100.0

---

7.3

82.8

Overseas

565,384

94.0

35,252

16.8

58.6

6.2

82.4

30 Sept. 1942:

             

Worldwide

3,670,954

92.4

283,331

100.0

---

7.7

81.1

Overseas

768,165

93.3

48,547

17.1

59.0

6.3

82.5

31 Jan. 1943:

             

Worldwide

5,370,755

92.2

417,307

100.0

---

7.8

83.9

Overseas

1,036,329

92.5

72,263

17.3

69.7

7.0

82.1

30 Apr. 1943:

             

Worldwide

6,147,248

91.5

499,657

100.0

---

8.1

84.9

Overseas

1,288,913

92.1

92,446

18.5

66.1

7.2

81.7

31 July 1943:

             

Worldwide

6,467,436

90.7

529,360

100.0

---

8.2

84.3

Overseas

1,634,890

91.9

114,162

21.6

64.2

7.0

81.8

31 Oct. 1943:

             

Worldwide

6,625,157

90.3

507,611

100.0

---

7.7

82.5

Overseas

2,054,499

91.7

146,959

29.0

65.6

7.2

81.7

31 Jan. 1944:

             

Worldwide

6,792,871

89.9

515,124

100.0

---

7.6

81.9

Overseas

2,580,104

91.7

196,696

38.2

69.9

7.6

82.3

30 Apr. 1944:

             

Worldwide

7,042,116

89.7

532,771

100.0

---

6.8

81.8

Overseas

3,251,857

91.5

248,003

46.5

69.8

7.6

82.5

31 July 1944:

             

Worldwide

7,191,703

89.3

558,828

100.0

---

7.8

82.2

Overseas

3,716,742

90.8

284,791

51.0

69.9

7.7

82.8

31 Oct. 1944:

             

Worldwide

7,204,580

88.9

562,796

100.0

---

7.8

81.9

Overseas

4,225,564

91.2

324,711

57.7

70.0

7.7

83.0

31 Jan. 1945:

             

Worldwide

7,139,700

88.5

537,303

100.0

---

7.5

80.5

Overseas

4,678,043

91.3

357,567

66.5

69.8

7.6

83.2

30 Apr. 1945:

             

Worldwide

7,274,779

88.2

532,029

100.0

---

7.3

79.1

Overseas

4,974,051

91.2

385,296

72.4

71.9

7.8

83.1

31 May 1945:

             

Worldwide

7,305,854

88.1

524,332

100.0

---

7.2

78.6

Overseas

4,925,323

91.1

377,231

71.9

69.8

7.7

82.9

30 June 1945:

             

Worldwide

7,283,930

88.1

521,282

100.0

---

7.2

78.4

Overseas

4,783,503

91.3

367,844

70.6

70.2

7.7

82.9

31 July 1945:

             

Worldwide

7,200,220

87.9

514,511

100.0

---

7.1

78.0

Overseas

4,491,271

91.2

350,056

68.0

71.1

7.8

83.0

31 Aug. 1945:

             

Worldwide

7,040,446

87.7

493,209

100.0

---

7.0

77.3

Overseas

4,214,725

91.2

311,047

63.0

67.3

7.4

82.5

30 Sept. 1945:

             

Worldwide

6,598,986

87.2

454,989

100.0

---

7.9

76.0

Overseas

3,788,062

91.1

273,049

60.0

65.7

7.2

82.4


1Male personnel only. All data are from "Monthly Strength of the Army, Continental United States," and "Monthly Strength of the Army, Foreign and En Route," in "Strength of the Army," 1 Oct. 1945, pp. 58-59, with the following exceptions: Oversea data for 31 March 1942 are from sources of corresponding data listed in table 31, footnote 2 (see the cited footnote for the reasons for the substitution); worldwide data for 31 March 1942 are oversea strength as shown here plus male enlisted strength for the same date reported in "Monthly Strength of the Army, Continental United States," cited above; data for 31 July 1944 are from "Strength of the Army" for the same date and exclude personnel unaccounted for by commands (such personnel are included in the male enlisted strength for oversea areas (3,734,062) reported in "Monthly Strength of the Army, Foreign and En Route," cited above, but are excluded from this table since the number of medical personnel among them is unknown).
2For total Army strength, see table 31.
3Worldwide strength for July and November 1941 from "Strength of the Army" for corresponding dates; for other dates, from table 1 (SGO data). Oversea strength from sources shown in table 31, footnote 3, for period prior to September 1942 and for April 1944 in part, from "Strength of the Army" in all other instances.
4For troop strength, see table 31; for worldwide rates, see table 1 (SGO data). 
5For total Medical Department strength, see table 31.


94

TABLE 6.-Guide for utilization of personnel in named general hospitals, Zone of Interior

Number of authorized beds

Officers

Enlisted men

Total personnel

Total personnel per 100 beds

Medical Corps

Dental Corps 

Medical Administrative Corps

Sanitary Corps

Veterinary Corps

Army Nurse Corps

Hospital dietitians

Physical therapists

Quartermaster Corps

Corps of Engineers

Signal Corps

Finance Department

Chaplain Corps

Corps of Military Police

Warrant officers

Total

1,000

35

7

24

4

1

67

6

5

1

1

1

1

2

2

3

160

558

718

71.80

1,500

46

8

30

4

1

100

7

6

2

1

1

1

3

2

5

217

838

1,055

70.33

1,750

50

9

33

5

1

117

7

6

2

2

1

2

4

3

5

247

965

1,212

69.25

2,000

55

12

36

5

1

133

8

7

2

2

1

2

4

3

6

277

1,096

1,373

68.65

2,500

60

14

39

5

2

167

9

8

2

2

1

2

4

3

6

324

1,383

1,707

68.28

3,000

64

16

44

6

2

200

10

9

3

2

2

3

5

4

7

377

1,653

2,030

67.66

3,500

70

19

47

7

2

233

12

10

3

3

2

3

5

4

7

427

1,952

2,379

67.97

4,000

80

21

53

9

2

267

14

12

5

4

2

3

7

5

9

493

2,291

2,784

69.60


Source: War Department Circular No. 209, 26 May 1944. Substitution of civilians for enlisted men on a three-for-two basis was permitted. This obtained until War Department Circular No. 87, 19 Mar. 1945, required that substitution be made only on a one-for-one basis.


95

As for the Zone of Interior general hospitals, The Surgeon General in 1942 instructed them to use the table of organization for oversea general hospitals as their guide. This table provided for 500 enlisted men in a 1,000-bed hospital. A guide specifically for Zone of Interior general hospitals was issued at the end of 1942 and a new one in May 1944. The latter allotted from 558 enlisted men for a 1,000-bed hospital to 2,291 for a 4,000-bed hospital (table 6). The new guides for both general and station hospitals permitted the replacement of enlisted men "by similarly qualified civilians generally on a three-civilian for two-enlisted-men basis" because of the disparity in working hours. The guide for Zone of Interior convalescent hospitals, issued in June 1945, also permitted the replacement of enlisted men by civilians, but made no reference to ratios. It allotted from 200 enlisted men for the 500-bed hospital to 1,400 for the 6,000-bed hospital (table 7). It will be noted that in these guides the ratio of enlisted men to bed capacity was much lower in convalescent hospitals than in station hospitals, and lower in the latter than in general hospitals.

Successive tables of organization for oversea units, like the manning guides for Zone of Interior installations, showed reductions in the number of enlisted men during the war period, as is illustrated in the tables for various types of hospitals and for the medical detachment of the infantry regiment (tables 8 and 9).

The total requirement for personnel in table-of-organization units of all types appeared in the troop basis issued from time to time by the War Department. An analysis of the troop basis for 1 October 1944, prepared by the Surgeon General's Office, showed the distribution of Medical Department personnel among table-of-organization units of the ground, air, and service forces at the actual strength on 30 September 1944 and at the strength planned on 1 October 1944 for 31 December 1944 and 30 June 1945. The distribution

TABLE 7.-Guide for utilization of personnel in convalescent hospitals, Zone of Interior

Number of authorized beds

Officers

Enlisted men

Total personnel

Total personnel per 100 beds

Medical Corps

Dental Corps

Medical Administrative Corps

Sanitary Corps

Hospital dietitians

Physical therapists

Chaplain Corps

Warrant officers

Total

500

13

3

30

1

1

2

1

1

52

200

252

50.4

1,000

20

5

50

1

1

4

1

1

83

323

406

40.6

1,500

24

6

60

1

1

5

2

1

100

428

528

35.2

2,000

28

8

68

1

1

6

2

1

115

529

644

32.2

2,500

34

10

80

1

2

7

3

1

138

649

787

31.5

3,000

40

12

91

1

2

7

3

2

158

768

926

30.9

4,000

50

16

109

1

2

8

3

2

191

958

1,149

28.7

5,000

63

20

130

1

3

10

4

3

234

1,203

1,437

28.7

6,000

74

24

146

1

3

12

4

3

267

1,400

1,667

27.8


96-97

TABLE 8.-Table-of-organization changes in certain types of hospitals, 1940-44

Type of hospital and authority

Officers

Total enlisted men

Aggregate

Medical Corps

Medical Administrative Corps

Dental Corps

Sanitary Corps

Chaplain Corps

Quartermaster Corps

Warrant officers

Army Nurse Corps

Hospital dietitians

Physical therapists

Total

General (1,000-bed):

                         

T/O 683, 6 July 1932

30

6

4

---

1

1

---

120

---

---

162

400

562

T/O 8-507, 25 July 1940

55

6

7

1

2

2

---

120

---

---

193

500

693

T/O 8-550, 1 Apr. 1942

38

7

5

2

2

2

1

105

---

---

162

500

662

T/O 8-550 (Ch 2), 5 Oct. 1942

37

8

5

2

2

2

1

105

---

---

162

500

662

WD Cir. 306, 22 Nov. 1943

37

8

5

2

2

2

1

100

3

3

163

500

663

T/O 8-550 (Ch 3), 4 Mar. 1944

37

8

5

2

2

2

1

83

3

3

146

500

646

T/O 8-550, 3 July 1944

32

110

6

2

3

---

1

83

3

2

142

450

2594

Station (250-bed):

                         

T/O 684-W, 1 July 1929

11

2

2

---

---

---

---

35

---

---

50

150

200

T/O 8-508, 25 July 1940

15

3

2

---

---

---

---

30

---

---

50

150

200

T/O 8-560, 22 July 1942

13

5

2

---

1

---

---

30

---

---

51

150

201

WD Cir. 306, 22 Nov. 1943

13

5

2

---

1

---

---

25

---

---

46

150

196

T/O 8-560 (Ch 3), 4 Mar. 1944

13

5

2

---

1

---

---

21

---

---

42

150

192

T/O 8-560, 28 Oct. 1944

10

5

2

---

1

---

---

21

---

---

39

138

2179

Station (500-bed):

                         

T/O 8-508, 25 July 1940

23

8

4

---

---

---

---

60

---

---

95

275

370

T/O 8-560, 22 July 1942

19

8

3

1

2

---

1

55

---

---

89

275

364

WD Cir. 306, 22 Nov. 1943

19

8

3

1

2

---

1

50

1

1

86

275

361

T/O 8-560 (Ch 3), 4 Mar. 1944

19

8

3

1

2

---

1

42

1

1

78

275

353

WD Cir. 99,3 9 Mar. 1944

16

11

3

1

2

---

1

42

1

1

78

275

353

T/O 8-560, 28 Oct. 1944

16

411

3

1

1

---

1

42

1

1

77

253

330

Station (750-bed):

                         

T/O 8-508, 25 July 1940

37

8

4

---

---

---

---

90

---

---

139

390

529

T/O 8-560, 22 July 1942

24

9

4

1

2

---

1

75

---

---

116

392

508

WD Cir. 306, 22 Nov. 1943

24

9

4

1

2

---

1

75

2

2

120

392

512

T/O 8-560 (Ch 3), 4 Mar. 1944

24

9

4

1

2

---

1

63

2

2

108

392

500

WD Cir. 99,3 9 Mar. 1944

21

12

4

1

2

---

1

63

2

2

108

392

500

T/O 8-560, 28 Oct. 1944

20

412

4

1

2

---

1

63

2

1

106

351

457

Evacuation (750-bed):

T/O 283-W, 1 July 1929

32

4

2

---

1

1

---

60

---

---

100

300

400

T/O 8-232, 1 Oct. 1940

37

5

3

---

1

1

---

52

---

---

99

318

417

T/O 8-580, 2 July 1942

34

8

3

---

1

1

---

52

---

---

99

318

417

T/O 8-580, 23 Apr. 1943

37

5

3

---

2

---

1

52

1

---

101

308

409

WD Cir. 306, 22 Nov. 1943

37

5

3

---

2

---

1

53

1

---

102

308

410

T/O 8-580, 31 Jan. 1945

37

5

3

---

2

---

1

53

1

---

102

303

405

Evacuation (400-bed):

                         

T/O 8-581, 2 July 1942

29

7

2

---

1

---

1

48

---

---

88

248

336

T/O 8-581, 26 July 1943

29

6

2

---

1

---

1

40

---

---

79

217

296

T/O 8-581, 25 Mar. 1944

28

7

2

---

1

---

1

40

---

---

79

217

296


1Five of these might be members of the Pharmacy Corps. Since none of the tables of organization or circulars cited in the table stipulated that a Pharmacy Corps officer had necessarily to be placed in any of these hospitals, no column has been shown for them. See also footnote 4.
2Includes one engineer officer and one officer, branch immaterial.
3In order to conserve Medical Corps officers, this circular stated that "executive officers and registrars of numbered or fixed general or station hospitals should preferably be Medical Administrative Corps officers commissioned because of prior training or experience as civilian hospital administrators or Medical Department noncommissioned officers." War Department Circular No. 152, 17 April 1944, allowed officers of other corps than the Medical Administrative Corps to be substituted in these jobs, stating that executive officers "of all numbered or fixed station hospitals and registrars of all numbered or fixed general or station hospitals" should preferably be either Medical Administrative Corps, Pharmacy Permission to use other than Medical Corps officers as executive officers of general hospitals was later withdrawn (War Department Circular No. 327, 8 Aug. 1944).
4These officers might be in the Pharmacy Corps.


98

of Medical Department enlisted personnel presented in this analysis was as follows:52

Actual strength, 
30 Sept. 1944

Planned strength,
 for 31 Dec. 1944 and 30 June 1945

Army Ground Forces:

Combat and communications zones

166,935

164,664

Zone of Interior

807

943

Total

167,742

165,607

Army Air Forces:

Combat and communications zones

24,709

25,011

Zone of Interior

117

193

Total

24,826

25,204

Army Service Forces:

Combat and communications zones

180,250

217,904

Zone of Interior

1,656

816

Total

181,906

218,720

Grand total

374,474

409,531


TABLE 9.-Table-of-organization changes in the medical detachment of the infantry regiment (T/O 7-11), 1938-45

Date

War strength of regiment

Medical Corps

Dental Corps

Medical Administrative Corps

Enlisted men in medical detachment

6 Dec. 1938

2,542

8

2

---

96

1 Mar. 1940

2,776

8

2

---

96

1 Oct. 1940

3,449

8

2

---

96

1 Apr. 1942

3,472

8

2

---

126

1 Mar. 1943

3,088

7

2

---

103

26 Feb. 1944

3,257

7

2

---

126

30 June 1944

3,207

5

2

3

126

1 June 1945

3,697

5

2

3

126

5 Sept. 1945

3,697

5

2

3

136

52Letter, Military Personnel Planning and Placement Branch, Military Personnel Division, Office of The Surgeon General (Lt. Col. Fred J. Fielding), to Director, Military Personnel Division, Office of The Surgeon General, 1 Dec. 1944, subject: War Department Troop Basis as of 1 October 1944.


99

ENLISTED WOMEN

The establishment of a requirement for enlisted women-members of the Women's Army Corps (usually called Wacs)53-evolved during the course of 1942. The Surgeon General rejected the idea of adding them to the hospital complements when it was first broached in the spring of 1942. His objection to taking them was that it would interfere with the employment of civilians and the training of enlisted men and would cause difficulties in the way of housing and recreation. His opinion changed as a result of pressure from various sources before the end of 1942-the insistence of the General Staff and Services of Supply headquarters that all services should make use of Wacs in order to release more men for combat duty, the recommendations of the Committee to Study the Medical Department that Wacs could supplement the supply of nurses, the difficulty of enlarging or even maintaining the civilian staffs, and the trend of thought in his own Office and among hospital commanders. Accordingly, after proposing a test at two hospitals, which could not be carried out because WAC personnel were not available, he appointed a board in January 1943 to consider the matter and asked for reports from the service commands, the Air Forces, the Transportation Corps, the Military District of Washington, and the Army Medical Center on the possibilities involved. While not all hospital commanders were favorable to the use of Wacs, Services of Supply hospitals of 600 beds or more estimated that Wacs could replace from 30 to 50 percent of their enlisted men; the Air Forces planned to make use of Wacs in hospitals having a capacity of as few as 200 beds. On this basis, The Surgeon General's board calculated that more than 10,000 Wacs would be needed in the hospitals. The Surgeon General sent the service commands tabulations of WAC personnel for hospitals to be used in making up anticipated requisitions. Before the matter could be carried further, a falling off in  WAC recruitment caused WAC headquarters to notify The Surgeon General in June 1943 that he could expect only 150 to 175 women a month for training, beginning in September. The use of large numbers of Wacs in hospitals therefore had to be postponed.

Late in 1943, when medical installations were requisitioning these women, the Deputy Surgeon General wrote that the Medical Department could employ all of them who could be made available, "in fact," he declared, "the entire WAC organization could be utilized in order to release male military operating personnel.''54 Several campaigns to recruit members of the Women's Army Corps for employment as Medical Department technicians (fig. 25) ensued during 1944 and 1945, one setting its quota as high as 7,000. This quota was met.

53For convenience, the later title of this organization will be used here. Its earlier title (until 1 July 1943) was "Women's Auxiliary Army Corps."
54
Memorandum, General Lull, for Commanding General, Army Service Forces, 27 Dec. 1943, subject: Reduction of Military Operating Personnel, Army Service Forces.


100

FIGURE 25.-Members of the Women's Army Corps learning from Army  nurse how to change surgical dressing.

CIVILIANS

No formula was established for computing the total number of civilians required for Army medical service in the Zone of Interior until the establishment of bulk authorizations in June 1943.55 Before then, the number of civilians who could be employed was unrestricted except through the allotment of funds. Under the new system, the permitted number varied inversely with the number of military personnel authorized.

Large numbers of civilians were used throughout the war as substitutes for military personnel in many kinds of work. The process of substitution was intensified during the later war years when the Medical Department had to move large numbers of officers and enlisted men out of its installations in the United States for service overseas. As the number of enlisted men remaining was more than ever inadequate to meet all demands, Medical Department authorities could hardly repeat their earlier protests against the free substitution of civilians in their installations with any prospect of being heeded. At one time (May 1944), the General Staff permitted the substitution of civilians in hospitals for enlisted personnel on a three-for-two basis (taking account of the civilians' work day of only 8 hours as against that of 12 for enlisted personnel); in 1945, however, the General Staff ordered that substitutions be

55This section deals only with developments in the Zone of Interior. Of necessity, there was no requirement for civilians in oversea theaters. They were used if they were available but could not be counted on in advance. Oversea use of civilians is therefore treated under "Procurement" in chapter VIII.


101

FIGURE 26.-Nurses' aides, Camp Fannin, Tex.

made on a one-for-one basis.56 This one-for-one rule handicapped commanders of hospitals and other installations which operated for more than 8 hours a day. 

Civilians employed in Medical Department installations represented all grades of skill, from the janitor who kept the floors of a hospital tidy to the highly specialized medical or surgical consultant. Technical positions, including those of dental hygienists and laboratory technicians, were more difficult to fill than those demanding less skill. As male help became scarcer, large numbers of women were employed. For example, in 1943, when many enlisted men were withdrawn from installations for shipment overseas, the commander of Percy Jones General Hospital, Mich., reported that he had elicited the help of the families of military personnel.57

In the nursing field, Army nurses were supplemented by civilian nurses' aides (fig. 26), both paid and volunteer; by cadet nurses, who were students receiving part of their training in Government hospitals, in the course of which they rendered nursing service and on graduation accepted employment as full-fledged nurses in one branch or another of the Federal hospital system; and finally, graduate nurses who for one reason or another could not meet the qualifications of the Army Nurse Corps but who could meet the qualifications of the Civil Service Commission.58

56(1) See footnote 55, p. 100. (2) War Department Circular No. 87, 19 Mar. 1945. 
57Annual Report, Percy Jones General Hospital, 1942.
58See footnote 34, p. 84.


102

Occupational therapists also were employed as civilians throughout the war by the Medical Department.

The Army Specialist Corps, as already mentioned, during 1942 furnished a limited number, possibly about a hundred, of administrative, professional, scientific, and technical specialists. In late 1942, the Secretary of War decided that it was not feasible to have two uniformed services and abolished the corps, permitting its members to the extent practicable to apply for commissions in the Army of the United States.59

Although some difficulties and complaints arose concerning the use and performance of civilian employees in the Medical Department, certainly thousands of intelligent, hard-working, and responsible civilian employees were to be found in its establishments. It is even more obvious that whatever drawbacks the use of civilians involved, the Medical Department would have been quite unable to carry its load without their assistance.

While Red Cross workers in Army hospitals were not regarded as making up deficiencies in the supply of military personnel, at least not in the same sense as were civilians hired for that purpose, they performed a variety of services in connection with the care of patients, for which they received no pay from the Government. The Medical Department had reason to be grateful for the contributions these workers made to the well-being of its patients.

ADDITIONAL UNIT REQUIREMENTS OVERSEAS

Additional requirements overseas60 were based on four factors: (1) Losses, both physical or administrative; (2) additions to non-table-of-organization personnel; (3) reorganizations of table-of-organization units; and (4) shortages.

Losses

An individual was officially recognized as a physical "loss" to his unit when the unit was notified of his death, capture, internment in a neutral country, absence without leave for an appreciable period, or hospitalization. The unit could then request a replacement. The question as to whether a hospitalized soldier should remain on the rolls of his unit was resolved in the light of the amount of time it was believed that the unit could operate efficiently without the services appropriate to his position. A difference necessarily existed between units functioning in forward areas and those operating in the rear. Under combat conditions, a unit could not afford to wait any appreciable period for the return of an individual, and its right to replace him arose simultane-

59Memorandum, Secretary of War, for Director, Army Specialist Corps, 31 Oct. 1942, subject: Disposition of the Army Specialist Corps.
60Unless otherwise indicated, this section is based on (1) Annual Reports, Surgeon, European Theater of Operations, U.S. Army, 1943 and 1944, and (2) Administrative and Logistical History of Medical Service, Communications Zone, European Theater of Operations, U.S. Army, chs. IV and X. [Official record.]


103

ously with his hospitalization.61 In July 1944, this situation was given official recognition when the War Department in effect directed that troops in combat areas officially designated by the theater commander be dropped from the rolls of their units immediately upon hospitalization. For most personnel whose hospitalization originated in locations not designated as combat areas, the assignment to the original unit was to be severed only after completion of 60 days' total hospitalization.62

Administrative losses occurred when table-of-organization positions were vacated by the transfer of individuals to other assignments within the unit or in other units or when they were separated from the military service altogether for reasons wholly within the control of the Army. From the middle of 1943 on, rotation was still another cause. Even if the vacancy were filled by reassignment or promotion, another vacancy was thus created.

Non-Table-of-Organization Allotments

The War Department recognized the need for oversea personnel beyond that shipped in units from the Zone of Interior and therefore established a "non T/O allotment" for each theater. In the European theater, the amount of personnel authorized for the medical service out of the non-table-of-organization allotment during 1943 and 1944 was as follows:

1 April 1943:

Total

1,143

Officers (including warrant officers)

281

Enlisted

862

1 September 1943:

Total

1,275

Officers (including warrant officers)

390

Enlisted

885

1 April 1944:

Total

1,710

Officers (including warrant officers)

362

Enlisted

1,348

6 September 1944:1

Total

1,403

Officers (including warrant officers)

416

Enlisted

987


   1This date is only approximate, the authorization being fixed about the time Headquarters, European Theater of Operations, U.S. Army, was established in Paris.

In relation to theater medical strength, the authorization for 1 April 1943 amounted to 10.86 percent; that for 1 September 1943, to 6.05 percent; 1 April 1944, to 1.54 percent; and 6 September 1944, 0.83 percent. During 1944, the

61In the European theater, units engaged in combat were authorized in November 1944 to include in their daily replacement requisitions a statement of anticipated losses for a period of 48 hours after the requisition was made as a basis for provision of replacements.
62War Department Circular No. 280, 6 July 1944.


104

number of Medical Department personnel actually assigned to non-table-of-organization establishments, including, besides the offices of the Theater Chief Surgeon and base section surgeons, two central dental laboratories, the supply depots, and other installations, declined from about 4 percent of the total number of medical personnel in the theater to less than 1 percent.

Additional and Reorganized Table-of-Organization Units

In some cases, the Zone of Interior failed to provide the oversea theaters with a sufficient number of table-of-organization units to meet the requirements. It was therefore necessary to set up such units locally and to provide them with personnel. In the early part of 1945, for example, the War Department authorized the European theater to activate 11 medical teams, each with a strength of 10 men; 34 mess teams, each with 4 men; 23 dental prosthetic teams, each with a similar strength; and 2 optical repair teams which required an aggregate of 9 men.63 The establishment of newly activated table-of-organization units in the Southwest Pacific Area in late 1944 was one of the factors which created a large number of vacancies for dental officers in that region.64

An increase in the authorized size of a unit after it had arrived in a theater of operations also made it necessary for authorities within the theater to provide it with additional personnel. In 1943, several small station and general hospitals arriving in the United Kingdom were rerated as larger units. This required additional personnel. Additional personnel also were required in certain units in the North African theater through augmentation in size of all 1,000-bed general hospitals by 50 to 100 percents.65 For example, the 6th General Hospital, by an increase of its authorized bed capacity from 1,000 to 1,500 beds in mid-1944, witnessed an expansion of its authorized enlisted strength from 500 to 562 men.66 When patients in excess of the table-of-organization bed capacity of certain hospitals in the Seine Section were hospitalized in these installations during January-March 1945, augmentation of the nursing personnel became necessary wherever this took place. Revisions of tables of organization that established additional authorizations for personnel, such as dental and medical administrative officers, likewise compelled theater medical authorities to look for the personnel with which to fill these slots. As one example, the revision of Table of Organization 8-560 on 28 October 1944 created 326 new medical administrative officer posts in oversea station hospitals.

63For the table-of-organization strength of the units mentioned see "Medical Department Service Organization," T/O&E 8-500, 23 Apr. 1944.
64Essential Technical Medical Data, U.S. Army Forces, Far East, for December 1944, dated 15 Feb. 1945.
65Logistical History of North African-Mediterranean Theater of Operations, U.S. Army, pp. 291-294. [Official record.]
66Historical Report, 6th General Hospital, Mediterranean Theater of Operations, 22 Oct. 1944. [Official record.]


105-106

Shortages

Another factor which created a need for personnel to fill vacancies overseas was the practice dating from the spring of 1944 of sending table-of-organization units abroad short of their full complements of medical personnel. In the latter part of that year, many general hospitals were sent to the European theater with only 16 Medical Corps officers in each; field units likewise were dispatched without their full complement of such officers. One justification for this procedure was that by this time the theater already boasted an ample supply of specialist personnel who could be assigned to these understaffed units, but there continued to be shortages outside the specialties. During June and July 1944, the European theater received 12 general hospitals, each of 1,000-bed capacity, without their nurse complements (table 10).

TABLE 10.-Medical Department overstrengths and understrengths in various oversea theaters or areas, 
30 November 1943

Theater or area

Authorized strength1

Overstrength

Understrength

Number2

Percent

Number2

Percent

Medical Corps

Europe

3,812

2

0.05

0

0

North Africa

3,434

102

2.97

0

0

China-Burma-India

671

0

0

0

0

Central Pacific

740

70

9.46

0

0

South Pacific

1,131

0

0

157

13.88

Dental Corps

Europe

729

0

0

0

0

North Africa

650

11

1.69

0

0

China-Burma-India

106

0

0

0

0

Central Pacific

195

0

0

26

13.33

South Pacific

207

0

0

21

10.14

Veterinary Corps

Europe

51

0

0

0

0

North Africa

30

7

23.33

0

0

China-Burma-India

85

0

0

0

0

Central Pacific

22

2

9.09

0

0

South Pacific

19

0

0

1

5.26

Sanitary Corps

Europe

91

0

0

0

0

North Africa

118

2

1.69

0

0

China-Burma-India

20

0

0

0

0

Central Pacific

17

0

0

0

0

South Pacific

61

0

0

19

31.15

Medical Administrative Corps

Europe

835

0

0

0

0

North Africa

786

33

4.20

0

0

China-Burma-India

125

0

0

0

0

Central Pacific

201

0

0

29

14.43

South Pacific

239

0

0

56

23.43

Army Nurse Corps

Europe

4,142

0

0

0

0

North Africa

4,120

5

.12

0

0

China-Burma-India

633

0

0

0

0

Central Pacific

1,054

0

0

157

14.90

South Pacific

1,117

0

0

290

25.96

Enlisted men

Europe

41,972

439

1.05

0

0

North Africa

39,349

924

2.35

0

0

China-Burma-India

6,200

3

.05

0

0

Central Pacific

14,056

0

0

1,521

10.82

South Pacific

13,593

0

0

1,105

8.15


1The exact authorized strength used in determining overstrength or understrength is unknown. For the purposes of this table, it is assumed that the authorized strength is the actual strength on 30 November 1943 as reported in "Strength of the Army" for that date minus the overstrength or plus the understrength.
2Memorandum, Acting Adjutant General, for Assistant Chief of Staff, G-3, subject: Monthly Reports of Replacements Available in Overseas Theaters, 27 Dec. 1943. (Overstrengths appear to be strength above T/O strength and non-T/O allotments plus permanent overstrength as authorized by the War Department.)


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In some instances, the overall strength was up to the table-of-organization requirement, but the personnel were not professionally suitable. For example, the 5th Auxiliary Surgical Group, after repeated depletions of its well-qualified professional personnel in order to fill other units, was finally shipped to the European theater in the summer of 1944 with whatever medical officers were available, regardless of their suitability to the organization's functions.67

During 1944, the European theater was almost consistently below authorized strength in Medical Corps officers. Even on D-day, there was a shortage of 35 Medical Corps officers in the theater. A persistent shortage of Dental Corps officers existed during the same year, which was aggravated by increases in table-of-organization authorizations; in November, the shortage amounted to 238. With regard to nurses, the situation was similar to that pertaining to Medical Corps officers. Consistent shortages began to appear in April and continued into June. From the end of July, the shortages reappeared and steadily increased so that by the end of the year the theater lacked 345 of its proper table-of-organization strength in nurses. Until October, there was a critical shortage of physical therapy aides. A severe shortage of dietitians also existed throughout the year. From November, there was a steady increase in the deficit in enlisted men, particularly in ground force units. Because of the losses occasioned by the Battle of the Bulge, a shortage of approximately 500 medical enlisted men appeared in each of the four field armies engaged in the theater.

The shortages persisted to the end of the war. In mid-March 1945, the medical service of the communications zone of the European theater was reported to be at 94.1 percent of its table-of-organization strength. In this respect, it was worse off than every other service except the Signal Corps. For all arms and services, the corresponding figure was 96.2 percent. As regards Medical Department officers, the shortage in table-of-organization strength was 9.9 percent and in this category of personnel, too, only the Signal Corps was at a greater disadvantage. The shortage of Army officers as a whole was 7.7 percent.

In other theaters, there were similar shortages in 1944. For example, as of 31 December 1944, the Southwest Pacific Area needed approximately 124 officers to reach the dental strength required under tables of organization.68 With regard to nurses, the shortage was in excess of 1,300.69

As of 31 May 1945, the Eighth U.S. Army, operating in the Pacific, had shortages of medical officers and nurses which were, respectively, in excess of 10 and 25 percent of authorized strengths (table 11). In July 1945, the shortage of medical officers in the entire Pacific was at least 300.70

67Annual Report, 5th Auxiliary Surgical Group, 1944, pp. 98, 144-145. 
68See footnote 64, p. 104.
69Annual Report, Surgeon, U.S. Army Services of Supply, Southwest Pacific Area, 1944, p. 47.
70Memorandum, Eli Ginzberg, Director, Resources Analysis Division, Office of The Surgeon General, for Lieutenant Colonel Lueth, 26 July 1945, subject: Notes on 10 July Conference With AFPAC.


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TABLE 11.-Authorized and actual strengths of medical personnel, Eighth U.S. Army, 31 May 1945 

Group

Strength

Percent short

Authorized

Actual

Medical Corps

786

703

10.6

Medical Administrative Corps

354

330

6.8

Veterinary Corps

3

4

0

Dental Corps

172

160

7.0

Sanitary Corps

41

42

0

Army Nurse Corps

372

278

25.3

Enlisted men

11,973

11,148

6.9


Source: Quarterly Report, Surgeon, Eighth U.S. Army, 1945 (2d quarter), p. 2.

In the Middle Pacific Area, although there was no shortage of Medical Corps officers in July 1945, there were inadequate numbers of medical and surgical specialists. After V-E Day, certain units designed for the European theater had been diverted to the Pacific and arrived in that area short of such specialists.71

In the period 7 December 1941-31 August 1945, Medical Corps officers in the Central Pacific attained their authorized strength only during the month of January 1945.72 In late 1943, reports to the War Department indicated that in terms of table-of-organization and table-of-allotment strength plus authorized overhead there was a surplus in the North African theater among all, or virtually all, Medical Department elements. At that time, there were also some surpluses in the European theater and the Central Pacific. The Central Pacific, however, had substantial shortages in dental and medical administrative officers as well as in enlisted men, the shortages apparently being greater than 10 percent of the authorized strength in each case. The situation was even worse in the South Pacific, every element reported being understrength. In some elements, the understrength was over 25 percent.

Both line officers and Medical Department authorities were sometimes extremely reluctant to use nurses in forward areas, particularly during the earlier phases of combat operations. Units sometimes were given additional enlisted personnel instead of nurses.73 In at least one case, after a unit had been transferred from Alaska to Europe, it was considered necessary or advisable to replace the extra enlisted technicians by nurses.74

71Col. Fred J. Fielding, formerly of the Military Personnel Division, Office of The Surgeon General, minimizes the extent to which units arrived in the Pacific short of specialists. Commenting on the statement in the text, he remarks (Letter to Col. J. B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12 Dec. 1955): "This was not the policy, however, and only one or two units were diverted while on high seas or before landing in ETO. Units from ETO were reorganized with balanced staff and shipped to Pacific after V-E Day."
72Whitehill, Buell: Administrative History of Medical Activities in the Middle Pacific, 1946, p. 12. [Official record.]
73This was authorized for certain evacuation hospitals by T/O&E 8-581 (25 Mar. 1944).
74Annual Report, 28th Field Hospital, European Theater of Operations, U.S. Army, 1944, p. 11.


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Shortages of enlisted specialists also existed although it is difficult to assess their prevalence. For example, the 3d General Hospital, through the operation of the 38-year draft limitation, lost 140 enlisted men in the 2 months before its departure for the North African theater on 12 May 1943. This created a shortage which was manifested overseas primarily in the clerical field since the unit had not obtained adequately trained replacements before leaving the United States.75

75Annual Report, 3d General Hospital, 1944.

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