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Chapter V

Contents

CHAPTER V

Procurement During the Emergency Period

During the period 1939-41, the problems of procurement were apparently of greater moment to The Surgeon General than those of requirements. Especially difficult was the procurement of Medical Corps officers although in no category of Medical Department personnel was the supply always equal to the demand. Shortages varied, of course, and according to Lt. Col. Paul A. Paden, MC, a former chief of The Surgeon General's Personnel Division: "Army-wide shortages were never so acute as local shortages."1

PREEMERGENCY PROCEDURES

The National Defense Act of 1920 stated that the Army of the United States should consist of the Regular Army, the National Guard, and the Organized Reserves. Thus, there were three means of entering the medical service of the Army

1. Regular Army.-Individuals interested in securing an appointment in the Regular Army could apply to The Adjutant General. Applicants having the necessary educational qualifications had to pass a competitive examination prepared by The Surgeon General and conducted by an examining board which also considered the candidate's physical condition, moral character, and general fitness.2 The board's report went to the Central Medical Department Examining Board for review and the necessary grading of papers. If the candidate was found qualified by this board and was recommended by The Surgeon General, and if the recommendation was approved by the Secretary of War, he was appointed to the appropriate Medical Department corps as a Regular Army officer.3

2. Officers' Reserve Corps.-Persons interested in obtaining Reserve commissions applied to the corps area commander. The latter, acting on the recommendation of a board which examined the candidates' qualifications (educational and otherwise), transmitted the names of successful applicants

1Letter, Lt. Col. Paul A. Paden, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 10 Dec. 1955.
2Beginning at least as early as 1921, the competitive examination was dispensed with in the case of medical and dental interns who had completed a year's internship in an Army hospital, and who were found qualified by a board of officers, and were recommended by the commanding officer of the hospital wherein their internship was served. Examinations for such interns were apparently in effect, however, from August 1939 to November 1941. (AR 605-10, 24 Feb. 1921; AR 605-20, 16 Aug. 1939 and C 1, 14 Nov. 1941.)
3Army Regulations No. 605-20, 16 Aug. 1939.


112

to The Adjutant General for issuance of letters of appointment to the appropriate Medical Department Reserve Corps.4

3. National Guard.-Any officer of a State National Guard Unit might be commissioned in the National Guard of the United States upon passing "such tests as to his physical, moral, and professional fitness as the President may prescribe."5 Most State National Guard officers obtained such commissions.6 In peacetime, this made them eligible for active duty with the Guard at the order of the State Governor, and in time of national emergency declared by Congress, it enabled the President to call them into the active service of the United States. Enlisted men of the National Guard also might hold commissions in the National Guard of the United States, which would give them officer status whenever the latter was called into active service.

EARLY RESERVE MEASURES

The Situation at the Beginning of the Emergency

The most important function of the procurement system during the early emergency period-at least from the standpoint of the Medical Department-was to provide additional officers and nurses, by way of the Reserves, for the medical service of the active forces. These forces were constantly expanding, and their needs were immediate. On 30 June 1939, the Nurse Corps and all officer corps except the Veterinary Corps were below their authorized active-duty strength, and authorizations of medical, dental, and veterinary officers, as well as nurses, increased considerably during the following year. The National Guard and the Regular Army could not furnish the additional strength that would be needed under conditions of rapid expansion. The National Guard was called in August 1940, but Congress did not authorize officer appointment to the Regular Army in sufficient numbers to correspond with the 1939-40 increases in enlisted strength. Even the small Regular Army additions which Congress permitted were not realized in full. Thus, at the end of June 1940, there were 46 vacancies in the Regular Army Medical Corps, 11 in the Dental Corps, and 10 in the Medical Administrative Corps; only the Veterinary Corps had filled its quota.7 The backlog of reservists, however, looked more than adequate on paper. On 30 June 1939, the Reserves of three of the five officer corps were above their procurement objectives (table 12), while Reserve nurses registered with the Red Cross were many times the number of the nurses on active duty with the Army.8 Changes in the Officers' Reserve Corps as of June 1940 and June 1941 are shown in table 13. Comparable figures for the National Guard are in table 14.

4 Army Regulations No. 140-33, 30 July 1936. 
548 Stat. 53.
6Annual Report of the Chief, National Guard Bureau, 1940, p. 9.
7Annual Report of The Surgeon General, U.S. Army, Washington: U.S. Government Printing Office, 1940, p. 162.
8The active duty strength was 672; the Red Cross Reserve amounted to 15,761.


113-115

TABLE 12.-Active-duty strength of Medical Department groups, by Army components, 30 June 1939-30 November 19411

Component

30 June 1939

30 June 1940

30 June 1941

30 November 19412

Regular Army:3

Medical Corps

1,094

1,160

1,206

1,271

Dental Corps

220

252

266

270

Veterinary Corps

126

126

126

126

Medical Administrative Corps

64

62

61

68

Army Nurse Corps

672

942

1,280

1,402

Total officers and nurses

2,176

2,542

42,939

53,137

Enlisted men6

9,359

14,974

731,343

831,872

Grand total

11,535

17,516

34,282

35,009

Reserves:9

Medical Corps

706

414

8,025

8,984

Dental Corps

157

101

102,090

2,531

Veterinary Corps

96

45

10404

541

Sanitary Corps

---

8

186

226

Medical Administrative Corps

1117

4

772

933

Army Nurse Corps

---

---

4,153

5,409

Total officers and nurses

976

12572

15,630

18,624

Enlisted men13

---

---

1

10

Grand total

976

572

15,631

18,634

National Guard:

Medical Corps

---

---

1,080

1,072

Dental Corps

---

---

280

280

Veterinary Corps

---

---

33

28

Sanitary Corps

---

---

1

Medical Administrative Corps

---

---

275

266

Total officers

---

---

141,669

151,647

Enlisted men

---

---

1614,715

12,075

Grand total

---

---

16,384

13,722

Army of the United States:

Medical Corps

---

---

---

---

Dental Corps

---

---

---

---

Veterinary Corps

---

---

---

---

Medical Administrative Corps

---

---

---

76

Total officers17

---

---

---

76

Enlisted men18

---

---

755

794

Grand total

---

---

755

870

Selectees, enlisted men19

---

---

2051,255

63,351


1Unless otherwise specified, data on officers and nurses from 30 June 1939 to 30 June 1941, inclusive, are from corresponding "Annual Reports of The Surgeon General, U.S. Army"; and data on enlisted men are from equivalent "Annual Reports of The Secretary of War."
2Data for male officers, with the exceptions mentioned in other footnotes, are from Memorandum, F. M. Fitts, to Colonel Lull, 29 Oct. 1942, subject: Status of Medical Department Officers as of 7 Dec. 1941, addendum to "History of Military Personnel Division, Personnel Service, 1939-April 1944." The figures represent strength on 5 December 1941.
3Authorized Regular Army strengths were: (1) For 30 June 1939: MC, 1,133; DC, 233; VC, 126; MAC, 72; ANC, 675; and enlisted men, 8,643. (2) For 30 June 1940: MC, 1,210; DC, 264; VC, 126; MAC, 72; ANC, 949; and enlisted men, 13,628. (3) For 30 June 1941: MC, 1,230; DC, 267; VC, 126; MAC, 72; ANC, 1,875; (no figures for enlisted men). (Data are from "Annual Reports of The Surgeon General, U.S. Army" for dates corresponding to those shown except authorization for enlisted men in 1939 which is from the report for 1940, p. 170.)
4Probably includes retired officers on active duty as follows: MC, 18; VC, 2; and MAC, 3. (Figures pertaining to the Medical and Medical Administrative Corps are for the week ending on 4 July 1941 and were provided by the Military Personnel Division, Office of The Surgeon General, on 30 August 1949.)
5Includes the following retired officers on active duty: MC, 38; DC, 2; VC, 2; and MAC, 7. (Data from source of Regular Army strength figures on the same date, see footnote 2, above.) 
6Includes Philippine Scouts.
7
Includes an estimated 608 members of the Regular Army Reserve. The number of Regular Army Enlisted Reserves who, regardless of branch, were called into active service was 12,190; all of these went on duty in February 1941. Of the total, 672 or somewhat more than 5 percent were Medical Department personnel. By 30 June 1941, the Regular Army Enlisted Reserves on active duty had declined to 10,919. Assuming that 5 percent of the decline had occurred in the Medical Department, the loss to the medical service amounted to 64, leaving a balance of 608.
8Figure supplied by Statistics and Accounting Branch, Statistics Section, Office of The Adjutant General, 24 October 1957. Includes an estimated 548 members of the Regular Army Reserves. This estimate is based on the rate of decline of the Regular Army Reserves without distinction of branch between February and 30 June. As shown in footnote 7, above, this rate when applied to the Medical Department left a balance of 608 on 30 June. If the rate of decline, approximately 12 per month, is assumed to have continued, the loss between this date and 30 November 1941 amounts to 60, and the strength on the latter date is reduced to the figure stated at the beginning of this note.
9Authorized active-duty strengths for the Reserves are known only for 30 June 1940. At that time they were: MC, 1,271; DC, 219; VC, 76; and MAC, 4. The number authorized for the Medical Corps was 1,283 minus the number of Medical Administrative and Sanitary Corps Reserve officers on active duty.
10Divisional reports in the source for these figures (Annual Report of The Surgeon General, 1941) show 1,745 dental Reserve officers and 435 veterinary Reserve officers on extended active duty (pp. 183, 190). The explanation for the discrepancy in the case of the dental officers may be similar to that mentioned in footnote 12 (that is, the figure stated in the table may include individuals for whom active-duty orders had been requested), but it does not explain the difference in the Veterinary Corps figures.
11Includes Sanitary Corps.
12Data are described in the source as "on duty or duty orders requested as of June 30, 1940." Except in the case of the Sanitary Corps, where the strength is reduced to 6, the same figures are reproduced in the report for 1941 (p. 142) under the simple heading of "on duty June 30, 1940." The report for 1940 also states (p. 209) that 25 Veterinary Corps reservists were on active duty on 30 June; failure to include those who had not yet come on active duty may account for the discrepancy. 
13Does not include Regular Army Reserve (see footnotes 7 and 8, above). The figure for 30 November 1941 was provided by the Statistics and Accounting Branch (see footnote 8, above) on 24 October 1957.
14Commissioned personnel of the Medical Department in the National Guard of the United States, as reported by the Chief of the National Guard Bureau in his annual report for fiscal year 1941.
The Annual Report of The Surgeon General, U.S. Army, for the same date (p. 260), gives the following figures instead of those shown: For MC, 1,120; DC, 243; VC, 60; MAC, 153; total, 1,576. 
No strength is shown for the Sanitary Corps, but 16 warrant officers are credited to the Medical Department; presumably, these were men serving in medical units.
Elsewhere in the 1941 Annual Report of The Surgeon General, the number of Veterinary Corps officers of the National Guard is stated to be 34 (p. 190), and the number of Dental Corps officers, 282 (p. 183). These figures, which approximate those shown in the body of this table, undoubtedly are more accurate than the corresponding personnel figures stated. It also is unlikely that the strength of the Medical Corps personnel, like that of the Veterinary Corps personnel, could have exceeded the strength shown for the National Guard of the United States, which consisted of all individuals who had been inducted since the federalization of the National Guard minus those who had been completely separated from the Federal service and also had been dropped from their National Guard status. On the other hand, the figure for the Medical Administrative Corps probably is very low in view of the much higher strength shown for the group at later periods and the fact that few if any members of the corps could have been inducted after 30 June 1941. (See footnote 15.) As late as 30 June 1943, the active-duty strength of the Medical Administrative Corps in the National Guard was shown to be 277. (Annual Report, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1943.) Similar considerations govern the strength of the Dental Corps personnel, which at the same date was reported to be 273.
The Annual Report of the Secretary of War for the fiscal year 1941 shows no breakdown for the Medical Department corps in the National Guard but reports the aggregate strength of these groups on 30 June 1941 as 1,491.
15Adjustment of strengths shown for 1 November 1941, in memorandum cited in footnote 2, p. 114, for MC is 1,072; for DC, 300; for VC, 28; and for MAC, 266.
In view of the considerations mentioned in footnote 14, it is unlikely that the Dental Corps personnel of the National Guard numbered 300, since at the end of June it had been only 280. At that time, the total number of Medical Department officers of the National Guard remaining to be inducted had been six. (In Annual Report of Chief of National Guard Bureau for the fiscal year 1941, pp. 117-118.) For that reason, the number of Dental Corps officers of the National Guard on active duty on 1 November 1941 has been reduced to 280. In view of the fact that the Active National Guard as late as 30 June 1942 is credited with one Sanitary Corps officer, one such officer is credited to the active duty strength on 1 November 1941. A breakdown of the National Guard strength of Medical Department officers on 30 November 1941 is not available, but it is assumed that it did not differ greatly from the same strength at the beginning of the month. However, according to information supplied by the Statistics and Accounting Branch, Statistics Section, Office of The Adjutant General, on 24 October 1957, the aggregate of the strength on 30 November 1941 was 1,590, but for purposes of consistency, the total of 1,647 as of 1 November 1941 is stated in the body of this table.
16Strength for 30 June 1941 is based on Annual Report of Secretary of War for 1941, which shows medical enlisted strength of National Guard on that date to be 15,470. Since 755 of these are estimated to be Army of the United States personnel (see footnote 18), the strength of the National Guard personnel proper is deemed to be 14,715. Strength of 30 November 1941 is based on data supplied by Statistics and Accounting Branch, 24 October 1957, showing medical enlisted strength of the National Guard on the former date to be 12,869. Since no separate strength figures for AUS enlisted personnel are shown in these data, it is assumed that the estimated 794 medical enlisted men in that category (see footnote 18) must be subtracted from 12,869 in order to arrive at approximately the true National Guard strength, that is, 12,075.
17Personnel who entered the Army of the United States directly, without previous service as members of the Regular Army, the Reserves, or the National Guard. Strength information from Statistics and Accounting Branch (see footnote 8), 24 October 1957. This information is not broken down by corps, but the number 76 corresponds closely to the strength (77) of the first class for MAC's at Carlisle Barracks, Pa., which graduated in September 1941. The entire 76 therefore have been attributed to the Medical Administrative Corps. According to "Officers Appointed in the MC, DC, VC, MAC, and PhC. From 1 January 1939 through 1946. Month of Occurrence OTN 337," (prepared by the Adjutant General's Office, Strength Accounting Branch, 8 July 1946), 161 Medical Department officers classified as AUS had come on duty by 30 November 1941. They included the following: MC, 28; DC, 38; VC, 10; MAC, 85. However, some of these are shown as having come on active duty as early as January 1941, and it is possible that many of those comprehended in the data entered upon active duty at the time stated but as members of the Reserves or the National Guard, acquiring AUS status later.
18Comprises volunteers on 1-year enlistments. According to the Annual Report of the Secretary of War, 1941, a total of 767 enlisted volunteers had come on duty with the Medical Department from September 1940 to the end of June 1941. The corresponding number for the Army as a whole was 22,390. Of these, 22,060 remained on duty on 30 June 1941, for a loss of 1.5 percent. Applying the same percentage to the enlisted volunteers of the Medical Department, the balance remaining on 30 June 1941 was 755. The number of such personnel on duty on 30 November 1941 is unknown, but on 31 December 1941, it was 802. (Information from Statistics and Accounting Branch, 24 October 1957.) By prorating the difference between the numbers present on 30 June and 31 December on a monthly basis, the estimated strength of Medical Department enlisted personnel classified as "AUS" is found to be 794.
19The figure for 30 November was prorated by the Statistics and Accounting Branch (see footnote 8), 24 October 1957.
20Of these, 38,756 were serving in Regular Army units and 12,799 in National Guard units. (Annual Report of Secretary of War, 1941.)
At this time, the total authorized strength of Medical Department enlisted personnel, both selectees and others, was approximately 82,150. Of these, about 20,437 were allotted to National Guard units, 1,387 to the veterinary service, and 60,326 to the remainder of the Medical Department establishment. (Annual Report of The Surgeon General, 1941, p. 148.)


116-118

TABLE 13.-Strength of Medical Department Reserves (Regular Army Reserve and Reserve Corps), 1939-41

Personnel

Strength, 30 June 1939

Changes, 1 July 1939-30 June 1940

Strength, 30 June 1940

Net change since 30 June 1939 (percent)

Changes, 1 July 1940-30 June 1941

Strength, 30 June 1941

Net change since 30 June 1940 (percent)

Changes, 1 July-30 Nov, 1941

Strength, 30 Nov. 1941

Net change since 30 June 1941 (percent)

Procured

Lost

Procured

Lost

Procured

Lost

Regular Army Reserve

Enlisted men:1

All branches

19,301

---

---

28,020

+45

---

---

10,919

-61

---

---

---

---

Medical Department

1,028

---

---

1,475

+43

---

---

---

---

---

---

---

---

Reserve Corps

Total officers:

All branches2

131,726

---

---

132,652

+0.6

---

---

---

---

---

---

---

---

Male only3

115,965

411,008

510,120

3116,853

+0.8

417,541

511,647

3122,747

+5

---

---

---

---

Medical Department

39,100

---

---

39,918

-0.5

---

---

---

---

---

---

---

---

Male only6

23,339

501

701

23,139

-0.9

4,903

6,740

21,302

-8

---

---

20,609

-3

Medical Corps

15,198

308

207

15,299

+0.7

3,919

5,244

13,974

-9

---

---

13,745

-1

Dental Corps

5,063

0

398

4,665

-8

722

959

4,428

-5

---

---

4,060

-8

Veterinary Corps

1,381

163

7

1,537

+11

74

218

1,393

-9

---

---

1,346

-3

Sanitary Corps

454

0

9

475

+5

47

63

459

-3

---

---

415

-10

Medical Administrative Corps

1,243

0

80

1,163

-6

141

256

1,048

-10

---

---

1,043

-0.5

Army Nurse Corps (Red Cross Reserve)7

15,761

---

---

15,779

+0.01

---

---

---

---

---

---

---

---

Enlisted men:8

All branches

3,054

---

---

3,233

+6

---

---

2,149

-34

---

---

157,000

+720

Medical Department

16

---

---

49

+206

---

---

---

---

---

---

13,020

---

Affiliated units, officers:

All branches

---

---

---

---

---

---

---

---

---

---

---

---

---

Male only

---

---

---

---

---

---

---

---

---

---

---

---

---

Medical Department, 
 male only

---

---

---

---

---

---

---

91,639

---

---

---

---

---

Medical Corps

---

---

---

---

---

---

---

91,414

---

---

---

---

---

Dental Corps

---

---

---

---

---

---

---

9176

---

---

---

---

---

Medical Administrative Corps

---

---

---

---

---

---

---

949

---

---

---

---

---

Affiliated Reserve Officers:10

All branches

---

---

---

---

---

---

---

---

---

---

---

---

---

Male only

---

---

---

---

---

---

---

111,561

---

---

---

---

---

Medical Department, 
male only12

---

---

---

---

---

---

---

1,410

---

---

---

1,405

-0.4

Medical Corps

---

---

---

---

---

---

---

1,257

---

---

---

1,264

+0.6

Dental Corps

---

---

---

---

---

---

---

122

---

---

---

120

-2

Medical  Administrative Corps

---

---

---

---

---

---

---

31

---

---

---

21

-32


1Figures for 1939 and 1940 are, respectively, from "Annual Report of the Secretary of War" (1939) p. 85, and (1940) p. 61. Figure for 1941 is number of members of the Regular Army Reserve on active duty on 30 June 1941. (See table 12.) Since the entire membership of the Regular Army Reserve was required to be called to active duty by 15 February 1941, it is assumed that those on active duty on 30 June 1941 constituted the entire strength of this Reserve. The corresponding figure for the Medical Department is estimated to be 608 (table 12, footnote7) which is 59 percent less than the strength for Medical Department members for the Regular Army Reserve on 30 June 1940.
2Aggregate of strengths, as shown in this table, of male officers in all branches and nurses.
3Adjustments of strengths shown in "Annual Reports of the Secretary of War" for corresponding dates; that is, for 1939-116,719; for 1940-116,636; for 1941-122,020, by subtracting from these strengths the amounts attributed in the same sources to the Medical Department; namely,

1939

1940

1941

Medical Corps

15,956

15,187

14,497

Dental Corps

4,979

4,627

4,630

Veterinary Corps

1,509

1,525

1,319

Sanitary Corps

432

451

498

Medical Administrative Corps

1,217

1,132

1,631

Total

24,093

22,922

22,575


and adding the aggregate strength of the corps listed as shown in the body of this table.

4Computed by subtracting from total accessions for Officer Reserve Corps as shown in "Annual Reports of the Secretary of War" for 1940 and 1941; that is, for 1939-40-12,300, for 1940-41-16,189, accessions of Medical Department officers reported in the same sources as follows:

1939-40

1940-41

Medical Corps

1,518

2,686

Dental Corps 

35

649

Veterinary Corps

143

57

Sanitary Corps 

47

35

Medical Administrative Corps

50

124

Total

1,793

3,551


and adding aggregate accessions of the same groups as stated in this table.
5Computed by adding number procured to strength at beginning of the period and subtracting the strength at the close of the period from the total.
6Basic data through June 1941 from "Annual Reports of The Surgeon General, 1939-41." Basic data for November 1941 from Memorandum, F. H. Fitts to Colonel Lull, 29 Oct. 1942, subject: Status of Medical Department Officers as of 7 Dec. 1941, addendum to History of Military Personnel Division, Personnel Service-1939-April 1944.
7Basic data from Memorandum, Superintendent, Army Nurse Corps, for The Surgeon General, 2 Dec. 1941, in Miss Byers' Book Data on Army Nurses, 1941.
8Basic data through June 1941 from "Annual Reports of the Secretary of War" for dates corresponding to those shown. Strength on 30 November 1941 is unknown, but is estimated to have been 157,000 for the Army in general. The vast increase in the strength of the Enlisted Reserve Corps which this figure signifies is the result of amendments to the basic Selective Service law in August 1941 authorizing release from active duty of men inducted under the act who were over 28 years of age upon their own request and release of men below this age upon showing that their retention in the Army would subject them or their wives and dependents to undue hardship. Under these provisions over 155,000 men were released between 1 September 1941 and Pearl Harbor, but all of them were retained in the Enlisted Reserve Corps ("Selective Service in Peacetime," First Report of Director of Selective Service, 1940-41, pp. 267-268). Since more than 2,000 were in the corps on 30 June 1941, this figure has been added to 155,000 to determine the estimated strength of the corps on 30 November. Medical Department enlisted strength during the period July-November 1941 was in the vicinity of 8.4 percent of the total draftee strength of the Army. (According to "Annual Report of the Secretary of War" for 1941), the total number of drafted enlisted men on active duty was 606, 915 on 30 June 1941. Of these, 8.5 percent (see table 12) were Medical Department personnel. On 30 November 1941, in accordance with data supplied by the Statistics and Accounting Branch, Statistics Section, Office of The Adjutant General, on 7 May 1958, the total number of selectees on active duty was 756,747. The proportion of those assigned to the Medical Department was 8.4 percent (table 12). Assuming that the same percentage of the 155,000 released men comprised Medical Department personnel, the number of such personnel placed in the Enlisted Reserve Corps was 13,020. The number of Medical Department enlisted men who were in the Enlisted Reserve Corps after 30 June 1940 and before 1 September 1941 is unknown, but in view of the earlier figures on the same topic, it must have been negligible. Consequently, 13,020 is taken as an approximation of the Medical Department membership in the Enlisted Reserve Corps on 30 November 1941.
9From "Annual Report of The Surgeon General" for 1941. Includes members of the Affiliated Reserve (footnote 10) and members of the Officers Reserve Corps who were not members of the Affiliated Reserve although members of the affiliated units.
10Members of the Officers Reserve Corps who possessed Reserve Status only through assignment to an affiliated unit.
11Adjustment of strength of all branches as shown in "Annual Report of the Secretary of War" for 1941; that is, 1,659, by subtracting strengths reported therein for the Medical Department (Medical Corps, 1,326; Dental Corps, 137; and Medical Administrative Corps, 45) and adding the strength of the Affiliated Reserves in these corps as stated in the body of this table.
12Basic data for June 1941 from "Annual Report of the Surgeon General," 1941, pp. 145-146. Slightly different figures are also given in the same source (pp. 146-147); namely, Medical Corps, 1,264; Dental Corps, 120; and Medical Administrative Corps, 31. (The source states that these figures represent the strength of the affiliated units, but their size indicates that they really apply to the Affiliated Reserve.) Basic data for November are from Memorandum, F. H. Fitts, to Colonel Lull, cited in footnote 6. This source reports the total number of Medical Administrative Corps officers in the Affiliated Reserve to be 31, but the distribution of the same group by rank results in a total of 21. However, since 31 is the strength which the group possessed on 30 June 1941, it is possible that the figure 31 is correct for 30 November.


119-121

TABLE 14.-Strength of Medical Department Reserves (National Guard), 1939-41

Component

Strength, 30 June 1939

Changes, 1 July 1939-30 June 1940

Strength, 30 June 1940

Net change since 30 June 1939 (percent)

Changes, 1 July 1940-30 June 1941

Strength, 30 June 1941

Net change since 30 June 1940 (percent)

Changes, 30 June-30 Nov. 1941

Strength, 30 Nov. 1941

Net change since 30 June 1941 (percent)

Procured

Lost

Procured

Lost

Procured

Lost

National Guard of United States:1

Officers:2

  All branches

16,341

---

---

16,415

+0.5

---

---

19,069

+16

---

---

15,926

-16

  Medical Department

1,592

---

---

1,509

-5

---

---

1,669

+11

---

---

1,557

-7

Medical Corps

1,078

---

---

1,022

-5

---

---

1,080

+6

---

---

1,081

+0.9

Dental Corps

245

---

---

288

-7

---

---

280

+23

---

---

260

-7

Veterinary Corps

73

---

---

65

-11

---

---

33

-49

---

---

29

-12

Sanitary Corps

2

---

---

1

-50

---

---

1

0

---

---

1

0

Medical Administrative Corps

195

---

---

193

-1

---

---

275

+42

---

---

186

-32

Warrant officers3

212

31

28

215

+1

73

87

201

-7

---

---

196

-2

Enlisted men4

---

---

---

---

---

---

---

---

---

---

---

---

---

  All branches

183,233

---

---

224,882

+23

---

---

243,057

+8

---

---

213,449

-12

  Medical Department

12,144

---

---

14,745

+21

---

---

14,735

-.07

---

---

12,075

-18

Sources of National Guard of United States:5

Active National Guard officers:6

  All branches

14,465

1,523

1,426

14,562

+0.7

5,125

3,471

16,216

+11

---

---

15,926

-2

  Medical Department

1,537

309

274

1,572

+2

808

767

1,613

+3

---

---

1,557

-3

Medical Corps

1,089

242

216

1,115

+2

593

587

1,121

+0.5

---

---

1,081

-3

Dental Corps

235

48

40

243

+3

138

111

270

+11

---

---

260

-4

Veterinary Corps

67

1

8

60

-10

14

40

34

-43

---

---

29

-17

Sanitary Corps

1

0

0

1

0

0

0

1

0

---

---

1

0

Medical  Administrative Corps

145

18

10

153

+6

63

29

187

-22

---

---

186

-0.5

Warrant officers7

212

31

28

215

+1

73

87

201

-7

---

---

196

-2

Enlisted men8

---

---

---

---

---

---

---

---

---

---

---

---

---

  All branches

184,825

---

---

266,837

+23

---

---

243,057

+6

---

---

213,449

-12

  Medical Department

12,197

---

---

14,799

+22

---

---

14,735

-0.4

---

---

12,075

-18

Inactive National Guard officers:

  All branches

674

---

---

739

+10

---

---

533

-28

---

---

343

-36

  Medical Department

42

---

---

47

+12

---

---

24

-49

---

---

15

-38

Medical Corps

30

---

---

33

+10

---

---

14

-58

---

---

9

-36

Dental Corps

4

---

---

4

0

---

---

6

+50

---

---

3

-50

Veterinary Corps

7

---

---

8

+14

---

---

3

-63

---

---

2

-33

Sanitary Corps

0

---

---

0

0

---

---

0

0

---

---

0

0

Medical Administrative Corps

1

---

---

2

+100

---

---

1

-50

---

---

1

0

Warrant officers9

---

---

---

---

---

---

---

---

---

---

---

---

---

Enlisted men9

---

---

---

---

---

---

---

---

---

---

---

---

---

  Holding commissions in National Guard of United States:10

  All branches

1,602

---

---

1,955

+22

---

---

3,081

+57

---

---

3,001

-3

  Medical Department

53

---

---

54

+2

---

---

115

+113

---

---

120

+4

Medical Corps 

0

---

---

1

---

---

---

7

+600

---

---

7

0

Dental Corps

4

---

---

0

-100

---

---

20

---

---

---

20

0

Veterinary Corps

0

---

---

0

0

---

---

0

0

---

---

0

0

Sanitary Corps

1

---

---

1

0

---

---

0

-100

---

---

0

0

Medical Administrative Corps

48

---

---

51

+6

---

---

88

+73

---

---

93

+6


1Members of the National Guard who had taken an oath and had been appointed for Federal service whenever it became necessary (Dictionary of United States Army Terms TM 20-205, 18 Jan. 1944).
2Basic data through June 1941 from "Annual Reports of Chief of National Guard Bureau" for corresponding dates. Strength on 30 November 1941 computed by prorating on a monthly basis the difference between the strength on 30 June 1941 and the strength of the Active National Guard on 30 June 1942 (see footnote 5). Membership in the Active National Guard of the United States and the difference prior to completion of the induction of the Guard into the Federal service between the commissioned strength of the Active National Guard and that of the National Guard of the United States (exclusive of enlisted men holding commissions) was the result almost entirely of the timelag between appointment in the Active National Guard and recognition of the appointee by the Chief of the National Guard Bureau. (See "Annual Reports of Chief of National Guard Bureau" for 1939 and 1941.) With the induction of the Guard and termination of appointments therein, the difference disappeared. (In the Annual Report of the Chief of the Bureau for 1942, only the strength of the Active National Guard was reported.)
3Comprises individuals with the status of warrant officers in the Active National Guard.
4Enlisted men in the Active National Guard did not have a separate status in the National Guard of the United States. Figures shown are therefore the same as those stated under Active National Guard except those for 1939 and 1940 which are the difference between the number of enlisted men in the Active National Guard at those times and the number of enlisted men of the National Guard holding commissions in the National Guard of the United States. The numbers of enlisted men actually inducted with the National Guard were substantially in excess of the strengths shown here; by 30 June 1941, according to the National Guard Bureau, the number in all branches had reached 278,526 and those in the Medical Department had grown to 17,238. (Annual Report of Chief of National Guard Bureau, 1941.) The number further increased slightly so that on 30 November 1941 the total inducted for all branches reached 279,358. The number inducted in the Medical Department is unknown but could scarcely have been more than 100 greater than it had been on 30 June. (Annual Report of Chief of National Guard Bureau, 1942.) Figures provided by the Secretary of War relative to 30 June 1941 are considerably less than those reported by the National Guard Bureau: 272,559 in all branches and 15,011 in the Medical Department. (Annual Report of the Secretary of War, 1941.)
5All basic data pertaining to officers and warrant officers through 30 June 1941 come from the "Annual Reports of the Chief of the National Guard Bureau" corresponding to the dates shown. Figures for 30 November 1941 were computed by prorating on a monthly basis the differences between the strengths on 30 June 1941 and the corresponding strengths on 30 June 1942. According to the "Annual Report of the Chief of the National Guard Bureau" for 1942, the strengths on the latter date were as follows:

Active 
National 
Guard

Inactive 
National 
Guard

Enlisted 
men holding 
commissions

All branches

15,524

75

3,001

Medical Department:

Medical Corps

1,043

4

7

Dental Corps

251

1

20

Veterinary Corps

27

0

0

Sanitary Corps

1

0

0

Medical Administrative Corps

184

0

99

Total

1,506

5

126

Warrant officers

189

1

---


6Basic data on losses are from the sources of the accompanying strength data. (See footnote 5.) Figures on procurement were computed by adding losses to the strength at the end of the period and subtracting the strength at the beginning of the period from the resulting sums.
7Strengths for 1939 and 1940 include 1 cornet.
8Basic data for 1939 and 1940 from the corresponding "Annual Reports of the Chief of the National Guard Bureau." Basic data for June and November 1941 are active-duty strength of National Guard enlisted men at these times (see table 12).
9Information not available.
10Basic data through June 1941 from corresponding "Annual Reports of the Chief of the National Guard Bureau." Figures for 30 November 1941 were computed by prorating on a monthly basis the difference between the strengths on 30 June 1941 and 30 June 1942. In addition to enlisted men, the following held commissions in the National Guard of the United States: 1939 and 1940, warrant officers, 2; cornets, 1; June 1941, warrant officers, 1. None of these held commissions in a Medical Department component. All data from "Annual Reports of the Chief of the National Guard Bureau," 1939 to 1941, inclusive.


122

Since no means existed at this time by which persons could be compelled to accept appointments in the Regular Army or the Reserves, or even (if reservists) to accept a call to active duty, Army authorities had to depend on appeals to the patriotism or self-interest of those they wished to reach; in the case of nurses, the Red Cross joined in the appeal. During the spring and summer of 1940, publicity campaigns were undertaken to speed the entry of medical reservists into active service. The Surgeon General requested medical journals to print informational letters, and prominent civilian members of the Reserve Corps as well as Reserve Officers' Training Corps instructors in medical schools were utilized to encourage recruitment.

The procedure for bringing Reserve officers and nurses on active duty began with a summons from the chief of the reservists assignment group (the corps area commander or The Surgeon General). The reservist had the right to either accept or refuse the call as he wished. If he accepted, the next step was a physical examination. If that was satisfactory, the necessary papers were forwarded to The Adjutant General, who issued duty orders.

Act of 3 April 1939

But the problem of applying the officer Reserves to actual needs proved to be acute. The first move of any importance to draw on the Medical Department Officers Reserve Corps for the benefit of the active forces was made in the act of 3 April 1939-the same act that fixed the authorized strength of the Regular Army officer corps. Under this act, the President was empowered to call up 255 male Reserve lieutenants and captains of the Medical Department for not more than 1 year of voluntary active duty with an extension, at the discretion of the Secretary of War, to as long as 2 years. Only during an emergency declared by Congress could Reserve officers be ordered to duty without their consent; virtually no means existed by which, in time of peace, they could be compelled to serve even their 2-week tour of active duty when called upon. They could resign, or if they persisted in ignoring the call, one of two courses was open to the Army: It might place them on the ineligible list for the remainder of their 5-year term of appointment, or if they had had 15 years of satisfactory service to their credit, it could transfer them to the Inactive Reserve. In either case, they lost certain privileges, such as right of promotion.9 Like all previous legislation pertaining to reservists, the new act imposed no penalties whatever on those who declined to serve for the 1 or 2 years specified; in fact, it was only on their application that the duty orders could be issued. This concession was necessary as a matter of good faith, since reservists had accepted their commissions under no obligations of lengthy peacetime service.

The act of 3 April 1939 was the last occasion, until the later emergency period, that Congress itself laid down the conditions under which new incre-

9Army Regulations No. 140-5, 16 June 1963.


123

ments of Reserve officers were to be called to active duty.10 Thereafter, the War Department assumed that function.

Modification of the act

In making allotments to the Medical Department for the purpose of bringing Reserve officers on duty, the General Staff did not always prescribe the same conditions of service as were laid down in the act of 3 April 1939. With only 139 of the 255 medical officers allotted under this act procured and placed under orders by the end of November, the General Staff modified the rules. A proposed further enlargement of the Army would give the Medical Department an additional 508 officers, whenever the necessary legislation should be passed. In anticipation of such legislation, corps area commanders were instructed to recruit only captains and lieutenants who were less than 35 years old. These men could be placed on active duty for 1 year only.11 The Surgeon General, foreseeing administrative difficulties arising from these differences, recommended to The Adjutant General (1) that procurement of officers over 35 years of age for active duty be permitted, and (2) that the allowable tour of duty be extended beyond 1 year. The latter step would reduce the annual turnover to a number "considered more within reason."12 A few months later, the War Department granted authority to extend the tour of all Medical Department officers to 2 years, but there is no indication that, for the time being, the age limit was raised above 35.13 The restriction was lifted only after the enactment of compulsory service for the Reserves in August 1940.

Since the bulk of the new officer and nurse strength added during this period was to come from the Reserves, anything that limited the number of reservists subject to call, that interfered with summoning them to active duty, or that prevented the Medical Department from using them as long as necessary might mean that requirements could not be fully met. Late in December 1939, therefore, the War Department authorized new appointments in the Reserve if the existing members would not accept active duty voluntarily and if the new appointees would agree to serve immediately. This authority seems to have had a rather limited application and to have resulted in the appoint-

10Letter, Secretary of War, to Hon. Daniel W. Bell, Acting Director, Bureau of the Budget, 27 May 1939.
11(1) Letter, The Adjutant General, to each Corps Area Commander, 23 Oct. 1939, subject: Additional Reserve Officers To Be Placed on Duty With the Regular Army. (2) Letter, The Adjutant General, to each Corps Area Commander, 8 Dec. 1939, subject: Age Limit, Reserve Officers, Medical Department. (The policy was laid down in October 1939, in anticipation of the appropriation act of February 1940 which made the procurement possible.)
12Letter, The Surgeon General, to The Adjutant General, 18 Jan. 1940, subject: Removal of Certain Restrictions Governing Selection of Additional Medical Department Reserve Officers.
13Memorandum, Brig. Gen. William E. Shedd, Assistant Chief of Staff, G-1, for Chief of Staff, War Department General Staff, 27 May 1940, subject: Medical Department Reserve Officer Personnel, with 1st endorsement thereto, 4 June 1940.


124

ment of no more than 125 Medical Department officers between June and August 1940.14

Emergency Measures

An indication of the scarcity of officers is the fact that, in January 1940, The Surgeon General was forced to recommend the summoning of Reserve officers to active duty for periods of 28 days as a provision for the year's maneuvers. The General Staff approved the use of 138 Medical Department Reserve officers on this basis for service in tactical units.15

At almost the same time, the General Staff announced two measures of more permanent relief. One was a program recalling retired Regular Army officers to active duty for utilization with Reserve Officers' Training Corps units and the recruiting service. This was of small importance numerically, and it was not until 6 months later that The Surgeon General substituted retired officers for some of the 23 Regular Army Medical Corps officers on Reserve Officers' Training Corps duty.16 Much more significant from the standpoint of policy was the grant of authority to substitute reservists of the Medical Administrative and Sanitary Corps for members of the Medical Corps Reserve in meeting the quotas for active-duty assignments.

THE BEGINNING OF MOBILIZATION

The Change From Voluntary to Involuntary Service

Full mobilization began with the calling of the National Guard into Federal service (27 August 1940) and the enactment of the Selective Training and Service Act less than a month later (16 September). More or less concurrently with these measures, a number of steps were taken to increase the supply of Medical Department officers and nurses. The law ordering the induction of the National Guard was itself perhaps the most important in this respect. This law also made active duty compulsory for all reservists, including those of the Medical Department. It authorized the President during the

14(1) Letter, The Adjutant General, to each Corps Area Commander, 22 Dec. 1939, subject: Procurement of Medical Department Reserve Officers. (2) Letter, The Surgeon General, to The Adjutant General, 15 Aug. 1940, subject: Reserve Officer Personnel. (3) Letter, The Surgeon General, to The Adjutant General, 24 Aug. 1940, subject: Appointments in Medical Department Reserve. (4) Memorandum, Assistant Chief of Staff, G-1, for Chief of Staff, 30 Dec. 1940, subject: Cancellation of Authority to Appoint in the Medical Department Reserve.
15
(1) Letter, The Surgeon General (Executive Officer), to The Adjutant General, 18 Jan. 1940, subject: Additional Medical Department Reserve Officers Required for Temporary Duty With Regular Army. (2) Memorandum, War Department General Staff (Personnel Division, G-1), for Chief of Staff, 3 Feb. 1940, subject: Additional Medical Department Reserve Officers Required for Temporary Duty With Regular Army, with 2d endorsement thereto, 6 Mar. 1940.
16(1) Letter, The Adjutant General, to Corps Area and Department Commanders, 22 Jan. 1940, subject: Assignment of Retired Officers to Active Duty. (2) Letter, The Surgeon General, to The Adjutant General, 3 July 1940, subject: Utilization of Retired Officers (cited in Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Director, Historical Division, Office of The Surgeon General, 20 Apr. 1944, subject: History of Procurement Branch, Military Personnel Division, Personnel Service, Office of The Surgeon General.)


125

period ending on 30 June 1942 to call to active duty for a period of 12 months, with or without their consent, members and units of the Reserve components of the Army of the United States (Officers' Reserve Corps, National Guard, and Enlisted Reserve Corps) and retired members of the Regular Army. There were important restrictions, however. Reserve components could not be employed beyond the limits of the Western Hemisphere, except in territories and possessions of the United States. The law also stipulated that any reservist called to duty, if below the rank of captain and having no income beyond what he himself earned to support dependents, could resign and be discharged upon his own request if made within 20 days of his entry upon duty.17

Signalizing as it did the passing from voluntary to involuntary military service, this law constituted an important step toward placing the United States on a preparedness basis as far as personnel was concerned. Physically qualified Reserve and National Guard officers holding the rank of captain or above were for the first time compelled to serve. Previously, too, Congress had in one way or another limited the numbers of Reserve officers to be placed on active duty; this law, carrying no such limitations, opened the way for mobilization on a much wider scale. The effect of granting individual officers below the grade of captain the right to resign, however, reduced the benefit of the law, for hundreds of Medical Department Reserve officers exercised this right before it was canceled on 13 December 1941, shortly after entry of the United States into the war. Desirable as it was from the standpoint of the Army to prohibit resignations entirely, Congress may have felt that public opinion demanded some concessions to officers in the lower ranks; it is worth noting that these concessions were similar to the exemptions granted draftees when selective service legislation was enacted shortly afterward.

Further Emergency Reserve Measures

Immediately following the enactment of the Selective Service Act, two measures were introduced to increase the supply of officers for the Army as a whole and therefore for the Medical Department. On 27 September 1940, the War Department called Reserve officers employed with the Civilian Conservation Corps to active duty for assignment within Army installations.18 The second measure came in October when the system of corps area debits and credits was initiated. If the number of Reserve officers available to a corps area commander was insufficient for his needs, he was ordered to report the shortage to the War Department, which would then start action to supply additional officers from other corps areas. Such a system was necessary because the distribution of men in training by corps areas did not correspond to the distribution

1754 Stat. 858.
18Letter, The Adjutant General, to each Corps Area Commander and Commanders of Arms or Services, 13 Sept. 1940, subject: Placing on Active Duty of Reserve Officers Who are Employees of the Civilian Conservation Corps.


126

of Reserve officers.19 A similar system had already been applied to nurse procurement.20

Medical Administrative Corps

Members of the Medical Administrative Corps Reserve responded to the call to active duty in larger proportion than did Medical Corps reservists (tables 12 and 13). A possible reason is that some of those holding Reserve commissions in the Medical Administrative Corps were enlisted men of the Regular Army who for reasons of pay and prestige would accept active duty as officers more readily than would civilian doctors in the Medical Corps Reserve. Yet the number responding fell far short of the demand for qualified personnel who could act as instructors in medical training centers or serve in hospital administration. Men therefore had to be trained for commissioning in the corps. It was not until July 1941, however, that the first officer candidate school, at Carlisle Barracks, Pa., opened for Medical Administrative Corps training. In April, The Surgeon General had asked for the establishment of such a school, to accommodate 100 candidates with eventual expansion to a capacity of 200. As part of a general enlargement of the officer candidate school program (planned but not yet put into effect), the Chief of Staff authorized a school for 100 Medical Administrative Corps candidates, to be opened on 1 July instead of on 1 August 1941, although The Surgeon General had recommended the latter date. One class of 77 second lieutenants graduated before Pearl Harbor.21

Sanitary Corps

The procurement of Sanitary Corps officers presented no great problem, from the standpoint of actual numbers, during this period. Members on active duty increased from 6 on 30 June 1940 to 186 a year later; the shortage on 30 June 1941 was only 22. The Sanitary Corps in the prewar period consisted of professional men, such as entomologists, bacteriologists, and sanitary engineers. As such, its members required long periods of civilian training. No officer candidate school, therefore, was established for the corps at this time-or even later when the practice of commissioning nonprofessional men in the corps began.

19(1) Letter, The Adjutant General, to Commanding General, each Corps Area, 2 Oct. 1940, subject: Additional Reserve Officers for Extended Active Duty with Corps Areas. (2) Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Director, Historical Division, Office of The Surgeon General, 20 Apr. 1944, subject: History of Procurement Branch Military Personnel Division, Personnel Service, Office of The Surgeon General.
20Letter, The Adjutant General, to each Corps Area Commander and The Surgeon General, 24 Sept. 1940, subject: Procurement of Reserve Nurses.
21(1) Letter, The Surgeon General, to The Adjutant General, 3 Apr. 1941, subject: Officer Candidate School. (2) Memorandum, Operations and Training Division, War Department General Staff, for Chief of Staff, 9 Apr. 1941, subject: Officer Candidate School. (3) Memorandum, Reserve Division, Office of The Adjutant General (Col. H. N. Sumner), for Major West, G-3, 15 Oct. 1941, with enclosure thereto.


127

DEFERMENT OF SERVICE FOR RESERVE OFFICERS

While The Surgeon General was anxious to place many reservists on active duty as possible, he recognized that in some cases they might, at least temporarily, be employed to greater advantage in a civilian capacity. Reserve officers on inactive status were exempt from the draft, and the process of granting them deferment of service differed from that employed with respect to potential draftees. On his own authority, The Surgeon General could defer the service of Medical Department Reserve officers in the Arm and Service Assignment Group only. Appeals for deferment by officers in the Corps Area Assignment Group (which contained much the larger portion of the Reserve) could be acted upon only by the corps area commanders. At times, in order to protect civilian interests, The Surgeon General recommended the transfer of officers from the latter to the former group.22 In September 1940, he recommended to the Office of the Secretary of War that Reserve officers who held key positions as public health officers or as teachers at medical institutions be transferred to the War Department Reserve Pool for assignment and retention in their civilian jobs. That office disapproved the proposal, stating that they must be available for active duty if their services were needed, but agreed that the military service of State public health officers and teachers at medical institutions would be deferred as long as possible.23 Throughout the emergency and war periods, deferment continued to be granted to certain members of faculties (either reservists or civilians) who were declared by the respective deans to be essential.

U.S. Public Health Service and Veterans' Administration Reserves

The U.S. Public Health Service and the Veterans' Administration cooperated with The Surgeon General in keeping to a minimum the deferments of members of their staffs who were also Reserve officers in the Medical Department. The Surgeon General of the U.S. Public Health Service stated in a circular addressed to members of his organization that except in cases of emergency or in unusual situations, where the services of the men who happened to be Reserve officers were most essential to the conduct of Public Health Service work, no effort would be made to delay or prevent such officers from being ordered to active duty. When called, they were to be released immediately from employment by the Public Health Service.24

22Letter, The Surgeon General, to Dean, School of Medicine, Creighton University, Omaha, 7 Feb. 1941.
23Memorandum, The Surgeon General, for Maj. F. H. Kohloss, Office of Assistant Secretary of War, 2 Dec. 1940, subject: Deferment of Extended Active Duty of Certain Categories of Officers of the Medical Department Reserve.
24Circular (unnumbered), Surgeon General, U.S. Public Health Service, to Commissioned Officers in Charge, U.S. Public Health Service, and Others Concerned, 9 Oct. 1940, subject: Commissions in Reserve Corps of Army, Navy, or Marine Corps.


128

The Veterans' Administration and the War Department, beginning in August 1940, worked out a plan by which the Medical Department when necessary could obtain the services of the Medical and Dental Corps Reserve officers employed as civilians by the Veterans' Administration without disrupting the medical service of the latter. The Veterans' Administration employed about 400 such Reserve officers, and to call to duty any appreciable number at one time would obviously have disorganized the work of that agency. The plan agreed upon provided that the War Department would defer the military service of key employees as long as possible; it would submit names of officers desired but would not order anyone to active duty until the Veterans' Administration had an opportunity to secure a replacement.25 The War Department would ascertain from the Veterans' Administration the earliest date on which an officer could be made available. If that date was more than 60 days ahead, the officer would be transferred to the War Department Reserve Pool and not called to active duty. A similar plan was adopted for Reserve nurses who were in the employ of the Veterans' Administration.26 Later, this plan was modified, at the request of The Surgeon General, by a provision that the headquarters having assignment jurisdiction was to make every reasonable effort to determine the officer's physical fitness before requesting his release from the Veterans' Administration.27 Obviously, an officer found physically unfit for duty was not requested, and the Veterans' Administration therefore was spared the trouble and expense of obtaining a replacement for a man who later was returned to it after being rejected for Army service.

Establishment of Rosters for Reserve Officers

In November 1940, the Secretary of War directed each assignment authority (corps area, departmental, and arm or service headquarters) to prepare and maintain rosters for the purpose of establishing priority in which Reserve officers would be ordered to active duty. These headquarters were to maintain separate rosters for Medical Department Reserve officers, general provisions and restrictions on selection of Reserve officers being clearly defined. The position of an officer on a roster was to depend on the following factors: Extent of deferment proposed by the officer and reasons therefor, personal obligation as to dependents, professional attainments and value to the service (in this connection age and physical aptitude were to be considered), and the need for the officer's services to the community in his civilian status. In the

25(1) Letter, The Secretary of War, to the Administrator of Veterans Affairs, 18 Oct. 1940. (2) Letter, The Surgeon General, to Senator Chan Gurney (South Dakota), 22 Oct. 1940.
26(1) See footnote 25(1), above. (2) Letter, Col. Florence A. Blanchfield, USA (Ret.), to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 21 Feb. 1956, with enclosure thereto.
27(1) Letter, The Surgeon General, to The Adjutant General, 25 Aug. 1941, subject: Release of Medical Department Reserve Officers by Veterans' Administration for Extended Active Duty. (2) Letter, The Adjutant General, to Commanding General, First Corps Area [and other corps areas], 11 Sept. 1941, subject: Release of Medical Department Reserve Officers by Veterans' Administration for Extended Active Duty.


129

preparation of these rosters, assignment authorities were directed to use the supplementary classification questionnaires for Medical Department Reserve officers (W.D., A.G.O. Form No. 178-2).28 Such a system of rosters became necessary after the Chief of Staff stated that as individuals had accepted commissions in the Officers' Reserve Corps with the understanding that a national emergency meant war, they would be consulted as to their availability before being arbitrarily called to duty for training during peacetime.29

EXTENSION OF RESERVISTS' TOUR OF DUTY

As early as January 1939, even before the augmentation of the Army began, The Surgeon General stated that the tours of duty of Medical Department Reserve officers might have to be extended beyond 1 year. As voluntary procurement measures failed to secure the desired number of officers, it became more evident that an extension of the 1-year tour was necessary.30 In 1939 and 1940, Medical Department Reserve officers were brought on duty for 1 year, with a possible extension of service to 2 years.

Extension by Interpretation

After Congress made active duty compulsory (or partially so) for both Reserve and National Guard officers (August 1940), the Judge Advocate General ruled that officers who had entered on active duty before passage of this legislation could be compelled to serve an extra year without their consent. He ruled further that officers called to duty under the new law without their consent were exempt from the extra duty unless they agreed to it.31 In other words, those who had volunteered prior to August 1940 for 1 year's service were now forced to stay in for 2; those who had been brought on duty involuntarily after August 1940 did not have to stay in for the second year unless they so requested.

At first, The Surgeon General favored retaining Medical Reserve Corps officers on duty for the second year.32 Two months later, however, he conceded that since few officers were concerned, the number thus made available for military service would be negligible, and the psychological reaction of the individual and the profession at large would be unfavorable. The Secretary of War adopted The Surgeon General's point of view and announced that, with

28Letter, The Adjutant General, to Commanding Generals, all Corps Areas, and Commanders of War Department Arms and Services, 20 Nov. 1940, subject: Reserve Officers for Extended Active Duty Under Public Resolution 96, 76th Congress.
29Letter, Lt. Col. F. M. Fitts, to Col. Calvin H. Goddard, Director, Historical Unit, Office of The Surgeon General, 21 Jan. 1952.
30Letter, General Magee, to Colonel McCornack, 24 Jan. 1939.
31(1) Letter, The Adjutant General, to each Corps Area and Department Commander, 19 Sept. 1940, subject: Reserve Officers Ordered to Active Duty Without Their Consent. (2) Letter, The Adjutant General, to Chiefs of all War Department Arms and Services, 10 Oct. 1940, subject: Continuation of Active Duty, Without Their Consent, of Reserve Officers Now on Extended Active Duty. 
32Letter, The Surgeon General, to The Adjutant General, 15 Jan. 1941, subject: Extensions of Tours of Active Duty for Medical Corps Reserve Officers.


130

the exception of officers whose current tours of active duty were based on agreement for extension of tour, the policy of the War Department was that Reserve officers of the Medical Department be not continued on active duty for a period longer than 1 year without their consent. With minor exceptions, Reserve officers of the Medical Department whose tours had been extended without their consent under the law of August 1940 would upon application be relieved from active duty.33

Service Extension Act, 1941

The Service Extension Act of August 1941 permitted the President to extend for 18 months the service of members of the Reserves and National Guard. The act also provided for the release of officers whose retention would cause them undue hardship. The War Department announced that so far as practicable it would release all Reserve officers (other than officers of the Air Forces) having 12 months' service if they did not wish to extend their tours beyond that period. The Surgeon General, under pressure to obtain more officers, recommended and the War Department in response directed that the tours of all Medical Reserve Corps officers be extended where it had been determined that replacements were not available.34

Establishment of the Army of the United States

On 22 September 1941, a joint resolution of Congress permitted the President to commission newly appointed officers in the Army of the United States as an alternative to one of its several components (including the Reserves). Persons so appointed might be ordered to active duty for any period the President prescribed, and the appointment might continue "during the period of the emergency and six months thereafter."35 On this basis, the Secretary of War declared that, with exceptions that would not include many officers, all persons commissioned thereafter during the emergency were to be appointed in the Army of the United States. Applications for appointment in the Officers' Reserve Corps then being processed would, with the exceptions mentioned above, be considered as applications for appointment in the Army of the United States.36 Shortly after Pearl Harbor, the problem of extending the term of active duty for National Guard and Reserve officers was solved by an act of 13 December 1941 which obliged all members of the Army to serve for the duration of the war and 6 months thereafter.

33Letter, The Adjutant General, to Commanding Generals of all Armies, Army Corps, and others, 1 May 1941, subject: Extension of Tours of Active Duty, Reserve Officers.
34Letter, Office of The Surgeon General, to Office of The Adjutant General, 3 Sept. 1941, subject: Extension of Tours of Active Duty, Reserve Officers, with 1st endorsement thereto, 20 Sept. 1941. (It must be assumed that National Guard officers, although they were not specifically mentioned in this correspondence, were covered by the same policy.) 
3555 Stat. 728.
36Letter, The Adjutant General, to Commanding Generals of all Armies, Corps Areas, Departments, and others, 7 Nov. 1941, subject: Policies Relating to Appointments in the Army of the United States Under the Provisions of Public Law 252, 77th Congress.


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FIGURE 27.-Col. Richard H. Eanes, MC, Chief Medical Officer, Selective Service System.

EFFECT OF SELECTIVE SERVICE LEGISLATION

When the Selective Training and Service Act was passed on 16 September 1940, no occupational group, as such, was excluded except ordained ministers of religion and students preparing for the ministry. Therefore doctors, dentists, veterinarians, and other professional people of value to the Medical Department would be drafted as needed and duly commissioned in any of the corps except the Nurse Corps (women were exempt from the draft). In addition, age limits were originally broad enough (21 to 35, inclusive) to cover a large number of the physicians and a much larger proportion of the dentists in the country.

The prospect of drafting professional men in both the numbers and types needed was dimmed by the action of the Selective Service boards. These boards, in whom sole authority for the selection lay, may not have been technically qualified to pass upon the essentiality of professional personnel either to the Army or to the local community; their decision as to whether a doctor or dentist was or was not to be deferred might depend somewhat on his local popularity. On the other hand, Col. Richard H. Eanes, MC (fig. 27), who was on duty with Selective Service headquarters during the war, stated later


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that while it was "technically correct" that local boards were not technically qualified to make decisions concerning the absolute essentiality of the individual for the medical needs of the community, "sound judgment on the part of many local boards generally resulted in decisions that were proper."37 It was quite reasonable to expect, however, that since the boards had to consider the health needs of their local communities they would consider these needs first before taking into account those of the Army.

On the other hand, however lenient the draft boards might be toward doctors and dentists, individual members of those professions could not be certain of escaping the draft. That fact undoubtedly caused some to apply for commissions before the blow fell. In that way, they avoided the indignities-as some considered them-of being compelled to enter the Army and serve as enlisted men until accepted for a commission, as all draftees must do. Such a prospect was rather remote, especially for physicians, but it remained a possibility.

The Medical Department, partly at the request of the professional organizations, desired to remove that possibility completely. The Army felt that it would be the target for widespread criticism if the services of professional men were wasted in relatively minor, nonprofessional activities. On the day the Selective Training and Service Act was passed (16 September 1940), therefore, The Surgeon General recommended to the War Department that appointments in the Reserves be opened to persons who might be drafted. Since no action was taken, substantially the same request was repeated on 26 October, again with no immediate result.38 About the same time, The Surgeon General reminded the corps area surgeons that they could make appointments in the Reserve Corps if vacancies existed and when an applicant was desired for active duty.39 Meanwhile, the heads of selective service and the local draft boards, foreseeing no shortage of civilian dentists, did not hesitate to induct as an enlisted man any dentist who was not needed at the moment in his own community. The American dental profession, supported by The Surgeon General, voiced its concern, claiming that serious difficulties might ensue if dentists were not used in their professional capacity.40 In January 1941, the chief of the Dental Division, Office of The Surgeon General, suggested to the Assistant Chief of Staff, G-1, that qualified physicians, dentists, and veterinarians who stood high on the list for induction should be granted commissions in the Reserve Corps "without reference to procurement objectives." He also advised that such persons be "assigned to active duty as soon as commissioned." This suggestion was no doubt vitiated from the War Department General Staff's point of view by a further and apparently

37Letter, Col. Richard H. Eanes (Ret.), Chief Medical Officer, Selective Service System, to Col. C. H. Goddard, Office of The Surgeon General, 5 Sept. 1953.
38Letters, The Surgeon General, to The Adjutant General, 16 Sept. 1940, and 26 Oct. 1940, subject: Appointment in Medical, Dental, and Veterinary Corps Reserve.
39Letter, Office of The Surgeon General (Executive Officer), to each Corps Area Surgeon, 29 Oct. 1940, subject: Extended Active Duty Vacancy Required for Approval of Applicant for Commission.
40Memorandum, Office of The Surgeon General (Brig. Gen. Albert G. Love), for G-1, 25 Mar. 1941.


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conflicting proposal that a person so commissioned should be called to active duty "as soon as his services can be properly utilized."41 No action was taken on these proposals.

Congressional Action

In the meantime, several bills were introduced in Congress to commission licensed physicians and dentists in lieu of induction, and also to defer students and teachers in medical and dental schools. The Army disapproved all these bills on the grounds that no one group should get preferential treatment. In addition, The Surgeon General did not want to be placed in the position of commissioning all doctors and dentists.42

War Department Action

At this same time, The Surgeon General desired to add to the numbers in the Dental, Veterinary, and Sanitary Corps Reserve, but he wished to retain the power to determine just which officers were to be commissioned. The publicity surrounding the induction of dentists for service as enlisted men continued to embarrass him; communities and professional societies persisted in demanding that dentists be commissioned rather than be allowed to serve as enlisted men. On 5 May 1941, the War Department finally stated that inducted individuals who qualified for appointment in the Dental or Veterinary Corps Reserve should be encouraged to apply for appointment in the Reserve so that they could serve in a professional capacity. Those qualified would be discharged as enlisted men and ordered to active duty as commissioned officers for a period of 12 months,43 after which they would, presumably, return to inactive status in the Reserve. Although this order undoubtedly accommodated many inducted men, it did not prevent the induction of dentists or veterinarians. Agitation continued both to commission inducted men and to open the Reserve Corps to permit further commissioning,44 thereby preventing the induction of additional dentists. The Office of The Surgeon General, however, held that the Army could not justify commissioning unlimited numbers in the Reserve without reference to its needs, as this would be tantamount to granting a deferment denied to persons outside the medical profession.45

41Letter, Brig. Gen. Leigh C. Fairbank, to Brig. Gen. William E. Shedd, G-1, 22 Jan. 1941, subject: Reserve Commissions for Physicians, Dentists, and Veterinarians Subject to Induction.
42(1) S. 783 and 197, 77th Cong. (2) Senate Committee on Military Affairs, 77th Cong., 1st sess., hearings on S. 783, "Doctors and Medical Students Under the Selective Service," pp. 155, 159, 163-164. 
43
Letter, The Adjutant General, to each Commander of Army or Service, 5 May 1941, subject: Appointment in the Dental and Veterinary Corps Reserve of Inducted Individuals.
44Letter, C. Willard Camalier, Chairman, Dental Preparedness Committee, American Dental Association, to James Rowe, Jr., Administrative Assistant to the President, 17 Sept. 1941.
45Memorandum, Office of The Surgeon General (Col. Robert C. Craven), for The Adjutant General, 8 Oct. 1941.


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By the spring of 1941, the selective service authorities were beginning to show some alarm over the professional personnel situation, and on 22 April they cautioned local boards that a shortage of dentists might impend. This warning was strengthened on 12 May.46 At that time, local boards were reminded that (1) they still had full responsibility for determining whether a dentist was indispensable to his community; (2) the Army did not need dentists for the time being; and (3) if a board felt that a dentist should nevertheless be inducted, he should be advised that he might apply for a commission as soon as he went on active duty. This directive must have discouraged the draft of dentists, but it did not positively prohibit it. Although the Selective Service System maintained that group deferments should not be granted, it can be seen from these memorandums that the authorities of that agency moved closer to sanctioning the deferment of at least one group. There were no major changes of policy on the subject during the remainder of 1941, and with the creation of the Procurement and Assignment Service in the fall of that year, a new agency was to determine whether doctors, dentists, and veterinarians were available for military service or should be kept in their communities.

ARMY NURSE CORPS

Applicants for appointment to the Army Nurse Corps underwent a somewhat different routine from the other Medical Department corps. To enter the Regular Army component of the corps, they applied directly to The Surgeon General, and did not ordinarily have to take a professional examination, although The Surgeon General might prescribe one if he chose. An applicant must, however, present a certificate from the superintendent of the nursing school attended, and if she was qualified professionally, morally, and physically, according to Army standards, and was registered in the State in which she had graduated or in which she was practicing nursing, she became eligible for appointment. Entrance to the Reserve could be gained primarily but not exclusively by enrollment with the Red Cross Nursing Service which furnished The Surgeon General a list of available nurses who could be called upon in time of emergency. While Reserve nurses must be obtained from the Red Cross "so far as practicable," they could also be recruited "from any other acceptable source."47

The law calling up the Reserves did not affect Reserve nurses, since the latter were not part of the Army Reserves. Two weeks after the law was enacted, however, the General Staff authorized the assignment of 4,019 Reserve nurses to active duty on a voluntary basis. Previously, all nurses procured for active duty had to be appointed to the Regular Army. They could now also

46Memorandums I-62 and I-99, Selective Service Headquarters, 22 Apr. 1941 and 12 May 1941, respectively, for State Directors.
47Army Regulations No. 40-20, 31 Dec. 1934.


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be brought in with the status of reservists serving for 1 year, but under suitable conditions, the period could be extended.48

The recruitment of nurses proved to be much less simple than The Surgeon General had expected. With over 15,000 enrolled in the First Reserve of the Red Cross, he anticipated little difficulty in meeting the first requirements for Reserve nurses, amounting to 5,019, by January 1941. At first, however, relatively few accepted active duty, and only 607 had been assigned by 1 February 1941. The Red Cross sometimes found it necessary to canvass as many as 10 Reserve nurses before discovering one willing to accept active duty.49

The meagerness of the response impelled The Surgeon General to recommend invoking the more liberal terms of Army regulations, and corps area commanders were accordingly authorized to procure Reserve nurses not only from the Red Cross but from "any acceptable source."50 The Red Cross was thus prodded to more vigorous action. A publicity campaign was undertaken, using the radio, newspapers, and magazines, to promote recruitment. These measures apparently had their effect-between the first of February and the middle of March 1941, 1,000 nurses were placed on active duty. By 30 June 1941, 1,280 Regular Army and 4,153 Reserve nurses were in service, 500 of the Regulars having been brought in within the past 12 months, and all the Reserves since September 1940. This represented 595 and 866 fewer than the respective authorizations as they existed on 30 June 1941.51

Procurement for the Army Nurse Corps, unlike that for other Medical Department Corps, was hampered by the fact that its Reserve, built up by the Red Cross, was never under legal compulsion to accept active duty. On the other hand, no limit was ever placed on the number who could be recruited for the Red Cross Reserve. The War Department could restrict only the number of nurses who were placed on active duty as Reserve appointees; it could not-as in the case of other components-impose procurement objectives which limited the inactive as well as the active membership to a certain figure. Adherence to these procurement objectives for other corps sometimes reduced the number of transfers from inactive to active status by preventing the recruitment of new reservists who might be more amenable to accepting active duty or more available for performing it than the existing members. The Red Cross, however, could go on enlarging its backlog of Reserve nurses indefinitely, with the prospect that among the larger number more would be found to volunteer for active service.

48(1) Letter, Office of The Surgeon General (Executive Officer), to The Adjutant General, 10 Sept. 1940, subject: Procurement of Reserve Nurses. (2) Letter, The Adjutant General, to each Corps Area Commander and The Surgeon General, 24 Sept. 1940, subject: Procurement of Reserve Nurses.
49(1) Annual Report of The Surgeon General, U.S. Army, Washington: U.S. Government Printing Office, 1941. (2) Statement of Medical Department Activities by Maj. Gen. James C. Magee, The Surgeon General, for the Sub-Committee of the Committee on Appropriations, House of Representatives, 77th Cong., 1941, p. 10. (3) Blanchfield, Florence A., and Standlee, Mary W.: The Army Nurse Corps in World War II. [Official record.]
50(1) Letter, The Surgeon General, to The Adjutant General, 16 Dec. 1941, subject: Reserve Nurses. (2) Letter, The Adjutant General, to each Corps Area Commander and The Surgeon General, 4 Jan. 1941, subject: Procurement of Reserve Nurses.
51See footnote 49 (1).


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STUDENTS IN PROFESSIONAL SCHOOLS

Only one phase of the problem of obtaining professional personnel has so far been discussed-that which concerned fully trained doctors, dentists, veterinarians, and sanitarians. This aspect overlaps the second phase of the problem, which concerned students in professional schools. Recent graduates were a highly regarded source of officer personnel. For them and for the community at large, the transition to military service was easier than for men already established in civilian practice. As a group, these young men were also physically best able to perform arduous military duties. The Medical Department was therefore anxious to obtain their services as soon as they had finished their education. But to do this, it was desirable to place a claim on them some time in advance-while they were still students. They also had to be permitted to complete their studies, which meant protecting them against the draft and against a premature call to duty as officers. Thus, the phase of procurement having to do with fully trained doctors (and other professional personnel) merged with that of maintaining the source of future supply-students in professional schools. The civilian community was also interested in maintaining such a supply for its own needs, and the Medical Department could therefore cooperate with leaders of the civilian profession in protecting the student group.

Although at the beginning of mobilization the Officers' Reserve Corps seemed to contain ample numbers of dentists and veterinarians for immediate needs, it was early recognized that a continuing supply of men in those fields as well as in medicine could come only from the group of graduating students, interns, and residents if civilians as well as military needs were to be met.

Medical Students

In 1939, medical educators raised the question of how the Army would utilize its young Reserve officers who, upon the declaration of a national emergency, might be engaged in the study of medicine. Among those in process of receiving their medical education, the Army had some claim on those holding commissions in either medical or nonmedical sections of the Officers' Reserve Corps, or enrolled in either of the corresponding sections of the Reserve Officers' Training Corps.

In February 1940, the War Department announced that Medical Corps Reserve officers would not be called up until they had completed one year of hospital internship.52 A considerable number of medical students, however, held commissions in nonmedical sections of the Officers' Reserve Corps, commissions which they had received on completing a course in the Reserve Officers' Training Corps undertaken during their premedical years. Retention of these commissions would have eliminated them as future officers in the Medical

52Letter, The Adjutant General, to all Corps Area and Department Commanders and The Surgeon General, 19 Feb. 1940, subject: Extended Active Duty for Medical Reserve Officers.


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Corps. The growing possibility of war caused their status to receive careful study within the War Department. As a result, the Department in April 1940 authorized the transfer of these nonmedical Reserve officers to the Medical Administrative Corps section of the Officers' Reserve Corps if they were full-time students in approved medical, dental, or veterinary schools. The transfer was to be effective only at the direction of the War Department during mobilization, and the call to active duty was made a function of The Surgeon General. The War Department ordered the transfer in August 1940. By June 1941, 529 medical, 48 dental, and 32 veterinary students had been transferred to the Medical Administrative Corps Reserve.53

Students in the medical units of the Reserve Officers' Training Corps were few; only 23 medical schools and colleges had such units and only a small percentage of their students were enrolled. No similar units existed in dental or veterinary schools. There were many more nonmedical Reserve Officers' Training Corp units in the educational institutions of the country, but how many premedical students belonged to them is unknown. In September 1940, the Selective Service Act granted deferment of service to third- and fourth-year students in all sections of the Reserve Officers' Training Corps.54

But the vast majority of medical students, interns, and residents had assumed no military obligations whatever. At first, The Surgeon General attempted to obtain for immediate service in the Medical Department some of those who had just completed their studies as interns or residents. Later on, as selective service became imminent, he tried to protect others of the unobligated group-veterinary and dental as well as medical students-from calls to service until they had finished their schooling. In the early months of 1940, The Surgeon General appealed to residents and interns (the latter after they had finished a year's internship) to take commissions in the Officers' Reserve Corps with the obligation of accepting active duty for 1 year beginning about 1 July 1940. He appealed to them because he thought they might be more willing than others to accept such duty since they had not committed themselves to practice. As their acceptance had to be voluntary, The Surgeon General was limited to publicity and persuasion in his efforts to commission these young physicians.

When it seemed probable in the summer of 1940 that selective service would be introduced, the situation of students, interns, and residents changed considerably. The vast majority of them, not being members of the Officers' Reserve Corps or Reserve Officers' Training Corps, could lay no claim to exemption or deferment. The War Department made no plans to exempt them, and it was assumed that they would be faced with the choice of accepting commissions in the Medical Department Reserve or being inducted into the Army, in which case they would serve as privates. At the same time, the leaders of medi-

53(1) Letters, The Adjutant General, to Corps Area and Department Commanders and each Chief of Arm or Service, 17 Apr. 1940, and 25 Aug. 1940, subject: Special Mobilization Procedures for Procurement of Medical Department Reserve Officers Who are Students in Approved Schools. (2) See footnote 49 (1), p. 135. 
54
54 Stat. 858.


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cine, dentistry, and veterinary medicine expressed their concern over the harm these professions might suffer if the supply were cut off by an interruption of training. In this matter, Army authorities, including The Surgeon General and his assistants, had a dual responsibility. They must first of all provide the necessary medical service for an expanding Army. At the same time, they had to take into account the problems of civilian medicine during periods of mobilization and war.

Commissioning of Interns

The Surgeon General had followed the policy of approving interns' applications for commissions with the understanding that they would not be called to active duty before the completion of training.55 In May 1941, the War Department authorized the commissioning of interns in the Medical Corps Reserve "with the understanding that they will be ordered to one year's active duty immediately upon completion of their internship."56 On 19 December 1940, the War Department had issued an order authorizing appointment of a sufficient number of applicants to fill any vacancies in the procurement objectives of the Medical Department Officers' Reserve Corps. Men accepting commissions under the terms laid down in this order had to agree that they did not come within the category of those entitled to resign (granted by the law of August 1940 making active duty for reservists compulsory) and that they would not exercise the right if ordered to active duty.57

Deferment Under Selective Service

The Selective Training and Service Act deferred the service of all college and university students until July 1941. Otherwise, local draft boards were to grant deferments for persons whose employment or activity was necessary to the maintenance of the national health, safety, or interest. Spokesmen for the medical profession objected to leaving the decision on interns and residents to the "wisdom or lack of wisdom" of the local draft boards, demanding that medical men should have a voice in deciding "what is important to protect in medical training and in the maintenance of American medical institutions."58 A full-scale controversy was soon in progress, as the War Department attempted to persuade a large number of students who would graduate in June 1941 to apply for commissions in the Medical Corps Reserve. The procedure for granting such commissions was simplified in February 1941, and, as the end of the school year approached, considerable publicity was given to the plan among military authorities and deans of medical schools. The

55Statement of Brig. Gen. A. G. Love, Office of The Surgeon General, at Conference, Committee on Medical Preparedness, Chicago, 23 Nov. 1940, reported in the Journal of the American Medical Association, 7 Dec. 1940, p. 2008.
56Letter, The Adjutant General, to all Corps Area and Department Commanders and The Surgeon General, 26 May 1941, subject: Deferment of Medical Students.
57Letter, The Adjutant General, to each Corps Area and Department Commander and The Surgeon General, 19 Dec. 1940, subject: Appointment in the Medical Department Reserve.
58Wilbur, R. L.: Some War Aspects of Medicine. J.A.M.A. 116: 661-663, 22 Feb. 1941.


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response was not satisfactory. Of the 5,000 male students who graduated in medicine in 1941, only 1,500 made application for commissions in the Medical Corps Reserve.59 Many interns and residents preferred to take their chance with the draft, knowing the reluctance of local boards to induct physicians as enlisted men. If actually drafted, that would be time enough to apply for a commission.

The policy of the Selective Service authorities toward students was an important factor in the situation. Although at first this agency stood firmly against group deferments, it stated in February 1941 that it was of great importance that the supply of physicians "be not only maintained but encouraged to grow" and that no medical student or intern who gave promise of becoming an acceptable physician should be called for military duty prior to his becoming one. A short time later (May 1941), the Selective Service office made the same statement apropos of dental students.60 There is no doubt that local boards placed vast numbers of students-medical, dental, and veterinary, as well as other-in class II and deferred them for occupational reasons. A compilation prepared by the Selective Service Administration covering the period from the passage of the Selective Service Act to Pearl Harbor shows the percentage of deferred students in several fields of study:61

Field of study

Percentage in class II

Dentistry

81

Medicine

80

Veterinary medicine

72

Engineering

71

Chemistry

69

Pharmacy

66

Physics

59

Geology

56

Biology

46


Medical Administrative Corps Reserve Commissions

In February 1941, The Surgeon General, linking a desire to build up the strength of the Reserve Corps with his wish to permit the continuance of training in civilian schools, submitted to the War Department a detailed analysis of the problem with a recommendation that provision be made for the granting of commissions in the Medical Administrative Corps Reserve to junior and senior students not only in approved medical schools but in approved dental

59(1) Letter, The Adjutant General, to all Corps Area Commanders, 18 Feb. 1941, subject: Appointment in Medical Corps Reserve of Graduates of Approved Medical Schools. (2) See footnote 49(1), p. 135.
60(1) Memorandum I-91, National Headquarters, Selective Service System, for all State Directors, 22 Apr. 1941, subject: Supplement to Memorandum I-62: Occupational Deferment of Doctors, Internees and Medical Students (III). (2) Memorandum I-99, National Headquarters, Selective Service System, for all State Directors, 12 May 1941, subject: Supplement to Memorandum I-62: Occupational Deferment of Dentists and Dental Students (III).
61
Selective Service in Peacetime, First Report of the Director of Selective Service, 1940-41, p. 172.


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and veterinary schools. This would have extended the practice already adopted to the case of interns but not yet formally approved by the War Department. In rejecting this new proposal, the General Staff expressed the view that "such action would constitute special treatment for a particular class of students which would result in exempting them from Selective Service"; exemptions from selective service could not be granted for any particular group unless it could be clearly demonstrated that personnel in that group would be required in key positions in industries essential to the national defense.62

Under pressure from various medical and dental societies and backed by the knowledge that the Under Secretary of War, Robert P. Patterson, was keenly interested in the problem, on 10 May 1941 The Surgeon General again recommended to the War Department that either of the following actions be taken: To commission a medical student in the Medical Administrative Corps Reserve as soon as he was enrolled in a grade A medical school or to enroll him at that time in the Enlisted Reserve Corps for a period of 3 years and then commission him in the Medical Administrative Corps Reserve until graduation, when he would be commissioned in the Medical Corps Reserve and called to duty on completing his internship.63

On 26 May 1941, the War Department went part of the way by granting authority to commission as second lieutenants in the Medical Administrative Corps Reserve, after 1 July 1941, male junior and senior students in approved medical schools in the United States who were fit for military service. Under regulations published several weeks later, students so commissioned were transferred to and retained in the War Department Reserve Pool64 until eligible for appointment in the Medical Corps Reserve (at the end of their 4-year course). No examination except the physical was necessary. Appointments were to be made without reference to the procurement objective for the Medical Administrative Corps Reserve. Officers were to be discharged from the Reserve if they discontinued their medical education, dropped out of school entirely, matriculated in an unapproved school of medicine, or failed to secure appointment in the Medical Corps Reserve within a year of the completion of the 4-year course in medical school.65 Discharge from the Medical Administrative Corps Reserve placed the individual again within the purview of selective service. It will be noted that this grant of authority took no account of dental and veterinary students or of first- and second-year medical students. No further concessions, however, were made until after the outbreak of war.

62Memorandum, The Surgeon General, for The Adjutant General, 18 Feb. 1941, subject: Commissioning of Junior and Senior Students in the Medical Department Reserve Corps, with 1st endorsement thereto, 18 Mar. 1941.
63(1) Memorandum, Under Secretary of War, for General Marshall, 1 May 1941. (2) Memorandum, The Surgeon General, for Assistant Chief of Staff, G-1, 10 May 1941.
64Officers in this pool could be ordered to active duty only with the approval of the War Department.
65Letter, The Adjutant General, to The Surgeon General (and others), 26 May 1941, subject: Deferment of Medical Students.


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RESERVE UNITS

Revival of Affiliated Units

The affiliated Reserve units constituted a special type of Reserve, and, from the personnel viewpoint, they possessed a character in many respects different from that of other medical units. They had their own quotas and their own system of procurement, and their development affected the general personnel situation in a number of special ways.

The Protective Mobilization Plan

As the threat of war increased, the value of an affiliated Reserve such as that so successfully used in World War I again became evident. The Protective Mobilization Plan of 1939 called for a number of tactical hospitals to be brought into service during the first months of an emergency. A reserve of personnel for these hospitals composed of men and women highly skilled and already trained to work together as a unit would make them quickly available if the need arose. It was for this purpose that The Surgeon General, Maj. Gen. Charles R. Reynolds, in March 1939 proposed the revival of affiliated units.

He had made the suggestion several times before without effect. This time, he submitted a formal and detailed request, beginning with a statement of the case for affiliated units. Hospitals called for by the Protective Mobilization Plan, he argued, must be completely integrated units with harmonious staffs of competent and qualified physicians and surgeons, which would be sufficiently coordinated and organized to be able to function in a theater of operations with a minimum of delay. General Reynolds stated it to be his firm conviction that such units would be forthcoming only if they were affiliated in peacetime with large and well-staffed civilian hospitals. An obstacle to the provision of a superior medical service for mobilization, in any case, was the fact that the necessary specialists could not be recruited under existing Reserve regulations. These regulations provided that appointees to the Officers Reserve Corps must be less than 35 years of age and must enter the corps as first lieutenants. Few of the outstanding specialists who would be needed in case of mobilization or war were under 35, for very few physicians acquired the desired proficiency before reaching that age. Those who were qualified could not be expected to accept commissions as first lieutenants and thus find themselves in the same grade with recent graduates of medical schools.

On the basis of the facts just outlined, General Reynolds made a series of recommendations, the most important of which was that selected hospitals and medical schools rated as satisfactory by the American College of Surgeons and the American Medical Association be invited to organize hospital units. He also recommended that selected individuals in participating institutions, above the age of 35 years, be commissioned in the Reserve with grades (and oppor-


142

tunities for promotion) which were commensurate with their professional qualifications.

During succeeding months, the War Department General Staff studied this proposal; it opposed the recommendation that officers be commissioned above the rank of first lieutenant as contravening current policy, but, on 3 August 1939, the proposal was approved, subject to the determination of certain details.66 These details concerned the proposed waiving of restrictions on the appointment, promotion, and training of Medical Department Reserve officers for these units. The Surgeon General was requested to submit recommendations on these points, and also on the allocation of units and other administrative details.

In reply, General Magee, who had succeeded General Reynolds in June 1939, advised that, as a beginning, all theater of operations hospitals provided for in the Protective Mobilization Plan-32 general, 17 evacuation, 13 surgical, and 4 station hospitals-be affiliated units. He proposed to allocate these, as far as possible, to institutions that had sponsored similar units in World War I. The commanding officer of each unit was to be a member of the Regular Army, as was the executive officer in general and evacuation hospitals; these two officers would join the unit when it was activated. It was recommended that all other officers be members of the Reserve. The unit director was to be the senior staff member, and he would be the responsible peacetime head of the organization. General Magee outlined a detailed procedure for the appointment and promotion of Reserve officers which included authority to appoint officers between the ages of 23 and 55 to any grade for which there existed an appropriate vacancy. Promotion in the unit was to be by virtue of appointment to a position which carried a higher grade. Withdrawal from the staff of the sponsoring institution would automatically operate to terminate the Reserve appointment. Active- and inactive-duty training requirements were also listed.67

On 19 October 1939, General Magee submitted a revised list of sponsoring institutions, including all of the proposed units except the four station hospitals.68 War Department approval followed a month later. At the same time, The Surgeon General was given assignment jurisdiction over officer personnel prior to mobilization and was authorized to proceed with the organization of these affiliated units upon issuance of the necessary War Department directive. Details of the plan were approved early in 1940.69

66Letter, The Adjutant General, to The Surgeon General, 3 Aug. 1939, subject: System of Affiliating Medical Department Units With Civilian Institutions, and Appointment and Promotion in the Medical Reserve Corps.
67Letter, The Surgeon General, to The Adjutant General, 22 Sept. 1939, subject: Affiliation of Medical Department Units With Civilian Institutions.
68Letter, The Surgeon General, to The Adjutant General, 19 Oct. 1939, subject: Affiliation of Medical Department Units With Civilian Institutions.
69(1) Letter, The Adjutant General, to The Surgeon General, 22 Nov. 1939, subject: Affiliated Medical Units-Allocation, Organization, and Mobilization. (2) Letter, The Adjutant General, to The Surgeon General, 26 Jan. 1940, subject: Officers of Affiliated Medical Units-Appointment, Reappointment, Promotion, and Separation. (3) Letter, The Adjutant General, to The Surgeon General, 11 May 1940, subject: Officers of Affiliated Medical Units-Appointment, Promotion, and Separation.


143

Organization of the units

Meanwhile, the Office of The Surgeon General had been actively engaged in implementing this project. Once the sponsoring institutions had been chosen and approved, The Surgeon General notified these institutions, outlined the plan, asked their acceptance of it, and requested them to begin the necessary work of establishing and training the proposed units. Upon receipt of concurrence, the Office of The Surgeon General advised The Adjutant General, and thus affiliation was formally established.70

The response during the spring and summer of 1940 was enthusiastic. Since the project had been first proposed, Germany had overrun Norway, France, and the Low Countries, and involvement of the United States seemed imminent to many. The resulting patriotic appeal was reinforced by the fact that most of the proposed sponsors had organized similar units in the First World War, and the old numerical designations were revived for the new units. Not only did the listed institutions respond to the appeal, but many others applied to General Magee during 1940 and 1941 for inclusion in the project. He rejected these offers, stating that the program might later be broadened to include additional smaller hospitals.

The actual organization of the units through the commissioning and assignment of officers was a long and tedious process, requiring many months to complete. Detailed instructions were distributed .71 With rare exceptions, officer appointments made by the institution were not questioned by The Surgeon General. The Office of The Surgeon General maintained contact with the sponsoring institutions through its Reserve Subdivision and during the organization period established rosters of unit personnel. At the time, there was no definite provision for furnishing these hospitals with enlisted men. It turned out, however, that when the hospitals were activated-in 1942-43-a large part of this personnel was drawn from existing theater of operations hospital units. Another part came from the reception or training centers. Special arrangements were also made whereby men from the sponsoring institution could be voluntarily inducted into the service and earmarked for assignment to the affiliated unit when it was activated.72

The original list of hospitals proposed by The Surgeon General and approved by the General Staff provided for the necessary theater of operations hospitalization envisaged by the Protective Mobilization Plan for the first 120 days of mobilization. There still remained the problem of insuring the additional hospitalization required for the four successive augmentations of the basic plan. It had been The Surgeon General's intention to create additional affiliated units for this purpose, once the organization of the first group of

70Memorandum, Lt. Col. Paul A. Paden, Director, Medical Personnel Division, Office of The Surgeon General, for Colonel Love, Historical Division, Office of The Surgeon General, 15 Apr. 1944.
71Letter (mimeographed), The Surgeon General, to each affiliating institution, 16 May 1940, subject: Affiliated Units, Medical Department, U.S. Army.
72(1) Smith, Clarence McKittrick: The Medical Department: Hospitalization and Evacuation, Zone of Interior. United States Army in World War II. The Technical Services. Washington: U.S. Government Printing Office, 1956. (2) See footnote 70.


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hospitals had been accomplished. By June 1940, the preparation of the approved hospitals had proceeded sufficiently to make the organization of additional affiliated units feasible. The widespread publicity given to the program had resulted, as already mentioned, in a large number of requests for affiliation from institutions not on the first list, including some that had sponsored units in 1917. It seemed the proper time therefore to expand the program. On 26 June 1940, General Magee requested permission to organize additional hospitals. He proposed that neither the exact number of units nor their distribution be determined at that time. On 22 July 1940, the War Department approved the organization, as affiliated units, of an additional 36 general hospitals, 13 evacuation hospitals, and 10 surgical hospitals as part of the first augmentation of the Protective Mobilization Plan.73 This authorization almost doubled the number of affiliated hospitals to be made available.

The original plan had been to provide, at the time of activation, Regular Army officers as commanding officers of these affiliated units who would replace the directors when the units were called into service. As the organization proceeded, however, it became apparent that in certain instances it would be desirable to continue unit directors as commanding officers during mobilization. Four unit directors, each of whom had had experience and training during World War I and who had maintained an unusually active interest in the Organized Reserve since that time, were considered qualified to command their units. General Magee recommended that these men receive mobilization assignments as commanding officers, and that officers of the Regular Army Medical Corps be assigned as executive officers. He further proposed that if similarly qualified directors were appointed in other units he should be authorized to make similar assignments. The request for the assignment of the four officers (fig. 28) was approved: Col. Thomas R. Goethals, MC, to the 6th General Hospital, Lt. Col. (later Col.) Henry R. Carstens, MC, to the 17th General Hospital, Col. E. T. Wentworth, MC, to the 19th General Hospital, and Col. J. G. Strohm, MC, to the 46th General Hospital; but The Surgeon General was required to make separate requests for future assignments, as these would involve changes in the approved allotments of officers.74

By October 1941, the organization of affiliated units had reached an advanced stage, and 41 general hospitals, 11 evacuation hospitals, and 4 surgical hospitals actually had been organized. A certain number of institutions had not shown interest in the project, and no personnel were assigned to those units; a number of additional units also were contemplated, but the Secretary of War had not yet authorized them.75

73Letter, The Surgeon General, to The Adjutant General, 26 June 1940, subject: Affiliated Units, Medical Department, with 1st endorsements thereto, 22 July 1940.
74Letter, The Surgeon General, to The Adjutant General, 18 June 1940, subject: Affiliated Units, Medical Department, with 1st endorsement thereto, 8 July 1940.
75(1) Memorandum, Lt. Col. Francis M. Fitts, Office of The Surgeon General, 7 Oct. 1941, subject: Status Report, Affiliated Units. (2) The publication cited in footnote 72(1), p. 143, contains lists (tables 6 and 7) of the affiliated general and evacuation hospitals, showing Army number, institution with which affiliated, dates of activation and embarkation, and initial destination.


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FIGURE 28.-Early appointments as commanders of affiliated units. Upper left: Col. Thomas R. Goethals, MC, to the 6th General Hospital. Upper right: Col. Henry R. Carstens, MC, to the 17th General Hospital. Lower left: Col. E. T. Wentworth, MC, to the 19th General Hospital. Lower right: Col. J. G. Strohm, MC, to the 46th General Hospital.


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Deferment of Active Duty for Members of Affiliated Units

While affiliated units awaited activation, the Reserve officers in them enjoyed what amounted to a deferment of service. The possibility of calling the officers of these units to active duty received consideration in September and October 1940. During the spring and summer of that year when large numbers of Reserve officers in other categories were being called to duty, the directors of affiliated units were recruiting for their organizations on the understanding that appointees would remain on inactive status until the units themselves were called up. Following mobilization of the National Guard and the advent of selective service in the autumn of 1940, however, a number of persons suggested calling the officers of affiliated units individually to active duty. The Surgeon General not only rejected these proposals but attempted to get assurances from the War Department that neither individual reservists nor the affiliated units in which they served would be called to active duty before war came. While the General Staff would make no clear-cut declaration of policy to that effect, it followed (for the time being) The Surgeon General's recommendation in practice.76 No affiliated unit was activated until after Pearl Harbor, and no steps were taken to call up individual members until still later (table 15).

The urgent demand for additional Medical Corps officers throughout 1941 drew attention once more to the affiliated units as a source of supply, and particularly to the more than two hundred Medical Corps Reserve officers in these units who were of draft age. In May 1941, The Surgeon General submitted a recommendation to The Adjutant General that these officers be discharged from their special commissions and that upon application they then be appointed in the Reserve in the grade of first lieutenant and ordered to active duty as soon as their services were required; they were also to be instructed that if their units were called they would be assigned for duty with them. Apparently, the heavy demand for additional officers prompted The Surgeon General to recommend a measure which would in effect have abrogated

TABLE 15.-Medical Department officers of affiliated Reserve in affiliated medical units, February 1941

Status

Medical Corps

Dental Corps

Medical Administrative Corps

Total officers

Original appointments in the affiliated Reserve

547

53

13

613

Transfers from nonaffiliated to affiliated Reserve

239

19

6

264

Total

786

72

19

877


Source: Report, Operations Service, Office of The Surgeon General, subject: Officers in Affiliated Units, as of February 26th, 1941.

76(1) Memorandum, The Surgeon General, for Assistant Chief of Staff, G-1, 28 Sept. 1940. (2) Memorandum, The Adjutant General, for The Surgeon General, 29 Oct. 1940, subject: Mobilization of Affiliated Units.


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the original understanding with some of the officers in the sponsoring institutions. To this recommendation, the War Department replied that a program to discharge affiliated Medical Corps Reserve officers from their commissions and permit them then to volunteer for appointment in the nonaffiliated Reserve as first lieutenants would probably result in the loss of many officers. It was pointed out that many of these officers would not accept reappointment in that grade. However, the War Department authorized the discharge of affiliated officers above the rank of first lieutenant who, prior to discharge, volunteered to accept an immediate appointment in the nonaffiliated Reserve in the lower rank. The number of affiliated Reserve officers who accepted active duty on these terms is unknown, but past experience indicates that it was probably approximately 2 percent.77

While The Surgeon General was suggesting means of placing on active duty some of the officers in affiliated units already formed, he was also sanctioning the formation of additional units for use in case of war. In June 1941, the general regulations for affiliated units were modified, providing for some amelioration of the condition mentioned above.78 The Surgeon General announced that no additional appointments would be made to affiliated units in the age group eligible for induction under selective service. Officers of the nonaffiliated Reserve who had been assigned without change of grade to affiliated units were to be considered as available for active duty. But officers of the affiliated Medical Corps Reserve could be brought on active duty only when they requested appointment in the nonaffiliated Reserve in the grade of first lieutenant.

The number of personnel assigned to affiliated units on 30 June 1941 is given in table 16. Of those shown, 1,257 Medical Corps, 122 Dental Corps, and 31 Medical Administrative Corps officers were said to belong to the affiliated Reserve and the remainder to the nonaffiliated Reserve. In October

TABLE 16.-Medical Department officers in affiliated units, 30 June 1941

Type of hospital

Medical Corps

Dental Corps

Medical Administrative Corps

General

1,144

157

44

Evacuation

233

15

3

Surgical

37

4

2

Total

1,414

176

49


Source: Annual Report of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1941, pp. 145-146.

77(1) Letter, Office of The Surgeon General (Executive Officer), to The Adjutant General, 5 May 1941, subject: Physicians of Draft Age Holding Commissions in Affiliated Units, with 1st endorsement thereto, 26 May 1941. (2) Letter, The Surgeon General, to The Adjutant General, 5 Aug. 1941, subject: Active Duty Orders for Medical Officers (Affiliated).
78Letter, Office of The Surgeon General, to each affiliating institution, 2 June 1941.


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1941, 158 Medical Corps, 3 Dental Corps, and 1 Medical Administrative Corps officers from affiliated units were on active duty.79 Thus, the basic problem of obtaining the services of medical personnel in affiliated units for the rapidly expanding Army remained unsolved right up to the outbreak of war-and even afterward.

OTHER SOURCES OF OFFICER PERSONNEL

Additional sources of professional personnel for the Medical Department in the prewar years existed, but for a variety of reasons were still looked upon as "off limits." These included graduates of foreign and of substandard American medical schools, Japanese-Americans, female doctors and dentists, and certain other professional minorities.

Graduates of Foreign and Substandard American Medical Schools

Foreign graduates

As early as 1933, the National Board of Medical Examiners, while not raising a general bar against graduates of foreign schools, stipulated that a student matriculating in a European medical school after the school year 1933 would have to submit evidence of the following in order to be admitted to the board's examination: (1) A premedical education equivalent to the requirements of the Association of American Medical Colleges and the Council on Medical Education of the American Medical Association; (2) graduation from a European medical school after a course of at least 4 academic years; and (3) a license to practice medicine in the country in which that school was located. In 1939, the same board barred from its examinations the graduates of "extramural" (that is, not university connected) British medical schools.80

Army Regulations No. 140-33, issued on 30 July 1936, required a candidate for the Medical Corps Reserve to possess a license to practice in a State, Territory, or the District of Columbia, or a diploma from the National Board of Medical Examiners; he must also hold the degree of Doctor of Medicine from a class A medical school-that is, one approved by the American Medical Association. Although in the fall of 1940 The Surgeon General received many protests, both from individuals and from organizations such as the American Jewish Congress,81 protesting the exclusion of foreign graduates from the Medical Corps, a revision of AR 140-33 on 15 December 1940 did not change essentially the previous conditions for admission to the Medical Corps.

79See footnotes 49(1), p. 135, and 75(1), p. 144.
80Letter, Office of The Surgeon General (Colonel Lull), to George L. Cassidy, Associate Editor, New York Post, 14 Nov. 1940, with enclosure thereto.
81Letter, Carl Sherman, Chairman, Administrative Committee, American Jewish Congress, to Assistant Secretary of War, 28 Nov. 1940.


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At that time, The Surgeon General stated that he himself had no means of classifying foreign medical schools definitively. While some were undoubtedly satisfactory, there was considerable evidence that many did not have acceptable standards, and he did not desire to have the American soldier treated by physicians not fully qualified in accordance with the standards of approved American schools.82 Several officers who were in the Surgeon General's Office at the time have restated and enlarged upon these points. Brig. Gen. Albert G. Love (Ret.) has pointed out that "in the years prior to World War II, the American Medical Association had done * * * a tremendous job in classifying medical schools, raising the standard of medical education, and forcing substandard schools to raise their standards or close their doors." A former staff member of The Surgeon General's Personnel Division, who dealt with hundreds of graduates of foreign medical schools, wrote that "some were unquestionably well qualified professionally, mentally, physically and socially. Others were, however, very undesirable as Medical Corps officers * * * many had failed in American medical schools before entering foreign schools. Others had Arts school academic averages so low that their admission to an approved [medical] school was not justified. It was also known that many European medical schools, particularly German, had deteriorated rapidly in the late twenties and in the thirties.83

Also in December, 1940, Dr. J. John Kristal, Chairman of the Executive Committee of the American Alumni of British Medical Schools, wrote to Dr. Irvin Abell, Chairman of the Committee on Medical Preparedness of the American Medical Association, listing six "quite stringent" requirements that might be established for graduates of the British medical schools in order to obtain commissions in the U.S. Army Medical Corps Reserve. His proposal was approved by The Surgeon General who on 30 December 1940 forwarded it to the War Department General Staff, substituting, however, the word "foreign" where Dr. Kristal had used "British," and including a stipulation of citizenship. The six requirements were as follows:

1. They shall be citizens of the United States. They shall present satisfactory evidence of premedical education equivalent to the requirements of the Association of American Medical Colleges and the Council on Medical Education of the American Medical Association.

2. They shall have completed a medical course of at least four academic years.

3. They shall have obtained a license to practice in the country in which the medical school from which they graduated is located.

4. They shall have evidence of a year's internship or more in a hospital acceptable to the Council on Medical Education and the Committee on Hospitals of the American Medical Association.

5. They shall be eligible to take the examination given by the National Board of Examiners.

6. They shall have a license to practice medicine in some state or territory of the United States.

82Letter, Office of The Surgeon General (Colonel Lull), to The Adjutant General, 23 Nov. 1940. 
83(1) Letter, Brig. Gen. Albert G. Love (Ret.) to Col. John B. Coates, Jr., Director, Historical Unit, U.S. Army Medical Service, 29 Nov. 1955. (2) Letter, Col. Paul A. Paden, to Col. C. H. Goddard, Office of The Surgeon General, 21 Jan. 1952.


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Two months later (5 February 1941), the War Department General Staff approved these recommendations.84

Graduates of unapproved American schools

As to graduates of unapproved schools in the United States, The Surgeon General continued to hold that they should be rejected, urging that as soldiers had to take what the Army offered in the way of doctors they should be afforded at least the protection which most States accorded them as civilians. Therefore, only doctors who could be licensed to practice in a majority of the States should be granted commissions in the Medical Corps.85 (The graduates of these unapproved schools could receive licenses in only one or two States.)

Again, as in the case of graduates of foreign schools, objections were raised to the existing policy. This time, however, it was felt that considering the shortage both in the Armed Forces and in civilian life the policy not only subjected doctors to the chance of being drafted, after which they would serve not as doctors but as enlisted men,86 but also that it worked to the economic disadvantage of doctors already in the service. "When these men get out of the Army," the president of a State medical society wrote to The Surgeon General, "they will find that [graduates of unapproved schools] have adopted [that is, taken over] their practices." He considered this an unfair advantage to take of any doctor and asked if it was possible to commission graduates of unapproved schools as second lieutenants "or some lower commission" and allow them to serve as mess or sanitary officers. The Surgeon General replied that the advantage given to graduates of unapproved schools was more apparent than real. However, he held out a promise: "If the general thought of the medical profession should be that these men should be accepted on the same footing as graduates of Grade A schools, thought can be given to a modification of our present practice."87

Soon, thereafter, the Directing Board of the Procurement and Assignment Service suggested terms on which graduates of unapproved medical schools might be accepted for commissions. In April 1942, accordingly, The Surgeon General announced that such graduates would be commissioned in the Medical

84(1) Letter, Office of The Surgeon General (Col. G. F. Lull), to The Adjutant General, 30 Dec. 1940, subject: Appointment of Graduates of Foreign Medical Schools. (2) Letter, The Adjutant General, to The Surgeon General, 5 Feb. 1941, subject: Appointments of Graduates of Foreign Medical Schools in Medical Department Reserve. (3) Letter, The Adjutant General, to Corps Area and Department Commanders and The Surgeon General, 5 Feb. 1941, subject: Appointments of Graduates of Foreign Medical Schools in Medical Department Reserve.
85
Letter, The Adjutant General, to President, Association of Medical Students, Middlesex Hospital, Cambridge, Mass., 22 Dec. 1941. (The Surgeon General had sent this reply to The Adjutant General for forwarding to the president of the Association of Medical Students, 16 Dec. 1941.)
86(1) Letter, Dr. John F. McGuinness, Woburn, Mass., to President Roosevelt, 7 Jan. 1942. (2) Letter, Senator C. Wayland Brooks (III), to The Surgeon General, 13 Feb. 1942. (3) Letter, Joseph H. Dorfman, Detachment Commander, Headquarters Detachment, Detachment of Illinois, Sons of American Legion, to The Surgeon General, 10 Feb. 1942.
87(1) Letter, President, Massachusetts Medical Society, to Surgeon General Magee, 31 Jan. 1942. (2) Letter, Surgeon General Magee, to Dr. Frank R. Ober, President, Massachusetts Medical Society, 7 Feb. 1942.


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Corps of the Army of the United States if they met the following conditions: The applicant must, in addition to possessing the doctor of medicine degree, have had a 1 year's rotating internship, and have a license to practice medicine in one of the States or in the District of Columbia; he must also have been engaged in the ethical practice of medicine and must present five letters to this effect from doctors who knew him and who were graduates of recognized schools of medicine. The Surgeon General would determine whether the graduate was eligible. The final stipulation-that the applicant must be a member of his local county medical society and be indorsed by his State medical society-had to be changed later because some medical societies refused to admit graduates of unapproved schools until they had been practicing for 5 years. The Surgeon General agreed, therefore, that he would accept those who met the other conditions if they presented a statement from the secretary of the county or district medical society that they were engaged in the ethical practice of medicine and would be eligible for society membership except for the fact that they had been in practice less than 5 years.88 Schools whose graduates the Medical Department agreed to accept on these terms were Middlesex University College of Medicine, the Chicago College of Medicine, and the Cincinnati College of Eclectic Medicine. The Surgeon General judged the graduates of two other schools more on their individual merits. Doctors graduated from any of these unapproved schools were commissioned only in the grade of first lieutenant.

When in the fall of 1943 the State authorities of Massachusetts declared that graduates of the Middlesex University College of Medicine would not be eligible for the licensing examinations held after June 1944, the Medical Department refused to recommend for appointment additional graduates of that school (not waiting until Massachusetts examined the last ones it had stipulated it would admit to examinations); in July 1944, the Medical Department announced, however, that it would accept recent graduates of that school under terms previously in effect. No figures are available on the total number of graduates of unapproved schools who joined the Army Medical Corps under the terms laid down by The Surgeon General, although in early 1944 it was stated that between 200 and 300 graduates of Middlesex University College of Medicine alone had been appointed.89

The problem of unapproved schools did not arise in the case of dentists, there being no such dental schools. As for veterinary schools, The Surgeon General refused to commission graduates of the sole unapproved institution of

88(1) Letter, The Adjutant General, to The Surgeon General, 28 Apr. 1942, subject: Admission of Graduates of Certain Nonrecognized Schools of Medicine to the Army of the United States. (2) Letter, The Surgeon General, to Dr. Frank H. Lahey, Boston, Mass., 15 July 1942.
89(1) Letter, The Surgeon General, to Dr. Frank H. Lahey, War Manpower Commission, 24 Aug. 1942. (2) Memorandum, The Surgeon General, for Officer Procurement Service, Army Service Forces, Attn: Col. E. G. Welsh, Acting Director, 3 Dec. 1943, subject: Discontinuance of Appointments * * * of Graduates of Middlesex University College of Medicine. (3) Memorandum, The Surgeon General, for Director, Officer Procurement Service, Army Service Forces, 20 July 1944, subject: Middlesex University School of Medicine. (4) Letter, The Surgeon General, to The Adjutant General (for forwarding to the Hon. David I. Walsh, U.S. Senator (Mass.) ), 7 Jan. 1944.


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that kind, the veterinary school of Middlesex University.90 Graduates of that school who were drafted served in enlisted status-unless they received commissions in an officer component, such as the Medical Administrative Corps, which required completion of the regular course at an officer candidate school.

Alien and Naturalized Physicians

Alien and naturalized physicians in the Army in an enlisted status could be commissioned in the Army of the United States provided they met the following requirements: (1) Citizens of cobelligerent Allied countries had to meet requirements for professional training and the necessary War Department investigations, such as those of the Military Intelligence Service and the Provost Marshal. Such applicants had to have a release from the military attaché of their country's legation in the United States, and as The Surgeon General pointed out, that process involved many difficulties. Since the applicant's government had to be acceptable to the U.S. Department of State, it was often necessary for The Adjutant General to determine from day to day that Department's evaluation of the foreign government concerned. (2) Enemy aliens had to meet the investigation of all agencies, including that of the Assistant Chief of Staff, G-2 (intelligence), and in addition had to be naturalized. (Naturalization had been rendered easier in March 1942 by an enactment of Congress that persons who had served 3 months in enlisted status could obtain citizenship immediately.)91 They must, moreover, have arrived in this country before 1 January 1938, and also "as a general, but less rigid rule," they had to prove that they did not have relatives remaining in enemy countries. (This meant that, even though naturalized, they had some of the legal disabilities of aliens.) As a further barrier, most foreign physicians applying for commissions had been educated in foreign schools and hence had to meet the special requirements The Surgeon General had laid down for such graduates.92

The question of what to do about alien physicians not serving in the Army was a matter of concern to the Procurement and Assignment Service. Since many States required applicants to establish American citizenship as one prerequisite to admission to State licensing examinations, and other States issued temporary licenses which were subject to cancellation unless the holder obtained American citizenship within a specified time, the Department of Justice took steps in January 1943 to have the Immigration and Naturalization Service assist in relieving the shortage of civilian physicians by expediting the legal process of naturalizing alien physicians.

90Letter, Office of The Surgeon General (Col. J. F. Crosby, VC), to Dr. Louis Karasoff, Middletown, N.Y., 17 Apr. 1942, with 2d wrapper endorsement thereto, 10 Jan. 1945.
9156 Stat. 182.
92Memorandum, The Surgeon General (Chief, Personnel Service), to Col. Richard H. Eanes, Medical Division, National Headquarters, Selective Service, 8 Feb. 1943.


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Japanese-American Medical Personnel

Physicians and dentists

Japanese-American citizens were treated differently from other groups. The Surgeon General recommended in May 1942 against commissioning them, whether they were serving in enlisted status or were civilians. He stated that although they might meet all the requirements for commissions "they would be placed at a personal disadvantage and in many embarrassing positions. They would inspire a lack of confidence and distrust throughout the Army * * * rendering no military value and being under suspicion at all times.''93

Regulations prohibited the assignment of Japanese-American officers to units made up of others than their own group. At Camp Shelby, Miss., however, when the 442d Regimental Combat Team (a Japanese-American unit) had an oversupply of doctors and dentists, the commander loaned one of the doctors to another unit and the excess dentists to the camp dental clinic, where their services proved very satisfactory. They could not, however, be permanently assigned to these organizations for the reason stated above. On a visit to Camp Shelby in October 1943, the Assistant Secretary of War learned of this incident and called it to the attention of The Surgeon General as an indication of what might be done if War Department policy were changed, remarking that Japanese-American medical talent was "not being usefully employed." The Surgeon General followed this suggestion by attempting to detach some of the Japanese-American doctors from the Army Ground Forces, but without success.94

Nurses

The question of whether to commission nurses who were Nisei (that is, American citizens of Japanese ancestry) caused considerable discussion, particularly after it had been announced (January 1945) that a draft of nurses was necessary to meet the Army's needs. The Surgeon General had previously stated that there were no position vacancies for Nisei nurses. This assumed that because of their racial background they could be placed only in special jobs. Possibly the belief existed in some quarters that use of such nurses would antagonize soldier patients. In August 1944, however, the Secretary of War ruled out the factor of race by announcing that qualified Nisei nurses could be appointed in the Army if their loyalty was vouched for by the

93Letter, Office of The Surgeon General (Col. J. A. Rogers, Executive Officer), to The Adjutant General, 11 May 1942, subject: Physicians, Dentists, and Veterinarians of Japanese Ancestry.
94
(1) Letter, Assistant Secretary of War, to The Surgeon General, 23 Oct. 1943. (2) Letter, Surgeon General Kirk, to Assistant Secretary of War (McCloy), 10 Nov. 1943.


154

Provost Marshal General's Department, and that The Surgeon General would direct their assignment to duty.95

Early in 1945, the Surgeon General's Office estimated that about 300 of the 800 Nisei nurses in the United States would be available for military duty. Under pressure from the New York newspaper, PM, which had also previously criticised him for rejecting these nurses because there were no vacancies for them, The Surgeon General announced that he would take them on the terms laid down by the Secretary of War. This meant that while they were subject to the same conditions of availability, professional training, and physical condition as other nurses they would not be rejected because of ancestry alone. They would, however, be used only in the United States. These transactions did not lead to the admission of any large number of Nisei nurses into the Army. By February 1945, only four had been appointed, all that were accepted during the war.96

Female Doctors and Dentists

With a few possible exceptions, before World War II, the Army had not accepted women of any group in full commissioned status,97 although nurses had held relative rank. In late 1942, dietitians and physical therapists received the same status. During World War I, 55 female doctors had served on a contract basis.98 Even before World War II, certain civilian groups had agitated to have women commissioned in the Medical Corps in the event of war. In England, after war broke out, female doctors were commissioned in the "women's forces," but not in the Royal Army Medical Corps.99

In June 1942, the Services of Supply took steps to procure female doctors, not for service with the Medical Corps, but with the Women's Auxiliary Army Corps. They served as contract surgeons when first placed on duty and if found acceptable were made members of the corps, in the status of "second officer," which was not a commissioned status. In January 1943, 25 female doctors were assigned to the Women's Auxiliary Army Corps or were being considered for assignment.100

In 1942, The Surgeon General testified before the Committee to Study the Medical Department that he had requested that a few women doctors be com-

95Letter, G-1, to The Adjutant General, 11 Aug. 1944, subject: Enlistment of Japanese-American Nurses.
96(1) Memorandum, Acting Chief, Personnel Service, Office of The Surgeon General, for The Surgeon General (and others), 17 Mar. 1945. (2) Weekly Diary, Acting Chief, Personnel Service, Office of The Surgeon General, week ending 17 Mar. 1945. (3) Manuscript, Col. [Florence A.] Blanchfield, and Mary [W.] Standlee, The Appointment of Racial Minorities in the Army Nurse Corps, p. 32. 
97
During the Civil War, at least one woman, a Dr. Mary Walker, was commissioned as an Assistant Surgeon. (Letter, Office of The Surgeon General (Col. Albert G. Love), to Dr. Morris Fishbein, American Medical Association, 5 Apr. 1943.)
98
Letter, Office of The Surgeon General (Lt. Col. Francis M. Fitts), to Unit Director, 2d General Hospital, Presbyterian Hospital, N.Y., 16 Aug. 1941.
99Crew, F. A. E.: Army Medical Services, Administration. London: Her Majesty's Stationery Office, 1953, vol. 1, p. 206.
100Memorandum, Office of The Surgeon General (Brig. Gen. Larry B. McAfee, Acting Surgeon General), for Commanding General, Services of Supply, 4 Jan. 1943, subject: Utilization of Women Doctors, with 1st endorsement thereto, 19 Jan. 1943.


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missioned to serve the Women's Auxiliary Army Corps, but the Comptroller of the United States had informed him that women could not hold commissioned rank in the Army of the United States. A few months later, he reiterated the Comptroller General's ruling to General Somervell and added that if enabling legislation were introduced, women belonging to other professional and technical groups might feel that they had been discriminated against. He stated that there was no other objection to commissioning qualified female doctors in the Army of the United States, but suggested that their use be limited to service with the Women's Auxiliary Army Corps either in the United States or abroad. The Secretary of War, undeterred by the thought that introduction of a bill to grant commissions to female doctors might antagonize women of other professional and technical groups, pressed for such legislation; he suggested that, once commissioned, female doctors should be confined for the time being to duties with the Women's Auxiliary Army Corps and to hospitals where there was a large number of women patients.

The necessary legislation was passed in April 1943. Applying to both Army and Navy, it provided that licensed female physicians could be granted commissions in the Army of the United States or the Naval Reserve, "during the present war and six months thereafter." Such officers were to enjoy the same rights, privileges, and benefits as other members of those organizations having the same grade and length of service.101 This law did not limit their service to the United States, and a number served abroad. It made female doctors the first women to hold full commissioned rank in the Army of the United States, antedating not only the nurses,102 dietitians, and physical therapists (by more than a year), but the officers in the Women's Army Corps, who attained that status a few months later (1 July 1943).

Desirable though it was in itself, the new law did little to meet the Medical Department's demand for personnel. Although the Army placed no limit on the number of professionally and physically qualified female doctors it would accept, only 76, or 1 percent of the approximately 7,600 women doctors in the United States, were ultimately commissioned.103 On 28 February 1945, when 74 women were serving in the Army Medical Corps, 4 were majors, 36 captains, and 34 first lieutenants; on the same date, 17 were overseas. At least one received a promotion to the grade of lieutenant colonel upon being separated from the Army.104

Between June 1943 and March 1945, several attempts were made in Congress to authorize the commissioning of women dentists, but all attempts failed,

10157 Stat. 65.
102Two exceptions were the Army Nurse Corps Superintendent, and her Assistant Superintendent, promoted to the grade of colonel and lieutenant colonel, respectively, in March 1942. (Letter, Col. Florence A. Blanchfield, USA (Ret.),  to Col. J. B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 21 Feb. 1956.) 
103(1) Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Brig. Gen. G. F. Lull and Col. J. R. Hudnall, Office of the The Surgeon General, 21 Apr. 1943. (2) Sixteenth Census of  United States: 1940, Population: The Labor Force, vol. III, p. 75 (table 58).
104Army Medical Bulletin No. 88, 1945. p. 50.


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probably because the War Department felt that there was no shortage of dentists in the Army.105

Other Minority Groups

Efforts to secure commissioned status for certain other groups serving in the enlisted ranks occurred spasmodically throughout the emergency and war periods. Groups who sought such status included chiropractors, optometrists, osteopaths, and podiatrists. Of these groups, the optometrists alone were commissioned and these only after the cessation of hostilities.

CONTRIBUTIONS OF ORGANIZED MEDICINE AND NURSING

Before the end of 1940, civilian professional organizations in the medical field were becoming involved in the process of recruiting medical officers and nurses for the Army. The most influential of these organizations was the American Medical Association, whose interest in procurement extended beyond the Reserves-at first the main source of officers-and included the entire civilian profession. It was for this reason that The Surgeon General requested the cooperation of the association. To obtain much larger numbers of officers than it already had, the Medical Department would have to go outside the ranks of those previously enrolled in the Reserves and recruit officers directly from civilian life. Moreover, if a major war occurred, even though the United States had more physicians per capita of population than any other country,106 the supply would have to be rationed between the military and civilian medical services. The civilian professional organizations would be vitally interested in both processes and might render valuable aid in solving the problems they involved. A precedent for collaboration had been set during World War I, when the American Medical Association and its constituent groups, the State medical societies, had participated in the recruitment of medical officers.

Committee on Medical Preparedness

The American Medical Association, having offered its services to the Federal Government in May 1940, responded to The Surgeon General's request at its annual session in June 1940 by creating a Committee on Medical Preparedness. This committee, consisting of 10 members, was to establish and maintain contact with appropriate governmental agencies "so as to make available at the earliest possible moment every facility that the American Medical Association can

105Medical Department, United States Army. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955.
106According to figures compiled probably in 1942, by the Procurement and Assignment Service for Physicians, Dentists, and Veterinarians, the United States had 1 physician for each 750 people. The latest figures available for other countries, published in 1932, showed that England and Wales, on the other hand, had only 1 for each 1,490; Germany, 1 for each 1,560; France, 1 for each 1,690; and Sweden, 1 for each 2,890. "Final Report of the Commission on Medical Education" (New York, 1932), p. 99.


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offer for the health and safety of the American people and the maintenance of American democracy."107 The committee was to cooperate with the Advisory Commission to the Council of National Defense, the U.S. Public Health Service, and other Federal agencies, as well as with the Medical Department of the Army and the Bureau of Medicine and Surgery of the Navy. The committee was also to consider problems in other fields besides those concerned with providing medical personnel for military needs.

At the same session, the American Medical Association considered a plan presented by The Surgeon General of the Army; at his request, it agreed to conduct a survey of the medical profession, and accepted in principle his suggested procedure for designating physicians who could be spared from civilian practice and brought into the Army. The plan had to receive the sanction of the General Staff before it could become in all respects operative, and was evidently intended to take full effect only "in the event of a national emergency of great magnitude"108-or, more specifically, a war.

The survey of the medical profession, however, was undertaken immediately by the Committee on Medical Preparedness. To get information for the preparation of a roster, the committee sent questionnaires to all physicians in the United States. The committee realized that the returns would be based on the individual doctor's own estimate of his availability and utility as a medical officer, but it planned to control this by using data from the various specialty boards and other information in the possession of the American Medical Association. The questionnaire was a single-sheet schedule, coded for transfer to machine record cards. In addition to the usual personal data, the committee asked for information concerning details of medical education, licensure, membership in medical societies, full-time appointments, type of practice, certification of examining boards, details of specialty practice, previous military experience, present commission, willingness to volunteer in the event of war, "service you consider yourself best qualified to perform," and physical disabilities.109

The questionnaires were mailed in July 1940. Eventually, more than 185,000 physicians received them, and by 2 January 1942, 85.8 percent had been returned. About 26,000 had to be completed for those who failed to do so for themselves. These were prepared from available information on file in the offices of the State and county medical societies. Eventually, 96 percent of the questionnaires were completed.110 Meanwhile, the process of transferring the information on the returned questionnaires to punchcards began, and the cards were sorted into specialist groups and others. Various directories and lists were constantly used in editing the returns.

The object of the survey was to determine (1) the number of physicians licensed to practice medicine, (2) the number suitable for active service and the

107Medical Preparedness. J.A.M.A. 114:2466, 22 June 1940.
108Memorandum, Colonel Dunham, for The Surgeon General, 14 June 1940. 
109Medical Preparedness. J.A.M.A. 115: 137, 13 July 1940.
110Information from Lt. Col. Harold C. Lueth, MC, former liaison officer, Office of The Surgeon General, with Chicago office of the American Medical Association, 26 May 1945.


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FIGURE 29.-Lt. Col. Harold C. Lueth, MC, liaison officer from the Office of The Surgeon General, to American Medical Association, 1942-45.

number incapacitated, (3) the number and location of physicians who were qualified and available for the Armed Forces and for other essential services in case of national emergency, (4) the number available for service to the civilian population under emergency conditions, (5) the availability and qualifications of those who could serve in special fields of medicine, (6) the number and identity of physicians qualified for teaching and research who were essential to the maintenance of educational institutions, and (7) the number, age, qualification, availability, and other characteristics of all members of the medical profession.

In planning and carrying out this project, there was close liaison between the Committee on Medical Preparedness and the Office of The Surgeon General. The latter assigned a representative, Lt. Col. (later Col.) Charles G. Hutter, MC, to the headquarters of the American Medical Association in Chicago; he reported for duty in October 1940. His successor, from 15 March 1942 to 26 March 1945, was Lt. Col. Harold C. Lueth, MC (fig. 29). An important part of the liaison work consisted of an exchange of information. From data supplied by corps area commanders, the Journal of the American Medical Associa-


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tion published weekly lists of Medical Corps Reserve officers ordered to active duty, and the same information was recorded in the files of the committee. In turn, the corps area surgeons were assisted in the classification and procurement of Reserve officers by members of the committee.111

When the federalization of the National Guard and the inauguration of selective service created a heavy demand for more medical officers in the fall of 1940, the Committee on Medical Preparedness offered to aid in procuring and classifying physicians qualified to act as chiefs of services, if a sufficient number could not be obtained from the Reserve. The Surgeon General accepted this offer.

Acceptance of The Surgeon General's Plan

Meanwhile, in August 1940, The Surgeon General presented to the General Staff for approval a revised version of the plan placed before the American Medical Association in June. The original plan had involved a rather elaborate system of cooperation between Army authorities and the national, State, and county organizations of the American Medical Association for the purpose of designating physicians available for the Army. This one developed the first more fully in some respects and curtailed it in others. The General Staff criticized two points of the proposal-the decentralization of responsibility for the Army's part in the program to the corps area commanders and the commissioning of newly appointed civilians in a rank appropriate to the position they were to fill. Nonmedical officers of the War Department had difficulty in appreciating the fact that the average Medical Department Reserve officer who held advanced rank by virtue of length of service and the fulfillment of certain nonprofessional training requirements was not necessarily qualified to act as chief of the medical or the surgical service in a large hospital. To bring in qualified civilians for such positions and commission them in grades appropriate to their responsibilities meant changing the rules pertaining to rank and promotion in the Reserves, which the General Staff wished to uphold. After some discussion, however, G-1 was inclined to go part of the way, conceding that the grade should "in all cases be appropriate to the age of the applicant."112

The approved version of the plan appeared on 3 February 1941.113 It made no mention of advanced rank (although this was already being granted in some cases) and allowed for only a small part of the decentralization which

111(1) Letter, Office of The Surgeon General, to each Corps Area Surgeon, 30 Oct. 1940, subject: Weekly Report for Liaison Officer, U.S. Army, in Care of the American Medical Association. (2) Letter, Office of The Surgeon General, to Corps Area Surgeons, 27 Nov. 1940, subject: Assistance of the American Medical Association in Classification and Procurement of Physicians.
112Memorandum, Office of The Surgeon General (Col. L. B. McAfee), for Assistant Chief of Staff, G-1, for Chief of Staff, 7 Oct. 1940, subject: Assistance of American Medical Association in Classification and Procurement of Physicians.
113Letter, The Adjutant General, to The Surgeon General and Corps Area and Department Commanders, 3 Feb. 1941, subject: Assistance of American Medical Association in the Classification and Procurement of Physicians.


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The Surgeon General had recommended as a means of speeding the appointment of new medical officers. The plan stated that the American Medical Association would prepare and maintain a roster of civilian physicians, with their specialties and qualifications, who had agreed to accept commissions in the Army of the United States when needed for active duty in a "national emergency." The Surgeon General was to designate one or more officers to represent him at the headquarters of the American Medical Association in Chicago for all matters concerning the association and the Medical Corps Reserve. Vacancies existing in any corps area were to be reported to the War Department, which would attempt to fill them by transfers of Reserve officers from the Arm and Service Assignment Group or from the surplus of other corps areas before the services of the American Medical Association were called upon. If no qualified Reserve officers could be found, The Surgeon General was to notify the American Medical Association concerning the professional vacancies required to be filled and their respective locations. His representative would then forward the recommendations of the association to the corps area commander who would have the designated person or persons examined physically and send their applications for commissions to The Adjutant General for final action. The corps area commander could not grant waivers for physical defects, but could reject an applicant on these grounds. Applicants appointed in this way must not be more than 55 years of age and their appearance before the examining board would be dispensed with.

The War Department General Staff announced that the plan would be put in operation "at such time as the War Department may direct." It took no further action before Pearl Harbor. Nevertheless, The Surgeon General, the American Medical Association, and the corps areas had already carried out some features of the plan before it was approved. The American Medical Association had compiled its roster (which was intended to include all physicians in the country, not merely those willing to accept commissions), The Surgeon General had appointed his liaison officer with the association in Chicago, and information had been exchanged concerning the availability of civilian physicians for certain appointments in the Army.

The plan, while it might have met the requirements of a war situation from a military standpoint, would not have insured adequate civilian medical service under war conditions. In his original proposal to the American Medical Association, The Surgeon General had made the point that in time of war such a plan would "distribute the professional load, and if properly administered, should prevent the stripping of rural and isolated communities of their necessary medical personnel."114 This was a point that greatly concerned the profession before and during the war. But, in the first place, neither The Surgeon General's original plan nor the one finally approved by the War Department specifically exempted members of the Reserves from a call to active duty even if their departure should "strip" the local com-

114See footnote 108, p. 157.


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munities. As early as November 1940, the secretary of the American Medical Association warned the Surgeon General's Office that certain localities in Kentucky and Tennessee were being deprived of doctors by that means.115 Moreover, nothing prevented a civilian doctor from volunteering his services to the Army, and only the self-restraints of the latter and the limits of the procurement objectives would keep it from accepting him. There were few volunteers, however, in relation to the total need.

The plan had certain advantages in that it initiated joint action between various agencies of the Federal Government and the American Medical Association, and after it was approved by the association, several conferences took place between representatives of the Army, Navy, and Public Health Service. It failed, however, to provide for the creation of an "independent" government agency to control the apportionment of doctors between the civilian community on the one hand and Federal agencies on the other.

Origin of the Procurement and Assignment Service

While The Surgeon General was seeking the approval of the War Department for his procurement plan, the American Medical Association was projecting a broader plan of collaboration which led ultimately to the establishment of the Procurement and Assignment Service in October 1941. The association's Committee on Medical Preparedness, seeing "evidence of duplication of effort and of much confusion," felt that "the early appointment of a coordinator for medical and health services is greatly desired to speed mobilization of medical resources for any emergency." It voted that a message to that effect be sent to President Roosevelt and the Advisory Commission to the Council of National Defense. Whether or not as a result of this action, the Council of National Defense established a Health and Medical Committee in September 1940 to coordinate these aspects of defense and to advise the Council concerning them.116 Its membership consisted of the chairman of the American Medical Association's Committee on Medical Preparedness, who served as chairman, the Surgeons General of the Army, Navy, and Public Health Service, and the chairman of the National Research Council's Division of Medical Sciences. Six months later (31 March 1941), its Subcommittee on Medical Education117 recommended the establishment of an official procurement and assignment agency. The Health and Medical Committee transmitted this proposal to the American Medical Association, which resolved on 3 June 1941 that the Government be urged "to plan * * * immediately for the establishment of a central authority with representatives of the medical profession to be known as the Procurement and Assignment

115Letter, O. G. West, American Medical Association, to Gen. A. G. Love, 18 Nov. 1940.
116(1) Medical Preparedness. J.A.M.A. 115: 465, 10 Aug. 1940. (2) Minutes of the Advisory Commission to the Council of National Defense, pp. 90, 92.
117Membership: The Chairman of the Health and Medical Committee (chairman), the Commissioner of Hospitals of New York City, and members of the Harvard, Minnesota, and Tulane Medical Schools and the Stanford University Hospital.


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agency for physicians for the Army, Navy, and Public Health Service and for the Civilian and Industrial needs of the nation." The Surgeon General's Office expressed its full support of this resolution.118

The Health and Medical Committee in turn voted to adopt the association's resolution in principle and held a meeting on 22 October 1941 to "initiate the development of a Procurement and Assignment Service." At this meeting, which included the Surgeons General of the Army, Navy, and Public Health Service, a number of consultants from the American Medical and Dental Associations and one from the Veterans' Administration, a committee was appointed to draft a program for the proposed agency.

The committee submitted a detailed report analyzing the medical and allied personnel needs of the various public and private agencies and outlining the organization and duties of the proposed Procurement and Assignment Agency. Two days later (30 October 1941), Paul V. McNutt, the Director of Defense Health and Welfare Services (under whom the Health and Medical Committee now functioned), sent a letter containing the substance of these proposals to President Roosevelt for his approval which was given the same day. After outlining the purpose and organization of the new agency, Mr. McNutt stated:

The functions of the Agency would be: (1) to receive from various Governmental and other agencies requests for medical, dental and veterinary personnel; (2) to secure and maintain lists of professional personnel available, showing detailed qualifications of such personnel; and (3) to utilize all suitable means to stimulate voluntary enrollment, having due regard for the overall public needs of the Nation, including those of governmental agencies and civilian institutions.

The letter concluded with a statement proposing to instruct the Agency to draft legislation providing for the "involuntary recruitment" of medical, dental, and veterinary personnel if the national emergency appeared to require it.119

On 17 November 1941, The Surgeon General appointed Capt. (later Lt. Col.) Paul. A. Paden, MC, as his liaison officer with the Procurement and Assignment Agency.120 (The "Agency" had been designated a "Service" shortly after its creation.) Another medical officer of the Army, Maj. (later Col.) Sam F. Seeley, MC (fig. 30), became Executive Officer of the Service's Directing Board.121

War came a few weeks after the new Service was established and before it had begun to function. It should be emphasized here, however, that the Procurement and Assignment Service neither procured nor assigned personnel. Its purpose was simply to assist in these operations. In that respect, it differed

118(1) Proceedings of the Cleveland Session [American Medical Association], 2-6 June 1941. J.A.M.A. 116: 2783, 21 June 1941. (2) Letter, American Medical Association, to Henry L. Stimson, Secretary of War, 12 June 1941, with 2d endorsement thereto, 23 July 1941.
119Letter, Paul V. McNutt, Administrator, Federal Security Agency, to the President, 30 Oct. 1941.
120(1) Letter, Paul V. McNutt, Administrator, Federal Security Agency, to The Surgeon General, 14 Nov. 1941. (2) Letter, The Surgeon General, to Paul V. McNutt, 17 Nov. 1941.
121For composition of the directing board, see Mordecai, Alfred: A History of the Procurement and Assignment Service for Physicians, Dentists, Veterinarians, Sanitary Engineers, and Nurses-War Manpower Commission.


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FIGURE 30.-Col. Sam F. Seeley, MC, Executive Officer, Directing Board, Procurement 
and Assignment Service.

little from the machinery contemplated in The Surgeon General's plan approved by the War Department 9 months before-which, in fact, it superseded. The Procurement and Assignment Service had no powers of compulsion-other than moral force-over the men it declared available for Federal service; and if they entered the service, it could only exhibit their qualifications, not insure their assignment to jobs for which they were specially equipped; in fact, "assignment" in the title of the new agency referred to the declaration of availability for one or other of the services rather than for a particular job. Some of the objections that might have been made to the earlier War Department plan therefore applied to the new agency. It met the request of the American Medical Association, however, in being a coordinating body for all Federal services; it also had the prestige of a Federal agency.

Subcommittee on Nursing

Meanwhile, the nursing profession was being organized for defense purposes not only by the Red Cross but by other organizations as well, both governmental and private. A Federal agency, the Subcommittee on Nursing,


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established late in 1940 under the Medical and Health Committee of the Office of Defense Health and Welfare Services, had the following broad functions:122 

To coordinate on a national level all nursing for defense in the Government agencies and the American Red Cross.

To act as a two-way channel between the Government agencies and the Nursing Council on National Defense.

To assist the Health and Medical Committee and its various subcommittees in all questions dealing with nursing.

To act as the Nursing Advisory Committee to the Office of Civilian Defense. 

To suggest Federal legislation regarding nursing and to assist in the development of policy under which nursing programs are carried out.

The National Nursing Council

Private nursing groups had also created organizations designed to assist in supplying the Armed Forces and to distribute nurses equitably in civilian life. The National Nursing Council for War Service, originally formed on 29 July 1940 as the Nursing Council for National Defense, represented five national nursing organizations-the American Nurses Association, the National League of Nursing Education, the National Organization for Public Health Nursing, the Association of Collegiate Schools of Nursing, and the National Association of Colored Graduate Nurses-together with the Red Cross. The National Council encouraged the creation of State councils. In 1940, it had also initiated a National Survey of Registered Nurses, "to determine the number of professional nurses, their availability for military and particularly, for civil duty, and their special attainments." Lacking the money to complete such an ambitious project, however, it turned it over to the Subcommittee on Nursing, where it was placed under the guidance of a Special Inventory Committee, which completed it in 1941.123 The Public Health Service assisted in coding and compiling the information gathered. This survey was comparable in purpose to the survey of doctors conducted by the American Medical Association.

PROCUREMENT OF ENLISTED MEN

The enlisted strength of the Medical Department on 30 June 1939 was 9,359 and by 30 November 1941 had risen to 108,674, representing 8 percent of that of the Army as a whole (table 1). Most of the increment came by way of voluntary enlistment, or after November 1940 by selective service, although the induction of the National Guard into Federal service also added sizable

122Haupt, Alma C., Executive Secretary of Subcommittee: Report of the Subcommittee on Nursing, Health and Medical Committee, Office of Defense Health and Welfare Services. Read before Joint Boards of the National Nursing Associations, New York City, N.Y., 24 Jan. 1942.
123(1) See footnote 49 (3). p. 135. (2) "News About Nursing." Am. J. Nursing 41: 223, 1941. (3) Speech presented by Pearl McIver, 12 July 1941, to joint meeting of the Subcommittee on Nursing, Nursing Council on National Defense, and the American Red Cross Advisory Committee.


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numbers. The Medical Department Enlisted Reserve was only a negligible source of personnel; in contrast with the Medical Corps Reserve, which had many times the strength of the Regular Army Medical Corps, the medical sections of the Enlisted Reserve Corps and the Regular Army Reserve in June 1940 together numbered 1,524, only a little over one-tenth of the Regular Army enlisted strength of the Medical Department. None of its members was on active duty.124

The supply of enlisted personnel could be increased-in effect and over short periods-by speeding the production of trained men, for the Medical Department could not make full use of a man's services until he had received a modicum of instruction in medical techniques. The establishment of training centers was one means of attaining this goal. In the prewar period, medical replacement training centers were established at Camp Lee, Va., and Camp Grant, Ill., in January 1941, and at Camp Barkeley, Tex., in November 1941. In the latter month, The Surgeon General asked for additional training-center facilities and requested that those in being should be kept at full capacity by the prompt shipment of selectees to them. Reduction of the training period from 13 to 11 weeks at those centers and elsewhere, which The Surgeon General recommended at the same time, would also increase the rapidity of supply. It was the maximum reduction he then considered possible.125

It was important that after enlistment or induction enlisted men with medical skills should find their way into the Medical Department and remain there; it was also important that if possible they should be put in jobs where their civilian experience or natural intelligence could best be utilized. One interesting experiment to this end was undertaken by the Medical Department in collaboration with the Red Cross. Under an agreement signed in January 1940, the Red Cross established a Registry of Medical Technologists, listing individuals who met age and technical qualifications set by the Medical Department. Male registrants who qualified physically were to serve as either staff or technical sergeants in the Medical Department when called to duty in case of mobilization. Female registrants and men who did not qualify physically would be employed as civilian workers by the Medical Department in case of war, and civil service grades were established for them. The Army set age limits of 21 to 45 years. Members of the Regular Army, National Guard, or Reserve were not eligible for enrollment. Types of technologists enrolled included the following: Dietitians; physiotherapy and occupational therapy aides; dental hygienists; dental and orthopedic mechanics; laboratory, chemical laboratory, pharmacy, and X-ray technicians; meat and dairy hygiene inspectors; and statistical clerks. By September 1940, after almost 80,000 announcements had been mailed to these groups, 639 men and 403 women technologists were enrolled.

124Annual Report of the Secretary of War. Washington: U.S. Government Printing Office, 1940, pp. 45, 61.
125Letter, The Surgeon General, to Assistant Chief of Staff, G-1, 3 Nov. 1941, subject: Replacements From Medical Replacement Training Centers.


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Vastly more important than any other means of channeling newly inducted men with appropriate backgrounds into the Medical Department was the system of classification used from September 1940 onward at the Army's reception centers, a system which performed a similar service for all branches of the Army. The classification at reception centers, although it did not, or could not, always produce the desired results, was not only extremely useful in channeling new recruits into the proper branch of the Army but aided in directing them to the proper type of job within that branch.

The Medical Department experienced difficulty in the emergency and war periods in retaining trained noncommissioned officers. During the emergency, many Regular Army enlisted men and some National Guardsmen in the first three grades (master or first sergeants, technical sergeants, and staff sergeants) quickly became commissioned officers. Some were commissioned directly, others after a course in officer candidate school; still others accepted active duty under commissions which they already held in the Officers' Reserve Corps. Most of these were only "paper" losses, for the great majority of the men concerned accepted commissions within the Medical Department as Sanitary and Medical Administrative Corps officers; thus, a loss in the enlisted group became a gain in officer personnel.

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