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

HISTORY OF THE OFFICE OF MEDICAL HISTORY

AMEDD BIOGRAPHIES

AMEDD CORPS HISTORY

BOOKS AND DOCUMENTS

HISTORICAL ART WORK & IMAGES

MEDICAL MEMOIRS

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

ORGANIZATIONAL HISTORIES

THE SURGEONS GENERAL

ANNUAL REPORTS OF THE SURGEON GENERAL

AMEDD UNIT PATCHES AND LINEAGE

THE AMEDD HISTORIAN NEWSLETTER

Chapter VI

Contents

CHAPTER VI

Procurement, 1941-45: Medical, Dental, and Veterinary Corps

LEGISLATION

Immediately following Pearl Harbor, two important measures were passed regarding manpower in the Army. An act, approved on 13 December 1941,1 extended the tour of active duty of all officers and enlisted men, including retired officers in service, to a date 6 months after the end of the war. Under it, reservists no longer served a stipulated period of time on active duty and then reverted to inactive status. Reserve officers who had been relieved from active duty following a period of satisfactory service were recalled. Restrictions on age-in-grade for service other than with troop units were removed as were geographic restrictions on the use of reservists and guardsmen.

A week later, 20 December 1941, an amendment to the Selective Service Act provided for registration of all men between the ages of 18 and 65, and sanctioned military service for those between 20 and 45. The same law permitted the President to defer the military service of draftees by age groups if this seemed in the national interest. The subsequent lowering of the maximum induction age from 45 to 37 years, which had certain adverse effects on the procurement of Medical Department officers, did not, however, take place until a year later.

Believing that it was unnecessary for officers to meet the rigid physical requirements then in force in order to perform many types of duty, the War Department about the same time took steps to relax the physical requirements for Reserve officers not yet called to active duty and for civilians who might be commissioned as officers. For minor deficiencies such as slight overweight or defective vision, the prospective officers were permitted to sign waivers, subject to final acceptance or rejection by The Surgeon General in accordance with the recommendations of his Division of Physical Standards.2 The "limited service" category was later used as a means of designating and classifying such officers.

155 Stat. 799.
2(1) Memorandum, Under Secretary of War, for The Surgeon General, 12 Dec. 1941. (2) Statement of Dr. Durward G. Hall, to the editor, 27 May 1961.


168

MEDICAL CORPS

Lag in Procurement During the First Months of War

There were three means of getting physicians into the Army: By calling up those who belonged to the Reserve or the National Guard; by organizing affiliated units to be called into service when needed; and by direct commissions from civilian life. The hard core of the wartime Medical Department was the Reserve, made up for the most part of men who believed in their obligation to perform military service. The ranks these men held in the Reserve were often lower than those given to men of no greater competence who volunteered at later dates.

In the first months after Pearl Harbor, the number of doctors that came into the Army was relatively quite small. It is true that the Army in general was growing rather slowly. Nevertheless, the Medical Department wished to have more than enough doctors for immediate needs so as to be well prepared for the vast increases in the size of the Army that were bound to come. Physicians entering the Army directly from civilian practice needed some training in military methods before they could work with full effectiveness; moreover, it was better to have an adequate system of medical care ready beforehand than to build one in the midst of pressing need.

Five months after the declaration of World War II, approximately 3,000 fewer physicians were on active duty with the Army than at the end of the same length of time after the declaration of World War I.3 In the first place, the Army depended on the doctors to volunteer. In the second place, many doctors misunderstood the functions of the Procurement and Assignment Service and, believing that that agency actually did procure, waited for some notification from the agency. And, finally, the prevalent rumors about the idleness and misassignment of Reserve doctors after they had gone into service undoubtedly discouraged some from accepting active duty in an Army which, they believed, either did not need them or could not or would not use them properly. As time went on, the knowledge of affiliated units which had been called early in the war and had remained in this country without useful work confirmed many doctors in their belief that the Army did not-at least not yet-need additional doctors.

Role of the Procurement and Assignment Service

Organization

Although the Procurement and Assignment Service was established in November 1941, it became an active factor in procurement only after the United States entered the war. For several months, it was engaged in setting up its organization, and functions changed somewhat during the course of the war.

3Memorandum, Procurement Branch, Military Personnel Division, Office of The Surgeon General, for Director, Historical Division, Office of The Surgeon General, 20 Apr. 1944.


169

FIGURE 31.-Directing Board, Procurement and Assignment Service. Left to right: Abel Wolman, Dr. J. E. Paullin, Dr. H. S. Diehl, Miss Mary Switzer, Dr. F. H. Lahey, Dr. H. B. Stone, and Dr. C. W. Camalier.

From the standpoint of governmental organization in general, the Procurement and Assignment Service was one of the agencies in the Executive Office of the President. There, it occupied a subordinate position, being at first directly responsible to the Office of Defense Health and Welfare Services, a branch of the Office for Emergency Management, which in turn was a main division of the President's Executive Office. Later, in April 1942, it was shifted to the Bureau of Placement of the War Manpower Commission, another main division of the Office for Emergency Management. In both positions, the Procurement and Assignment Service was under the jurisdiction of Paul V. McNutt, at first directly when he was Director of the Office of Defense Health and Welfare Services, and then indirectly when he became Chairman of the War Manpower Commission. Its head throughout the war continued to be Dr. Frank H. Lahey, Chairman of the Volunteer Directing Board. Whatever its position on an organization chart happened to be, the Procurement and Assignment Service in practice seems to have worked somewhat independently of control from above other than from Mr. McNutt.4

The Procurement and Assignment Service at first concerned itself only with doctors, dentists, and veterinarians. Eventually, nurses and sanitary engineers also came within its scope. The Directing Board (fig. 31) was the policymaking body of the Service and was instrumental in establishing the

4Letter, Mary E. Switzer (Administrative Assistant to Mr. Paul V. McNutt, during World War II), to Col. C. H. Goddard, Office of The Surgeon General, 19 Aug. 1952.


170

central and field organizations. It also created a number of advisory committees. Their names indicate the aspects of the Board's work with which it believed it would need special assistance; there was a committee on each of the following: Allocation of Medical Personnel, Dentistry, Hospitals, Industrial Health and Medicine, Information, Medical Education, Negro Health, Public Health, Sanitary Engineering, Veterinary Medicine, and Women Physicians. In 1943, two members of the nursing profession were appointed to the Directing Board, and a Nursing Advisory Committee and a Nursing Division were created.

To carry out its functions locally, the Procurement and Assignment Service early established a system of committees for the corps areas, States, and districts or counties. The committees were composed of members of the medical professions-physicians, dentists, veterinarians, medical and dental educators, hospital administrators, and public health representatives. Later, in 1943, a system of State and local committees on nursing was also organized. Most of this apparatus was modeled on or taken over from agencies set up by the national nursing organizations.

Since it was agreed that representatives of the Procurement and Assignment Service should act in an advisory capacity to the Selective Service System, the relationship between these two agencies was close. In fact for a time (5 December 1942 to 23 December 1943), both were part of the War Manpower Commission. Other agencies with which the Procurement and Assignment Service worked closely were the National Roster of Scientific and Specialized Personnel, the National Research Council, and the national medical, dental, and veterinary associations.

Functions

The unique function of the Procurement and Assignment Service was to assure the continuance of adequate medical care for the civilian population by determining minimum local needs and calling a halt to recruitment when the supply of physicians and dentists dropped to the indicated level. For a short time, the Procurement and Assignment Service also assisted in ascertaining the professional eligibility of applicants for the Army and Navy, but for the greater part of the war, this function was carried out in the Chicago offices of the American Medical Association by personnel of the Office of The Surgeon General.

On 21 January 1942, the War Department issued a directive to corps area and department commanders stating that applications received by the Army were to be sent to the Procurement and Assignment Service, who would then determine the eligibility of the applicant according to the requirements of Army regulations on the basis of information from the authorities of the National Roster of Scientific and Specialized Personnel and send eligible applicants forms for appointment. When returned, the completed forms were forwarded to The Surgeon General together with a statement of the applicant's


171

eligibility and a description of his classification and evaluation as determined by the recent nationwide survey made by the Medical Preparedness Committee of the American Medical Association.5

In May 1942, however, The Surgeon General requested the Service to send all applications to him after retaining them only long enough to obtain a statement of the applicant's availability from the Service's State chairman. Three months later, he recommended revocation of the directive of 21 January, stating that the Procurement and Assignment Service no longer took any part in processing applications.6 The reason for The Surgeon General's action undoubtedly included the need to speed commissioning as the flow of applications increased, but it also reflected some dissatisfaction with the existing state of things. The Procurement and Assignment Service, with its nonmilitary orientation, protected the civilian community better than The Surgeon General could have done, but it was only as effective as its local administration. At this time and throughout the war, the actual recruitment of medical and paramedical personnel for the Army was the primary business of the Personnel Service in the Office of The Surgeon General.

While the Procurement and Assignment Service ceased to have much to do with determining the eligibility of professional men applying for appointment in the Army, it continued to need information concerning the qualifications of civilian professional personnel. A number of agencies had been collecting information of this nature since before the war, information which in many instances proved useful to the Medical Department as well as to the Procurement and Assignment Service. One of these agencies was the National Roster of Scientific and Specialized Personnel. The National Roster had as its function the registration of all persons trained in the sciences and in other specialized fields, the coding of their registrations, the machine processing of data, and the machine selection of papers of qualified registrants. As the American Medical Association was engaged in a similar task for physicians, the National Roster at first registered only a small specialized group of the medical profession. However, the American Medical Association, the American Dental Association, and the American Veterinary Medical Association made available to the National Roster all punchcard files they had collected. Later on, the Roster, cooperating with the Procurement and Assignment Service, developed questionnaires and enrollment forms which were sent to all physicians, dentists, and veterinarians. The National Survey of Registered Nurses, initiated in 1941 by the Nursing Council for National Defense, was also carried on and completed in 1941.

5(1) Letter, Office of The Surgeon General, to War Department General Staff, subject: Appointment of Physicians, Dentists, and Veterinarians in Army of the United States. (2) Letter, Office of The Adjutant General, to all Corps Area and Department Commanders, 21 Jan. 1942, subject: Procurement of Officers for Medical Department, Army of the United States.
6
(1) Memorandum, Office of The Surgeon General, for Procurement and Assignment Service, 12 May 1942. (2) Letter, Office of The Surgeon General (Maj. D. G. Hall), to The Adjutant General, 31 Aug. 1942, subject: Procurement of Officers for Medical Department, Army of the United States.


172

In determining minimum local civilian needs and deciding which and how many professional men could be spared for the Armed Forces, the Procurement and Assignment Service began with an individual approach. If the doctor was so necessary to his community that he could not be permitted to volunteer for military service, he was classified as essential and prohibited from accepting a commission. If not, the Service classified him as available and encouraged him to enter the Army or the Navy. This procedure was soon partially superseded, in the case of doctors, by what amounted to classifying them as essential en masse; that is, the Procurement and Assignment Service prohibited recruitment in any State which had less than the ratio of doctors to population it considered a necessary minimum. In States having a higher ratio, recruitment was permitted on the former basis. As the ratios were computed on the basis of each State as a whole, urban areas might conceivably have a much higher ratio than rural districts, but the Procurement and Assignment Service had no power to redistribute doctors.

The Procurement and Assignment Service attempted to classify as available or essential all doctors within the age group which was eligible for military service, but it did not do this fast enough to prevent some doctors from accepting commissions before being classified.7 The difficulty would have been obviated if the Service had promptly classified all applications for commissions. In some cases, however, this was not done.

The task of classification was performed mainly by the State committees of the Service. If an individual objected to the way he was classified, or if his community or institution protested that he had been wrongly designated "available," an appeal could be carried to the corps area committee, which would reappraise the judgment. If the decision there went against the appellant, he could carry the matter to the Directing Board in Washington, D.C.

Probably the most important of the Directing Board's advisory committees, so far as the Medical Department was concerned, was the Committee on Allocation of Medical Personnel. This committee obtained information for the Directing Board and appraised the sources of medical manpower. The committee based its determination of civilian needs on studies carried on in cooperation not only with the official agencies concerned (the U.S. Public Health Service, the Children's Bureau of the Department of Labor, and the Department of Agriculture) but also with the American Medical Association, the American Dental Association, the American Public Health Association, and other similar groups.8 It established criteria for determining the minimum personnel requirements of medical schools, hospitals, industry, and the civilian population. In this respect, it was, to some extent, a "rationing" board. The committee also determined and set up State quotas of physicians for military service, taking into consideration the overall needs of the civilian population.

7Committee to Study the Medical Department, 1942. 
8
See footnote 4, p. 169.


173

Since the Procurement and Assignment Service established the criteria which controlled the recruitment of professional personnel for the Medical Department of the Army and Navy, the Service could state rather definitely the maximum number of doctors, dentists, veterinarians, and other groups which the Armed Forces could contain. It thus restricted, and at the same time promoted, the procurement of medical personnel for the military forces. It forbade any procurement whatever in certain States; in others, it classified certain individuals as essential to their communities and so kept them from entering either the Army or the Navy. On the other hand, by classifying a person as available, it directed recruiting effort toward him and in effect told him that he should be in uniform. True, it had no legal power to compel him to join up-the legal power was all on the side of preventing essential practitioners from doing so-but the moral pressure which a committee of professional men could exert on their colleagues by labeling them "available" must in many cases have been decisive. Another effective influence was the pressure from local medical societies. And back of these intangibles stood the ever-present threat that local draft boards could if they chose call up any able-bodied man within the prescribed age group, regardless of his professional training.

Medical Officer Recruiting Boards

The Procurement and Assignment Service came too late, and had too little actual authority, to effect Medical Department procurement in the early months of the war. In March 1942, the Surgeon General's Office had no alternative but to inform Headquarters, Services of Supply, that there was a serious shortage of physicians for the Army. The 1940-41 procurement program had fallen 1,500 short at the end of that fiscal year, and was still falling behind. There were in fact only 12,465 medical officers then on active duty, with orders for another 500 requested, compared with an objective of 28,656 by the end of 1942. Although the Procurement and Assignment Service was sending applications and related papers to the Office of The Surgeon General at a rate of about 75 a day, an average of only 50 a day could be completed and sent to The Adjutant General, owing to inadequate data. These figures, if projected through the remainder of 1942, forecast a shortage of some 4,000 medical officers by 1 January 1943.9 The analysis impressed both the Services of Supply and the Assistant Chief of Staff, G-l, resulting in the establishment of the Medical Officer Recruiting Board.

Procedures

On 12 April 1942, the Director of Military Personnel, Services of Supply, instructed The Surgeon General to prepare a plan embodying the following points: (1) The authority to accept, examine, and commission applicants

9Memorandum, Office of The Surgeon General (Col. G. F. Lull), for Gen. J. E. Wharton, Military Personnel Division, Services of Supply, 20 Mar. 1942, subject: Shortage of Medical Corps Officers.


174

was to be decentralized to 48 State representatives; (2) commissions in sufficient numbers were to be tendered in grades above the lowest to attract qualified applicants, and upper age limits were to be relaxed to provide experienced Medical Corps officers in appropriate grades; (3) corps area and station surgeons were to be charged with active participation in the campaign to recruit Medical Corps officers; and (4) an intensive publicity campaign would be launched to call the attention of physicians and the public to the Army's need for doctors.10

These provisions were carried out, and as his contribution to the plan, The Surgeon General issued instructions to the new recruiting boards, each board consisting of one Medical Corps officer and one officer whose branch was not specified (branch immaterial). They were authorized to secure applications for commissions in the Army of the United States (Reserve officers were to apply to The Surgeon General himself for active duty) of qualified physicians under the age of 55 and of dentists under 37. The boards were to function in cooperation with the Procurement and Assignment Service and where possible would obtain office space at or near the headquarters of the State chairman of the Service. Medical societies also cooperated with the board, rendering them considerable assistance. The boards were to obtain applications, authorize physical examinations at the most convenient Army medical installation empowered to perform such examination, and evaluate the professional qualifications and physical findings. They could appoint, without further delay, applicants under the age of 45 years to the grade of first lieutenant or captain, the grade to depend upon experience and professional qualifications. The boards were to administer the oath and forward the completed papers to The Surgeon General. Regulations which determined rank on the basis of age and professional qualifications were to remain unchanged-applicants under the age of 37 years were appointed in the grade of first lieutenant, except that those who had passed the age of 30 were appointed as captains when they had been certified by an American specialty board or had completed 3 years' residency in a specialty in addition to the required 1 year's internship; or, if they were older than 36 years and 10 months and would reach 37 years about the time active duty began, they could be appointed in the grade of captain. The boards were not empowered to appoint certain types of applicants, but were to complete the applications and send them to The Surgeon General. Such were applicants in the age group from 45 to 54, those applying for a grade higher than that of captain, Negro physicians, graduates of American substandard or foreign schools, Federal employees, or persons drawing Federal pensions, and others whose qualifications the board questioned.11

10Memorandum, Director, Military Personnel Division, Services of Supply (Brig. Gen. James E. Wharton), for The Surgeon General, 12 Apr. 1942.
11Instructions to Medical Officer Recruiting Boards, by Col. John A. Rogers, Executive Officer, Office of The Surgeon General, May 1942.


175

The Surgeon General's control

Until 1 September 1942, The Surgeon General controlled the boards on behalf of the War Department, and he issued instructions to them either directly or through The Adjutant General. His authority included the power not only to establish but to close a board. He might also be directed by higher authority to open additional boards.12

Accomplishment of the boards

The boards had remarkable success in recruiting doctors. Bringing to doctors, individually or in groups, for the first time during the war the story of the Army's urgent need for their services, clearing up misunderstandings, and having the power to examine and commission directly, they swore in very large numbers in their few months of operation. One board reported in June that its record for minimum time elapsed between receipt of an application and the commissioning of the applicant was 5 days and that it was prepared to maintain an average of 7 days.13 For the most part, the board cooperated closely with the State representatives of the Procurement and Assignment Service, requesting availability clearance for doctors who expressed willingness for Army service. In some instances, however, the boards, in their enthusiasm, did not await these availability rulings.14 The Surgeon General informed the Procurement and Assignment Service that the need for medical officers was so pressing that it would not be possible to delay appointment of qualified applicants to ascertain their availability "as determined by anyone other than the applicant himself." But Mr. McNutt complained to the Secretary of War, and The Surgeon General was directed to agree not to commission any more medical officers unless they had been cleared by the Procurement and Assignment Service.15 Thus, however great his need, The Surgeon General's attempt to shake off the reins of a civilian agency was unsuccessful.

Air Forces activities

The Army Air Forces, meanwhile, had sought authority as early as March 1942 to procure its own medical officers, on the ground that The Surgeon General was not able to allot enough physicians to meet Air Forces needs, nor proc-

12(1) Instructions to Medical Officer Recruiting Boards, by Order of The Surgeon General, 23 May 1942. (2) Memorandum, The Surgeon General, for The Adjutant General, 28 Apr. 1942. (3) Letter, The Surgeon General, to Hon. E. D. Smith, Senator from South Carolina, 20 June 1942. (This refers to a request to The Adjutant General for remova1 of a board from South Carolina to another State.) (4) Letter, Director, Military Personnel Division, Services of Supply (Brig. Gen. James E. Wharton), to The Surgeon General, 23 June 1942, subject: Officer Procurement Program Medical Department.
13Letter, Lt. Col. R. F. Olmsted, to Col. J. R. Hudnall, Office of The Surgeon General, 22 June 1942.
14Memorandum, Lt. Col. Durward 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.
15(1) Memorandum, Office of The Surgeon General (Col. F. M. Fitts, MC), for Executive Officer, Procurement and Assignment Service, 15 May 1942. (2) See footnote 7, p. 172.


176

ess them fast enough. The Surgeon General agreed to place Air Forces medical officers on duty with the recruiting boards to handle the applications of those interested in serving with the Air Forces, although each applicant's preference as to branch of service already appeared on the papers sent to The Surgeon General.16

Simultaneously, the General Staff granted the Air Surgeon the right to determine the grade of appointment for doctors in company grade and to send the papers directly to The Adjutant General; papers recommending appointment in grade of major or above he still had to send to The Surgeon General.17 The following tabulation shows the results of the Air Surgeon's procurement efforts from 21 March 1942 to 1 July 1942:

Applicants physically disqualified

280

Applicants rejected by the Air Surgeon

486

Applicants not desiring Air Forces service (presumably persons who had changed their minds)

155

Orders requested for duty with Air Forces

2,053


The figure of 2,053 approximated the objective of 2,200 which the Air Surgeon had set for this period.18

Officers in the Surgeon General's Office were forced to admit that the Air Surgeon's efforts had relieved them of the responsibility of recruiting for him. Probably the "glamor" which many people attached to service in the Air Forces, in addition to the aggressiveness with which the recruiting campaign was waged, accounted in a considerable degree for its success. It accounted also for much of the dissatisfaction that later developed, especially among qualified specialists who had come on active duty from the Medical Corps Reserve, often at some personal sacrifice. As the Chief Surgeon of the European theater recalled it: "These specially trained men understandably expected that their special skills would be used; but the Air Forces did not have sufficient beds under their control to utilize all of this talent * * *. In the E.T.O., from 1944 on, we traded * * * with the Air Forces, giving it good young medical officers without special training for qualified specialists."19

Procurement and Assignment Service reaction

In June 1942, Dr. Frank H. Lahey, Chairman of the Directing Board of the Procurement and Assignment Service and President of the American Medi-

16(1) Letter, Air Surgeon (Col. David N. W. Grant, MC), to The Surgeon General, 22 June 1942, subject: Medical Corps Officers for Duty. (2) See footnote 12(1), p. 175.
17Letter, The Adjutant General, to Commanding General, Army Air Forces, 6 July 1942, subject: Coordination, The Surgeon General and The Air Surgeon. (The Army Air Forces Medical Service historian states, however, that it appears that the Air Surgeon never used the authority to "sign and issue letters of appointment" of Medical Corps officers in company grades. See Link, Mae Mills, and Coleman, Hubert A.: Medical Support of the Army Air Force in World War II. Washington: U.S. Government Printing Office, 1955.)
18(1) Memorandum, Chief Clerk, Personnel Division, Air Surgeon's Office, for Chief, Personnel Division, Air Surgeon's Office (undated). (2) See publication cited in footnote 17.
19Letter, Maj. Gen. Paul R. Hawley, USA (Ret.), to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12 Mar. 1956.


177

cal Association, and Mr. Paul V. McNutt, Chairman of the War Manpower Commission, took occasion in addressing the House of Delegates of the American Medical Association in Atlantic City, N.J., to inform doctors of the Army's great need for them. Dr. Lahey stated that he believed that the medical profession was still not facing the facts as frankly as it should and that the country was still not convinced that its situation was one of urgent necessity. Mr. McNutt spoke much more bluntly, saying: "We are not getting enough [doctor] volunteers." Then, reviewing the armed services' need for doctors, and pointing out the different fields of civilian medicine where needs were large, he told the delegates that the careful safeguards that the Procurement and Assignment Service had set up had apparently slowed down the rate of recruitment. "The voluntary plan must work and work promptly-or some other more vigorous plan will have to be produced." After stating that the medical profession was the first to require rationing, he concluded: "The issue is who shall do the rationing, for America must have the doctors it needs."20 Although he did not explain what the "more vigorous plan" would be, many believed Mr. NcNutt was referring to the possibility of a draft of doctors.

Dental officers assigned to boards

Since the boards had been commissioning dentists as well as doctors and since there were few vacancies in the Dental Corps during the first 2 months of their existence, the efforts of the two original officers on each board filled the needs. In July 1942, however, when The Surgeon General received authority to procure 4,000 more dentists, a Dental Corps officer was added to each of the 30 boards then operating in 25 States. (In June 1942, the Services of Supply had ordered additional recruiting boards created in seven of the more populous States-New York, Pennsylvania, Illinois, Ohio, Massachusetts, California, and Texas.)21 The objective was soon reached; the Dental Corps officers were removed from the boards on 1 September 1942, and the boards were instructed at that time to process no more dental applications except for men classified as I-A by selective service-those who might be drafted.22 The boards did not procure veterinarians or any other Medical Department personnel. In September 1942, the boards were limited to appointing first lieutenants only, forwarding the papers of applicants for all other grades to The Surgeon General, who decided whether to commission the applicant.23

20(1) Medicine and the War. J.A.M.A. 119: 647-648, 20 June 1942. (2) McNutt, P. V.: The Urgent Need for Doctors. J.A.M.A. 119: 605-607, 20 June 1942. 
21See footnote 12(4), p. 175.
22(1) Medical Department, United States Army. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955. (2) Letter, The Adjutant General, to Commanding Generals, all Service Commands, 9 July 1942, subject: Dental Corps Member for Certain Medical Department Recruiting Boards.
23(1) War Department Memorandum No. S605-5-42, 1 Sept. 1942. (2) Radio, Commanding General, Services of Supply, to Commanding General, each Service Command, 10 Sept. 1942.


178

Civilian reaction

Although the total number enrolled by these boards was gratifying to The Surgeon General, physicians' responses to the boards' appeals varied in different sections of the country. Some States went far beyond the 1942 quota set by the Procurement and Assignment Service; others lagged. In some areas, critical shortages of doctors for civilian care were developing, due in part to voluntary enrollment and in part to the shifting of population to industrial areas. On the other hand, several populous States, where the number of doctors was relatively large, fell far behind their quotas.

The boards drew criticisms of various kinds, the most frequent being that they antagonized doctors and threatened them with being drafted if they did not volunteer.24 Learning of such conduct by the boards, the Director of the Selective Service System issued a strong statement declaring that the System had not delegated the power to induct and could not if it wished but that, despite this, some boards had told doctors they must accept a commission or they would be drafted. "This is a half truth and a misrepresentation of the worst possible kind," he asserted.25

On 20 June 1942, the Surgeon General's Office, possibly forewarned of the Director's concern in this matter, had informed the boards that they were not in a position to threaten induction; they might, however, tell physicians that need for them was so great that Selective Service might consider inducting them.26

The Chairman of the War Manpower Commission, although he had talked sternly to doctors in June about the Army's great need for them, testified in the fall of 1942 before the Committee to study the Medical Department that in many States the boards "use entirely unwarranted methods to scare doctors into volunteering * * *. Every possible means was used, short of shanghaiing, to force the doctors to join up." He complained to the committee that these boards had paid little attention to essential work a doctor might be doing and that before State Chairmen of the Procurement and Assignment Service could complete their lists of essential doctors in communities, health departments, the staffs of universities and hospitals, and industry, the boards had taken many essential men. "We have had," he said, "occasional instances where they have taken every single person [physician] in the community * * *. They have gone in and high-pressured these men."

In a move to regain the control he had lost when others were empowered to issue commissions, The Surgeon General stated in the fall of 1942 that as his Office possessed the machinery to handle applications and recommend commissions, the few boards still functioning were to do no more actual commis-

24Letter, Chamber of Commerce, Kalamazoo, Mich., to Senator Prentiss W. Brown, 23 Nov. 1942. 
25Letter, Director, Selective Service System, to Brig. Gen. James E. Wharton, Director, Personnel Division, Services of Supply, 22 June 1942.
26Information Letter, Office of The Surgeon General, to Medical Officer Recruiting Boards, 20 June 1942, subject: Instructions.


179

sioning. With all applications for commissions in the Medical Corps passing through his Office, he could exercise tighter control on the initial rank granted an officer and on the classification of each man according to his training and experience. The Officer Procurement Service, established in November 1942 under the Commanding General, Services of Supply, to procure officers for the entire Army, was willing, however, to have the Medical Officer Recruiting Boards complete and send applications to The Surgeon General or the Air Surgeon: those officers then transmitted them to the Officer Procurement Service for consideration and for forwarding to the Secretary of War's Personnel Board.27

Closing of the boards

The recruiting boards were closed at different times, beginning with the board in South Carolina in June 1942; the last ones were closed in February or March 1943. As States approached the Procurement and Assignment Service's quotas of physicians that could be withdrawn from civilian practice, that Service became concerned that civilian medical care might suffer unduly and brought pressure on the War Department to close the boards in those States. Furthermore, in States which had reached their 1942 quota, the Service refused to declare any more doctors available for military duty. As a result of pressure from this Service, The Surgeon General in July 1942 ordered the boards in 16 States to be closed at the earliest practicable date.28

Control shifted to service commanders

At the end of the same month, General Somervell, on being reminded at a meeting of his service command commanders that the medical officer recruiting boards were under the orders of The Surgeon General, declared that they were to be "under the Service Commander, and I don't want any direct staff control any more." On 1 September 1942, an order was issued to that effect.29 Accordingly, when a week later the Procurement and Assignment Service asked The Surgeon General to close the recruiting boards in additional States which had reached or nearly reached their quotas, the Surgeon General's Office suggested other channels.30 On 21 October 1942, a War Department directive terminated the activities of the boards in all remaining States except California, Illinois, Pennsylvania, New York, and Massachusetts.31 Early in 1943,

27Memorandum, Chief, Procurement Division, Officer Procurement Service, for Chief, Field Operations Branch, Officer Procurement Service, 1 Dec. 1942, subject: Appointment of Doctors of Dentistry, Veterinary Medicine, and Medicine.
28(1) General Report, Second Service Command, 1943, p. 26. (2) Proceedings, Directing Board, Procurement and Assignment Service, 24 July 1942. (This order closed boards in the following States: Delaware, West Virginia, Virginia, North Carolina, Georgia, Mississippi, Alabama, Oklahoma, Indiana, North Dakota, South Dakota, Idaho, Montana, Wyoming, Nevada, and New Mexico.)
29(1) Conference of Commanding Generals, Services of Supply, Fourth Session, 30 July-1 August 1942, 31 July 1942. (2) See footnote 23 (1), p. 177.
30Proceedings of the Directing Board, Procurement and Assignment Service, 19-20 Sept. 1942. 
31War Department Memorandum No. S605-14-42, 21 Oct. 1942.


180

the Officer Procurement Service was authorized to recruit doctors and dentists, but responsibility for processing applications and recommending their approval still rested with The Surgeon General.

Direct commissions

During the life of the recruiting boards, doctors and dentists were permitted to apply for commissions directly to The Surgeon General or to the Procurement and Assignment Service, which would send the papers to The Surgeon General. In these cases, The Surgeon General did the work of getting all necessary information from the applicant and evaluating it; if acceptable, The Surgeon General recommended a grade and assignment and, if physically qualified, requested The Adjutant General to commission the applicant in that grade and to issue orders placing him on duty at the station specified. In all instances, whether the applications were received directly or from the boards, The Surgeon General classified the applicants as to specialty, made an assignment, and requested The Adjutant General to issue orders placing them on duty.32

Indeed, The Surgeon General often went further than merely processing papers of those who applied for commissions, actively seeking out and persuading candidates. Among those brought into the Medical Department in this way were a number of returned medical missionaries, whose intimate knowledge of climate, sanitary conditions, and endemic diseases in strategic areas, such as Okinawa, later proved of inestimable value. Many of these men went into preventive medicine; others devoted themselves to medical intelligence work.33

In late 1942, the Secretary of War, concerned about the method of appointing noncombat officers in the Army, had had a study made of the subject and created the Secretary of War's Personnel Board. (This group succeeded one known as the War Department Personnel Board.) The new board reviewed all applications for appointment in the Army of the United States from civilian life (or from the Army Specialist Corps) before appointments could be made; it performed a final review before recommending a commission.34

Increase in procurement in 1942

The success of the Medical Officer Recruiting Boards and of the Surgeon General's Office in getting doctors on duty is indicated by the growth of the Medical and Dental Corps during the time that the boards were in operation (table 1). The increase during the first month or so of their operation, significant though it is, cannot be compared with the numbers the boards brought

32Report, Albert W. Gendebien, Military Personnel Division, Office of The Surgeon General, of Survey of Non-Technical Segments of the Surgeon General's Office, 24 Sept.-10 Oct. 1942. This survey was made for the benefit of the Committee to Study the Medical Department.
33
Statements of Durward G. Hall, M.D., and Maj. Gen. George F. Lull, USA (Ret.), to the editor, 27 May 1961.
34
Memorandum, Deputy Chief of Staff, for Commanding General, Services of Supply, 31 Oct. 1942, subject: Procurement of Officers for Army of the United States From Civilian Life.


181

on duty later, after they had become accustomed to their work and were bringing the Army's need for doctors forcibly to the attention of increasing numbers. So far as the Air Forces was concerned, its most fruitful period for the procurement of doctors was during the 5 months from 1 July to 1 December 1942, when 4,576 entered the service; in the following 13 months to January 1944, only 1,102 came in.35

During that portion of 1942 in which the Medical Officer Recruiting Boards functioned, the strength of the Medical Corps of the Army of the United States increased by 24,252; during 1943, after these boards had been abolished, the increase was only 4,734. This comparison illustrates, however, not only the success of the boards as compared with that of the Officer Procurement Service that followed them, but likewise the increasing scarcity of physicians whom the Procurement and Assignment Service was willing to declare available in 1943, and the fact that the proportion of doctors whom this Service declared available but who did not apply for military duty increased as the scarcity became greater in civilian life.

The Officer Procurement Service

Procedures

The Officer Procurement Service, established on 7 November 1942 under the Commanding General, Services of Supply, dealt directly with the Army Air Forces, Army Ground Forces, and the chiefs of supply and administrative services.36 It undertook to obtain not only doctors and dentists, as the Medical Officer Recruiting Boards had done, but also members for other Medical Department officer components. The Service continued the practice, initiated shortly before the Medical Officer Recruiting Boards were closed, of sending each application to the Secretary of War's Personnel Board for approval before a commission was granted; it never had the power to tender commissions directly to applicants as had the boards.

The Officer Procurement Service began its work for the Medical Department on 15 January 1943. The program for the procurement of doctors, dentists, and veterinarians constituted one of its major activities in 1943 and 1944.37 In early 1943, the Service had district offices in 38 large cities throughout the country. In practice, it was a country-wide recruiting office, with its activities at first limited to procuring officers, although later in the war it also lent its efforts to procuring certain types of enlisted personnel as well.

35See footnote 17, p. 176.
36War Department Circular No. 367, 1942. (The Officer Procurement Service did not handle the appointment of graduating aviation cadets, officer candidates, or members of the Reserve Officers' Training Corps.)
37Memorandum, Central Office, Procurement and Assignment Service, for Col. Robert Cutler, Officer Procurement Service, Services of Supply, through Lt. Col. D. G. Hall, Personnel Division, Office of The Surgeon General, 16 Jan. 1943, subject: Correction Paragraph 6 in Covering Letter From Officer Procurement Service to Officer Procurement District.


182

The method of procuring physicians under the Officer Procurement Service appears to have been cumbersome and time consuming. The Office of The Surgeon General pointed out somewhat later that, although the Officer Procurement Service had been very cooperative, its functioning had of necessity lengthened the time required to appoint physicians and dentists from civilian life. Only the Procurement Service could solicit a doctor, dentist, or veterinarian, but before doing so it had to receive an application from him by way of the Procurement and Assignment Service, which had previously notified him of his "availability," ascertained his preference for the Army or Navy, and checked his professional qualifications and ethics with the Surgeon General's Office. The Officer Procurement Service interviewed him to gain information as to his character, reputation, and other qualifications for commission as an officer. If these were found satisfactory, it helped him to fill out a proper application for a commission. Since the Surgeon General's Office had already cleared him as to professional standing and ethics, that Office did not believe the interview by the Procurement Service was necessary. It considered this step a burden on the individual in time and expense, especially in the Middle West, where the offices of the Procurement Service were too widely dispersed, and in the densely populated Eastern States, where they were too few in number.38 The Surgeon General recommended to G-1 that if by the end of March 1943 procurement of doctors and dentists had not reached a satisfactory rate, the Officer Procurement Service be divested of that function and the Medical Officer Recruiting Boards be set up again in those States which had not furnished their quotas.39 G-1 did not permit him to restore the boards. The Officer Procurement Service had two advantages over its predecessor-it saved the time of a small number of Medical Corps officers who had been in recruiting duties in the field; it also procured Medical Department officers other than doctors and dentists and recruited enlisted women as well. But it did not succeed in speeding the procurement of medical officers.

Procurement lag in 1943

Information from the Officer Procurement Service showed that in the period from 15 January to 11 February 1943, 24 of its district offices had received the names of 868 doctors cleared by the State Chairman of the Procurement and Assignment Service. Of these, the Officer Procurement Service had had to abandon action on 302 (34.6 percent) because of their refusal to complete the papers or for "other reasons." The names of 103 had been sent to The Surgeon General as ready for his approval. Almost 400 cases (45.6 percent) were

38(1) Memorandum, Office of The Surgeon General (Lt. Col. Durward G. Hall), for Officers on Duty in the Office of The Surgeon General, 27 Jan. 1943. (2) Letter, Office of The Surgeon General, to G-1, through Director, Military Personnel, Services of Supply, 16 Feb. 1943, subject: Procurement of Physicians and Dentists. (3) War Department Circular No. 367, 1942. (4) Field Transmittal-24, Officer Procurement Service, to Officer Procurement Districts, 27 Jan. 1943, subject: Revision of FT-15 (1-13-43): Processing Doctors, Dentists, and Veterinarians.
39See footnote 38(2).


183

in process, awaiting completion.40 Meanwhile, figures issued by the Procurement and Assignment Service for 31 January 1943 indicated that already a few States had reached their second quota, but these were States whose quota was very small. The States with large quotas for 1943 were ranging between only 70 and 83 percent of them.41

During April, when the total Army strength increased by more than 200,000, the number of doctors on duty not only did not keep pace with this increase, but actually declined (table 1). Some doctors were procured during this month, but a larger number evidently left the service. During the month, The Surgeon General advised the Procurement and Assignment Service that the monthly allotment should be revised upward in order to take care of losses.42

In July, The Surgeon General reported that between 15 January and 2 July 1943 the Procurement and Assignment Service had declared 6,357 doctors available. Of that number, the cases of 2,632 (41.4 percent) had already been closed because physicians refused to be processed or because they had moved from a State, had already been appointed, were already in process of being appointed, or for like reason. Of the remaining 58.6 percent, experience showed that slightly over half would be tendered commissions, the others being found unsatisfactory for physical or other reasons. In other words, the yield would be about 30 percent of the 6,357, or about 1,900. According to The Surgeon General, the trend was for a lower yield from the doctors declared available.43

Meanwhile, The Surgeon General, employing other means to get more doctors on duty, had, at the suggestion of the Secretary of War, instituted a program of reexamining doctors and dentists previously rejected on physical grounds, using the lower standards that had been promulgated since their first examination. These standards included more waivers for physical defects. Under this "reconsideration program," he reexamined over 14,000 doctors and dentists rejected before April 1942 on physical grounds. The result was that under this program, extended into 1944, 700 doctors were found acceptable and were tendered commissions.44 The program encountered complications. After failing their original physical examination, men had been declared essential to civilian care by the Procurement and Assignment Service; some had

40Memorandum, Field Operations Branch, Officer Procurement Service (Maj. Edward W. Gamble, Executive Officer), for The Surgeon General, 20 Feb. 1943, subject: Report of Referrals of Doctors, Dentists * * *.
41Memorandum, Procurement and Assignment Service (Maj. Harold C. Lueth, MC, Consultant), for State and Corps Area Chairmen for Physicians, 1 Mar. 1943, subject: Percentage of Second Quota for Physicians Attained.
42
Memorandum, The Surgeon General's Office, for Procurement and Assignment Service, 17 Apr. 1943.
43
Memorandum, Office of The Surgeon General (Lt. Col. D. G. Hall), for Special Assistant to Secretary of War, 8 July 1943.
44(1) Annual Report, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1943-44. (2) Letter, Surgeon General Kirk, to Dr. Guy Caldwell, Secretary-Treasurer, American Board of Orthopedic Surgery, 3 Feb. 1944.


184

made arrangements in civilian practice that rendered it difficult for them to accept military duty; and others simply refused to apply for a commission.45

Early in 1943, several individuals, including the Chairman of the Directing Board of the Procurement and Assignment Service, and the Chairman of the War Manpower Commission, expressed the belief to The Surgeon General and the Secretary of War that granting doctors an initial rank higher than that of first lieutenant would speed procurement. The two latter officials demurred against holding out such an enticement, on the ground that records indicated that physicians who refused an appointment as first lieutenant in the Medical Corps because of the grade alone constituted a small proportion of the total number declared available by the Procurement and Assignment Service. Neither would such action be fair to others who, with no less civilian experience, had entered the Army at lower rank. Further, it would stagnate advancement for doctors already in the Army. The proposal was renewed at the end of 1943, but was again rejected for much the same reasons.46

The Reynolds Plan

As the Procurement and Assignment Service could not induce a high percentage of available physicians to accept commissions, in May 1943 General Magee recommended a special draft of doctors under the Selective Service Act.47 However, The Surgeon General and the Procurement and Assignment Service soon afterward made an agreement which was designed to accelerate the procurement of doctors and which continued voluntary recruiting.48 Since G-1 preferred this plan, the idea of a draft was not followed up for the time being. The agreement, later known as the Reynolds Plan, after the Director of the Military Personnel Division, Army Service Forces, who proposed it, was concluded on 22 May 1943.

Under this agreement, the Procurement and Assignment Service promised to take the following action: (1) Declare available at once the entire list of doctors already placed in that category; (2) permit representatives of the Officer Procurement Service to try to "persuade" the persons so designated to volunteer in the 20 States and the District of Columbia whose quotas had not been filled; (3) report all eligible doctors refusing commissions to their draft boards for reclassification (thus presumably placing them in the group under selective service which was available for immediate induction into the Armed Forces as enlisted men); (4) establish at once quotas

45Letter, New York State Procurement and Assignment Service, to Comdr. M. E. Laphman, Procurement and Assignment Service, 29 Mar. 1943.
46(1) Letter, Secretary of War, to Paul V. McNutt, Chairman, War Manpower Commission, 8 May 1943. (2) Proceedings, Joint Session With Representatives of the Several Federal Services and Directing Board, Procurement and Assignment Service, 20 Mar. 1943. (3) Letter, Dr. Frank Lahey, War Manpower Commission, to Commanding General, Army Service Forces, 23 Dec. 1943. (4) Transmittal Sheet, Brig. Gen. R. B. Reynolds, Director, Military Personnel Division, Army Service Forces, to The Surgeon General, 28 Dec. 1943, with endorsement thereto, 5 Jan. 1944.
47Letter, Surgeon General Magee, to G-1, through Director, Military Personnel Division, Army Service Forces, 13 May 1943, subject: Procurement of Physicians and Dentists.
48Disposition Form, G-1, to Military Personnel Division, Army Service Forces, 24 May 1943.


185

by States or "other areas" to be furnished the Army during 1943; the quota being arrived at as follows: subtract the total number on duty on 31 May 1943 from 48,000 (the current ceiling strength for doctors in the Army) and consider the remainder as the total number of doctors to be procured, which would be divided into "area quotas." The Army, for its part, agreed (1) to clear each doctor with the Procurement and Assignment Service before commissioning him, and not even to approach any doctor, such as a senior professor in a medical school or certain types of specialists in civilian hospitals, whom the Procurement and Assignment Service had declared irreplaceable; and, further, (2) to reconsider the physical qualifications for appointment as officers. The parties also approved of publicity to stress the medical needs of the American soldier and sailor.49

A month after this agreement was reached, it was abrogated by the Procurement and Assignment Service but subsequently (in July 1943) revived to permit the Army-and the Navy, if it so desired-to solicit physicians for appointment in Illinois and Massachusetts. The abandonment, or curtailment, of the plan helped to clear the way for the improvement in favor of a special draft of doctors.50 However, one point about the plan is worth noting. The reference in the agreement to "State or other area" meant that instead of keeping the 1:1,500 physician-civilian ratio on a statewide basis, the Procurement and Assignment Service would have permitted the Army to procure doctors in certain well-stocked metropolitan areas, even though the statewide ratio might stand at no more than 1 physician per 1,500 civilians. It can be seen that by this concession the Procurement and Assignment Service recognized the irrationality of setting and attempting to maintain any statewide ratio when doctors were concentrated in the cities where the ratio would be much higher than 1 to every 1,500 of population. It also was a clear admission that the Procurement and Assignment Service lacked power to "relocate" doctors from areas of plenty to those of scarcity. The Service in fact frankly admitted that it had no such power of compulsion and, lacking that power, it must have seemed useless both to the Service and to the representatives of The Surgeon General to insist on statewide ratios of 1:1,500.

Procurement of doctors subsequent to the partially abortive plan of May 1943 showed no marked increase. During the following 7 months, June through December 1943, 3,801 doctors accepted commissions; and this figure must have included 1,000 or more interns and residents who came on active duty in July, after completing their training.

Thus, in 1943, procurement of doctors fell far short of the goal set by The Surgeon General. The Procurement and Assignment Service designation of "essential" placed on doctors narrowed the field of possible recruits,

49Proceedings, Directing Board, Procurement and Assignment Service, 8 June 1943.
50(1) Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Chief, Personnel Service, Office of The Surgeon General, 24 June 1943. (2) Memorandum, Director, Military Personnel Division, Army Service Forces, for Deputy Director, Military Personnel Division, Army Service Forces, 13 July 1943.


186

and of those available, there were many who refused to accept a commission. It would appear that conscription of medical and allied personnel on a national basis would have obviated many of these problems.

A Special Draft of Doctors Proposed

The failure of doctors to volunteer for Army service in the numbers which The Surgeon General considered necessary led him to recommend stronger means of compulsion. Under the existing draft law, very few doctors were being brought into military service by that method-only 217 during the period from November 1940 to September 1942. Even these included a number of persons whom The Surgeon General would not have recommended for Medical Corps commissions-unethical practitioners, graduates of unapproved schools (drafted before The Surgeon General laid down the terms on which he would accept them as Medical Corps officers), doctors who had not been engaged in practice, and others. During the same period, more dentists (346) and almost as many veterinarians (211) were drafted, although both were much less numerous in civilian life than physicians.51

Probably the main reason why few doctors came into the Army by way of the ordinary draft was that local selective service boards were opposed to depriving their communities of the services of medical men. To induce the boards to act, the Procurement and Assignment Service in June 1943 agreed to report to their local draft boards all doctors whom the Service had declared "available" but who had refused to volunteer for the Army. This plan was soon very much curtailed, but in any event, it would have left the final decision in the hands of the local draft boards.

The Surgeon General proposed stronger methods-a "special call" on the draft boards requiring them to induct physicians. In order to gain his end, several authorities had to be persuaded of the necessity and legality of the step: The Chairman of the War Manpower Commission, who beginning in December 1942 controlled the Selective Service System, his adviser and subordinate in medical personnel matters, the Procurement and Assignment Service; and The Surgeon General's own superiors in the War Department. In the end, the decision was made at a White House conference.

A special draft of doctors had been proposed in the Surgeon General's Office as early as 5 November 1942. Nothing was done at that time, and on 16 February 1943, The Surgeon General recommended planning for it as an eventual step if the procurement of doctors did not move faster. Three months later (13 May), he counseled the draft, of both doctors and dentists

51(1) For a period of 9 months beginning in September 1941 (the month in which the War Department ordered that appointments in the Officers' Reserve Corps cease to be made and that all future appointments must be made in the Army of the United States), there appears to have been no recognized way of commissioning drafted veterinarians. In July 1942, however, The Surgeon General succeeded in obtaining a quota of 250 from the General Staff for this purpose. In Medical Department, United States Army. Veterinary Service in World War II. Washington: U.S. Government Printing Office, 1961. (2) Selective Service in Wartime, Second Report of the Director of Selective Service, 1941-42. Washington, 1943.


187

under 45 years of age as an immediate necessity.52 On 22 June, staff representatives agreed to the measure in principle and decided that the Secretary of War should be asked to present a proposal to the President. Later, G-1 suggested bringing the Navy into the negotiation, a step which was subsequently taken.53

In the following months, further discussion within the War Department took place, having to do with the number of doctors needed and the legality of the proposed draft. No occupational group had previously been singled out for induction in quite the way that was now suggested. However, War Department authorities decided that this could legally be done within the terms of the Selective Service Act, and on 18 October 1943, a letter signed by the Secretaries of War and the Navy was sent to the Chairman of the War Manpower Commission formally requesting a special call on Selective Service for doctors.

Meanwhile, the Procurement and Assignment Service and the War Manpower Commission had been informed that the Army intended to make such a request. There was some reason to believe that these agencies would support it. In October 1940, at the time that the Procurement and Assignment Service was being initiated, the future Chairman of its Directing Board, Dr. Frank H. Lahey, had stated, in effect, that a draft of doctors would be necessary if they failed to volunteer. Moreover, the future Director of the War Manpower Commission, Paul V. McNutt, in recommending the establishment of a Procurement and Assignment Agency, had proposed that it frame legislation to draft medical, dental, and veterinary personnel for submission to Congress if the emergency seemed to require it.

In July 1943, while the War Department had its own proposal under consideration, Dr. Lahey expressed the belief that the only way the Procurement and Assignment Service could obtain more doctors for the armed services was through some means of coercion.54 On the same day, Mr. McNutt stated that stronger measures would be taken through Selective Service to bring doctors into the military forces. After October 1943, he said, every physician under 45 years of age who was reported to the Selective Service System as having refused to accept a commission after he had been declared available for military service by the Procurement and Assignment Service would be called for induction by his local board. At the same time, a system of appeals against the board's decision enabled the individual to carry his case as high as the National Headquarters of the Selective Service System, a procedure which might still have enabled a good many doctors to avoid military service.55

52(1) See footnote 47, p. 184. (2) Memorandum, Commanding General, Army Service Forces, for Chief of Staff, 11 Sept. 1943, subject: Special Call on Selective Service for Physicians.
53(1) See footnote 50 (1), p. 185. (2) Memorandum, G-1, for Director, Military Personnel Division, Army Service Forces, 11 July 1943.
54Proceedings, Directing Board, Procurement and Assignment Service, 31 July 1943.
55(1) Memorandum, Chief, Procurement Division, Officer Procurement Service, for Director, Officer Procurement Service, 2 Aug. 1943, subject: Procurement of Physicians. (2) Letter, Col. Richard H. Eanes, USA (Ret.), to Col. C. H. Goddard, Office of The Surgeon General, 5 Sept. 1952.


188

Two months later, 8 September 1943, The Surgeon General made an approach to the problem slightly different from the one he had previously advocated. After agreeing on the terms of this new proposal with officials of the Selective Service System, who considered a special draft of physicians "impracticable," he presented it in the form of a request to G-1 through Army Service Forces headquarters. Instead of a special call on Selective Service for doctors, he asked that:

* * * in the next call placed by the War Department with the National Selective Service System for the delivery of registrants to the Army for purposes of induction, 7,000 such registrants between the ages of eighteen and forty-four years, inclusive, be included in said "regular call" who have the following qualifications: a. Are graduates of a school of medicine approved by The Surgeon General of the Army. b. Are physically qualified in accordance with [Mobilization Regulations]. c. Have completed one year of internship or its equivalent, as determined by The Surgeon General of the Army, after graduation from medical school.56

This move seems to have brought no results, and The Surgeon General returned to his original line of action. On 2 October, he and a representative of the Navy met with members of the Directing Board of the Procurement and Assignment Service, a spokesman for the Selective Service System, and others. The Procurement and Assignment Service felt that it should not initiate a special call for doctors, but it would be "glad to endorse and implement" one if the conditions of the call met with its approval. One indispensable condition, from the viewpoint of the Procurement and Assignment Service, was that only doctors declared available by it should be drafted. The Surgeon General was quite willing to accept this as a condition. Selective Service announced that physicians in the 18 to 45 age group could be drafted in given numbers with given qualifications if the War Department's request was approved by the Director of the War Manpower Commission.57

On 16 October 1943, 2 days before the Secretaries of War and the Navy made their formal request, at a meeting of the Directing Board of the Procurement and Assignment Service, an assistant to the War Manpower Commission's Director reported that both Mr. McNutt and the head of Selective Service thought that there was no present need for a special draft-that "the Army is not that short of doctors." The Acting Chairman of the Directing Board pointed out that he had given only a qualified support to the plan. "I also told General Kirk [The Surgeon General of the Army]," he added, "that it was the feeling of the Board, for all practical purposes, that the military services have obtained just about as many doctors as they are going to get under

56(1) Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Director, Military Personnel Division, Army Service Forces, 8 Sept. 1943, subject: Inclusion of Physicians and Surgeons in Regular Selective Service Call for Inductees. (2) Memorandum, The Surgeon General, for Assistant Chief of Staff, G-1, through Director, Military Personnel Division, Army Service Forces, 8 Sept. 1943.
57(1) Minutes of Session, by Executive Officer, Directing Board, Procurement and Assignment Service, 2 Oct. 1943. (2) Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for G. H. Dorr, Special Assistant to the Secretary of War, 6 Oct. 1943. (3) Proceedings of Directing Board, Procurement and Assignment Service, 16 Oct. 1943. (4) Memorandum, The Surgeon General, for G. H. Dorr, Special Assistant to the Secretary of War, 30 Nov. 1943.


189

the present legal setup. There may be 2,000 or 3,000 more, plus the increment from [medical school] classes."58

The Secretaries' letter to Mr. McNutt stated that "despite the greatest effort" on the part of their departments "in cooperation with agencies under your leadership, including successive reductions in ratios of medical officers to personnel it has been found impossible to induce a sufficient number of qualified physicians to accept appointment as medical officers voluntarily." The shortage was "so critical as to endanger the health of our forces." The procurement measure remained "which the services feel must now be utilized in order to meet requirements. We are attaching hereto requests for a special call on the Selective Service System for 12,000 physicians (Army, 5,000 * * * Navy, 7,000)."59

The verbal reaction of Mr. McNutt was hardly propitious; he told G-1 that the Army and Navy "would get such a special call only over his dead body."60 The Secretaries' letter, transmitted to the Procurement and Assignment Service, drew the charge from that agency that the terms of the proposed special call violated the understanding between the Armed Forces and itself in two ways: It was not limited to men marked available by the Service, and the total number of doctors asked for exceeded that "calculated in previous negotiations with the military forces to allow a safe reserve for the care of the civil population." Accordingly, the Procurement and Assignment Service authorized a letter to Mr. McNutt stating that it would approve a draft only if one could be legally formulated which would meet the original conditions; it believed that "at present not more than 7,000 additional withdrawals from the civilian medical profession would be wise." While the Procurement and Assignment Service thought that the draft "may prove to be the only method of securing any considerable number of additional medical officers," it should first "be determined that the actual need of the armed services, not merely an assumed or traditional need, is great enough to justify" such a "serious change of policy."61

On 23 November 1943, following a White House conference attended by the Surgeons General of the Army and Navy, Assistant Secretary of War John J. McCloy, and Mr. McNutt, Mr. McNutt formally replied to the Secretary of War.62 In this reply, Mr. McNutt stated that a special draft of doctors would be approved if it was possible to formulate one with the restrictions that he and the Procurement and Assignment Service deemed essential. But they must first assure themselves by "a thorough study of the present needs of the military services and constant reevaluation of the manner in which physicians are employed" that such a call was necessary. He added that the Navy seemed

58See footnote 57(3), p. 188.
59Proceedings of Directing Board, Procurement and Assignment Service, 6 Nov. 1943.
60Memorandum Routing Slip, 26 Oct. 1943, attached to draft of proposed letter, The Surgeon General, to Chairman, Directing Board, Procurement and Assignment Service.
61Proceedings of Directing Board, Procurement and Assignment Service, 6 and 20 Nov. 1943.
62Letter, Paul V. McNutt, Federal Security Administrator, to Secretary of War, 23 Nov. 1943.


190

to be in more urgent need of doctors than the Army and should therefore have prior claim on the remaining doctors in civilian life "up to at least 3,000 or 3,500." This did not mean that "a number of physicians will not be added to the Army Medical Corps as a result of the recruiting campaign now under way and planned." While he would not object to a draft in the last resort,

* * * a survey of the legal situation * * * appears to make it exceedingly doubtful whether the draft of doctors could be as selective as would be necessary to preserve the balance of distribution worked out by the Procurement and Assignment Service * * *. I believe you will agree that it is in the public interest to accomplish our objective or come close to it without resorting to a special call. It has been decided, therefore, that final action on the special call will be postponed until after the first of the year [1944] at which time the matter will be reviewed again by our respective staffs and appropriate recommendations made to the President.

In commenting on this letter, The Surgeon General felt that one reason for Mr. McNutt's rejection of the special call was that the Secretaries had failed to include in their request the proviso that only doctors declared available by the Procurement and Assignment Service should be drafted. He had advised including it, but it "was omitted * * * I understand, for the reason that, as Mr. McNutt controlled both Procurement and Assignment Service and Selective Service, he could take appropriate steps to see that the proper action was taken to make this plan effective." As to the magnitude of the numbers requested, he stated that although the Navy had asked for 7,000, when the White House conference was called the Surgeon General of the Navy had said that he could get along with half that number; he himself, on the other hand, having already cut down his estimate to 5,000, which he considered a minimum, felt and still felt that no further reduction should be made. He rejected Mr. McNutt's implication that the requirements of the Army were overstated and insisted that "the War Department and the War Department alone should * * *determine the need for Medical Corps officers * * *. This office has certain views relative to the needs of the civil population, but has accepted the arbitrary figure adopted by the Procurement and Assignment Service which is based on their opinion solely.''63

Although there were further discussions of a draft of doctors during 1944, The Surgeon General's efforts in that direction during the remainder of the war came to nothing.

Procurement in 1944

Recruiting attempts

The number of doctors brought into active duty from civilian practice became very small during the 12 months preceding November 1944, when the War Department ordered procurement from that source stopped. Beginning in the fall of 1943, teams composed of representatives of the Surgeon General's Office, the Procurement and Assignment Service (national and State), the Navy, and the U.S. Public Health Service visited many large cities in an effort

63See footnote 57(4), p. 188.


191

to procure additional civilian doctors. These visits were predicated on the belief that a personal appeal would get many who had been declared available to volunteer. A team first informed representatives of local and State medical associations and leaders in the medical profession of the need for doctors, then held a public meeting of doctors who had been certified as available. Interviews with these doctors followed the meeting. During the interviews, the members of the teams were able to clear up many of the problems that had been troubling these doctors, and according to The Surgeon General's representative, the conferences resulted in "a considerable number" of applications for active duty with the Army.

Probably, for several reasons, the success of these teams did not match that of the Medical Officer Recruiting Boards of 1942. They functioned only in large cities, where, to be sure, the proportion of doctors to civilian population was highest. But more important was the fact that by this time, and owing in no small part to the activities of the Boards in 1942, the surplus of doctors above civilian needs had been drained off. Probably, too, those left in civilian practice were more confident than ever that draft boards, feeling pressure from fellow citizens, would not induct them.

Supplementing and abetting the work of these traveling teams, other means, such as publicity by press and radio, were used to impress upon doctors the Army's need for their services. The Surgeon General complained in December 1943 that most of such publicity up to that time had stressed the need of retaining sufficient physicians in civilian and industrial practice. He suggested that an organized program pointed directly at doctors and involving the use of posters, pamphlets, radio announcements and programs, magazine articles, and other available means should be employed to stress military needs. Such a campaign was launched in early 1944, aimed at procuring nurses as well as doctors.64

Complaints of doctors' idleness in Army service continued to be made, and in February 1944, the Surgeon General's Office took cognizance of their bad effect on those still in civilian life whom it was endeavoring to persuade to accept commissions. An officer in The Surgeon General's Military Personnel Division admitted to a superior that "in many instances officers and Commanding Officers themselves, apparently, have too much free time, which is a fact that is generally known in the civilian profession." In these circumstances, The Surgeon General decided to draw to such an extent on service command installations for Medical Corps officers in order to fill table-of-organization units that those remaining in those installations would "be completely and economically utilized even though on an overtime basis * * *."65

64(1) Letter, Deputy Surgeon General, to Appointment and Induction Branch, Office of The Adjutant General, 3 Dec. 1943, subject: Recruiting Publicity Program. (2) Memorandum, Lt. Col. D. G. Hall, Military Personnel Division, Office of The Surgeon General, for The Surgeon General, 2 Jan. 1944, subject: Procurement and Assignment Meeting With Surgeons General.
65(1) Memorandum, Lt. Col. D. G. Hall, Military Personnel Division, Office of The Surgeon General, for The Surgeon General, through Chief, Personnel Service, Office of The Surgeon General, and Director, Training Division, Office of The Surgeon General, 7 Feb. 1944. (2) Routing Slip, Lt. Col. Hall, to Col. J. R. Hudnall, Col. F. B. Wakeman, and others, 7 Feb. 1944.


192

The 9-9-9 plan

As already noted, service in the Army for students graduating from medical school had been deferred for at least the 1-year internship. At the end of that year, some received a further deferment of service for a junior residency and following that a senior residency. There was no assurance beforehand, however, that such deferments for residencies would be given, with the result that civilian hospitals, to fill their vacancies for residents, could depend definitely only on an inadequate number of women and of men who were physically disqualified for military service. A change in the system of internships and residencies, requested in the summer of 1943 by the civilian hospitals, concurred in by the medical schools and the Procurement and Assignment Service, and implemented by the Armed Forces, altered this situation to the advantage of the hospitals and at the same time speeded the production of interns and residents for the benefit of the Army. The new system provided that, beginning on 1 January 1944, internships and each class of residency should run for only 9 months apiece. This program applied to all personnel, both civilian and military. Furthermore, one-third of the interns holding military commissions were to be deferred for a junior residency and one-half of the latter number (one-sixth of the total) could be deferred for a senior residency. Thus, the Army got each intern who was not deferred for additional training 3 months earlier than previously; the greatest possible postgraduate deferment for military personnel became 27 months instead of the previous 36. It developed specialists not only for the armed services, but for the civilian population as well. Likewise, civilian hospitals received a guarantee of getting some number of both junior and senior residents. Those not under military control-physically disqualified male and all female doctors-although having a 9-month limitation for each of the three periods, might be continued on the staff of a civilian hospital as long as the hospital desired them.

When the Directing Board proposed this thing, which came to be known as the "9-9-9 plan," The Surgeon General stated that although he would accept it and take officers into the Medical Corps who had only a 9-month internship, he would not assume any responsibility for the plan or for persuading civilian hospitals to accept it. He made one proviso-that civilian hospitals should seek to fill the internships and residencies only with women and overage, or physically disqualified, men.66

A professional organization-the Association of American Medical Colleges-and individuals, too, criticized the plan, asserting that in shortening the internship it lowered the standards of medical education. The Council on Education and Hospitals of the American Medical Association, replying that while everyone interested in high standards of medical education and medical service shared the concern felt by critics of the plan, approved it as the best

66Annual Report, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1944.


193

one under conditions then existing.67 The Surgeon General for his part directed (December 1943) that the 9-month interns who entered the Army be given not only 6 weeks of basic military training (either at the Medical Field Service School or a replacement training center), but an additional 6 weeks at a named general hospital. Nor were they to be sent overseas without having served a minimum of 60 days after completing their basic military training.68

After the 9-9-9 program had been underway for a year, the American Surgical Association in a long appeal to the President requested him to direct that the military service of resident surgeons in teaching hospitals throughout the United States be deferred. The Surgeon General stood out against this step, arguing that an exception could hardly be made in favor of one group when medical training generally was being curtailed. If the service of surgical residents was deferred, he foresaw "immediate requests for deferment of residents in all other specialties."69 The matter was dropped without action. 

Procurement of doctors from all sources during 1944 was only a little larger than it had been in 1943-6,897 as against 6,678. An additional 916 doctors came in from January to June 1945. Almost all of them were recent graduates; after November 1944, appointment of practicing physicians virtually ceased.

Training Medical Specialists

Throughout the war, the Army found it more difficult to procure qualified specialists than general practitioners. Therefore, in order to combat the procurement lag, the Army commissioned general practitioners and then trained them, either at military installations or in civilian schools, in the various specialties. While approximately 8,000 doctors completed some specialty training during the war, there is no record of how many of those 8,000 were actually classified as specialists at the end of the war or ever served in a specialist capacity.

Pressure From Civilian Sources

While military procurement was not entirely to blame for the decline of civilian medical service (other factors were the removal of doctors from rural to urban, and more lucrative areas and the rapid growth of war-boom towns), it was certainly an important cause and one of growing concern to the civilian population. The Surgeon General, therefore, encountered attempts to prevent or offset the effects of procurement of civilian physicians for the Army.

67(1) Letter, Chairman, Executive Council, Association of American Medical Colleges, to The Surgeon General, 29 Oct. 1943. (2) Letter to the Editor, the Journal of American Medical Association, 1 Jan. 1944, with reply of Council on Education and Hospitals.
68Report, The Surgeon General's Conference With Service Command Surgeons, 10 Dec. 1943.
69(1) Letter, W. M. Firor, Secretary, American Surgical Association, to President Roosevelt, 19 Feb. 1945. (2) Memorandum, Deputy Surgeon General, for William D. Hassett, Secretary to the President, 5 Mar. 1945.


194

As early as December 1942, a subcommittee of the Senate Committee on Education and Labor conducted hearings on the procurement objectives of the Army and the adequacy and distribution of doctors remaining in civilian life.70 The subcommittee does not seem to have issued a final report. However, even before it had heard testimony from representatives of the Surgeon General's Office, the Procurement and Assignment Service, or any other members of the medical profession, it released (29 October 1942) a preliminary report on the recruitment of physicians for the armed services. That report shows clearly that the subcommittee, after almost a year of war, was alarmed at a maldistribution of doctors in civilian life-some communities having none at all or far too few-and was concerned by the heavy procurement of doctors for the armed services.

The report stated that it was submitted at that time "because of the need of speedy action to prevent an immediate peril to the health of the Nation." Conditions were so acute and dangerous, it continued, that this preliminary report was made public with the recommendation that at the earliest possible moment the following steps should be taken: (1) The President should order a survey of oversupply and undersupply of medical personnel for both the Armed Forces and civilian needs; (2) a reallocation should be made wherever it was determined an oversupply or undersupply existed; and (3) the War Manpower Commission should be ordered to cease its procurement drive for doctors in all States where quotas had already been attained. The report further suggested that "an overall civilian authority should be established at once to supervise and control the drafting and recruiting of doctors," and declared that "no recruiting of doctors for the armed forces should be permitted until this authority was actually functioning." There is no indication that any action was taken on this report.

In late 1943, a member of Congress proposed to the Secretary of War that Army doctors be furloughed to civilian life until "a more pressing need for their services arose [in the Army]." About the same time, the dean of a medical school requested the discharge of a doctor to replace a retiring professor. The Surgeon General turned down both requests off the ground of the Army's acute need for doctors.71

Eventually, however, the pressure of members of Congress on the War Department to do something to prevent further draining off of doctors from civilian practice became so intense that in October 1944 The Surgeon General asked that the General Staff stop procurement in all but cases involving individuals commissioned for specific vacancies. The request was complied with.72

70Hearings before a Subcommittee of the Committee on Education and Labor, U.S. Senate, 77th Cong., 2d sess., on S. Res. 291, Investigation of Manpower Resources (Washington, 1943), Part 2, 14, 15, and 16 Dec. 1942.
71(1) Letter, Representative A. Willis Robertson (Va.), to John J. McCloy, Assistant Secretary of War, 23 Nov. 1943. (2) Letter, Lt. Col. P. A. Paden, Military Personnel Division, Office of The Surgeon General, to A. Willis Robertson, 1 Dec. 1943. (3) Letter, Surgeon General Kirk, to Dr. William Pepper, Dean, University of Pennsylvania School of Medicine, 4 Dec. 1943.
72(1) Memorandum, Executive Officer, Office of The Surgeon General, for Commanding General, Army Service Forces, 14 Oct. 1944. (2) Memorandum, The Surgeon General, for General Somervell, 14 Nov. 1944.


195

The discontinuance was not to affect interns who completed the Army Specialized Training Program or residents. Since neither group had been engaged in civilian practice, they could be commissioned and placed on active duty without further adversely affecting the existing medical provision for civilians. Naturally, those male medical students who had accepted Medical Administrative Corps commissions pending completion of their medical training were not affected; they were considered military personnel, not civilians, and would be commissioned in the Medical Corps upon finishing their training. The Surgeon General also requested that he be permitted to continue to commission individuals for specific vacancies; what he had in mind was probably highly trained specialists for the most part.

In these ways, the Army was continuing to draw into its service many physicians who had just completed their education and who might otherwise have entered civilian practice. But it could no longer be charged with denuding the civilian community by taking large numbers of physicians who were already practicing civilian medicine.

DENTAL CORPS

The procurement of dentists did not become a serious problem until virtually the end of the war.73 When, in July 1942, The Surgeon General received authorization for 4,000 more dentists, he anticipated some difficulty in procuring them and therefore obtained permission from The Adjutant General to make appointments from groups not previously considered eligible; that is, dentists who were between 37 and 45 years of age, or who were qualified only for limited service, or whose training and experience justified an appointment above the rank of lieutenant. Procurement under this quota was so successful, however, that between September and November 1942 applications were discouraged. In November, The Surgeon General obtained an additional quota of 7,500 to bring the total strength of the Dental Corps to 17,248. The Procurement and Assignment Service shortly afterward agreed to declare 400 civilian dentists a month available for military service; the remainder were expected to come from the output of the Army Specialized Training Program, from recent graduates holding interim Medical Administrative Corps commissions, and from dentists inducted into the service as enlisted men.

The procurement program lagged somewhat in early 1943, but the response improved by May of that year, and by September the Dental Corps was only 1,700 below the ceiling of 15,200 imposed upon it at that time. The procurement agencies were notified not to accept applications from dentists over 38 years of age or from those fit only for limited service. Early in 1944, the Dental Corps was within a few hundred of its ceiling strength, and a surplus appeared likely as a result of the coming influx of graduates from the Army Specialized Training Program.

73See footnote 22(1), p. 177.


196

There were several possible methods of dealing with the anticipated surplus-the ceiling on the strength of the Dental Corps could be raised, some dentists already in the service could be discharged and replaced by others who were graduating under Army control, or the Army could give up its claim to some of the graduates. The last method would involve reducing the Army's commitments under the Army Specialized Training Program, since graduates of the Program constituted the principal source of supply. To all intents, the first of these alternatives was not resorted to; the peak strength of the Dental Corps, reached in November 1944, exceeded the ceiling by only about 100. Instead, the Army discharged some of its dentists to make way for new men; it also reduced its commitments under the Army Specialized Training Program. With regard to this latter action, the 900 members of the class of June 1944 were released from their obligations to the Army and-what was more important-the Program for dental students who would graduate after July 1945 was discontinued.

During 1944, out of about 1,400 dentists procured, some 70 percent came from the Army Specialized Training Program; 23 percent directly from the civilian profession; and the remainder-aside from a handful inducted under Selective Service-from graduates who had held temporary Medical Administrative Corps commissions.

Early in 1945, although the Dental Corps was near its maximum authorized strength (15,200), prospective replacements from the curtailed Army Specialized Training Program and from future graduates holding interim Medical Administrative Corps commissions numbered less than 300. Procurement during January-June was almost precisely the same. After V-E Day, The Surgeon General suggested certain measures to encourage procurement and advised that the Dental Corps be maintained at 15,000 until the end of 1945. The measures were not expected to produce any large increment of dentists and, even though adopted, the strength of the Corps declined rapidly to about 9,600 by the end of the year.

At least as late as October 1945, no serious difficulty in meeting the dental needs of the Army during demobilization seems to have been anticipated, although the possibility that demobilization might cause a temporary increase in the demand for dental treatment had been mentioned 4 months before. Full-scale demobilization brought the problem to a climax, however, and in 1946, a draft of dentists became a necessity.

VETERINARY CORPS

Up to the beginning of 1945, the Veterinary Corps was on the whole in a better position with regard to procurement than any other corps of the Medical Department, mainly because it entered the war with a Reserve unusually large in comparison to its needs. Until well into 1942, it drew almost exclusively on the Reserve for additional active-duty strength. In fact, at


197

one time, the Veterinary Corps had placed more of its Reserves on active duty than it actually needed.

The possible sources of procurement for the Veterinary Corps were veterinarians still in civilian practice, veterinarians who had been drafted as enlisted men, and graduates of veterinary schools who held student commissions in the Medical Administrative Corps or who had obtained their education under the Army Specialized Training Program.

In October 1943, G-1, War Department General Staff, restricted procurement of veterinary officers to the latter group, except in special cases which were to be referred to G-1 for decision. Later, however, permission was granted to commission veterinarians who had entered the Army by way of the draft.74

As late as March 1944, The Surgeon General's Chief of the Veterinary Service stated that the commissioning of graduates of the Army Specialized Training Program and those holding temporary Medical Administrative Corps commissions was more than sufficient to meet the needs of the Veterinary Corps, and that graduates in these categories for whom no vacancies existed were being discharged from the Army.75 In May 1944, the veterinary phase of the Army Specialized Training Program was ordered discontinued after the graduation of the current senior class and the completion of current terms for other classes.76

In January 1945, the newly established ceiling strength of 2,150 was only 100 above existing strength, but very few additional officers could be obtained from the permitted sources.77 Consequently, the strength of the corps never rose above 2,070 during the remainder of the war. The previous practice of discharging graduates of the Army Specialized Training Program and those holding temporary Medical Administrative Corps commissions when no vacancies existed for them at the time of graduation eventually made it difficult to find new officers. It also, in the opinion of Col. George L. Caldwell, VC, (fig. 32), assistant chief of The Surgeon General's Veterinary Division, caused much dissatisfaction among Reserve officers who had entered the service early in the war and were compelled to remain in it till the end of hostilities: "They felt, and quite properly, that these men who were partly educated at Army expense should repay their government with active duty service and by so doing permit the release of * * * officers with long service."78

74(1) Letter, The Adjutant General, to The Surgeon General, 26 Oct. 1943, subject: Requirements for Veterinarians. (2) Annual Report, Veterinary Division, Office of The Surgeon General, U.S. Army, 1944.
75Letter, Maj. Gen. G. F. Lull, to Hon. George H. Mahon, House of Representatives, 23 Mar. 1944.
76Army Service Forces Circular 164, 13 May 1944.
77Semiannual Report, Procurement Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1. Jan.-31 May 1945.
78History of Procurement of Veterinary Corps Officers. [Official record.] For further details concerning procurement for the Veterinary Corps, see publication cited in footnote 51(1), p. 186.


198

FIGURE 32.-Col. George L. Caldwell, VC, Assistant Chief, Veterinary Division, Office of The Surgeon General.

The following numbers of veterinarians accepted Army commissions during the war years:

September-December 1943

87

January-June 1944

47

July-December 1944

26

January-June 1945

33


Of this total, 174 were described as coming from "enlisted" ranks and 14 from "civil life and other"; 3 were reported as flight officers, and 2 as members of the Officers Reserve Corps. Some few among the 174 were veterinarians who were commissioned after having been drafted; the rest were graduates of the Army Specialized Training Program.

DEFERMENT OF PROFESSIONAL STUDENTS

Early Methods

The outbreak of war, with the consequent acceleration of the draft, increased the pressure to grant students in all 4 years of dental and veterinary as well as medical schools some type of status that would not only permit them


199

to become practitioners in their chosen field but assure their service in that capacity in the Armed Forces. About a month after Pearl Harbor, the National Director of Selective Service, in an effort to protect the country's supply of doctors and dentists, advised his State directors of "the necessity of seriously considering for deferment" students in specialized professional fields, stating that the number of doctors and dentists needed by the Army and Navy would not be available "if those students who show reasonable promise * * * are inducted prior to becoming eligible for commissions."79 This put a further damper on drafting students in the medical schools for service as enlisted men but left where it was the problem of eventually getting them into service as officers. For the time being, the only solution was to offer more categories of students a military status while permitting them to continue at school.

Medical Administrative Corps commissions

After some discussion, the Secretary of War approved the plan of The Surgeon General, and on 11 February 1942, corps area commanders received authority to commission as second lieutenants in the Medical Administrative Corps, Army of the United States, all physically qualified male citizens who had been accepted for matriculation at approved medical schools within the United States.80 This was later changed to "within or without the United States," thus including American students in approved Canadian schools. Officers so appointed would not be ordered to active duty until eligible for appointment as first lieutenants in the Medical Corps, which meant after they had completed their internship. The authority also stated the circumstances under which an officer's commission would be terminated, which were essentially those already in operation for third- and fourth-year students.

There remained, however, the problem of protecting the future supply of dentists and veterinarians. On 17 April 1942, the War Department granted authority to corps area commanders to appoint as second lieutenants in the Medical Administrative Corps, Army of the United States, all physically qualified male citizens who were accepted matriculants in approved dental and veterinary schools in the United States. The terms were similar to those previously announced for commissioning medical students.81

As with individuals accepted for medical schools although not entered, those accepted as dental and veterinary students were likewise to be commissioned. Students in dentistry and veterinary medicine, however, received only 3 months' instead of a year's grace after graduation in which to apply for

79Memorandum I-347, National Headquarters, Selective Service System, for all State Directors, 12 Jan. 1942, subject: Supplement to Memorandum 1-62: Occupational Deferment of Doctors, Internes, Medical Students, Dental Students, and Instructors (III).
80(1) Memorandum, The Surgeon General, for Special Assistant to the Secretary of War, 23 Jan. 1942. (2) Letter, The Adjutant General, to all Corps Area Commanders and The Surgeon General, 11 Feb. 1942, subject: Commissions for Medical Students.
81(1) Letter, Secretary of War, to Paul V. McNutt, Office of Defense Health and Welfare Service, 14 Apr. 1942. (2) Letter, The Adjutant General, to Corps Area Commanders, 17 Apr. 1942, subject: Commissions for Dental and Veterinary Students.


200

commissions in the professional corps. A month later, male citizens above the age of 18 years who were students at approved dental and veterinary schools outside the United States were included, and although the directive specified that all such students be physically qualified, it also stated that appointment would be made without physical examination.82 It seems inconceivable that the Army would commission anyone clearly unfit; it must have planned, however, to accept the student's word that he had no hidden disabilities. The deans of the schools and the corps area commanders played important roles in the processes by which these commissions were issued.

The measures to protect medical, dental, and veterinary students raised certain problems. The provision that a student's commission in the Medical Administrative Corps would be terminated if he failed to secure an appointment in the Medical, Dental, or Veterinary Corps within a specified time after graduation made it possible for him to obtain his release from the Army simply by taking no action to convert his commission. The Surgeon General, in fact, recommended the discharge of certain dental students on these grounds. In 1943, however, the War Department prohibited such discharges and directed that students who failed to convert their commissions should be called to active duty in the Medical Administrative Corps.83 Since professional men were not apt to prefer service in that corps, it is improbable that many delayed converting their commissions after the order was published.

Another problem, as the Chief of The Surgeon General's Veterinary Division saw it, was that the Veterinary Corps would not be able to absorb all veterinary students graduating with Medical Administrative Corps commissions, since he believed that the Veterinary Corps Reserve contained enough officers to meet war needs. If on the other hand it should absorb them, he feared that the civilian supply would be entirely cut off. Accordingly, The Surgeon General persuaded the War Department to direct that no more graduates be selected for veterinary and dental commissions than these corps actually required.84 Why the Dental Corps was included is not apparent.

Not all newly eligible students accepted Medical Administrative Corps commissions, even though physically qualified, probably for much the same reasons that had deterred many third- and fourth-year medical students. Other arrangements were made for students then enrolled in Reserve Officers' Training Corps units in branches other than medical who intended to enter medical schools. No mention seems to have been made of dental or veterinary schools. If time permitted them to fulfill requirements for a commission, before they entered medical school, they were to be commissioned in the branch in which they had been trained. But even if commissioned in another branch, they were

82Letter, The Adjutant General, to all Corps Area and Department Commanders and The Surgeon General, 18 May 1942, subject: Commissions for Dental and Veterinary Students.
83(1) Memorandum, The Surgeon General, for The Adjutant General, 4 Aug. 1943, subject: Discharge of Medical Administrative Officers. (2) Letter, The Adjutant General, to all Services (and others), 15 Mar. 1943, subject: Authority to Order to Active Duty.
84(1) Memorandum, Brig. Gen. R. A. Kelser. Army Veterinary Service, for Chief, Personnel Division, Office of The Surgeon General, 3 Apr. 1942. (2) See footnote 82.


201

not be called to active duty until they had completed their medical education. If they could not complete the requirements for a commission before entering medical school, they were permitted to withdraw from their advanced Reserve Officers' Training Corps contracts with the Government. Medical units of the Reserve Officers' Training Corps were suspended in 1943 for the remainder of the war.85

Students who accepted interim commissions received no financial benefit from the Army. In July 1942, however, Congress appropriated $5 million to be loaned to students whose education in technical and professional fields, including medicine, dentistry, and veterinary medicine, could be completed within 2 years.86

Enlisted Reserve Corps

The Army and Selective Service insured the scholastic careers not only of full-fledged students and matriculants in medicine, dentistry, and veterinary medicine but of students who were in the preliminary stages of their training. Besides granting interim Medical Administrative Corps commissions, the Army permitted a number of premedical, predental, and preveterinary students to enter the Enlisted Reserve Corps and retain an inactive status in it while they continued their schooling. When, in September 1942, the Army announced that members of the Enlisted Reserve Corps would be called to active duty immediately upon reaching draft age (20 years, reduced 2 months later to 18), it exempted such of these students as had acceptances from professional schools for the 1943 and 1944 entering classes. Moreover, in March 1943, the Selective Service System granted deferment of service to premedical, predental, and preveterinary students who held acceptances from professional schools and who would finish their preprofessional training in 24 months.

The Army Specialized Training Program

The Army Specialized Training Program and the Navy College Training Program (V-12) were established in December 1942 under the auspices of the appropriate departments. The Army Specialized Training Program applied not only to students of medicine, dentistry, and veterinary medicine, but to all students of specialized or professional subjects who might constitute officer material for the Army at large. Enlisted men selected for the program were placed in training units at numerous colleges and universities throughout the country, where they began (or continued, if already students) the regular course of instruction.87

85(1) Letter, The Adjutant General, to all Corps Area and Department Commanders, 12 May 1942, subject: Commissions for Medical Students. (2) Information obtained from Albert McIntyre, Reserve Officers' Training Corps Unit, Officer Procurement Branch, Personnel Division, Office of The Adjutant General, October 1953.
8656 Stat. 562.
87
This section is based, almost in its entirety, on Final Report, Col. Francis M. Fitts, MC, Chief, Curricular Branch, Army Specialized Training Division, Army Service Forces, subject: Training in Medicine, Dentistry, and Veterinary Medicine, and in Preparation Therefor, Under the Army Specialized Training Program, 1 May 1943 to 31 December 1945.


202

FIGURE 33.-Col. Francis M. Fitts, MC, Director of Military Training Army Service Forces.

To enter the Army Specialized Training Program, medical students who were members of the Medical Administrative Corps might resign their commissions and enlist in the Enlisted Reserve Corps, after which they, together with other medical students who were already members of the Enlisted Reserve Corps, were called to active duty with the program without interrupting their studies. The medical aspects of the program were handled in the Office of the Director of Military Training, Army Service Forces, by Col. Francis M. Fitts, MC (fig. 33).

Members of the program had the status and perquisites of privates, or privates first class, in the Army. The Army likewise defrayed all their expenses, including food, clothing, lodging, and the cost of schooling. For medical students, school costs, such as tuition, books, and laboratory fees, amounted to $62.47 per man per month; for dental students, $61.10; and for veterinary students, $45.50.

Upon graduation, students in these fields were to be commissioned in the Army of the United States. Graduation from other fields, such as sanitary engineering, gave students no similar assurance of a commission. It did not preclude them from receiving one, either directly (as may have happened in some cases) or after successfully completing a course at an officer candidate


203

school. But the mere fact of graduation did not necessarily enhance their opportunities in these respects, and the understanding was that unless such opportunities occurred they would continue to serve in an enlisted status.

Dental trainees were commissioned in the Dental Corps and called to active duty as soon as they graduated. Since the demand for Veterinary Corps officers was less acute, students newly commissioned in that corps were called up as the situation required. Medical trainees, commissioned upon graduation, were not called to active duty until they had completed a minimum of 9 months' civilian hospital intern training. In order to meet the needs of civilian hospitals, and so that the military service might profit by the additional postgraduate training, a small fraction was not called to duty until after 9 months' additional experience; an even smaller fraction until after total of 27 months' graduate training as residents.

At the time the program was set up, The Surgeon General estimated that the existing body of professional and preprofessional students as they were graduated would meet his needs until 1947; that is, 4 years longer. If the war lasted so long, new students brought in by the program would from then on furnish most if not all of the supply. To obtain the proper quota of graduates after 1947, a large number of new students would have to be placed in the pipeline of the program considerably before that date. The Surgeon General's Office decided that enough veterinary students had already been blanketed into the program so that no additional ones were needed. To meet the requirements for doctors and dentists after 1947, students were to be selected from among those who had successfully completed two or three terms of the "Basic Curricula" of the program-the introductory course which all new students had to enter.

By the end of 1943, the Army Specialized Training Program and its Navy counterpart had absorbed most of the male students of medicine, dentistry, and veterinary medicine who were in the professional and preprofessional stages of their training and who were physically qualified for military service. In addition, they were beginning to take, in students of these subjects who were just entering upon their academic careers; like the others, they were committed to enter medical service of the Armed Forces upon completion of their studies.

Curtailment of the program

When the War and Navy Departments had first announced the program a much longer war had seemed inevitable. By late 1943, moreover, the men enrolled were urgently needed for combat duty. The Army Ground Forces had never expressed enthusiasm for the program, and by then, the Army Air Forces wanted to use those of their men who were assigned to the program. In March 1944, the War Department announced that the entire program would be cut back from 145,000 men to 35,000.

A month later, Army Service Forces headquarters announced that the Army's share of the classes entering medical schools during 1945 would be 28


204

percent instead of the previously planned 55 percent, and for dental schools 18 percent instead of 35 percent; no commitments would be made at that time to cover classes to start in 1946.88

Meanwhile, the question of reducing the dental Army Specialized Training Program was becoming involved with that of discharging dentists already in the service.89 In March 1944, the Dental Corps reached its ceiling strength and had in immediate prospect more than enough graduates of the program to meet its needs in the way of replacements at the existing rate of attrition. On 18 July, the War Department announced the termination of the dental Army Specialized Training Program. Only those who were seniors in July continued under the program, and the dental Army Specialized Training Program came to an end with the classes graduating in April 1945.

In May 1944, the veterinary phase of the Army Specialized Training Program had been marked for closure with the approval of The Surgeon General. Apparently, his Veterinary Division considered this program no longer necessary since the Veterinary Corps was near its authorized strength and little difficulty was to be anticipated in inducing veterinarians in civil life to join the corps-a source of procurement which, in fact, the Director of the Division seems to have preferred.

The future of the medical phase of the Army Specialized Training Program was a matter of more concern to the Surgeon General's Office. The collapse of Japan brought discussion of whether the Army should continue to spend money to help meet civilian needs for doctors by maintaining the medical part of the program. Some War Department authorities feared the Army might be criticized for the lack of medical training during the war period if it did not continue such training, while others believed that the Army should limit its medical training to meet its own future needs.90 General Somervell, believing that the Army could not justify large expenditures in continuing the Army Specialized Training Program as then contemplated, recommended, among other things, that medical courses be terminated during the school year 1945-46.91 The Surgeon General for his part stated that his policy had been, and would be for the duration of the emergency, to order to active duty young medical officers who had received their education at Government expense. They were being used as replacements, he said, to accelerate the return of those older medical officers who had served for long periods of time.92

Two months after the defeat of Japan, the Deputy Surgeon General recommended to G-3 that the program be continued as a source of replacements. He

88Memorandum, Brig. Gen. W. L. Weible, G-3, for The Surgeon General, 18 Apr. 1944, subject: War Department Policy Governing Training in Medicine and Dentistry Under Army Specialized Training Program.
89A complete discussion of this phase of the Army Specialized Training Program is contained in the publication cited in footnote 22(1), p. 177.
90Letter, Maj. Gen. I. H. Edwards, G-3, to Prof. Philip Lawrence Harrison, Bucknell University, 23 Aug. 1945.
91Memorandum, Lt. Gen. Brehon Somervell, Commanding General, Army Service Forces, for Chief of Staff, 4 Sept. 1945, subject: Future of Army Specialized Training Program.
92Letter, Surgeon General Kirk, to Hon. Mendel Rivers, U.S. Congressman from North Carolina, 16 Oct. 1945.


205

said he could not view lightly the potential loss of 5,000 medical officers if the program terminated in June 1946, as had been suggested. He mentioned the difficulties experienced in the past in getting volunteers for the Regular Army Medical Corps.

The Chief of Staff, however, recommended that the medical program be terminated on 1 July 1946; men who had not graduated by that date should be dropped as soon as possible, but in accordance with a plan that would allow time for students and schools to make adjustments.93 This policy was announced in November 1945. In the same month, the War Department ordered that Army Specialized Training Program students who were scheduled to graduate before 1 July 1946 should not be separated for either of two reasons applicable to other persons-their adjusted service rating score or the possession of three or more dependent children under 18 years of age. They might, however, be discharged for certain reasons that also applied to others-hardship (as in the case of enlisted personnel generally) or their importance to the national health, safety, or interest. Moreover, a claim based on the possession of dependents-though not the standard one just mentioned-might be considered sufficient to warrant their discharge.94 The Army wanted all others of this group to graduate as doctors available for service in the Medical Corps, a desire expressed by the Secretary of War not long before. On the other hand, medical students who were scheduled to graduate after 1 July 1946 were directed to be separated from the program during March 1946. Enlisted men so separated who planned to continue their study of medicine and who were acceptable to an approved medical school were, upon their request, transferred to an inactive status in the Enlisted Reserve Corps. They were subject to recall to active duty if they quit school or made unsatisfactory progress in their studies. Those who did not plan to continue the study of medicine or who were unacceptable to an approved school were discharged if eligible or transferred to other duties upon separation from the program. The latter group of students could be discharged from the Army when they became eligible.95

Thus, the medical phase of the Army Specialized Training Program ended a year later than that of the veterinary or dental phases, enabling proportionately more medical graduates to become available for commissions and permitting the Medical Corps to solve its postwar personnel problem with less strain than the Dental Corps experienced. Assignment was not, however, automatic. Immediately after the war, the Navy Surgeon General, who was also the President's personal physician, persuaded the Commander in Chief to divert a thousand of these fledgling doctors, just through with their internships, to the Navy.

93Memorandum, Chief of Staff, for Secretary of War, 20 Nov. 1945, subject: Medical Training Under Army Specialized Training Program.
94Disposition Form, Maj. Gen. W. S. Paul, G-1, to Commanding General, Army Service Forces, through Deputy Chief of Staff, 29 Nov. 1945, subject: Policy Regarding Separation of Army Specialized Training Program Medical Students.
95(1) Army Service Forces Circular 7, 9 Jan. 1946. (2) Army Service Forces Circular 56, 6 Mar. 1946.


206

TABLE 17.-The Army Specialized Training Program: Students of medicine, dentistry, and veterinary medicine assigned, separated, and discharged and transferred through curtailment of the program 

[Figures in parentheses are subtotals]

Student status

Medicine 

Dentistry

Veterinary medicine

Assigned

20,336

7,734

1,660

Separated

15,216

3,031

679

By graduation

(13,373)

(2,458)

(598)

By failure

(1,045)

(472)

(41)

For other reasons

(798)

(101)

(40)

Curtailment

5,120

4,703

981

Discharged

(5,120)

(4,651)

(940)

Transferred

---

(52)

(41)


Source: (1) Final Report, Col. Francis M. Fitts, MC, Chief, Curricular Branch, Army Specialized Training Division, Army Service Forces, subject: Training in Medicine, Dentistry, and Veterinary Medicine, and in Preparation therefor, Under the Army Specialized Training Program, 1 May 1943 to 31 December 1945. (2) Letter, Col. Francis M. Fitts, MC, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 15 Nov. 1955.

One of those so transferred turned out to be the son of an Army dentist who promptly explained to The Surgeon General in two pages of well-chosen words that he had not raised his boy to be a sailor.96 The total enrollment in and output of professional courses in medicine, dentistry, and veterinary medicine as a result of the Army Specialized Training Program are shown in table 17.

The maximum enrollment of members of the program in these courses was reached in March 1944, when 21,581 enlisted men were under instruction: 14,042 in medicine, 6,143 in dentistry, and 1,396 in veterinary medicine. The number of students receiving preprofessional training in the same fields under the program attained its peak in April 1944 with 4,093 enlisted men enrolled.97 Satisfactory figures for the total number of Army Specialized Training Program students enrolled in preprofessional courses during the life of the program are not available, but approximately 3,500 were assigned to premedical, about 1,400 to predental, and an unknown number to preveterinary studies.98

THE AFFILIATED UNITS AFTER PEARL HARBOR

The affiliated units constituted one of the most important sources of officer personnel available to the Medical Department. Many of the physicians who entered the Army by this route were ones who would not have

96The incident is recalled in a letter, Maj. Gen. George F. Lull, USA (Ret.), to Col. John Boyd Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 31 May 1961.
97(1) See "Final Report" cited in footnote 87, p. 201. (2) Memorandum, G-1 (Brig. Gen. M. G. White), for Combined Chiefs of Staff, 30 June 1943, subject: Training of Female Students Under Government Program.
98(1) See "Final Report" cited in footnote 87, p. 201. (2) Letter, Col. Francis M. Fitts, MC, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 21 Nov. 1955.


207

volunteered as individuals, but were willing to accept military service as part of a familiar organization. The role was rendered more attractive by the deferment it carried until the unit was actually called up. Only the officers, however, were procured in peacetime. Nurses and other female elements, and enlisted men, all were added when the affiliated hospitals became eligible for activation with the actual advent of war.

The Surgeon General directed that nurses for the staff must be obtained exclusively from the Red Cross Reserve, though at least one hospital enrolled nurses first and then persuaded them to join the Reserve. Nurses and enlisted technicians could be recruited by these hospitals before activation. The Surgeon General urged nurses so recruited to volunteer for active duty immediately, thus making their services available anywhere in the Army. He assured them that they would be returned to their unit when it was activated. In the case of technicians recruited before activation, the General Staff permitted the units to place them in the Enlisted Reserve Corps, and in this way to protect them from the draft, pending activation of the unit. If, however, activation did not take place within 6 months, these men would be called to active duty elsewhere. With this exception, the corps area commander procured enlisted men for the affiliated units through the regular channels. Women could join these units as dietitians, physical therapists, or dental hygienists. Female dental hygienists could join them in civilian status, as could the dietitians and physical therapists before they attained military status.

Problems Connected With Keeping the Units Intact

Although The Surgeon General and other Army authorities did not commit themselves to a policy of untouchability where affiliated units were concerned, such a policy was nevertheless implied. In practice, the right of these units-or at least their commanding officers-to be consulted before removing any of the officers was recognized, and in general there were few changes in organization as long as the units remained in the United States. Keeping their intact had unduly divergent results. On the one hand, the members, particularly the officers, felt a certain esprit de corps, drawn as they were from a single institution. On the other hand, restriction of personnel to a single unit limited promotion and could have affected morale, for once the organization was completed there were no opportunities for advancement except when vacancies resulting from attrition within the unit occurred. One method of circumventing this problem was to initially give the officers a grade lower than the highest permitted by their tables of organization, thereby enabling promotions to be given later.

Restrictions on the transfer of personnel also had an adverse effect on medical service generally, if it prevented a man from being placed where he was most needed. Affiliated units were generally well staffed with specialists-sometimes with several of equal professional standing in the same specialty-


208

who were in greater demand than were any other category of personnel. If a specialist was kept from being transferred to a unit where his talents could be best utilized, it was a distinct loss to the medical service and a waste of personnel.

It is true that by no means all these units were kept intact, especially after their movement overseas. The Chief Surgeon of the European theater has stated that he was able to persuade the members of affiliated units within his jurisdiction to place regard for the needs of the Army above loyalty to their units and that this enabled him to use the affiliated units partly as specialist pools from which to staff or strengthen other units less fortunately provided.99 In the South Pacific, affiliated units upon arrival were assured that they would remain intact, but that if they found themselves overstaffed they might apply to the surgical consultant or theater surgeon for transfer of the excess personnel to a unit where opportunities for promotion existed. This method proved very effective and was the only one used in that theater for removing a surplus of qualified personnel from the affiliated units.100

In several instances, The Surgeon General saw fit to cause changes in the category of certain affiliated general hospitals while they were still in this country. For example, shortly after Pearl Harbor, three medical schools responded to his request by forming a second unit to be affiliated with the school, at the same time reducing the bed capacity of the first from 1,000 to 500 beds. Moreover, in 1943, he recommended the disbandment of the 71st General Hospital, sponsored by the Mayo Clinic, while it was still in this country; the personnel that had been in that unit then formed two 500-bed station hospitals. In another case, the 30th General Hospital, activated in 1942 with only a 600-bed capacity, was increased to 1,000 after it reached the theater of operations.101 Nevertheless, the understanding that affiliated units should usually be kept intact seems to have prevented the best possible use of all their members, at least so long as they remained in the United States. Early in 1942, when a number of institutions were applying for permission to organize new affiliated units, The Surgeon General refused many more of these requests than he approved on the ground that he needed doctors as individuals, available for assignment when and where they were required, and that he did not believe that still more doctors should be immobilized in groups.102

This is not to say that the drawbacks connected with the use of affiliated units outweighed the advantages; it is likely that if the Army had not virtually promised to keep these units intact many highly competent professional men

99Interview, Medical Department historians, with Maj. Gen. Paul R. Hawley, 18 Apr. 1950.
100Letter, Brig. Gen. Earl Maxwell, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 22 Nov. 1955.
101(1) Letter, Surgeon General Magee, to Dr. Elliott C. Cutler, Harvard University Medical School, 9 Mar. 1942. (2) Annual Reports, 42d and 105th General Hospitals, 1942. (3) Memorandum, Office of The Surgeon General (Lt. Col. D. G. Hall), for Officer Procurement Service, Army Service Forces, 4 Sept. 1943. (4) Letter, Headquarters, 233d Station Hospital, Charleston, S.C., to The Surgeon General, 24 June 1943, subject: Inactivation of 71st General Hospital. (5) Annual Report, 30th General Hospital, 1943.
102Letter, Lt. Col. Francis M. Fitts, MC, Office of The Surgeon General, to David P. Stearns, Boston, Mass., 22 Mar. 1942.


209

would have refused to join them, and that the Army would therefore have been deprived of their services, at least for the time being.

Other Problems

The slow rate at which the affiliated units were activated and sent overseas by the War Department was believed to have had adverse effects on the procurement of doctors and nurses generally.103 Numerous units, organized either before or after hostilities began, continued for long periods on inactive status during the progress of the war. Even when activated, they frequently waited for many months before being sent overseas, while their personnel received necessary field training and supplemented the staffs of post, camp, and station hospital.104

Of some 70 affiliated hospital units activated during the war, only about 20 were sent overseas within 3 months. Of the remainder, about 20 stayed in this country for a year or more (2 for nearly 18 months), while the rest averaged about 8 months.105 Meanwhile, the War Department was urging more doctors to join the Army or, if already in the affiliated Reserve, to accept active duty. Some doctors in the inactive affiliated units refused to heed the call until their own units were brought into service, probably on the theory that if they were really needed the units themselves would be called to duty,106 and that units already activated would be put to full use. Other doctors were probably discouraged from entering the Army for much the same reasons; one of The Surgeon General's procurement officers stated that activation of the last affiliated units (in June 1943) would remove an obstacle to procurement.107

A problem of internal morale resulted from the length of time that elapsed between activation of some of the affiliated units and their departure for overseas. One of the original purposes of these units had been to provide the Army

103Major General Kirk, who became The Surgeon General when the last of these units were being activated, has stated his belief that the delay resulted from enemy submarine activity and from the fact that the troops whom these units were expected to serve did not expand in numbers or complete their training as rapidly as was anticipated. (Letter, Major General Kirk, to Col. J. B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12 Dec. 1955.) Colonel Paden has interpreted the delay in a slightly different fashion which may supplement that of General Kirk. In his opinion, sections of the War Department General Staff responsible for furnishing hospitals to particular theaters competed with one another for units and often caused affiliated hospitals to be activated before they were actually needed. (Letter, Colonel Paden, to Col. J. H. McNinch, Office of The Surgeon General, 17 Jan. 1950.)
104According to Lt. Col. Paul A. Paden, in his letter (17 Jan. 1950) to Colonel McNinch, "The Surgeon General's Office generally (as far as I know) and particularly the Personnel Service, did not know exactly when or where affiliated units were to be employed." He felt that The Surgeon General should have had this information. Troop movement bases "were available late in the war, but these were only very rough estimates, often reflecting the desires of General Staff Section, subject to frequent change, and late publication and distribution tended to nullify their value."
105Smith, 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, tables 6 and 7.
106Letter, Chairman, Ohio Procurement and Assignment Service Committee for Physicians, to Executive Officer, Procurement and Assignment Service, War Manpower Commission, 26 Mar. 1943, subject: Base Hospital Unit 25, Cincinnati, Ohio.
107Address by Chief, Procurement Branch, Military Personnel Division, Office of The Surgeon General, before District Officers, Officer Procurement Service, 17 June 1943.


210

with a group of medical units which would be ready to function in a theater of operations with a minimum of delay, and no doubt the members expected that their units would go into action promptly once they were activated. As might have been expected, idleness and delay in shipment caused dissatisfaction. One Medical Department authority reported that "we have had many letters about * * * people [in the affiliated units] twiddling their thumbs when we knew that they should have been under some kind of training program."108 

Unaffiliated Units

During the emergency period and also after Pearl Harbor, individual physicians or groups of physicians offered to organize hospitals for service with the Army. In 1941, The Surgeon General declined these offers on the ground that he was authorized to accept only groups which were sponsored by and associated with a medical school or hospital capable of furnishing an adequate staff; in other words, only officially affiliated units were acceptable.109 In 1942, however, the policy changed. The Surgeon General accepted a number of offers to form unaffiliated units and encouraged the sponsors to recruit staffs for them.110 In one instance, he suggested that if the inquirer could recruit a balanced staff of about 16 medical officers for a 250-bed station hospital they could be commissioned and assigned as a group to such a hospital. However, he could not guarantee that officers so assigned would be kept together, since other hospitals might have greater need for them.111

It is unlikely that more than a very few hospitals were organized in this manner. One exception was the 61st Station Hospital, formed by a group of physicians and nurses from Camden, N.J. At the intercession of the executive assistant to the Medical Society of New Jersey, Dr. Norman M. Scott, the group was accepted and assigned to the 500-bed 61st Station Hospital, constituting its entire professional complement. All the members were drawn from the staff of the Cooper Hospital, a civilian institution, which approved their enterprise, but the military hospital was never considered a formally affiliated unit. The hospital arrived in North Africa in December 1942, and the group remained intact, except for two or three members who were evacuated because of illness, until September 1945, when it was relieved from duty with the 61st Station Hospital for return to the United States from the Mediterranean theater. At the request of Dr. Scott, The Surgeon General awarded the unit the certificate of appreciation customarily granted to affiliated hospitals.112

108Report, The Surgeon General's Conference with Chiefs, Medical Branches, Service Commands, 14-17 June 1943.
109Letters, The Surgeon General, to Dr. L. A. Andrew, Jr., Winston-Salem, N.C., 1 July 1941; Hon. Charles O. Andrews, Washington, D.C., 29 Dec. 1941; and Mr. C. V. Morris, Snyder, Tex., 30 Dec. 1941.
110Letters, The Surgeon General, to Dr. C. F. Fisher, Clarksburg, W. Va., 18 Aug. 1942; Dr. Addison G. Brenizer, Charlotte, N.C., 28 Nov. 1942; and Dr. A. K. Lewis, Homestead, Pa., 2 Jan. 1943. 
111Letter, The Surgeon General, to Col. Charles P. Stahr, Lancaster General Hospital, Lancaster, Pa., 22 June 1942.
112(1) Letter, Dr. Norman M. Scott, to The Surgeon General, 8 Apr. 1946. (2) Letter, The Surgeon General, to Dr. Norman M. Scott, 24 Apr. 1946. (3) Letter, Mr. LeRoi N. Ayer, to The Surgeon General, 1 May 1946

RETURN TO TABLE OF CONTENTS