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Chapter IX

Contents

CHAPTER IX

Classification

OFFICERS AND NURSES, 1939-41

Proper classification, in the Army as elsewhere, is a major factor in proper utilization of available resources. This is particularly true where the resources concerned are highly trained individuals whose total number is strictly limited. It was clearly recognized by The Surgeon General that, while the Medical Department must be prepared at all times to carry out its military mission, the members of the various corps must also keep abreast of civilian professional developments. The emphasis shifted between military preparedness and professional accomplishment in terms of the current mission of the Army as a whole.

Background of the Classification System

During World War I, while the Medical Department utilized professional consultants, little if any official classification of its officers took place. Between the two World Wars, specialization developed greatly in many civilian occupations and professions. The years in the 1930's were especially important to the medical profession in the various fields of specialization. In 1935, the first American specialty board, the American Board of Ophthalmology, was organized, followed by many others in the next few years. The Surgeon General kept in close contact with civilian medicine, and a count of Regular Army medical officers qualified as specialists shows that their number in 1938, on an overall percentage basis, was not seriously at variance with that of the civilian specialists. The distribution did, however, reflect the difference in needs in the various categories between civilian and military medical practice. Of all the members of the Medical Corps, 6.71 percent were diplomates of specialty boards, as against 8 percent of all physicians in the country.1 Nevertheless, specialization in the peacetime Medical Department was restricted by the limited number of personnel available to perform all the necessary tasks, and by the constant awareness that in a national emergency involving a general mobilization the officers of the Regular Army would be the nucleus on which the enlarged forces would be built. The role of leadership that would under emergency or war conditions fall to the officers of the Regular Army Medical

1(1) Kubie, L. S.: The Role of the Specialist in Military Medicine. Surg. Gynec. & Obst. 80: 109-110, January 1945. (2) Kubie, L. S.: Problem of Specialization in Medical Services of Regular Army and Navy Prior to the Present Emergency. Bull. New York Acad. Med. 20: 495-511, September 1944. (3) Correspondence: Letter, Maj. Gen. George F. Lull, USA, Deputy Surgeon General, to Editor. Surg. Gynec. & Obst. 80: 448, April 1945.


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Department also required that these officers be thoroughly versed in military subjects, such as command, tactics, logistics, and medical administration.

Although the pressure to do so was not great, the Medical Department between World War I and 1939 made constant but ineffective efforts to classify its Reserve officers professionally. On the Army-wide level, the Mobilization Regulations of September 1939 required that assignments which individuals would occupy during mobilization should be designated beforehand, and could be based not only on the qualifications of the individual but also on the requirements of the situation. By that date, neither the Medical Department nor the War Department General Staff had worked out a comprehensive and detailed system of classifying officers.

Classification of Reserve Officers, 1940

In 1940, however, the War Department ordered a classification of Reserve officers. Under this plan, all Reserve officers of the Army were required to fill out information forms (W.D., A.G.O. Form No. 178), supplementary information being required from Reserve officers of the Medical Department. These forms were reviewed in corps area headquarters and in the Office of The Surgeon General.2

Establishment of position categories

The Surgeon General established a set of position categories for Medical Corps officers, necessarily the first element in a system of classification for any group. It distinguished various types of positions and also four degrees of proficiency within each. A symbol was provided for each type of position and capacity, and the appropriate symbol could be entered in the individual's records as a guide to assigning him. Thus "S-3" stood for a general surgeon in the third degree of capacity, fourth being the lowest; "S (Ortho)-1" stood for an orthopedic surgeon in the highest grade, and so forth, the degree originally based on civilian credentials, education, and length of experience in his field. After he had been tested by performance in the Army, his classification could be changed, if necessary,3 although this kind of change was made more commonly in the later war period than earlier.

Work of civilian agencies

Various agencies throughout the country assisted the Medical Department in classifying the Medical Reserve officers. Soon after this work was undertaken in 1940, the American Medical Association, through its Committee on Medical Preparedness, began its survey and classification of all physicians

2Annual Report of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1940.
3An officer's classification was different from his efficiency rating. The latter was a grade-"superior," "excellent," "satisfactory," "unsatisfactory"-assigned at intervals to an individual by his commanding officer and denoting his general value to the service


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throughout the United States. This project supplied much information on specialty training and type of practice to The Surgeon General.4 But final classification could not be made from this information alone. Committees of the National Research Council began cooperating on this project with the American Medical Association as early as July 1940. The general plan was for these committees to send lists of specialists to the American Medical Association, where its committee would record additional information obtained from its survey or from other sources. Some of the lists submitted by the National Research Council were graded to show a man's proficiency within his specialty. The National Research Council sent duplicates of some lists to The Surgeon General, thus aiding him directly to evaluate members of the Reserve and National Guard, then coming on active duty.5

The system developed by committees of the National Research Council, for designating the proficiency of men in a specialty-assigning them a number from 1 to 4-was the first one adopted by the Medical Department.6

The National Roster of Scientific and Specialized Personnel, established in June 1940, also rendered assistance. The primary function of this agency was "to provide for the most effective utilization of * * * scientifically and professionally trained citizens * * *."7 Because the American Medical Association was developing its own lists of physicians, the National Roster during the early part of its existence undertook to list only the smaller groups of specialists, such as bacteriologists, immunologists, pathologists, anatomists, physiological chemists, psychologists, physiologists, zoologists, and entomologists.8 Colleges of medicine and specialty boards also cooperated in this effort, contributing whatever information they possessed. Of course, those charged with classifying officers used, in addition to other information, directories of physicians, such as those of the American Medical Association, the American College of Physicians, the American College of Surgeons, and the directory of medical specialists certified by American specialty boards.9 In the early pleases of the work of classifying officers, The Adjutant General's Office gave little assistance, and the systems it devised seem to have been none too effective.10

4Letter, The Surgeon General, to Dr. R. G. Leland, Committee on Medical Preparedness, American Medical Association, Chicago, Ill., 22 Jan. 1941.
5(1) Minutes, Meeting of Subcommittee on Cardiovascular Diseases, 23 July 1940, Division of Medical Sciences, National Research Council. (2) Minutes, Eighth Meeting of Subcommittee on Venereal Diseases, 20 Sept. 1945, Division of Medical Sciences, National Research Council.
6(1) Farrell, Malcolm J., and Berlien, Ivan C.: Neuropsychiatry, Personnel. [Official record.] (2) Special Meeting of Personnel Group, 16 Dec. 1940, Division of Medical Sciences, National Research Council. (3) Minutes, Meeting of Subcommittee on Tuberculosis, 23 Dec. 1940, Division of Medical Sciences, National Research Council.
7Carmichael, L. : The National Roster of Scientific and Specialized Personnel. Scient. Month. 58: 141, February 1944.
8
(1) Mordecai, Alfred: A History of the Procurement and Assignment Service for Physicians, Dentists, Veterinarians, Sanitary Engineers, and Nurses-War Manpower Commission. (2) See footnote 6(2).
9Letter, Office of The Surgeon General (Col. C. C. Hillman), to Surgeon, each Corps Area, 10 Apr. 1941.
10Davenport, Roy K., and Kampshroer, Felix: Personnel Utilization: Selection, Classification, and Assignment of Military Personnel in the Army of the United States During World War II. [Manuscript.]


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The work of classifying Reserve Medical Corps officers had only been initiated when mobilization began, but was completed by Pearl Harbor. This classification constituted a long step forward in providing the Medical Department with knowledge of its qualitative resources in the Reserve sections.11 Being the first real attempt to classify Medical Department officers, it served as the basis of the more intensive procedures developed during the war. Had this classification been completed before mobilization began, the Medical Department would have been in a much more advantageous position to make studies and satisfactory assignments. It is true that formal classification as a guide to filling jobs was less necessary when the number of persons and the number of places for them were small, as had been true before the great expansion of the Medical Department began. Officers responsible for making job assignments could be personally familiar with the attainments of each member of the group and assign him accordingly. Many assignments even in the early war years continued to be made on the basis of this kind of personal knowledge. Formal classification could not, of course, eliminate all or perhaps even most of the work in making assignments, for no system of classification-at least none that was devised-could take account of all variations in jobs (even of the same category) or in the personal qualifications of individuals. Nevertheless, formal classification became practically indispensable at least as a preliminary sifting when large numbers of personnel had to be dealt with.

OFFICERS AND NURSES, 1941-43

Although The Surgeon General had established a system of position categories for Medical Corps officers during the emergency period, no system of categories covering all types of positions to which officers of the Army at large were assigned appeared until 1943. In that year, The Adjutant General published such a comprehensive series, which included medical categories developed and tested by the Military Personnel Division of the Surgeon General's Office. Those mainly responsible for it were Lt. Col. Gerald H. Teasley, MC, and 1st Lt. (later Lt. Col.) Robert W. W. Evans, MC. This classification system, which served throughout the war, was first presented in January 1943 as Army Regulations No. 605-95 (Tentative). Volume I of the regulations was entitled "Officer Civilian Classification," and volume II, "Officer Military Classification and Job Specifications." Volume II is the more important to this discussion. Some months after its publication, the Surgeon General's Office was called upon to furnish additional information. This was incorporated in War Department Technical Manual 12-406, "Officer Classification, Commissioned and Warrant," which appeared in October 1943 and superseded the tentative regulation. The latter listed a code number, an MOS (military occupational specialty), and a job specification for nearly 700 Army

11Letter, Lt. Col. Francis M. Fitts, MC, Military Personnel Division, Office of The Surgeon General, to Maj. Gen. C. R. Reynolds, formerly The Surgeon General, 25 June 1941.


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jobs. The job specifications consisted of a summary statement of duties, a list of typical tasks, special skill and knowledge requirements, military and civilian occupational experience prerequisites, educational prerequisites, and the civilian jobs whose occupants would be most likely to meet the requirements of the military.

Establishment of the Code Number System

The tentative regulations (and also its successor, the technical manual), in its listing of job categories for Medical Corps officers, followed that already in use in the Medical Department, except that it substituted numerical symbols for the symbols previously used and fitted them into a series of job categories for all officers of the Army. Each numerical symbol or code number consisted of four digits, the first digit (0 to 9), indicating a major grouping. The major grouping for most types of medical jobs was that relating to health, distinguished by the figure "3." The second digit represented a subgroup while the third and fourth digits stood for a specialty within that subgroup. Thus, an orthopedic surgeon, instead of having the symbol "S (Ortho)," now had the code number 3153. Moreover, in designating degrees of capacity or proficiency within each job category, the letter A, B, C, or D was used instead of 1, 2, 3, or 4, and "S (Ortho)-1" became A-3153. Dietitians and physical therapy aides were listed in the technical manual but not in the earlier regulations, which was issued only a month after they achieved military status.

In April 1943, it was proposed that after the following 5 May Army officers should be requested by code number, but as Medical Department personnel had not yet been coded, they were not included in the proposal.12 Apparently, The Surgeon General found the changeover to the numbered coding system quite time consuming, for not until 1944 did that system supplant the lettered code.

Since the categories listed in the regulations and the technical manual did not include every type of position separately, the more difficult aspect in the whole process of classifying officers was choosing men for an unlisted category. The classifier would then have to consult the whole record of each of a number of officers and decide which of them fitted the need. There could be no automatic or pushbutton system of classifying officers; individual judgment played an indispensable part in the process.

Role of the Surgeon General's Office

In the Medical Department, the Surgeon General's Office continued to do much of the work of classification, and as early as March 1942, there was a Classification Branch in that office. For a time, however, it appears to have lost its identity and to have been reestablished under that name in

12Report of conference called by Military Personnel, Army Service Forces, signed by Lt. Col. Gerald H. Teasley, MC, Military Personnel Division, Office of The Surgeon General, 23 Apr. 1943.


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March 1943. At the latter date, this branch not only classified officers of the Medical Corps but recommended their original assignments, searched for misassignments, and recommended changes. It kept a body of records containing an enormous amount of information on which to base its classifications and its recommendations for assignments-surveys of the ability and assignments as well as records of the special schools officers had attended and of their attainments in foreign languages.13 Classification of officers other than members of the Medical Corps-and little of this took place during the early war years-was done not in the Classification Branch but in other segments of The Surgeon General's Military Personnel Division.

Role of the Field Commands

Classification was performed not only in the Surgeon General's Office but, at least during 1942, in corps area (service command) and Army headquarters as well. Since many Medical Department officers reported directly to these headquarters from civilian life, which meant that they had received no classification of any kind, it was necessary to classify them on the basis of data given on questionnaires and whatever additional information could be obtained about them.14 Although such methods were necessary in order that the officers be given assignments, unfortunately they did not always tend to promote the kind of uniformity The Surgeon General desired.

After the consultant system was established in 1942, some of the tasks of these specialists concerned the proper classification and grading of personnel. As used by the Medical Department, the word "consultant" applied not merely to specialists who acted as advisers only, but to those who, as in this case, had administrative functions. In early 1942, The Surgeon General brought to his Office from civilian life a consultant in surgery and one in medicine and, later in that year, one in neuropsychiatry. As the Office organization grew in size and complexity, other specialists were assigned to handle subspecialties. In the summer of 1942, a beginning was made in supplying a consultant in each of the three aforementioned specialties to each service command. All these men assisted, through their knowledge of specialists in their fields and through their training and accomplishments, in the proper classification of medical specialists. Those in the Surgeon General's Office not only aided in initial grading but in reviewing and revising the classification of officers after they had had an opportunity to demonstrate proficiency in a specified field while on duty with the Army. Those in the service commands traveled to hospitals, induction stations, and other installations where, by interview and inspection of the specialist's work,

13Annual Report, Classification Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1944.
14(1) Annual Report, Surgeon, Third U.S. Army, 1942. (2) Committee to Study the Medical Department, 1942.


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they were able to make more accurate judgments of ability than those who had only the records.

Classification Within the Air Forces

The Army Air Forces used similar measures to assure that a physician was properly classified according to his qualifications. The Chief of the Medical Branch and the Chief of the Section on Professional Care of Air Forces hospitals testified before the Committee to Study the Medical Department of the Army that they not only classified officers initially but also made investigations at Air Forces hospitals and in a man's civilian locality. The former stated that he had "somebody traveling all the time checking this thing."

The sources of information made use of by Medical Department classifiers at this period were much the same as those that had been available to them since 1940-the forms filled out by individual officers and data furnished by the American Medical Association, the Division of Medical Sciences of the National Research Council, the Procurement and Assignment Service, and the American specialty boards. The source that yielded more data than any other was W.D., A.G.O. Form No. 178-2, "Classification Questionnaire of Medical Department Officers," published on 1 August 1943. This was a revision of W.D., A.G.O. Form No. 178, published in 1940 when the War Department had begun to classify Reserve officers.

In helping the Medical Department to classify medical specialists, particularly as to the proper proficiency groups, the American specialty boards performed very useful work. They sent to The Surgeon General (or to his liaison officer, located at the headquarters of the American Medical Association) the names of men who had recently passed their examinations and had been certified by the boards as competent specialists. Sometimes, they indicated the proficiency grade they believed fitting for these men, together with information on whether they were in service, whether they were Reserve officers not yet called to active duty, or, if not committed to Army service, whether they were willing or unwilling to accept military duty.15 Thus, they helped incidentally to procure officers as well as to classify them.

In early 1942, at the suggestion of The Surgeon General, the "Directory of Medical Specialists" established a "control file," which listed about 10,000 names of uncertified applicants to the American specialty boards, men who had done varying amounts of work toward board certification. (These names were in addition to the 18,000 physicians already certified by American specialty boards

15(1) Letter, Secretary-Treasurer, American Board of Otolaryngology, Omaha, Nebr., to The Surgeon General, 13 June 1942. (2) Letter, Secretary-Treasurer, American Board of Radiology, Rochester, Minn., to Col. G. F. Lull, MC, Office of The Surgeon General, 23 June 1942. (3) Memorandum, Surgeon General's Liaison Officer, American Medical Association, for The Surgeon General, 28 July 1942, subject: List of Recommendations of the American Gastro-Enterological Association. (4) Letter, American Proctologic Society, to The Surgeon General, 17 Dec. 1942.


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who were listed in the "Directory of Medical Specialists.") The names in the central file were listed as "cleared" and "not cleared." The "cleared" group consisted of men whose training and other qualifications met board standards and requirements for admission to their examinations, but who had not yet gained certification. The "not cleared" group consisted of men who had done work in a specialty but who had not yet been accepted for examination, those who had had failures requiring complete reapplication for the examination, and those whose certification had been revoked. A set of name cards from this file was made available to The Surgeon General. He could also ask the appropriate specialty board for additional information on any man listed.16 As changes were made in the list of those physicians "cleared" or "not cleared" the directing editor of the "Directory of Medical Specialists" made the changes known to The Surgeon General.

The cited sources of information for classifiers applied mostly to data on physicians. Apparently, during the early part of the war, the organizations of dentists and veterinarians furnished information as to specialists in these professions,17 but methodical and painstaking efforts by the Medical Department to classify any officers other than members of the Medical Corps came only later in the war.

MALE AND FEMALE OFFICERS, 1943-45

Classification Measures

Throughout the war years, even though considerable emphasis had been placed by the Army Service Forces upon decentralization generally, an attempt was made to centralize more of the process of classification of medical officers in the Office of The Surgeon General. The effort to bring officer classifications up to date and, for that purpose, to assemble current information on their qualifications appeared in communications from the Surgeon General's Office and other agencies in the latter part of 1943 and afterward. A large part of this effort was directed toward revising the "proficiency" ratings of Medical Corps officers, which were more apt to be incorrect than placement of these officers in the larger categories of specialization. It was probably with the "proficiency" record in mind that The Surgeon General, in a letter to service command surgeons referring to changes in initial classification ratings of Medical Corps officers made by his office, advocated revising these ratings whenever competent professional observers found that the performance of officers, or their ability to perform, was not reflected in their ratings.18

16Letter, Directing Editor (Dr. Paul A. Titus), Board of Directory of Medical Specialists, 1942 issue, to Lt. Col. F. M. Fitts, MC, Office of The Surgeon General, 24 Apr. 1942, subject: Applicants for Certification by American Boards.
17Military Preparedness. J.A.M.A. 118: 634, 21 Feb. 1942.
18Letter, The Surgeon General, to Commanding General, First Service Command, attention Service Command Surgeon, 21 July 1944, subject: Classification of Medical Corps Officers.


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At the end of 1944, The Surgeon General was able to induce higher War Department authority to order an annual review of all Medical Corps officer classifications.19 Commanders overseas as well as in the Zone of Interior were directed to finish the first review by 31 March 1945 and forward the results to The Surgeon General. A fairly complete classification of all Medical Corps officers based on the latest available information was completed by the end of June 1945.20 The war ended, however, before any more such reviews could fall due.

Questionnaires

Officers themselves furnished data for classifications in the form of answers to the classification questionnaire (W.D., A.G.O. Form No. 178-2), whose form was revised twice during the war-in August 1943 and January 1944. In November 1943, The Surgeon General advised the service command surgeons to have all medical, dental, and veterinary officers complete classification forms. The next month, a War Department circular required officers of these corps returning from duty overseas to do the same.21 Some months later, Army Service Forces headquarters supplemented this directive by ordering all its officers who had not filled out questionnaires in the past to do so now; the order was intended to apply to officers returning from duty overseas, graduates of officer candidate schools, officers newly assigned to Army Service Forces from other commands, and officers newly commissioned from civilian life or from the enlisted ranks.22

Instructions of The Surgeon General

Aside from answers to questionnaires and reports from professional observers, there were other sources of information which The Surgeon General reminded the service commands to employ as a basis for classification. In his letter of 22 November 1943, he requested the service command surgeons to "establish a procedure by which information can be obtained from the professional consultants, the commanding officers of hospitals, and other available sources concerning the ability of Medical Department officers." This and "other pertinent information" should be "maintained on personnel records in the Office of the Service Command Surgeon." The medical officer responsible for classifying and assigning Medical Department personnel should be encouraged to obtain firsthand information by visiting the installations where such persons were assigned.

19War Department Circular No. 460, 5 Dec. 1944.
20Letter, Brig. Gen. Harold C. Lueth, USAR, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 10 Mar. 1956, with enclosure thereto.
21(1) Letter, Office of The Surgeon General (Maj. Gen. G. F. Lull, Deputy Surgeon General), to Commanding General, Second Service Command, attention: Service Command Surgeon, 22 Nov. 1943, subject: Classification and Assignment of Medical Corps Officers. (2) War Department Circular No. 33, 24 Dec. 1943.
22Army Service Forces Circular No. 212, 8 July 1944.


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How information from these sources should be produced and evaluated so as to permit a reestimate of a Medical Corps officer's rating was described in a letter from The Surgeon General to service command surgeons on 21 July 1944. The original recommendations for changes in officers' ratings could come either from their commanders, who should be encouraged to submit such proposals, or from the appropriate professional consultants, who should be instructed to make recommendations in the course of their inspections. The consultants should screen and evaluate the recommendations made by officers' commanders. Their judgment should be based not only on the record of an officer's formal training and experience but on an appraisal of his capability. The Surgeon General's Office would furnish each service command a list of the Medical Corps officers assigned to it and their current ratings. The service command consultants were to return the list, marked with the changes in ratings they recommended. The Surgeon General would then take final action.23

Role of the Classification Branch

In November 1943, The Surgeon General informed the service commands that his Classification Branch would classify all the medical, dental, and veterinary officers who were ordered to fill out questionnaires at that time. The War Department circular of December 1943, which required answers to the classification questionnaire from all officers of these corps returning from overseas, directed that the classification forms be sent to The Surgeon General, who was to distribute them and issue instructions concerning their use. In August 1944, the War Department directed that each officer of the same three corps in the Army Air Forces should prepare answers to the classification questionnaire and send one copy to the Surgeon General's Office. Whether or not the latter was to use it in the exercise of any power of classification, however, the circular did not state.24

More effort to centralize the classification of officers was directed at members of the Medical Corps than at those of any other Medical Department officer group. A proposal of The Surgeon General that his Office make the initial classification of all Medical Corps officers was agreed to by the Army Ground Forces in April 1944. In December of the same year, the War Department granted him that authority with respect to any officer thereafter appointed to the Medical Corps.25 As the War Department had stopped the procurement of doctors from civilian sources some months previously, this authorization applied mainly, if not exclusively, to future graduates in medicine who were enrolled in the Army Specialized Training Program or who held student commissions in the Medical Administrative Corps.

The classification of members of certain Medical Department officer components was not centralized in the Surgeon General's Office-at least not to the

23See footnote 18, p. 274.
24War Department Circular No. 349, 26 Aug. 1944.
25(1) Memorandum, Adjutant General, Army Ground Forces, for Chief of Staff, 26 Apr. 1944. subject: Assignment of Medical Corps Officers and Nurses. (2) See footnote 19, p. 275.


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same extent as was that of Medical Corps officers. This was true of Dental Corps,26 Medical Administrative Corps, and Army Nurse Corps officers. The Surgeon General carried on a classification of Medical Administrative Corps officers assigned to installations under his own jurisdiction; in the later war years, members of the corps graduating from officer candidate schools were classified at the schools where they received their commissions.

Efforts Toward Greater Uniformity in Classification

Manuals

The continuous efforts to promote uniformity in classification of officers for the whole Army came to fruition with the publication of War Department Technical Manual 12-406, on 30 October 1943. This manual was supplemented, so far as it related to the Medical Department, by special instructions embodied in War Department Circular No. 232, 10 June 1944. The groups of standard qualifications established by these instructions for each of the four degrees of proficiency within the Medical Corps specialties were stated in broad terms-so broad, in fact, that they could hardly, of themselves, produce a completely uniform classification of the officers to whom they applied. The four groups of proficiency qualifications were set forth as follows:

Group A (To be substituted for SGO Group 1). Officers with civilian or military background of recognized and outstanding ability in a specialty, for example, officers who were professors and/or heads of departments and associate professors in large teaching centers; officers who can function within their specialty without professional supervision.

Group B (To be substituted for SGO Group 2). Officers with superior training and demonstrated ability. Classification in this group indicates a probable training period of one year as an intern and a three year residency or fellowship devoted to the specialty in a recognized teaching center. Officers with mature experience and demonstrated ability may be classified in this group even though they have not had the formal training indicated above. Diplomates of American Specialty Boards are classified in this group or higher but absence of certification does not prohibit inclusion in this group. These officers can function within their specialty without professional supervision.

Group C (To be substituted for SGO Group 3). Officers who have recently completed periods of training including one year as an intern and one year of residency; officers who have demonstrated some ability in a specialty; officers with shorter periods of training but with minor proportion of practice devoted to a specialty such as general practitioners giving particular attention to the specialty for a period of at least three years.

The Air Forces issued its own classification manual in April 1944.27 Every job category listed in the Air Forces manual for the Medical, Dental, Veterinary, and Army Nurse Corps and for the Hospital Dietitians and Physical Therapists had appeared in the War Department manual.28 The only difference

26Report, Military Personnel Division, Office of The Surgeon General, to Historical Division, Office of The Surgeon General, summer 1945, subject: Medical Department Personnel.
27Army Air Forces Manual 35-1, 3 Apr. 1944, subject: Military Personnel Classification and Duty Assignment.
28No attempt has been made to compare the job listings in these manuals for members of the Medical Administrative, Sanitary, and Pharmacy Corps, since the job designations given do not always clearly indicate whether the post could be filled only by a member of one of these corps.


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was that the Air Forces manual listed fewer job categories for some of the components than did the War Department manual, presumably because certain types of jobs would not be needed in the Air Forces. Both manuals also appear to have contained the same set of qualifications for each kind of job.

Role of consultants

The Surgeon General, in addition to making full use of the consultants in his Office, designated the service command consultant in each specialty as the final authority within the service command for recommending all changes in the rating of specialists in his field. If the consultant was consistent in maintaining his own standards, this would result in considerable uniformity of classification within the service command so far as the proficiency ratings were concerned. Uniformity throughout a broader area, however, was desirable; the task of classification, it was held, must be performed not from the point of view of a single service command,29 but from that of the entire Army. No doubt, a certain uniformity of view among consultants in a given specialty resulted from their similar training and experience. Moreover, if The Surgeon General's scheme just mentioned was adhered to, their recommendations as to changes in ratings were passed upon finally in his own Office, where differences in standards could be reconciled.

Individual records

Uniformity of classification was also a matter of keeping the records up to date. If changes in men's capabilities were not promptly recorded, the effect was the same as if uniform standards were not being applied. It was necessary too that all records of a man's classification should agree with one another. The Surgeon General had urged uniformity in that sense when, in calling on the service commands for questionnaires from all medical, dental, and veterinary officers in November 1943, he had stated that the classification symbols given these officers by his Classification Branch should be entered on all their records in the service command surgeon's office. Almost a year later, he emphasized that revised questionnaires of all Medical Corps officers should be available in his Office and that copies of them should be filed in the service command headquarters. About the same time, a representative of The Surgeon General urged that the same classification should appear on all records used in the assignment and evaluation of an officer; when the rating was changed, it should be changed on all records simultaneously. It appears that in at least one service command, for a time at any rate, two groups of classification data were maintained-one determined by The Surgeon General, the other by the service command.30

29Speech, Maj. Robert W. W. Evans, MC, Office of The Surgeon General, "The Classification and Assignment of Personnel," 10 Oct. 1944. In Annual Report, Surgical Consultants Division, Office of The Surgeon General, U.S. Army, 1945.
30See footnote 29.


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Evaluation of the Classification System

Doctors

The classification process for Medical Corps officers improved gradually, beginning possibly about the middle of 1943. This was at a time when the number of doctors accepting active duty had for several months been relatively quite small. Specialists who were diplomates of specialty boards probably fared better than others in their initial classification, simply because the evidence of their training was more readily ascertained and they could be easily placed in their specialty with a proficiency rating of at least B, as the classification manual prescribed. There were of course doctors well trained in some branch of medicine for which no specialty board yet existed, who therefore might be classified as nonspecialists. There was also the case of doctors who had simply not acquired membership in a specialty board, even though they were as competent in the specialty as those who had. On this point, The Surgeon General repeatedly declared that mere lack of board membership would not place a specialist in a lower proficiency bracket if he had demonstrated top professional capacity in his specialty.

Initial classification was not enough.31 Reevaluations had to be made on the basis of actual performance. These were sometimes considerably delayed through lack of opportunity to make them. It was reported that even during 1943, units were arriving in the European theater in which the commanding officer and the chief of the medical service had had no opportunity to judge the capacity of officers in the field of internal medicine except by paper evaluation. Presumably, the same held true of officers in the surgical specialties. A period of confusion therefore ensued until a reevaluation, based on the officer's work, could be made.32

Knowledge of the workings of classification was not universal among Army doctors. In 1944, it was reported that few of them had any idea as to their own professional classification and that a considerable number, especially among those who had been overseas, were not even aware of the classification system itself. Their assignments, nevertheless, reflected their military occupational specialties as determined by the Personnel Service, Office of The Surgeon General, and a very high percentage of them were better than adequate.33

Dentists

While the major part of this classification discussion is given to the Medical Corps, it points up the problems and means of solving them as they relate to

31Initial classification in the sense of formally placing a man in one of the categories prescribed by the Army, so that this record would govern all future assignments, might be delayed until after his commander had examined his credentials and placed him in a job. The formal initial classification was therefore sometimes made on the basis of actual performance.
32Annual Report, Office of the Chief Surgeon, Headquarters, European Theater of Operations, U.S. Army, 1944, Exhibit A thereto.
33(1) Memorandum, Maj. Henry McC. Greenleaf, MC, for Colonel Schwichtenberg, MC, Office of The Surgeon General, 13 June 1944, subject: Informal Report of Trip to Several Zone of Interior Army Hospitals. (2) See also Chapter X, pp. 289-338, this volume.


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the full officer strength of the Medical Department, even though considerably less control of classification for the other components was ever centralized in the Surgeon General's Office. The classification of Dental Corps officers seems to have been less satisfactory than that of doctors. The Military Personnel Division of the Surgeon General's Office stated in April 1945 that "incomplete, insufficient, and improper classification of Dental Corps officers was a major problem throughout the war." It gave three reasons for poor classification of these officers during the early part of the war: (1) Dental Corps officers originally did not have to fill out a classification questionnaire; (2) in spite of the fact that instructions to fill out the questionnaire were changed to cover all Medical Department officers, doubt whether this included Dental Corps officers was so persistent that as late as April 1945 the Surgeon General's Office considered it necessary to call the matter to the attention of those concerned; and (3) the early classification questionnaire did not call for sufficient information to make it a reliable basis for accurate classification. Even when complete information became available, accurate classification was hampered by several conditions. In the service commands and oversea theaters, there was considerable variation in the evaluation of dental skills. The early form of the classification questionnaire authorized the commanding officer of a unit to recommend the classification he considered appropriate for his subordinate officers. In the Army Ground Forces, this was usually a line officer who understood little or nothing of professional standards and qualifications. Later, the senior medical officer made recommendations, but this did not solve the problem of evaluating dental specialties in any installations other than the large ones in which the commanding officer, a Medical Corps officer, took the time to confer with the chief of the dental service.

Many Dental Corps classification records dated only from 1943, and classification records on 20 percent of the members of the corps were never received at all. Classification would certainly have been better for Dental Corps officers, if procedures had been centralized in the Surgeon General's Office, if classification questionnaires had been submitted annually so that records could be kept current, and if professional evaluations had been reviewed by qualified classification officers. Personal visits to dental installations for the evaluation of the utilization of Dental Corps officers would also have proved useful.34 "Too much reliance had to be placed on the dentist's own estimate of his qualifications, so that men with little more than a desire to do a certain type of work were designated as specialists, while other trained officers were placed in routine jobs."35

Sanitary Corps officers

Some fault was also found with the classification of Sanitary Corps officers. In February 1945, The Surgeon General's Classification Branch heard

34See footnote 26, p. 277.
35Medical Department, United States Army. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955, p. 107.


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of "a pernicious method" of changing their classification-apparently one service command would sometimes alter an officer's classification simply to justify his promotion.36 As regards sanitary engineers, in particular, who formed a substantial part of the corps, some acquired that classification who were unfitted for it, despite the efforts of The Surgeon General's Sanitary Engineering Division and the vigilance of the service commands. This was probably because part of the work of classifying was done by surgeons of posts and commands, who were ordinarily unqualified to judge whether a man had the proper training in sanitary engineering. Some officers were also improperly classified as entomologists, entomology being another specialty of the Sanitary Corps.37

Development of Local Classification Systems Overseas

As early as 1942, it became apparent to oversea commanders that the classification system as it applied to medical officers was not adequate. In the first place, many of these officers had never been classified prior to being shipped overseas while others who had been classified failed to bring their classification records with them.38 Probably more inadequacies existed in the proficiency rating than elsewhere.39 Proper classification overseas was no less necessary than it was at home, but the experience attained by officers abroad and the opportunity to observe them under field conditions would have called for reclassifications regardless of any classifying that might have been done in the Zone of Interior. The result was the development within the theaters of local systems of categorization which were independent of those in the continental United States.

The North African and European theaters

The North African and European theaters had similar systems based primarily on (1) questionnaires issued to each medical officer arriving in the theater (the North African theater went one step farther and distributed these questionnaires to all medical officers already in the theater);40 and (2) evalua-

36Weekly Diary, Classification Branch, Military Personnel Division, Office of The Surgeon General, 24 Feb. 1945.
37
Hardenbergh, W. A.: Organization and Administration of Sanitary Engineering Division. [Official record.]
38Letters, to Col. C. H. Goddard, MC, Office of The Surgeon General, from (1) Theodore L. Badger, M.D., 25 Sept. 1952; (2) Alan Chalman, M.D., 11 Sept. 1952; (3) John M. Flumerfelt, M.D., 8 Sept. 1952; (4) George P. Denny, M.D., 25 Sept. 1952; (5) Garfield G. Duncan, M.D., 8 Sept. 1952; (6) Robert Evans, M.D., 8 Dec. 1952; and (7) Joseph S. Skobba, M.D., 10 Oct. 1952.
39Letters, to Col. C. H. Goddard, MC, Office of The Surgeon General, from (1) Garfield G. Duncan, M.D., 19 Aug. 1952; and (2) Walter D. Wise, M.D., 23 Sept. 1952.
40(1) Annual Report, Personnel Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1942. (2) Munden, Kenneth W.: Administration of the Medical Department in the Mediterranean Theater of Operations, U.S. Army. Vol. I. [Official record.] (3) Annual Report, Surgeon, North African Theater of Operations, U.S. Army, 1943. (4) Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944. (5) Report, Lt. Col. Stewart F. Alexander, MC, Personnel Officer, Surgeon's Office, Seventh U.S. Army, on Medical Department Activities in Mediterranean Theater of Operations, 14 July 1945.


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tion by consultants. The latter method had already proved helpful in the Zone of Interior.

In the European theater, Col. William S. Middleton, MC, Chief Consultant in Medicine, personally interviewed all officers on the medical service in each hospital unit arriving in the theater, evaluated them, and reported on their qualifications to the Chief Surgeon.41 Col. Elliott C. Cutler, MC, Chief Consultant in Surgery, requested the base section consultants to do virtually the same thing and send their reports to him.42 In addition, as early as 1943, each officer entering the theater as a casual was evaluated, if he had a specialty, by a senior consultant from the Chief Surgeon's Office.43 The consultants did not confine their attention to newcomers. As early as 1942, they assessed the quality of the personnel assigned to the medical and surgical specialties in hospitals.44 The following year, all units within the theater were evaluated by the consultants from the Professional Services Division of the Chief Surgeon's Office as to the professional capacities of their medical officers. In 1944, Colonel Middleton visited and interviewed the medical officers of 112 general and 13 station hospitals.45

Col. Perrin H. Long, MC, medical consultant in the North African theater, also used this method, reviewing the qualifications of Medical Corps officers as soon as possible after the hospitals had reached the theater.46 By the latter part of 1944, the consultants appear to have classified all of the medical officers in the theater.

Even in those theaters where classification activities were most advanced, however, they were marked by failure at least to use classification forms and job categories established by the Zone of Interior. Furthermore, in the case of individuals having more than one specialty, local conditions dictated which of these specialties was to be regarded as primary and which secondary. The Zone of Interior, for example, considered it important to classify a cardiologist primarily as such and secondarily as an internist whereas in the European theater the opposite was true. Similarly, an obstetrician and gynecologist was classified primarily as a general surgeon in the theater, but at home, his subspecialties were given first place. In each case, the practice was based on the principle of giving a man a classification in skills that the Army most needed, but the necessities of the Zone of Interior, with its comparatively large numbers of older troops, female personnel, and dependents entitled to Army medical

41Annual Report, Professional Services Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1943.
42Annual Report, Professional Services Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1944.
43Annual Report, Personnel Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1943.
44(1) Annual Report, Professional Services Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1942. (2) See footnote 43.
45Middleton, W. S.: Medicine in the European Theater of Operations. Ann. Int. Med. 26: 191-200, February 1947.
46Long, Perrin H.: History of the Medical Consultant in the North African and Mediterranean Theaters of Operation. [Official record.]


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care, were different from those of the oversea theaters with their preponderance of young combat men.47

Efforts Toward Uniformity in Theaters of Operations

The European and Mediterranean theaters

On 13 May 1944, the final plans for demobilization and redeployment were approved by the Deputy Chief of Staff, based on the 1 October date for the defeat of Germany. While the plans for redeployment of Medical Department strength were being developed, the necessity for establishing uniformity among the classification systems of the Zone of Interior and theaters became apparent. To accomplish this Lt. Col. Gerald H. Teasley, MC, of the Personnel Service, Office of The Surgeon General, and others from the Surgeon General's Office were sent to the European and Mediterranean theaters to observe the systems in operation.

As a result of this visit, War Department Circular No. 460 was issued on 5 December 1944, requiring classification of Medical Corps officers in accordance with established procedures. This circular was designed primarily to promote uniformity in classification procedures for all Medical Department officers.

The circular further directed that the commanding generals of oversea theaters and oversea commands were to be given final responsibility for accurate up-to-date classification of all medical officers over whom they had assignment jurisdiction and were not to delegate this responsibility to field agencies or lower headquarters. In reviewing classifications, each commanding general, furthermore, was directed to utilize the advice of his surgeon and the professional consultants. Finally, by 31 March 1945, each pertinent headquarters was required to furnish each Medical Corps officer over whom it had assignment jurisdiction a copy of W.D., A.G.O. Form 178-2 with a publication date of 1 August 1943 or later. By this same date, the first annual review of the classification of each Medical Corps officer was scheduled for completion.

As a result of War Department Circular No. 460, many officers received for the first time a War Department, or standard classification, number as opposed to theater classification.48 And for the first time in the European Theater of Operations, Medical Corps personnel came under the central classification activities of the theater.49

47(1) Memorandum, Lt. Col. J. C. Rucker, MC, for Lt. Col. G. H. Teasley, MC, 1 Nov. 1944, subject: Personnel Records in the European Theater of Operations. (2) Memorandum, Lt. Col. G. H. Teasley, MC, for The Surgeon General, 29 Nov. 1944, subject: Report of Trip to Mediterranean Theater of Operations. (3) Letters, Robert Evans, M.D., to Col. C. H. Goddard, MC, Office of The Surgeon General, 8 Dec. 1952 and 14 Apr. 1953.
48Letter, Col. Perrin H. Long, MC, to Col. C. H. Goddard, MC, Office of The Surgeon General, 29 July 1952.
49Annual Report, Personnel Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1944.


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Difficulties were eventually encountered in carrying out the provisions of the circular. The supply of forms was short; in the spring of 1945, units were moving so rapidly and so freely from one command to another that it was difficult to ascertain which ones had reported; and finally, the "human factor" entered the picture-to many individuals and unit commanders, this was "just another form." As a result, a fairly complete classification was not accomplished until June 1945.50

The Pacific and China-India-Burma theaters

The Pacific theaters and the China-Burma-India theater do not appear to have placed any early emphasis on the classification problem. No individual systems were initiated, as in the European and North African-Mediterranean theaters. In 1944, in the Central and South Pacific, medical officers were classified in accordance with the system established by the Surgeon General's Office.51

In the Southwest Pacific Area, however, nothing was accomplished until Maj. Robert W. W. Evans, MC, Chief of the Classification Branch of the Military Personnel Division in the Surgeon General's Office was transferred to the Southwest Pacific at the request of Brig. Gen. Guy B. Denit, Chief Surgeon. Following the consolidation of commands in the Pacific, Major Evans became, in the latter part of July 1945, head of the Personnel Division of the Chief Surgeon's Office in the Pacific theater.52

The increased availability of consultants also facilitated the work of classification and reevaluation both in the Pacific and in India-Burma. In the latter theater, the source of classification data had been information obtained in the Zone of Interior in the early part of the war, and such classification as had been performed in the theater had been accomplished by a nonmedical officer.53

ENLISTED PERSONNEL, 1939-45

The same reservation must be made when discussing the placement of enlisted personnel as when discussing that of officers-a man assigned to a job that did not call for his best talents cannot be said to have been misassigned if the overriding needs of the Army required him to be used where he was. With that exception, proper placement will be considered here as one that fitted the job to the man.

50Administrative and Logistical History of the Medical Service, Communications Zone-European Theater of Operations, 1945. Ch. X. [Official record.]
51(1) Whitehill, Buell: Administrative History of Medical Activities in the Middle Pacific (1946). [Official record.] (2) Annual Report, Surgeon, Central Pacific Base Command, 1944. (3) Letter, Verne R. Mason, M.D., to Col. C. H. Goddard, MC, Office of The Surgeon General, 18 Dec. 1952.
52Annual Report, General Headquarters, U.S. Army Forces, Pacific, 1945.
53
(1) Letter, Col. Herrman L. Blumgart, MC, to Col. C. H. Goddard, MC, Office of The Surgeon General, 7 Aug. 1952. (2) Letter, Hugh J. Morgan, M.D., to Col. C. H. Goddard, MC, Office of The Surgeon General, 7 Aug. 1952. (3) Graham, Stephens: History of Professional Surgical Experience in the India-Burma Theater in World War II (1945). [Official record.]


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It was not nearly so important, for the most part, to fit the job to the man in the case of enlisted personnel as it was in the case of officers. With few exceptions, jobs for enlisted men in the Medical Department called for a much shorter period of technical training than did most jobs for officers. If necessary, therefore, the Medical Department could train its own enlisted technicians after they entered the service. A great deal of such training was done, although there were complaints that the quality of the material was not always adequate-that too many men of limited physical endurance or mental ability were assigned to the Medical Department. Nevertheless, in order to economize on the training effort, it was desirable to place men in jobs for which they were already qualified and to keep them there until they could be used more effectively elsewhere.

The first essential was to see that enlisted men who were qualified for distinctly medical work got into the Medical Department-and stayed there-instead of being placed in some other branch of the Army, but only a comparatively small number were earmarked for medical work upon induction into the Army. In the vast majority of cases, enlisted men went, after induction, to the reception centers of the Army as draftees without any previous arrangement as to where they would be used and were only then assigned to some particular branch of the service. The Medical Department received its enlisted personnel mainly in this fashion or by transfer from some other branch of the Army.

Classification Guides

As early as September 1940, the reception centers and other assigning authorities had a better guide for classifying and therefore assigning enlisted men than for officers. An Army regulation issued at that time contained a list of occupational specialties required in the Army and a list of the specifications for those occupations. This regulation included a serial number to identify each specialty. A three-digit number designated each job. Thus, for example, under the heading "medical technician" appeared the specification serial number "123" under which were listed duties in military service, qualifications, and civilian occupations in which medical technicians would be found. Male nurses and medical students were placed in the same category.54 Later on, the job descriptions were refined, and some of the specification serial numbers were changed. In July 1944, the War Department replaced its existing guide with War Department Technical Manuals 12-426, "Civilian Occupational Classification of Enlisted Personnel," and 12-427, "Military Occupational Classification of Enlisted Personnel."

Such a guide, though useful, did not insure that all enlisted men would be either properly classified or assigned. In January 1942, The Adjutant General, after making a general statement on the need to utilize the abilities of

54Army Regulations No. 615-26, 3 Sept. 1940, subject: Enlisted Men: Index and Specifications for Occupational Specialists and Index to Military Occupational Specialists. (This list was superseded in December 1941, and still another appeared in September 1942.)


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enlisted men to full capacity, listed several skills that must be carefully conserved. This list, antedating the list of scarce-category specialists published later in the war, included the following Medical Department enlisted specialties: Dental hygienist, dental laboratory technician, medical technician, surgical technician, optician, orthopedic mechanic, pharmacist, sanitary technician, veterinary surgical technician, and X-ray technician. The Adjutant General designated the specialties on this list in which the shortage could be overcome in part by Army training.55

Proper classification was necessary, as set forth in Army Regulations No. 615-25, 3 September 1940, in order that-

a. All units and installations obtain a proportionate share of the abilities possessed by personnel coming directly from civil life.

b. Combat units obtain priority in the assignment of personnel possessing military training and qualities of leadership.

c. Men with occupational skills are assigned to units or installations requiring those skills in the proportion and to the extent available, avoiding wastage.

The System in Operation

The system was designed to work as follows: Recruits were to be classified at the reception centers. Classification was always to be in terms of what the individual could do best for the Army. On the basis of his score on the Army General Classification Test and an interview with a classifier, each recruit was to be assigned to the training center of the arm or service which could best utilize his education and experience.

Difficulties encountered

The immediate needs of the Army took precedence, of course, over this planned method of classifying and assigning. Moreover, the system did not always operate according to plan. Improper classification and assignment often occurred in the emergency and early war periods, owing in part to a lack of trained classifiers and to the fact that numbers of individuals were assigned to branches merely so that quotas could be met.

Another difficulty was that recruits spent an average of only 72 hours at reception centers, a limit imposed by the lack of housing and the rapidity of mobilization. This was not always enough time to determine where a man could be most properly assigned. It also meant that centers could not retain a man until a requisition for his specialty arrived. Particular centers might not have requisitions for a given specialty for several weeks, although the centers were meanwhile receiving men with the required qualifications. As the war progressed, procedures were improved, more experienced classification personnel were available, and more efficient placement ensued.

55Letter, The Adjutant General, to Commanding General, each Army Corps; Chiefs of Arms and Services, 29 Jan. 1942, subject: Reclassification and Reassignment of Enlisted Personnel.


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Continual reevaluations

Whether or not the reception centers did their work efficiently, men would in many cases have to be reclassified and in most cases reassigned after they left the centers. The reason, of course, was that some acquired specialized skills through Army training which entitled them to a new classification, and that most had to be moved about from post to post if not from job to job as the exigencies of the service demanded. In fact, The Adjutant General declared that classification procedure must be carried out during an enlisted man's entire Army career, and in January 1942, all commanders were directed to survey the classification cards of their enlisted men at least every 6 months for the purpose of improving their placement; commanders were to report any surplus of men whose skills they could not use "to the utmost."56

56See footnote 55, p. 286.

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