Annual Report of the Surgeon General United States Army Fiscal Year 1961
TRAINING OF OFFICERS
Residencies
As had been done in the past, with the exception of last year when selections were made in January, the annual meeting for the selection of residents was held during the month of November 1960. The decision to revert to the prior system of November rather than January selections was made by The Surgeon General?s PETC (Professional Education and Training Committee) which believed that there was greater merit in using the former date. In this way, those officers completing their active duty in June would be considered for training early enough so that, in the event they were not selected for training, they could be advised in time to make their plans for civilian life. Furthermore, the military interns, early in their internship, decide upon their specialty and also decide whether to pursue a medicomilitary career.
A policy was also decided upon by the PETC that individuals selected
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for residency training in Army hospitals, who are not available for training on the date for which selected, will be deferred for training in a selected status until they can be entered in residency, providing they maintain their military performance during this period.
In accordance with the DA restriction on PCS moves, the policy was made that interns selected for residency training would remain in their hospitals if space were available for residency training, if they listed it as one of their three choices for training. If they did not list the hospital to which they were currently assigned, they could be moved within the criteria of military and professional educational necessity.
Residency training in class I hospitals.?During this year, the plan that had been initiated during the last fiscal year, to affiliate certain class I hospitals with class II hospitals conducting residency training programs in general surgery for the second or third year of residency, was discontinued, and the AMA (American Medical Association) was advised.
During this year, the U.S. Army Hospital, Fort Hood, Tex., and the U.S. Army Hospital, Fort Ord, were approved by the AMA for prespecialty surgery training in preparation for residency training in the surgical specialties. The AMA has been requested to approve Ireland Army Hospital, at Fort Knox; Walson Army Hospital, at Fort Dix; and the U.S. Army Hospital at Fort Sill, Okla., for prespecialty surgical training, in addition. As the total prespecialty surgical training spaces were not increased, the result is that, with the additional hospitals approved for training, some hospitals who previously received as many as five residents will receive only two or three residents for training beginning in September 1961. The newly approved hospitals will receive one prespecialty resident each this coming year.
Residents completing training during fiscal year 1961.?During the period 1 July 1960-30 June 1961, 162 military residents and 46 civilian residents completed training and were assigned for duty.
General practice residency program.?In relation to the general practice residency program, the following policy was approved on 16 February 1961:
Applicants may apply for general practice residency, and if accepted, may withdraw from the program after 1 year of training, without prejudice in favor of specialization, without an interim duty tour. In being considered for specialized residency training, the general practice resident will be considered in competition with all other applicants, and if selected, may enter training immediately. If not selected for specialized training, the general practice resident may continue in his general practice residency, if he desires.
To participate in general practice residency training, an officer must be a member of the Regular Army, and year-for-year payback is required.
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Affiliate and Civilian Institution Training
Request was made in January 1961 to DCSPER that students participating in stipend programs be excluded from civilian personnel authorizations (Sec. 102(a), Public Law 79-106, as amended by Public Law 80-330). In support of the request, it was stated that the Army Medical Service has several such programs which are designed to orient and attract students to the Army Medical Service. The programs were, at the time of the request, for laboratory technicians, medical technologists, clinical clerkships, occupational therapy, clinical affiliation, occupational therapy summer practicum, dietetic summer practicum, student nurses, physical therapy summer practicum, and physical therapy clinical affiliation. These programs have been effective in attracting well-qualified individuals to both military and civilian positions in which shortages exist. A public service is performed in that valuable practical experience is provided participants, enhancing their educational and professional growth.
In denying the request for exclusion of these students from civilian personnel authorizations, DCSPER replied that Public Law 80-330 was designed only to exclude the student-employees from the fixed salary rates of the classification act. It was concluded by DCSPER that an employee-employer relationship exists and that student employees should be included on the ?Monthly Report of Federal Civilian Employment (SF 113).? It was thus required that a critical review be made of programs being conducted, adjustments made, or programs discontinued if spaces could not be made available.
The effects on three AMSC programs were the abolition of the occupational therapy clinical affiliation program which was instituted in 1947, the reduction of the dietetic summer practicum from 50 to 28 spaces, and the selection of only 5 of 9 applicants for the new occupational therapy summer practicum.
Additional requests were received during the year for favorable consideration on nonstipend affiliate training of civilian students; that is, training for certain of the categories listed in paragraph 26d, AR 40-108 (Persons Eligible To Receive Medical Care at Army Medical Treatment Facilities), who receive no stipend other than any maintenance provided (Sec. 27.4, Federal Personnel Manual). Processing of these ?student-employees? is accomplished under ?Excepted Appointing Authorities,? Civilian Personnel Regulation R.2.
These requests are submitted by hospital commanders for evaluation by the PETC. The general requirement is that when this assistance
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is given that it be within locally available resources and not interfere with military training programs. Guidance, which continues in effect, was initially furnished at the Joint Surgeons and Commanders? Conference, 12-13 November 1959. It was agreed that the benefit received by the student outweighed any benefit provided a hospital.
Service School Courses
Army Medical Service school courses.?Letter ATTNG-SCH, 350/lo, Hq, USCONARC, subject: Revision of Career Type Courses, dated 22 January 1960, directed the revision of officer basic orientation courses in line with recommendations 18 and 19 of the DA Board to Review the System of Officer Education and Training. (Lt. Gen. Edward T. Williams USA (Ret.), was chairman of the Board.)
In accordance with the aforementioned letter, programs of instruction for the four medical courses involved have been completed and submitted to USCONARC for approval. These courses are: AMEDS Officer Orientation 8-A-C20A, MSC Officer Orientation 8-A-C20B, ANC Officer Orientation 8-A-C20C, and AMEDS Officer Career 8-A-C22.
Revised programs of instruction were submitted to USCONARC for review and approval; USCONARC approved revisions for the following courses:
Medical Supply Officer 8-A-4490.?Training increased from 10 to 12 weeks.
Meat and Dairy Hygiene Officer 8-A-3221.?Title changed to ?Vetrinary Preventive Medicine and Food Inspection Officer.?
AMEDS Officer Career 8-A-C22.?Training increased from 21 to 34 weeks.
Table 15 contains a detailed listing of all AMEDS school courses and the personnel enrolled.
Training of foreign nationals.?In addition to the 71 trainees shown in table 15, an additional 22 were enrolled in 1-week formal short courses and another 131 in observer training. The observer-training periods ranged from 1 week to 1 year. This training is provided under AP (Military Assistance Program) and also on a non-MAP basis. Approximately 41 countries participated in the training programs during fiscal year 1961.
Other service school, civilian institution, and Federal service courses.?There were 409 AMEDS officers, enlisted personnel, and civilians enrolled during the year in service school courses other than those of the Army Medical Service (table 16). Although the AMEDS
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Table 15.?Army Medical Service school courses, fiscal year 1961
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Table 17.?Long courses at civilian institutions, fiscal year 1961
Training Guidance
The Surgeon General continues to place emphasis on the Army-wide training in emergency medical care for survival in the event of nuclear attack.
The following training media were released, or approved for release, during this fiscal year:
Publications:
Army Subject Schedule 8-5, Section Reports and Records.
Army Subject Schedule 8-910, Technical Training of Medical Corpsman, MOS 910.
ATP 8-111, Modified Basic Training Program for Conscientious Objectors (1-A-U) Without Prior Service.
C2, FM 8-35, Transportation of the Sick and Wounded.
FM 8-55, Army Medical Service Planning Guide.
C1, TC 8-1, Training in Emergency Medical Care.
TM 8-227-1, Laboratory Procedures in Clinical Serology.
TM 8-230, Medical Corpsman and Medical Specialist.
C1, TM 8-272, Army Health Nurse Manual.
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?TM 8-275, Centralized Materiel Section.
TM 8-300, Autopsy Manual.
TM 8-501, Nutrition.
TM 8-610, Handbook for Medical Equipment Repairman.
Films:
PMF 5335, Closure of Antra-Oral Fistula.
PMF 5336, Total Body Measurement of Radioactivity in Man.
PMF 5337, Intestinal Biopsy Capsule.
PMF 5338, Surgical Excision of Oral Leukoplakia.
PMF 5339, Basic Autopsy Procedures.
PMF 5341, A Simple Method for Tracheal Suction and Bronchoscopy.
PMF 5342, Enzyme Assisted Cataract Surgery.
PMF 5343, Splenoportography.
TF 8-2588, First Aid, Part III?Burns.
TF 8-3021, First Aid, Part IV?Resuscitation: Mouth-to-Mouth, Mouth-to-Nose.
TF 8-3032, Medical Supply Service, US Army, Part I?Organization and Administration. Part II?Operations at Class I, Class II, and Overseas Installations.
TF 8-3056, Army Health Nurse.
TF 8-3057, Steps to Recovery: Rehabilitation of the Patient With Pulmonary Tuberculosis.
TF 8-3098, Maintenance of Medical Service Equipment.
TF 8-3121, Catheterization Technique.
Training Aids and Devices:
GTA 8-4, Mosquito-Borne Diseases.
T 8-5-1 through 8-5-30, Military Sanitation, Part I (transparency set).
Staffing Requirements for Higher Headquarters and Senior Service College Attendance
By memorandum to the Secretaries of Army, Navy, and Air Force, on 31 March 1961, the Assistant Secretary of Defense (Manpower, Procurement, and Reserve) requested a report on any additional billets made available for medical representatives in the staffs, faculties, and student bodies of all services and joint staff schools, war colleges, and the Industrial College of the Armed Forces. Secondly, the Assistant Secretary requested information as to active participation in the senior service colleges? educational programs. This request was prompted as a followup to recommendations, approved by the Secretary of Defense,
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in memorandum of 14 March 1960 concerning a report entitled ?Evaluation of Medical Service Support for the Lebanon Operation.?
In April 1961, The Surgeon General replied that it had not yet been determined that any billets for medical representatives at service schools and senior colleges, in addition to those which were established, were required.
At the time of the reply, however, a request of The Surgeon General for an increased quota for AMEDS officers at the senior service colleges was receiving consideration by the Department of the Army. The request and recommendation was that the AMEDS be given the opportunity to nominate a sufficient number of officers to insure the attendance of 10 officers at the courses in 1962-63. The Army Medical Service currently has the capability to supply officers for staffing positions requiring senior service college level of training or experience because of the availability of officers with World War II qualifying experience. By 1965, however, there will be a loss of many, if not all, of these officers, and an increased and continuous input of officers into senior service colleges is required if capability to staff positions adequately is to be maintained.
The Deputy Chief of Staff for Personnel replied, in May 1961, that he did not concur in the recommendation that The Surgeon General?s quota be increased. As a basis for this action, it was stated that there was no positive evidence that the size of the nominating quota had a direct bearing on the number of selections by branch and that a comparison of percentages of selection showed that, of a nominating quota of 12 for The Surgeon General, the selection rate was 33 percent, while the average for all the technical services was 48 percent. To insure more selections, the answer suggested that only the best qualified officers be nominated.
Degree Program and Other Federal Service Courses
Tn addition to those officers enrolled in the Civilian Institution Training Program, 30 were enrolled in the Degree Completion Program; 2 of the 30 were enrolled at the master?s level. These 30 include 18 MSC, 11 ANC, and 1 AMSC officers. The Department of the Army has been very liberal in authorizing additional quotas in this program for AMEDS personnel. The original authorization was 12 spaces in any one academic period (table 18).
Further training was participated in by 88 officers in courses conducted by civilian Federal services (table 19). These ranged in length from 1 to 18 weeks. Most of these were conducted by the Department of Health, Education, and Welfare, USPHS, and the Defense Atomic
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Support Agency. The courses contained many subjects relating to the medical aspects of nuclear warfare.
Postgraduate Professional Short Courses
During fiscal year 1961, 1,242 AMEDS officers attended the postgraduate short courses held in medical installations and activities (table 20). These courses ranged in length from 3 days to 9 weeks and were attended by 495 MC, 199 DC, 216 MSC, 176 ANC, 88 VC, and 68 AMSC officers.
TABLE 18.?Long courses at civilian institutions under degree-completion program
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Institution | MC | VC | MSC | ANC |
Occupational Health Research and Training Facility, Cincinnati, Ohio | --- | --- | 2 | --- |
Oak Ridge Institute of Nuclear Studies, Oak Ridge, Tenn. | --- | --- | 1 | --- |
Institute for Federal Hospital Administrators, Arlington, Va. | 13 | --- | --- | --- |
Office of Civil and Defense Mobilization: |
|
|
|
|
| Battle Creek, Mich. | --- | --- | --- | 1 |
| Eastern Instructor Training Center, Brooklyn, N.Y. | --- | --- | 1 | --- |
Communicable Disease Center, Atlanta, Ga. | 4 | 13 | 3 | 3 |
Robert A. Taft Sanitary Engineering Center, Cincinnati, Ohio | 3 | 10 | 33 | --- |
Radiological Health Laboratory, Rockville, Md. | --- | --- | --- | 1 |
| Total | 20 | 23 | 40 | 5 |
Of the total number, 252 AMEDS officers attended the management of mass casualties courses, 4 of which were held at Brooke Army Medical Center and 1 at WRAIR. These courses are designed to keep the officers of the Army Medical Service abreast of the latest development in their field and specialization. At these courses, 55 spaces were allotted to personnel of other technical services and 135 spaces to civilians from professional medical organizations and civil defense.
Funding for postgraduate course training was controlled by The Surgeon General. It was planned to authorize a greater number of students for these courses, but a curtailment was necessary because of an 11-percent cut in fiscal year 1961 funds for these courses and for those of other Federal services.
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