Annual Report the Surgeon General United States Army Fiscal Year 1959
MILITARY PERSONNEL
Legislation
Provision for calling doctors to active duty.-The induction provisions of the Universal Military Training and Service Act,, including the special authority to order medical and dental personnel to active duty, were extended for 4 years until 1 July 1963, by Public Law 86-4, approved 23 March 1959 (73 Stat. 13). The law has continued to operate by indirection with sufficient numbers of draft-liable doctors of medicine and dentistry volunteering for commissions and active duty in lieu of induction under the Armed Forces Medical and Dental Officer Commissioning Programs.
Extension of special pay.-Public Law 86-4 also extended, until 1 July 1963, the authority for special pay to newly commissioned Medical, Dental, and Veterinary Corps officers.
Credit for wartime service to ANC and AMSC officers.-The Army Medical Service has long attempted to obtain the necessary legislative
58
action to grant credit as commissioned service in computing retirement benefits for duty performed by Reserve Army Nurse and Medical Specialist Corps officers before they attained commissioned status on 10 July 1944 (1 January 1949 in the case of occupational therapists). H.R. 3365, a bill to authorize the crediting of certain service for the purpose of retired pay for nonregular duty, and for other purposes, passed the House of Representatives on 4 March 1959. No action was taken on the bill in the Senate during the fiscal year.
Reduction in Officer Authorizations and Strength
The total number of spaces authorized for AMEDS officers was reduced by 361 in the fiscal year, from 13,256 on 30 June 1958 to 12,895 on 30 June 1959. While most of the lost spaces were in the Medical Service Corps, because of an arbitrary reduction in the MSC ceiling imposed by DCSPER (Deputy Chief of Staff for Personnel), the reduced authorization for the Medical Corps was even more stringent than would appear in table 12. The Medical Corps authorized spaces were reduced by 71, but there were increases of 22 in the number of spaces for residents and 14 for interns; the actual impact on operating spaces therefore was 107 rather than 71. This reduction had to be absorbed during a period in which there was no substantial change in the mission of The Surgeon General other than a general increase in research and development activities. No post of any substantial size was closed during the year. Thus, the ratio ceiling of 3.4 MC officers per 1,000 troop strength, imposed by the Secretary of Defense, became even more restrictive in fiscal year 1959. Had it not been for the sub-
Corps | Authorized strength | Actual strength | ||
30 June 1958 | 30 June 1959 | 30 June 1958 | 30 June 1959 | |
Medical | 3,560 | 3,489 | 3,786 | 3,614 |
Dental | 1,840 | 1,789 | 1,894 | 1,801 |
Veterinary | 415 | 400 | 398 | 402 |
Medical Service | 3,741 | 3,517 | 3,730 | 3,480 |
Army Nurse | 3,275 | 3,300 | 3,356 | 3,367 |
Army Medical Specialist | 425 | 400 | 412 | 421 |
| Total | 13,256 | 12,895 | 13,576 | 13,085 |
59
stantial overstrength generated by the summer accession of officers under the doctor draft legislation, the Medical Corps would have been in severe straits throughout the fiscal year.
The reduction in Dental and Veterinary Corps spaces paralleled the drop in total Army troop strength. The combined authorizations for the Army Nurse and Army Medical Specialist Corps remained unchanged, but there was a shift in the allotments between the two corps since their authorizations are based largely upon procurement. The Army Nurse Corps was authorized 25 spaces previously assigned to the Army Medical Specialist Corps and thus was the only one of the six corps to get an increased authorization. Since the ANC authorization is supplemented by some 1,300 civilian nurses, the total number of professional nurses on duty is considered adequate.
Although the total strength of AMEDS officers decreased from 13,576 on 30 June 1958 to 13,085 as of 30 June 1959, there was a total overstrength of 190 at the end of the fiscal year. As indicated in table 12, all of the corps, except the Medical Service Corps, had overstrengths. Net losses in total strength occurred in the Medical Corps (172), Dental Corps (93), and Medical Service Corps (250), while small net gains were registered in the Veterinary Corps (4), Army Nurse Corps (11), and Army Medical Specialist Corps (9).
Officer Procurement
The fiscal year 1959 procurement objectives for Medical and Dental Corps officers were met primarily from among participants in the Army'svarious personnel procurement programs; that is, Early Commissioning Program, ROTC, Berry Program, Senior Medical and Dental Student Programs, Medical and Dental Intern Programs, and the Army Resident Program. All vacancies were filled or committed by December1958. An increased authorization received in February 1959 for 100 medical officers to be placed on active duty in April and assigned to USAREUR posed a difficult problem, primarily because of the time limitation and the fact that it normally requires from 60 to 90 days to process an application. Added to this was the difficulty in obtaining uncommitted physicians in April, since most internships, residencies, and contracts terminate in June. Through an intensive procurement effort, 45 physicians were obtained for active duty in April.
Army Regulations No. 135-30, dated 23 July 1958, govern the Early Commissioning Program for Medical and Dental Students. This program is designed to interest medical and dental students in Reserve activities, as well as in careers in the Army Medical Service. Quotas are to be announced each year by separate action for the appointment
60
and assignment of medical and dental students to USAR (U.S. Army Reserve) medical TOE and TD (table of distribution) units, USAR schools, and USAR control groups (annual training). Students assigned to National Guard of the United States or to USAR units may be selected for clerkships at Army teaching hospitals, or at other appropriate AMEDS installations, for a period not to exceed 60 days. The Clinical Clerkship Training Program is announced each year by The Surgeon General, and clerkships can be accomplished either between the sophomore-junior or the junior-senior years. A limited number of clinical clerks may also be appointed as temporary civil service employees.
Several revisions in regulations pertaining to the student and intern programs were made as a result of suggestions received at the AMEDS Personnel Procurement Workshop in June 1958. These changes were designed to expedite the processing of applications and to eliminate the need for repetition in filling out certain forms for officers already appointed in the Army Reserve who are applying for commissions in the Medical or Dental Corps and for participation in the AMEDS professional training programs.
Former Regular Army officers, commissioned officers in the Reserve components, and officers serving obligated tours of duty are still being considered for appointment in the Regular Army under the provisions of DA Circular 601-17, dated 29 April 1958. The original expiration date of this circular was to have been 31 December 1958, but The Surgeon General decided to keep it in effect until further notice. The circular applies to all AMEDS officers.
Medical Corps.-The status of Regular Army medical officer procurement and retention continued to improve as a result of the strong emphasis placed on professional training programs designed to make a career in Army medicine more attractive to recent graduates of medical colleges and other young civilian physicians. During the fiscal year, there was a net gain of 52 Regular Army officers in the Medical Corps, increasing the total, as of 30 June 1959, to 1,607. This represents an increase of 266 Regulars since the low of 1,341 on 1 July 1956, but the number is still below the post-World War II peak of 1,733 attained on 1 July 1953. It is also far below the current Regular Army authorization of 2,217.
During the year, the Army ordered to active duty 210 medical specialists who had participated in the Armed Forces Reserve Medical Officer Commissioning and Residency Consideration Program (Berry Plan) and who had been deferred from active duty for a period of from 2 to 4 years for the purpose of completing residency training in
61
the various specialties. It is anticipated that within another year or so the Army should be able to fill all of its requirements for medical specialists in all fields except those of otolaryngology, preventive medicine, surgery, and pathology.
In all, the Army ordered only 840 medical officers to active duty during the year, as compared to 1,147 in fiscal year 1958. The totalstrength of MC officers, including reservists, varied during the year but continued the downward trend. The number on active duty, on30 June 1959, was 172 fewer than a year earlier and 264 below the total at the end of fiscal year 1957.
A study is in progress to assess the effectiveness of all the AMEDS personnel procurement programs for the Medical Corps and to determine what actions should be taken to increase interest in them. Particular attention is being devoted to the Medical Intern Program, sincethe number of applications for this program has been gradually declining each year.
There were 178 spaces allotted for the fiscal year 1959 intern program. The number for fiscal year 1960 has been increased to 182. The new Martin and Womack Army Hospitals have been added to the list of Army teaching hospitals in the United States participating in this program. Internships will also be conducted at Tripler Army Hospital, Hawaii. In accordance with an agreement between the Army Medical Service and the National Intern Matching Program, Inc., matched students were advised of their hospital assignments, on 16 March 1959, through the deans of their medical schools. The 72 students who participated in the Senior Medical Student Program reported to their assigned hospitals on 27 June 1959 while the others were to report on 8 July.
Of the 100 spaces established for the fiscal year 1959 Senior Medical Student Program, 89 were utilized. Seventy spaces were authorized for this program for fiscal year 1960, and the Professional Education and Training Committee selected 67 principles and 24 alternates. In order to obtain maximum representation and to foster a wider interest on the part of medical students in the AMEDS intern program, The Surgeon General decided that a student should be selected at each school from which applications were received, provided that the quality of applicants from each school warranted the selection of a representative. The selected senior students will enter the program on 1 September 1959, regardless of the academic schedule of the individual schools. Budgetary limitations and equality of treatment of all selected medical students necessitated standardizing the active-duty period under the program.
62
Tripler Army Hospital, Oahu, Hawaii
63
The Professional Education and Training Committee at its meeting in November 1958 selected 161 individuals from among the 361 who applied to enter the residency training program in September 1959 to fillvacancies in the various specialties. Of this number, 147 were selected for training in military residencies and 14 for training in civilian institutions. The 161 included 90 MC officers in the intern program, 64 MC officers other than interns, and 7 civilian physicians. Of the 200 applicants who were not selected for residency training, 40 were from the intern group, 76 were MC officers other than interns, and 84 were civilian physicians.
The purpose of the residency program is to provide the Army with sufficient career personnel having the required specialty training. Consideration is given on a priority basis as listed in AR 350-220 (par. 3b (1), as changed). All residency training spaces for fiscal year 1960 were committed at the November 1958 meeting of the committee, except those for anesthesiology, physical medicine, psychiatry, general practice, and preventive medicine. Selections for the fiscal year 1961 residency training program, starting in September 1960, will be made at the November 1959 meeting of the committee, and applications may be submitted any time after 1 August. Applications for resident vacancies which were not filled at the November 1958 meeting may be made at any time.
Graduates of foreign medical schools who desire appointment in the Medical Corps, either in the Regular Army or Reserve, are being advised to obtain certification as to their professional qualifications from the Educational Council for Foreign Medical Graduates and to forward such certification with their applications. This evidence is considered by The Surgeon General in evaluating the professional qualifications of these applicants, but such evidence in itself does not insure selection, since appointment in the Regular Army and in the residency training program continues to be highly competitive.
Dental Corps.-The Regular Army strength of the Dental Corps continued its upward trend, reaching a new alltime high of 536 at theend of the fiscal year as compared to 505 on 30 June 1958. The authorized Regular Army strength remained unchanged at 695. Only47 applications for Regular Army commissions were received in contrast to 101 in fiscal year 1958. This sharp decline was due in part to the withdrawal of the requirement that participants in the Dental Intern Program make application for a Regular Army commission. Since 24 of the 101 applicants in fiscal year 1958 were interns, the number of comparable applications submitted that year was 77. ArmyRegulations No. 601-131 was revised to incorporate the change in policy regarding dental interns.
64
The rate of resignation among Regular Army Dental officers declined further during the year, amounting to only 0.2 percent of the average strength. General improvement has been made in the procurement and retention status primarily as a result of the Career Incentive Act of 1956. Nevertheless, an increase in the number of Regular Army applications is desired, and senior dental surgeons are being urged to redouble their efforts to encourage qualified young dental officers on active duty to apply for Regular Army commissions.
At the beginning of fiscal year 1959, there were 1,981 dental officers on active duty, with an authorized year-end strength of 1,789. By the close of the year, the number had been reduced to 1,801, only slightly above the authorization, as contrasted to the large overstrength throughout fiscal year 1958. Of the 406 dental officers ordered to active duty during the fiscal year, 301 were procured in the first quarter. It was possible during the year to accept applications for active duty from 21 individuals who desired to serve in the Dental Corps as career reservists.
Although only 202 dental officers were obtained through the Armed Forces Reserve Dental Officer Commissioning Program as compared to 437 in fiscal year 1958, this program continues to be the prime source of procurement. More individuals were allocated to the Army than could be ordered to duty, and it became the responsibility of ZI army commanders to honor the requests for active duty on a 'first-come, first-served' basis.
The 40 students who were graduated from the Senior Dental Student Program in fiscal year 1959 were ordered to active duty during the year. This program has been suspended for fiscal year 1960.
The response to the Early Commissioning Program for dental students continued to be good, possibly because of the realization that participation increased the individual's chances of being called to active duty upon graduation. Army Regulations No. 135-30 governing the program were published on 23 July 1958. This is a program for the procurement of Reserve officers, and the graduates are called to active duty only when the needs of the service dictate.
Medical Service Corps.-Despite a net gain during the year of 175, the Regular Army strength of the Medical Service Corps continued to be far below its authorization of 1,612. The number of Regulars at the end of the fiscal year was 1,264, as compared to 1,089 on 30 June 1958. There was a substantial increase in the number of applications for Regular Army commissions. The change in policy which now permits MSC officers to apply for Regular Army appointment upon entry on active duty and the assignment of a full-time liaison officer from OTSG to the
65
Army Medical Service School at the Brooke Army Medical Center have contributed to this increase.
During the year, 500 officers (including 129 Senior Medical and Dental Students) were brought to active duty as MSC officers, as compared with 685 in the previous year. The total strength of the Medical Service Corps, however, decreased by 250 because of the considerable losses resulting from category expirations, completion of 20 years of service in the case of Reserve officers, and decrease in authorization. Even with the reduction of 224 spaces in its total authorizations, the Medical Service Corps was still slightly understrength at the end of thefiscal year.
The previous shortages of MSC officers in the specialties of medical registrar, medical supply, and optometry were largely overcome owing mainly to reclassification of available skills, to continued training activities, and to improvement in the procurement of officers. Shortages continued in the case of clinical psychologists and sanitary engineers. Spaces for applicants qualified in these specialties existed both for Regular Army officers and for Reserve officers on active duty. In addition, there were vacancies in the Regular Army within the various specialties of the Pharmacy, Supply, and Administration Section of the Medical Service Corps. At the end of the fiscal year, the Medical Service Corps was at, or over, its authorized Regular strength in the specialties of entomology, social work, and laboratory sciences (bacteriology, biochemistry, parasitology, and immunology).
With the exception of clinical psychology, substantial progress was made during the year in filling active duty vacancies in the MedicalService Corps. The procurement quota authorized for the Pharmacy, Supply, and Administration Section was filled earlier than anticipated because of (1) Regular appointments in the Medical Service Corps ofofficers not on active duty in the Medical Service Corps at the time of appointment, (2) voluntary extensions of active duty, (3) transfers from other corps, and (4) increase in initial ROTC quota. Fiscal year1959 spaces for social work officers, optometrists, and pediatrists were filled. At the end of the fiscal year, vacancies still existed in the SanitaryEngineering Section and in the Medical Allied Sciences Section, for clinical psychologists and for clinical psychology students in the Graduate Psychology Student Program (AR 601-138).
The lack of stabilization in the lieutenant grades has bee a major problem in the Medical Service Corps. In 1954, more than half of theofficers in the corps were in the grades of lieutenant, and only 7 percent of these were Regulars or career Reserves. Among the other MSC lieutenants, there was a complete turnover every 2 years. As a result of
66
the increased procurement of Regulars, lieutenants comprised only 37 percent of the total MSC strength at the end of fiscal year 1959, and more than 25 percent of these were Regulars or career Reserves.
Veterinary Corps.-Following the decision to continue the Veterinary Corps in its present status, the Secretary of Defense announced that the commissioning of veterinarians would be in accordance with existing regulations. Most of the vacancies in the Regular Army were filled with Reserve VC officers who had previously qualified for appointment, some as early as November 1955. Their appointment in the Regular Army had been held in abeyance pending a final decision as to the status of the Veterinary Corps. It is anticipated that a limited number of vacancies in the Regular Army will become available with the retirement of a few senior officers in that corps. Plans are to fill these vacancies with outstanding Reserve VC officers in the grade of first lieutenant.
During the fiscal year, 102 veterinarians were commissioned and entered on active duty. During the same period, 98 officers were separated, 7 of them from the Regular Army, making a net gain of 4 and resulting in a total strength of 402 as of 30 June 1959. This was the first time since fiscal year 1957 that the corps has been at full strength. Appointments in the Regular Army during the year numbered 15, increasing the total to 162 as compared to an authorization of 171.
Army Nurse and Army Medical Specialist Corps.-The Army Student Nurse Program, established in April 1956, continues to be the primary source for obtaining qualified young women for appointment in the Army Reserve for assignment to the Army Nurse Corps. During the fiscal year, 151 of these student nurses were commissioned and entered on active duty, following completion of their training. This represented more than 45 percent of the total number of ANC officers recruited during the year. Greater emphasis has been placed on this program through all media of communication, nationwide, with the result that the number of applications increased by more than 35 percent in fiscal year 1959, and 223 student nurses were newly enrolled. Continued efforts have been directed toward streamlining the administrative procedures for processing the applications and also for providing better orientation of these officer candidates both while they are in school and when they become eligible for commissions. Since general requirements are similar for the Army Student Nurse Program and the Army Student Dietitian Program, the regulations for both were combined into one entitled 'Army Student Nurse and Student Dietitian Programs' (AR 601-19, dated 28 August 1958, as changed).
67
In contrast to fiscal year 1958 when there was a net loss of 36, the total strength of the Army Nurse Corps, at 3,367 as of 30 June1959, registered a net gain of 11. This gain was accomplished despite the increasing impact of the Reserve Officer Personnel Act of1954 and the newly implemented mandatory retirement aspects of the Army Nurse and Medical Specialist Act of 1957. The upwardtrend in total strength is attributed to the increased educational and career opportunities, to the better housing policies, and to the improvement in job satisfaction. The Regular Army strength of the Army Nurse Corps at the end of the fiscal year was 1,222, a net loss of 28 during the year.
There was no appreciable change in the number of civilian nurses(more than 1,300) employed to supplement ANC officers. About 250 of these continued to be utilized overseas, primarily in Okinawa,Japan, and Germany. In addition, some indigenous nurses were employed in Germany and Japan.
Although the shortage of dietitians in the Army Medical Specialist Corps persisted, the prospect for overcoming this shortage appeared brighter. Thirteen students were selected for the Army Student Dietitian Program, which had been inaugurated in the fiscal year 1958.To participate in this program, a student enlists as a reservist for service in the Women's Army Corps, Army Reserve. Upon meetingthe qualifications, a student applies for a commission in the Army Medical Specialist Corps as a Reserve officer and for appointmentas an Army dietetic intern. The first student to be selected for the Student Dietitian Program participated in the 1958-59 Dietetic Internship at Walter Reed Army Hospital. Twenty-three students wereselected for the 1959-60 Dietetic Internship. Seven of these were participants in the Student Dietitian Program. The number of dietetic intern spaces was increased to 30 for fiscal year 1960. Thirtyjunior home economics students attended the first Dietetic Summer Practicum to be conducted by the Army Medical Specialist Corps.Students, designated as temporary civil service 'student employees,' were paid at the rate of $150 per month for the 4-week course. Travel and living expenses were the students' responsibility. Authority was granted to maintain this program for fiscal year 1960 because of the continued high degree of interest by colleges and students.
The Physical Therapist Section of the Army Medical Specialist Corps had a small number of unexpected losses but was eventually able to fill these vacancies through direct appointment. There were 24 applications for the Physical Therapy Course, the primary sourcefor obtaining Regular Army physical therapists-25 percent more than
68
in the previous year. However, as in the case of the Dietetic Internship Program, the number of applications was insufficient to permit the desired degree of selectivity.
Sixteen students completed the Occupational Therapy Clinical Affiliation in June 1959. Because this category of personnel remainedstable, the fiscal year 1960 procurement objective was reduced. Only5 applicants were selected to report in August 1959 instead of the12 originally programmed.
Applications for active duty in the Dietitian .and Occupational Therapist Sections of the AMSC Reserve have been suspended for the first quarter of fiscal year 1960 because all such vacancies have been filled.
The first male dietitians were appointed and called to active duty in the Reserve during the year. There are now 15 male AMSC officers on active duty, including 2 dietitians, 8 physical therapists, and 5 occupational therapists.
The total active-duty strength of the Army Medical Specialist Corps increased from 412, on 1 July 1958, to 421 as of 30 June 1959. Although interest in Regular Army careers is increasing, losses through resignations kept the Regular Army strength at 181, the same as it was a year ago.
Proposed Army Regulations for the Army Nurse Corps and the Army Medical Specialist Corps, entitled 'Personnel Procurement-Appointment and Active Duty Programs for Nurses and Medical Specialists,' to replace AR 140-101, were in the stage of final review for publication at the end of the year. The proposed regulations would eliminate formal evaluation boards for ANC and AMSC applicants and establish a selection method at the Department of the Army and army level, would streamline and clarify procedures for submitting and processing applications, and would provide for the ANC applicant a more liberal credit for education and experience upon initial appointment in the grades of second lieutenant through captain. Provision has been included for exceptions in the event of mobilization.
Studies have been made for the purpose of producing more attractive brochures and of improving the quality and content of all publicity for the Army Nurse and the Army Medical Specialist Corps. A new script was prepared for a 12-minute ANC color film suitable for both TV and movie presentations. The film, entitled 'Accent on Nursing,' was released in March 1959. A new 1-minute ANC TV clip with a 20-second lift (black and white) was released in April 1959. This depicts professional, educational, and other benefits for young students
69
and graduate nurses. Both visual aids are considered by critics who have reviewed them to be of superior quality.
Operation FEEDBACK, an AMSC publicity project, was continued. This project involves tape recorded reports (3-5 minutes) by student officers after they have started their professional training. The recordings, together with photographs of the students' professional and social activities, are then released to the students' home colleges for use in classroom presentation by faculty members. The response has been most favorable, and it is felt that this project has contributed to the increasing number of applications for AMSC student procurement programs.
Warrant Officer Program
During October 1958, the Department of the Army established a new policy governing the mandatory release of non-Regular warrant officers who are qualified for retirement. Such officers must be released upon completion of 20 years of active Federal service unless they are selected by the Department of the Army for further retention. Formerly, all warrant officers could remain on active duty until com?pletion of 30 years of active Federal service or age 62, whichever was earlier. Under the new policy, these retirement provisions apply only to Regulars and to those non-Regulars who are selected for retention beyond 20 years of active service.
The release of non-Regular warrant officers upon completion of 20 years of active duty started at the beginning of calendar year 1959. Of the 54 AMEDS warrant officers attaining retirement eligibility during the calendar year 1959, only 10 were selected for retention as best qualified; 1 of these declined retention, and the other 9 elected to remain on active duty.
The lack of a definite policy by the Department of the Army concerning the future of the warrant officer program continued to present a serious problem. With the probable elimination of MOS 4490 (medical supply officer) and MOS 3506 (field medical assistant) and the accompanying lack of authority to appoint and train warrant officers in these military occupational specialties, it became impossible to provide the necessary replacements required by TD and TOE authorizations in CONUS and overseas. Although warrant officers were being returned overseas after 16 to 20 months of service in CONUS, fewer than 25 percent of the oversea requirements could be met.
Requests for new military occupational specialties for warrant officers, in accordance with the new concept of limiting such MOS to warrant officers with highly technical skills, were submitted to The
70
Adjutant General for medical equipment maintenance technician and environmental health assistant.
Officer Assignment
The Surgeon General took several actions during the year to resolve a longstanding problem-the summer shortages of medical officers resulting from the fact that Reserve officers begin and conclude their obligated tours of active duty in the summer months. The anticipated losses in June, July, and August were even greater than in previous years. The major action designed to alleviate this condition was a de?cision to reduce the length of the July 1959 orientation course for MC officers from 5?weeks to approximately 2?weeks and thus make them available for assignment 3 weeks earlier. In order to ease the shortages of medical officers in USAREUR, permission was also granted to call additional physicians to duty during April 1959. The majority of this group, along with a few volunteers from stations in CONUS, reached USAREUR by mid-May. Fifty were in the group. In addition, authority was granted to waive the orientation-course requirement and assign physicians, trained in certain specialties, direct from civilian life to duty stations in CONUS. Fourteen obstetric and gynecology specialists were placed on orders to report from civilian life direct to duty stations during June 1959. These were officers who normally would have entered on active duty in July. It is anticipated that similar orders will be issued for a limited number of general surgeons and pediatricians to meet critical requirements.
A change in procedure was adopted as a result of the decision to reduce the length of the orientation course for medical officers. This year, advanced information regarding previous training and preference for assignment was requested from the officers scheduled to come on active duty. This information serves as the basis for making tentative assignments for these officers before they report to the Army Medical Service School. It is planned to adopt this same procedure in the case of all future officers coming on duty from civilian life.
Reorganization of the Personnel and Training Division, OTSG, during June 1958, included the consolidation of career planning and assignment activities which has resulted in improved assignment policies by combining theory with practice.
New career patterns for MSC officers were developed in personnel, registrar, hospital administration, and comptroller fields. Action was initiated to distribute career patterns with appropriate written comment to such officers in these career fields.
Reduction in the length of oversea tours of duty in Korea from 16
71
months to 13 months began a cycle of rapid turnover in the assignments of MSC officer personnel. Since more than 20 percent of the officers in that corps are on oversea assignment in Europe, the Far East requirement has caused a considerable drain upon resources in CONUS and, most recently, has necessitated sending to Korea officers who have 2 years or less of active duty remaining before they retire upon completion of 20 years of service. This problem of rapid turnover will undoubtedly become greater in the future and will reduce considerablythe length of tours in CONUS.
Officer Promotions
With two exceptions, the zones of consideration for the temporary promotion of AMEDS officers to grades of captain through colonel were identical during the fiscal year 1959 with those established for theAPL (Army Promotion List). Selections for promotion to the grade of captain in the Veterinary and the Medical Service Corps (in the case of those with a Ph. D. degree) could be made 18 months earlier than provided by the APL.
All selections for promotion to the grade of colonel were made by the 'best qualified' method. This same method was used in selecting of?ficers for promotion to the grade of lieutenant colonel in the Veterinary, Medical Service, Army Nurse, and Army Medical Specialist Corps, and to the grade of major in the Veterinary and Medical Service Corps. All other selections were made on the 'fully qualified' basis. Selectionrates used in selecting best qualified officers were governed by those established for the APL.
In the Medical and Dental Corps, there was a continuation of the policy of advancing officers to the temporary grades of captain, major,and lieutenant colonel on the basis of professional experience attained subsequent to graduation from medical or dental school.
Enlisted Personnel
Strength.-The authorized enlisted strength of the Army Medical Service dropped from 36,699 at the beginning of the fiscal year to 35,499at the close. The actual strength remained fairly constant with 32,957 on duty as of 1 July 1958, and 32,391 on 30 June 1959. The total of enlisted personnel authorized for medical units and activities Army-wide approximates 56,000. This figure includes support personnel in such general fields as administration, food service, motor, maintenance, and engineer, and other specialists representing the other technical and administrative services. The strength balance in the medical military
71
occupational specialties was considered excellent, with shortages of most concern existing in the lower grades in MOS 715 (medical records clerk), in MOS 910 (medical corpsman), in MOS 911 (medical specialist), and in MOS 932 (pharmacy specialist).
Reenlistment program.-In continuing his vigorous support of the Army Reenlistment Program, The Surgeon General placed emphasis on the need for retaining on active duty in the Army Medical Service those qualified individuals in whom the Army has invested training time and funds. The effectiveness of the AMEDS program is evidenced by the fact that the reenlistment rate of 28 percent in fiscal year 1959 was higher than in previous years when the rates ranged as low as 15 percent. The program was actively supported through such media as publicity releases, wall displays, literature, and incentive awards.
Training at military installations.-The number of trainees sent to the Medical Training Center at Fort Sam Houston for advanced individual training in MOS 910 was increased over the number programed owing to the efforts of The Surgeon General to bolster the availability of these individuals for assignment to medical units and organizations. The average of approximately 45 medical specialists trained per week on MOS 911.1 is not sufficient to maintain the authorized strength for this specialty. Consequently, action is planned to increase this training capability in fiscal year 1960. The numbers of enlisted personnel in the various other specialty courses were adequate. The midyear recomputation of training requirements resulted in a substantial increase in training man-years in the last half of the fiscal year.
A new enlisted course (8-R-F13), Food Inspection Procedures (Refresher), was established and conducted at the U.S. Army Meat and Dairy Hygiene School in Chicago during the last half of the fiscal year. A new MOS 715.1 course, Medical Records and Reports (Basic), was approved and will be instituted in fiscal year 1960. Advanced training at the second skill (journeyman) level was given in the following specialties: Medical records clerk, medical specialist, medical equipment repairman, and food inspection specialist. Refresher courses were conducted also for medical equipment repairmen and food inspection specialists. Special on-the-job training arrangements were made at selected hospitals for training in such clinical specialties as cytology, histopathology, and electrocardiography, and in the handling of radioisotopes, and in evaluating the basal metabolic rate. It is believed that more training of this type should be accomplished in the future. In conjunction with the increased emphasis on reducing attrition in the various courses, studies of attrition factors were sponsored by The Surgeon General, by USCONARC, and by the service schools.
73
Training at civilian institutions.-The Surgeon General sponsored a considerable amount of training of enlisted personnel at civilianeducational institutions, at trade schools, at industrial facilities, and at USPHS activities. The duration of such training courses variedfrom 3 days to 1 year. Under the new Army Enlisted Training Program in Civilian Educational Institutions, initiated during the fiscalyear, the Army Medical Service sponsored 14 enlisted men at selected colleges and universities. These individuals pursued an academic course of instruction in such fields as medical technology, entomology, psychology, and food chemistry, and, depending upon their academic standing and degree requirements, they may be selected for an additional year of training. This program is receiving strong support from the Department of the Army and is expected to expand during the next few years. Many commands utilized short courses of instruction offered by civilian schools, industry, the U.S. Public Health Service, and various colleges and universities. Such training is limited usually to highly specialized fields; for example, above-knee prosthetics, laboratory methods for prevention and control of foodhorne diseases, cytology screening, and others.
74
Classification and assignment.-The enlisted MOS classification system is being subjected to continual review, monitorship, and adjustment to meet the changing composition of the modern Army. This is particularly important because classification is fundamental to good assignment. During the fiscal year, the Army Medical Service eliminated MOS 920 (physical medicine helper) and initiated action to eliminate MOS 930 (medical laboratory helper). Action was also initiated to revise the military occupational specialties of food inspection specialist, orthopedic specialist, operating-room specialist, and neuropsychiatric specialist. A change in the oversea assignment system requires that the name of the specific oversea unit to which an individual is being assigned be furnished to his command in CONUS and that the information be included in the oversea transfer orders. This insures that an oversea vacancy actually exists, reduces the time lost in transit, and minimizes replacement center processing. Another change makes it possible for personnel completing oversea tours to be offered the opportunity to indicate a preference for assignment to specific stations in CONUS rather than to an army area, as in previous years. Improvements in the procedures for identifying personnel qualified in specialty fields at basic training centers and new regula?
75
tions on reporting personnel with unusual skills enabled the Army Medical Service to utilize more efficiently the civilian skills of personnel reported under this program. Longer lead time in assignment instruction and oversea levies also added to the efficiency of the reassignment system.
MOSimbalance in grades E-5, E-6, and E-7.-Efforts were continued to reduce the serious overstrengths that still exist in some of the military occupational specialties in the enlisted grades of E-5 (sergeant),E-6 (sergeant, first class), and E-7 (master sergeant), as a of promotions during World War II and the Korean War and the changing composition of the Army. This situation has presented many problems in classification and assignment that cannot be resolved by the usual Army reclassification procedures and attrition. The reclassifying and retraining program designed to correct the MOS imbalance included the imposition of mandatory retraining quotas on ZI armies. Some progress resulted from these efforts but certain specialists were not readily converted to other categories. In such instances, the only alternative is to assign the surplus individuals to the commands on a proportionate basis. This creates utilization problems at the unit level and has had some adverse effect on the promotion system. The most serious overstrengths in these three grades are in medical specialists, preventive medicine specialists, medical records clerks,and medical supply specialists.
Authorization of two higher enlisted grades.-The Army Medical has made considerable progress in implementing the Military Pay Act of 1958 (Public Law 85-422, dated 20 May 1958), which authorized two additional enlisted grades in the Army. The new grades were placed at the top of the enlisted grade structure and designated as pay grades E-8 and E-9. The law was designed to (1) afford more opportunity for advancement of enlisted personnel, (2) relieve the compression that has existed at the top of the enlisted structure, and (3) provide increased incentive for individuals contemplating an enlisted military career.
By the end of the fiscal year, one or both of the new grades had been authorized in the following medical specialties: Dental specialist, medical supply specialist, medical equipment repairman, optical laboratory specialist, medical specialist, medical laboratory specialist, and food inspection specialist. First sergeants and sergeant majors were authorized to hold grades E-8 and E-9, respectively. It will take 2 years to complete the gradual implementation of the program, including appointment quotas, MOS controls, and extension of the higher grades to appropriate MOS's and positions not identified during the first year of the program.
76
Proficiency testing and evaluating system.-Army personnel management authorities have long recognized the urgent need for some standard method of evaluating the job knowledge and performance of enlisted personnel in each MOS skill on an Army-wide basis. As a means to that end, a program for developing proficiency tests, primarily of a written nature, was instituted in fiscal year 1958, and the actual testing was started in January of this fiscal year. The Army Medical Service School, the U.S. Army Medical Service Meat and Dairy Hygiene School, and the U.S. Army Medical Optical and Maintenance Activity were the test development agencies for the Army Medical Service and prepared the test questions for the MOS applicable to their respective courses. The medical laboratory specialist (MOS 931) was one of the 26 MOS's tested in the first cycle. Generally speaking, the tests were well received.
The proficiency tests provide only a numerical rating for the specialist's skill and knowledge communicable through written tests. The second part of the evaluation system is the Commander's Evaluation Report, which is designed to evaluate the individual's actual job performance and personal characteristics The proficiency test and the evaluation rating result in a composite score and provide a relative standing of the individual as compared to all of the others in his grade and MOS. The composite score on an Army-wide basis furnishes the commander with an index which he can use in the personnel management of his enlisted personnel. Possible uses of this index are in such fields as promotion, proficiency pay, classification, assignment, and determination of training needs.
Proficiency pay.-One innovation of the Military Pay Act of 1958 implemented in the fiscal year was the authorization of incentive pay awards to enlisted personnel who are outstandingly proficient in the performance of their duties in specialties in which critical shortages exist. The provision for proficiency pay was based on recommendations of the Department of Defense Advisory Committee on Professional and Technical Compensation (Cordiner Committee). The first proficiency pay awards were made in November 1958 in the amount of $30 per month. This was under an interim program based on an evaluation by local commanders of the MOS they considered critical. With the establishment of the new enlisted evaluation system, it was possible by March 1959 to use this system for confirming or initiating proficiency pay awards. Because of the limitation on the number of proficiency payments authorized and the difficulty of fully implementing such a program immediately, as well as the fact that one of the objectives is to attract personnel from the military occupational specialties in
77
which there are overstrengths to those in which shortages exist, only 26 military occupational specialties were included in the original groups awarded proficiency pay. The only Army Medical Service MOS included was that of the medical laboratory specialist. Based on a mathematical formula which takes into account such factors as reenlistment rates, training time, retention objectives, and shortages, each MOS of the Army was assigned a 'criticality' index for use in connection with both proficiency testing and proficiency pay. The proficiency pay system is to be phased into the Army over a period of years, and it is expectedto take 4 years to implement it completely. Since a new computation of MOS criticality will be made annually in November and the relativecriticality position of the MOS changed accordingly, no stable forecast is possible as to the medical MOS's to be included in the coming fiscal year or years.
Personnel receiving proficiency pay must be assigned to appropriate position vacancies, and orders directing reassignment must include the proficiency pay identification. Better utilization is presumed to result from such control. Personnel receiving proficiency pay must reenlist for their own vacancy to retain the pay. This should reduce personnel turbulence caused by changes of unit assignment upon reenlistment. Thus, one of the first uses of the enlisted evaluation system was that of determining eligibility to receive proficiency pay.
