History

Annual Report the Surgeon General United States Army Fiscal Year 1960

MILITARY PERSONNEL

Officer Authorizations and Strength

Following the sharp reduction during the previous year in the number of spaces authorized for AMEDS officers, total authorizations were increased by 209 in fiscal year 1960, from 12,895 to 13,104. The only reduction in authorized strength was in the Medical Service Corps, which lost 27 spaces, making a total reduction of 251 spaces in that corps during the past 2 years. The Veterinary Corps ceiling remained unchanged at 400. The authorizations were raised for all the other corps, with the increases ranging from 10 for the Army Medical Specialist Corps to 90 for the Army Nurse Corps and 91 for the Medical Corps. The 3,580 authorization for the Medical Corps is the largest of the six AMEDS corps.

Despite the overall increase in authorizations, the total actual strength of AMEDS officers declined by 80 during the year, from 13,085 to 13,005, resulting in a net understrength of 99 at the end of the fiscal year. The only gains in actual strength were in the Medical Corps (30) and the Veterinary Corps (2). There were net losses in strength in the Dental Corps (54), Army Nurse Corps (53), Army Medical Specialist Corps (3), and Medical Service Corps (2). Table 14 shows the authorized and actual strengths of the various corps at the end of fiscal year 1960 as compared to those at the end of the previous year.

Officer Procurement

Appointments in Regular Army.-Procedures for the selection and commissioning of officers in the Regular Army of the various corps in the Army Medical Service were completely revised during the year to reduce the amount of administrative processing required for the majority of the applicants and to lessen the time required to make such appointments. The revised AR 601-124 will be distributed in July

TABLE 14.-Authorized and actual strength of AMEDS officers, by corps, fiscal years 1959and 1960

Corps	Authorized strength		Actual strength
Corps	30 June 1959	30 June 1960	30 June 1959	30 June 1960
Medical	3,489	3,580	3,614	3,644
Dental	1,789	1,834	1,801	1,747
Veterinary	400	400	402	404
Medical Service	3,517	3,490	3,480	3,478
Army Nurse	3,300	3,390	3,367	3,314
Army Medical Specialist	400	410	421	418
Total	12,895	13,104	13,085	13,005

1960 and become effective in fiscal year 1961. The new procedures pertain to initial Regular Army appointments in all the AMEDS corps, except for certain groups of applicants for commission in the Medical Service Corps. The exceptions are distinguished military graduates of the ROTC (Reserve Officers' Training Corps), who will continue to be commissioned in the Regular Army under the provisions of AR 601-197, and warrant officers, enlisted personnel, and civilians with special technical skills, whose applications will be processed under the provisions of AR 601-100. The revised AR 601-124 groups applicants into four categories in accordance with the extent of administrative processing involved. One of the features of the revised procedures is that action by evaluation boards will no longer be required in processing the applications of commissioned officers who have completed 20 consecutive months of active duty and those of former Regular Army officers who relinquished their commissions under honorable conditions. Evaluation board action will still be required in all other instances.

During this fiscal year, former Regular Army officers, commissioned officers in Reserve components, and officers serving obligated tours of duty continued to be considered for appointment in the Regular Army under the provisions of DA Circular 601-17, dated 29 April 1958. Although the original date of expiration of this circular was to been 31 December 1958, The Surgeon General requested that it remain in effect until further notice, and this was done.

Medical Corps.-Although there were still shortages in certain specialties, the situation in regard to the procurement and retention of MC officers was generally brighter in fiscal year 1960. The Army Residency

Program and the Berry Plan continued to provide more and more board-qualified officers to meet the AMEDS requirements. Somewhat ironically, one of the biggest shortages was in general-duty medical officers.

During the year, the Army procured 460 medical officers under the various provisions of the Berry Plan. Of that number, 284 were ordered to active duty after completing the residency training for which they had been deferred from service for a period of from 2 to 4 years. This was 74 more than the 210 who completed their training and were ordered to active duty in the previous year. Of the other 176 procured this year under the Berry Plan, 145 elected to enter on active duty at the start of their participation in the program, and 31 volunteered for active duty after finishing their first year of residency training.

A total of 182 officers entered the fiscal year 1960 Medical Intern Program, including 72 former participants in the Senior Medical Student Program who actually began their internship late in June 1959. Applications were received during the year from 328 medical school graduates for the fiscal year 1961 Medical Intern Program. Of the 182 internsselected, 56 were participants in the Senior Medical Student Program.

There were 67 enrolled in the Senior Medical Student Program in fiscal year 1960. Applications were received during the year from 199 students for the 70 spaces authorized for the fiscal year 1961 program. The 70 who were selected are expected to enter the program on 1 September 1960. In addition, two graduates of the U.S. Military Academy, who were granted excess leave of absence to attend medical school, will enter the program at the same time.

Since 1956, the Department of the Army has approved the requests of 13 officers of the Regular Army and 1 distinguished military graduate for excess leave-without pay-for a maximum of 5 years for the purpose of studying medicine. Such studies are entirely at the officer's expense, and he must personally arrange for admission to a medical school. Officers attending medical school in this manner are detailed to the Medical Service Corps and are reassigned to a medical facility near the medical school before being placed on leave. They are required to return to duty with pay during the summer months when school is not in session and are assigned appropriate duties as student, observer, or instructor in nontechnical subjects. This not only provides somemeasure of financial support but also affords an opportunity for earlyorientation in military medicine and identification with the Army Medical Service. Army support of these students is based upon the reasonable expectation of both immediate and long-range advantages to the Army. The plan provides an effective means of salvaging the long and expensive training invested in selected Regular Army offi?

cers whose overriding interest in medicine would otherwise impel them to resign upon completion of mandatory service. The objective is to develop a small nucleus of Regular Army MC officers of exceptional motivation who possess specific training for both the military and the professional aspects of their dual responsibilities.

The decrease in the number of applications for the Clinical Clerkship Training Program was disappointing. Only 142 applied and 103 were selected to enter the fiscal year 1961 program in July 1960, as contrasted to the 205 who applied and the 121 who were selected for the fiscal year 1960 program. It is believed that the Clinical Clerkship Training Program has the greatest potential for attracting Army medical intern applicants, since it affords the medical student the opportunity to see for himself what the Army has to offer. Students assigned to National Guard or Reserve units may be selected for clerkships at Army teaching hospitals, or at other appropriate AMEDS installations, for a period not to exceed 60 days, either between their sophomore-junior or junior-senior years. Personnel procurement officers are being urged to place more emphasis upon this program when they discuss the Army Medical Service with medical students.

The number of physicians who volunteered for active duty in the Army Medical Service during fiscal year 1960 exceeded the requirements. As a result, it was necessary to consider the applicants on the basis of their training and the Army's requirement in a given specialty, rather than on a first-come, first-served basis.

A review of fiscal year 1961 manpower requirements, conducted in December 1959, indicated that the Army would have a surplus of approximately 50 physicians who would complete their specialty training in dermatology, pediatrics, anesthesiology, and urology and be available for active duty. This problem was resolved by permitting these physicians to transfer either to one of the other military services or to the U.S. Public Health Service or to fulfill their military obligations by actively participating in Ready Reserve unit training. Such overages result from the fact that many unknown variables have to be estimated when physicians are deferred for specialty training under the Berry Plan.

The increasing impact of the professional training program upon the procurement and retention of Regular Army medical officers is indicated by the net gain during the year of 118 Regulars, as compared to the net gain of 52 in the previous year. At the end of fiscal year 1960, the Regular Army strength of the Medical Corps was 1,725-only 8 short of the post-World War II peak of 1,733 attained on 1 July 1953. This represents a net gain of nearly 400 in the past 4 years, but the number is still 492 below the current Regular Army authorization of

2,217 for the Medical Corps. Table 15 shows the Regular Army authorizations and the actual strength of the various AMEDS corps as of 30 June 1960.

TABLE 15.-Regular Army authorizations and strength of the Army Medical Service, by corps, 30 June 1960

Corps	Authorized strength	Actual strength
Medical	2,217	1,725
Dental	695	555
Veterinary	171	168
Medical Service	1,612	1,425
Army Nurse	2,500	1,194
Army Medical Specialist	350	175
Total	7,545	5,242

Dental Corps.-The Army Medical Service encountered no difficulty during the year in procuring general-duty dental officers but was again unable to meet the procurement objectives established for such dental specialists as oral surgeons, periodontists, orthodontists, and prosthodontists. Nine DC (Dental Corps) officers completed their residency training in three of these specialties (oral surgery, periodontics, and prosthodontics) and a similar number was selected to begin their residencies in the same fields.

The Armed Forces Reserve Dental Officer Program continued to be the prime source of procurement for the Dental Corps. This program produced 344 dental officers in fiscal year 1960 as compared to 202 in the previous year, and all of those who were allocated to the Army and volunteered for active duty were accepted in the Dental Corps.

Twenty-four young dentists, who were selected from a group of 100 applicants, entered the service as dental interns. The Senior Dental Student Program was suspended in fiscal year 1960 and again in fiscal year 1961.

The response of dental students to the Early Commissioning Program continued to improve. This program is designed to interest students in Reserve activities as well as in a career in the Army Medical Service. Those who participate are obligated to accept appointment in the grade of first lieutenant, Dental Corps, Army Reserve, upon graduation. They can volunteer for active duty in accordance with the needs of the active Army for a period of 2 years. There is no assurance that they will be

ordered to active duty at a particular time, since such a call is contingent upon the requirements of the Dental Corps.

During the fiscal year, 487 dental officers were ordered to active duty under the various procurement programs as compared to 406 in the previous year, and 383 of these were procured during the first quarter. It was possible during the year to accept the applications of 15 dentists who requested duty in the Dental Corps as career reservists.

Although the total strength of the Dental Corps continued to decline, from 1,834, to 1,747, the Regular Army strength of the corps increased from 505 to a new alltime high of 555, against an authorization of 695. There were 52 applications for Regular Army commissions in comparison to 47 in fiscal year 1959. While the rate of resignation among the Regulars rose to 1.8 percent, from 0.2 percent in the previous year, the increase was the result of resignations of those individuals who were required to accept a Regular Army commission in fiscal year 1959 in order to participate in the Senior Dental Student and Intern Programs. The requirement to accept a Regular Army commission for enrollment in these programs was removed in fiscal year 1958. Despite the high resignation rate this year, the continuing net increase in Regular Army strength reflects the improvement in the procurement and retention of dental officers that has resulted from the Career Incentive Act of 1956.

Veterinary Corps.-During the fiscal year, 61 veterinarians were commissioned as Reserve officers and ordered to active duty. This was only 5 short of the procurement quota of 66 that has been established. The quota was considerably less than for fiscal year 1959, when a total of 101 VC (Veterinary Corps) officers entered on active duty. The total strength of the Veterinary Corps, however, was 404 at the end of the fiscal year as compared to the authorized strength of 400.

In order to maintain a balanced Regular Army Veterinary Corps, theDepartment of the Army authorized The Surgeon General to procure 29additional Regular Army veterinary officers in the rank of first lieutenant. There was a net gain of 14 in the Regular Army strength ofthe corps, increasing the number on active duty at the end of the fiscalyear to 168.

Medical Service Corps.-The procurement of Regular Army officers for the Army Medical Service Corps continued at an unusually high rate in fiscal year 1960. There was a net gain of 161, increasing the total number of Regulars on active duty in the corps as of 30 June 1960 to 1,425, as compared to 1,264 at the end of the previous year. This was only 187 below the authorization of 1,612. Except for the current (fiscal year 1960) year group, few vacancies existed at the end of the year in any of the year groups other than 1940 and earlier years. In view of this and the current policy that no new appointments will be

made in the 1940 and earlier year groups, it is anticipated that future appointments in the Regular Army Medical Service Corps will be limited largely to the fiscal year 1960 and subsequent year groups.

Within the Regular Army, vacancies exist in all the specialties except entomology, research-experimental psychology, and in the various specialties included in the medical laboratory field other than for clinical laboratory officers. While there are currently no vacancies in these particular specialties, it is anticipated that a few outstanding specialists in these fields will be selected each year in order to maintain a balanced grade and rank distribution within each specialty.

A special procurement program was conducted during the year for the appointment of social workers in the Regular Army Medical Service Corps. There was a good response to this program, and all Regular Army vacancies in this specialty were filled.

With the number of vacancies in the Medical Service Corps steadily decreasing, The Surgeon General has raised the minimum educational requirements acceptable for appointment in either the Regular Army or the Reserve components of the corps. Under the new policy, announced during the fiscal year, no individual will be considered for an MSC commission unless he has a bachelor's degree.

In July 1959, DCSPER directed that, beginning with fiscal year 1961, most of the newly commissioned Reserve officers ordered to active duty in the Pharmacy, Supply, and Administration Section of the Medical Service Corps will be selected from ROTC graduates rather than through the direct Reserve appointment process. As a result, the direct procurement program will no longer be utilized as a means of obtaining Reserve officers for that section of the corps. Some direct appointments, however, will continue to be made in the Regular Army of specialists who have a technical or professional background not possessed by participants in the ROTC program. In addition, a small number of officers for this section are expected to be obtained from the Officer Candidate School and others from some form of recall program. One effect of the new ruling will be that whereas most of the young Reserve officers have been appointed directly to serve for 3 years, a majority of the new officers will serve only 2 years. As in the past, the direct appointment system will still be utilized for the procurement of Reserve officers for the Sanitary Engineering, Optometry, and Allied Sciences Section of the corps. During this fiscal year, most of the serious shortages of Reserve officers were in such specialties as clinical psychology, clinical laboratory, nuclear medical science, and sanitary engineering.

Direct procurement of individuals with the specialties required for the Pharmacy, Supply, and Administration Section of the corps resulted in

142 Reserve officers entering on active duty during fiscal year 1960. As a result of the restrictions placed on direct procurement, the number of ROTC graduates who will enter on active duty in fiscal year 1961 is expected to approximate 220, nearly four times as many as were obtained this year.

Medical Service Corps direct procurement quotas for fiscal year 1960 were essentially filled in all specialties except those of clinical psychology, sanitary engineering, and the various specialties included within the scope of the medical laboratory field. Since procurement quotas for such specialties have not been filled for the past several years, the shortages of officers trained in these fields have become chronic. In an effort to stimulate procurement of personnel in these categories, special procurement literature has been developed for sanitary engineers and clinical psychologists and is now being prepared for medical laboratory officers.

As shown in table 14, the total actual strength of the Medical Service Corps at the end of the fiscal year was 3,478, only slightly below the authorized strength of 3,490. During the past 2 years, approximately 27 percent of the Reserve officers appointed in the corps for 2 or 3 years of obligatory service have been retained.

Army Nurse Corps.-Although the authorization for Regular ANG officers remained at 2,500, the actual strength at the end of fiscal year 1960 was 1,194. There was a net loss of 28 officers during the year, thus continuing the downward trend of recent years in the Regular Army strength. During the year, the Reserve officer strength declined by 25, and as of 30 June 1960 the total strength of the corps was 3,314.

The steadily decreasing number of Regular Army nurses is a matter of great concern, since within the next 5 years many of them will be mandatorily retired (because of age) or will elect to retire voluntarily on the basis of their years of service. A vigorous and continuous recruitment program has been directed toward influencing young Reserve officers to apply for Regular Army commissions. While there has been an increase in applications and appointments in the Regular Army, the number has not been sufficient to offset the impact of the actual and projected losses.

Strenuous efforts are also being exerted to recruit Reserve nurses. The Army Student Nurse Program, established in April 1956, is still the primary source for obtaining qualified young women for appointment in the U.S. Army Reserve and for active duty in the Army Nurse Corps. The number of applications received during the year from participants in this program was larger than in the previous year, and 242 of the 250 spaces allocated were filled. There was a sharp decrease, however, in the percentage of students with baccalaureate degrees

who submitted applications-from approximately 37 percent in fiscal year 1959 to about 21 percent in fiscal year 1960 -because of the strong competition encountered by the Army from other programs that are available to the student nurse. More than 53 percent of the professional nurses commissioned in the Army Nurse Corps during the fiscal year completed their education as participants in the Army Student Nurse Program. This indicates the great extent to which the Army Medical Service has become dependent upon this program as a source of ANC officers.

The Army Nurse Corps procured a total of 298 officers during the fiscalyear. Of this number, 160 were from the Army Student Nurse Program (53.6 percent), 14 from the Registered Nurse Student Program (4.6 percent), 105 from direct appointments (35.2 percent), and 19 were ANC Reserve nurses who returned to active duty (6.3 percent).

Thegeneral shortage of licensed professional nurses is the basic reason for the difficulty encountered in filling the requirements for Army nurses. Greater specialization in nursing and the increasing demands for health services along with the development of new fields of medical practice have contributed to the problem. The recruitment of nurses for the military services has become increasingly competitive. This competition has been enhanced by the fact that civilian hospitals are payinghigher salaries for nurses, have improved the working conditions and the housing, and are offering other inducements to attract them. In fiscal year 1960, as in other recent years, the Army Medical Service had to employ approximately 1,300 civilian nurses to supplement ANC officers in order to fulfill nursing requirements.

Army Regulations No. 601-139, dated 22 July 1959, with Changes 1, dated 2 May 1960, provided a more rapid system for the processing of applications for Reserve commissions in the Army Nurse and Army Medical Specialist Corps. The regulations also allow more liberal credit for education and experience in the appointment of Army Nurse Corps officers. This recognition of advanced preparation is expected to promotethe recruitment of the personnel necessary to support the mission ofthe corps. The aggressive competition with civilian and other military medical organizations for nursing personnel has forced the Army Medical Service to study and revise constantly its procurement programs in order to obtain individuals who possess the greatest potential for a career in Army nursing.

Army Medical Specialist Corps.-The overall status of AMSC (Army Medical Specialist Corps) officer procurement and retention continued to improve, and all three sections of the corps were either at or above their authorized strength at the end of fiscal year 1960. Because of

the higher retention rate, procurement of AMSC officers was halted in the middle of the fiscal year in order to meet the programmed yearend strength. The total actual strength as of 30 June was 418, against an authorization of 410. The Dietetic Section, with 163 officers on active duty, and the Occupational Therapist Section, with 80, were exactly at their authorized strength. There were 175 officers in the Physical Therapist Section, an overstrength of 8. The authorizations for fiscal year 1961 were increased for dietitians from 163 to 170, and for physical therapists from 167 to 170.

Procurement of AMSC officers continues to be dependent primarily upon the six educational programs conducted each year. While there was an increase in applications, the numbers received were still not sufficient to permit the desired degree of selectivity, except for the Dietetic Summer Practicum, which is not a direct procurement program. This program, which has been increased from 4 to 6 weeks, is designed to provide practical experience for the undergraduate student with a major in foods and nutrition or institutional management. Its purpose is to interest young women in hospital dietetics as a career and to point out to them the advantages of such a career in the Army Medical Service. The 69 applications received from junior home economics students for participation in this program represents a large gain over the previous year. It is anticipated that 43 of these applicants will participate in the program during the summer of 1960 as temporary civil-service 'student employees.'

Fifteen home economics students participated in the Army Student Dietitian Program during the year. Of these, nine were selected in fiscal year 1960. Participants in this program are required to enlist in the Women's Army Corps, Army Reserve. When they can meet the qualifications, they apply for a commission as a second lieutenant in AMSC Reserve and for appointment as an Army dietetic intern. Nine participants in the Army Student Dietitian Program and ten other qualified applicants were selected for the fiscal year 1961 Dietetic Internship Program. During this fiscal year, 22 completed their internships and 25 entered the program. In addition, four qualified dietitians were ordered to active duty.

Twelve student officers completed the Physical Therapy Course, the primary source for obtaining Regular Army physical therapists. Nine others entered this course during the year, and seventeen were selected to participate in fiscal year 1961. Eight qualified physical therapists received their commissions and were ordered to active duty.

Because of the improved retention rate among occupational therapists, the quota for the Occupational Therapy Clinical Affiliation was reduced to five, and all of the participants completed the program during the

year. Eight of the nine occupational therapists ordered to active duty in fiscal year 1960 were clinical affiliates who will begin their training in fiscal year 1961.

Although the number of applications received for Regular Army commissions in the Army Medical Specialist Corps remained fairly stable, the losses sustained resulted in a decline in the Regular Army strength of the corps from 181 to 175. This is only 50 percent of the authorized strength.

Officer Assignment

Shortages of medical officers in the clinical specialties of obstetrics and gynecology, general surgery, otorhinolaryngology, and orthopedics occurred during the early part of the fiscal year. These were alleviated by the assignment to active duty of residents who completed their training in these specialties in December 1959. The most critical shortage during the year was that of general-duty medical officers (MOS 3100). This necessitated the assignment of a large number of specialists with the prefix 'D' rating as general-duty medical officers in order to meet the requirements.

One of the continuing problems in assignment was that caused by the relatively small number of officers in the Army Medical Service who have had experience in command and general staff duties. Only 189 Regular Army officers have a primary MOS in this field. During the fiscal year, Reserve field-grade officers with a primary MOS in clinical specialties had to be diverted to command and staff positions.

The change in Department of the Army policy, late in fiscal year 1959, regarding individual entitlement to temporary duty reimbursement, resulted in a revision of the method of issuing initial assignment orders. Under the revised system, orders are issued to an individual before he enters on active duty, designating his first duty station with temporary duty en route at the Army Medical Service School. This procedure has a number of advantages. It gives the individual advance knowledge of his assignment and entitles him to per diem allowance while he is a student at the school. It also obviates the necessity for sending personnel officers to the school from the OTSG to interview the officers concerning their assignment.

The policy for selecting officers to attend the AMEDS Officer Advanced Course at the Army Medical Service School was modified to permit maximum productive utilization of personnel who are completing specialty training and meeting the requirements of American specialty boards before being sent to the school. The availability of such officers for attendance at the advanced branch course should be improved by the current policy which projects assignments sufficiently in advance to

alleviate interference by unanticipated requirements and unscheduled extensions of oversea tours of duty.

A new system for planning in advance for the assignment of medical officers was devised during the year and will undergo its first real test in the first quarter of fiscal year 1961. This system takes into account such factors as station requirements, the individual's qualifications and preference, impact on careers, and the recommendations of professional consultants.

A new concept concerning tours of duty for MSC officers has been developed by the Department of the Army in recognition of the severe impact that the increasing number of losses resulting from the mandatory retirement of officers during 1960 and 1961 will have upon the effectiveness of the Army. It is not always possible to follow the previous policy of not reassigning officers who are within 2 years of mandatory retirement. It has become necessary to send a number of officers in this category overseas to short-tour areas. In the long-tour areas, the Department of Army policy provides that officers who have 6 months or less to serve upon their return to CONUS before mandatory retirement will be retained overseas until eligible for retirement. Officers who have from 6 to 18 months to serve before mandatory retirement will be encouraged to extend their oversea tour. This policy is based upon the desire to reduce the number of short-term CONUS assignments and thereby increase the effectiveness of CONUS units.

The steady drain of providing approximately 150 MSC officers annually for short-tour oversea assignments, in addition to maintaining other oversea area strengths, has reduced considerably the timespan between oversea tours. In the case of company-grade officers andmajors, the maximum tour in CONUS, except for certain specialists, is now 36 months. Within the next 18 months, the tour of company- grade officers in CONUS will probably be reduced to 24 months. Other technical services are presently assigning officers overseas after serving only from 18 to 24 months in CONUS.

Career patterns for MSC officers in 11 specialties were developed during the fiscal year. These include pharmacy, supply, hospital administrators, operations and training, medical technical intelligence, social work, podiatry, laboratory sciences, sanitary engineering, optometry, and entomology. Patterns for career officers in the fields of personnel, registrar, and comptroller were completed during the previous year, leaving only three patterns to be formulated-aviation, psychology, and nuclear medicine science. Patterns are being sent to each career officer, along with appropriate written comments. The new specialty of podiatry has won wide acceptance by all commands

alleviate interference by unanticipated requirements and unscheduled extensions of oversea tours of duty.

The steady drain of providing approximately 150 MSC officers annually for short-tour oversea assignments, in addition to maintaining other oversea area strengths, has reduced considerably the timespan between oversea tours. In the case of company-grade officers and majors, the maximum tour in CONUS, except for certain specialists, is now 36 months. Within the next 18 months, the tour of company-grade officers in CONUS will probably be reduced to 24 months. Other technical services are presently assigning officers overseas after serving only from 18 to 24 months in CONUS.

Experience has demonstrated that increasing utilization can be made of MSC officers in this field.

Because of the obvious discrepancy between the authorization and strength of the Army Nurse Corps during fiscal year 1960, most stations, particularly in CONUS, experienced a consistent shortage of ANC officers. The requirements for nurses decreased in Japan, and the closing of several CONUS installations released additional spaces. The authorization at the Tripler Army Hospital, however, was increased when the number of Navy nurses assigned there was decreased, and the authorizations of several class II installations in CONUS had to be augmented to meet the rising requirements for nurses needed to support medical advancement. There have also been increased requirements for nurses in other fields, such as ANC instructors at the Medical Training Center and at the Brooke, Letterman, Fitzsimons, and Walter Reed General Hospitals; for ANC procurement officers in the First, Third, and Fifth U.S. Army Areas; and for nurses assigned to STRAC units.

Officer Promotions

Promotion policies remained unchanged during the year. All zones of consideration for the temporary promotion of AMEDS officers continued to be identical with those established for the APL (Army Promotion List) with two exceptions. Selections for promotion to the grade of captain could still be made 18 months earlier than provided by the APL in the Veterinary Corps and in the Medical Service Corps (in the case of those with a Ph. D. in a science allied to medicine).

Selections for temporary promotion to grades of major and lieutenant colonel in the Medical and Dental Corps were continued on a 'fully qualified' basis, as were the selections for the grade of major in the Army Nurse and Army Medical Specialist Corps, and all selections for the grade of captain. Selections for all other grades were made on a 'best qualified' basis, with the selection rates governed by those established for the APL.

The Surgeon General continued the policy of advancing MC and DC officers when they attain the professional experience required for promotion to higher grades. These officers were considered for temporary advancement to the grades of captain, major, and lieutenant colonel upon completion of 1, 10, and 17 years of experience, respectively, subsequent to graduation from medical or dental school.

Warrant Officer Program

The Adjutant General issued a series of directives during the fiscal year establishing a new Warrant Officer Career Program. This program

will affect the warrant officers in the Army Medical Service as follows:

1. The only AMEDS warrant officer MOS in the foreseeable future will be that of the medical equipment repair technician (MOS 4890). The MOS's of field medical assistant (3506) and medical supply officer (4490) have been placed on the list of MOS's to be discontinued.

2. All Reserve medical administrative and medical supply warrant officers with less than 15 years of total active service will be required to (a) retrain in the medical equipment repair field, (b) apply for some authorized nonmedical MOS, or (c) be released from active duty.

3. All Regular Army warrant officers who are eligible to remain in the service for 5 years or more will be urged to complete any training necessary to qualify them for an authorized MOS. Those in this group who do not desire or are not qualified for retraining will be used, along with Reserve warrant officers with more than 15 years of service, to fill commissioned spaces until they retire.

All medical equipment maintenance commissioned officers (MOS 4890) were reclassified in March 1960 into other MOS's. At the same time, action was taken to start training and reclassifying some warrant officers in the specialties of field medical assistant and medical supply officers for transfer to the medical equipment maintenance field. The records of all warrant officers in these two specialties were screened in the Personnel and Training Division, OTSG, and those meeting the prerequisites for medical equipment maintenance training were notified. All 25 warrant officers who qualified as medical equipment repair technicians were awarded a permanent MOS 4890. A 46-week Medical Equipment Repair Course has been established at the U.S. Army Medical Optical and Maintenance Activity in St. Louis, Mo., to train warrant officers in this specialty. Tentative approval was received from DCSLOG and DCSPER to establish 75 AMEDS spaces in this field.

The Surgeon General has requested authority to accept qualified warrant officers from other arms and services for training as medical equipment repair technicians and also to give warrants to a few enlisted men who are highly qualified in the medical equipment maintenance field. Although the General Staff has tentatively approved these proposed procurement actions, formal authority had not been granted by the end of the fiscal year and no procurement spaces had yet been authorized.

The OTSG initiated action to amend all tables of distribution andtables of organization and equipment which contain MOS 3506 or4490 warrant officer positions, and those which contain commissionedofficer MOS 4890 positions. All commissioned officer MOS 4890 positions

tions in these tables will be converted to warrant officer MOS 4890 positions. Some of the MOS 3506 and 4490 warrant officer positions will be converted to commissioned officer positions; others will either be converted to enlisted personnel positions or be eliminated.

Of the 37 AMEDS warrant officers eligible for retirement from active duty in calendar year 1960, none were selected for retention. Since the Department of the Army, in October 1958, established the new policy governing the mandatory release of non-Regular warrant officers when they qualify for retirement (except those selected for retention), there has been a steady decline in the AMEDS warrant officer strength. As of 30 June 1960, only 216 warrant officers were on active duty, as compared to 248 a year earlier and 295 at the end of fiscal year 1958.

Enlisted Personnel

Strength.-The authorized strength of enlisted personnel under the overall command of The Surgeon General at the end of fiscal year was 38,274, while the actual strength was 42,586. Of the latter, 1,664 were in either a training or a transient status and not chargeable to personnel authorization. The net overstrength, therefore, was 2,648, which represents approximately the number of losses anticipated during the early months of fiscal year 1961. The only significant shortage of enlisted personnel was that of 80 pharmacy specialists (MOS 932) which has resulted from the fact that smaller numbers of pharmacists are entering the Army through the Selective Service System.

Reenlistment program.-The Surgeon General continued to emphasize the importance of making every effort to retain in the Army Medical Service qualified enlisted personnel in whom the Army has invested training time and funds. The improved retention rate indicates that these efforts are bringing results. Of the enlisted personnel under The Surgeon General's command who were separated upon completion of their term of service, 34 percent reenlisted the day following their discharge. Among the career Regular Army soldiers, 83 percent reenlisted, while 31 percent of the first-term Regular Army soldiers and 24 percent of the soldiers in the Reserve components reenlisted. On the other hand, only 4 percent of the inductees decided to reenlist upon completion of their obligated service during the year.

Training at military installations.-A total of 16,576 enlisted personnel participated in training programs at AMEDS facilities in the fiscal year. The bulk of these, 13,453, received advanced individual training at the Army Medical Training Center, Fort Sam Houston, to prepare them for duty as medical corpsmen or as a prerequisite for training in higher skills. The others were given preliminary or advanced

Enlisted medical personnel, after a simulated atomic bomb attack, administering treatment to simulated wounded

training in their assigned specialties. These included 2,708 who were trained at the Army Medical Service School, 181 at the U.S. Army Medical Service Meat and Dairy Hygiene School in Chicago, Ill., 92 at the U.S. Army Medical Optical and Maintenance Activity, and 142 at Brooks, Fitzsimons, Letterman, and Walter Reed General Hospitals.

Of the total number trained during the year, 4,442 were personnel who had enlisted under the RFA-55 (Reserve Forces Act of 1955) and were sent to the Army Medical Training Center for 14 weeks of medical instruction after completing 8 weeks of combat training. All the 4,442 completed 8 weeks of training as medical corpsmen (MOS 910.0). In addition, 2,232 of them completed 4 weeks of training as medical specialists (MOS 911.1), while 80 attended service school courses at the Army Medical Service School, and the others completed 6 weeks of basic unit training at the Army Medical Training Center.

A major improvement was made in the RFA-55 training program, effective 4 January 1960, when a separate line of training was established to provide medical specialist instruction to all these personnel immediately following their medical corpsman training. All the RFA-55 trainees will now receive 8 weeks of medical corpsman training, 4 weeks of medical specialist training, and 2 weeks of basic unit training; or, they will be given medical corpsman training followed by attendance at a service school course.

The combined annual training capability of the four hospitals (Brooke, Fitzsimons, Letterman, and Walter Reed General Hospitals) that conduct the 46-week Advanced Medical Specialist Course (8-R- 911.3) has been increased from 150 to 350 students for fiscal year 1961. This course produces an individual who is qualified to operate hospital wards as an assistant to the charge nurse or ward physician.

Because of the existing and projected shortages of pharmacy specialists, arrangements have been made to train approximately 50 Regular Army enlisted men annually in the Navy's 32-week Pharmacy Technic Course (NEC-HM-8482) at the U.S. Naval Hospital at Portsmouth, Va. This training will enable the Army to attain stability in this specialty and to utilize fully the limited number of pharmacists who enter the Army through the Selective Service System.

The Advanced Dental Laboratory Procedures Course (8-R-452.2) was reduced from 20 to 18 weeks and the Advanced Dental Assistant Course (8-R-917.2) from 20 to 16 weeks, thereby making both courses available to personnel in a temporary-duty status without a change of permanent station. The Basic Medical Equipment Maintenance Course has been renumbered 8-N-208.1 and shortened from 18 to 10 weeks; the Advanced Medical Equipment Maintenance Course renumbered

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numbered 8-N-208.2, and shortened from 32 to 30 weeks; and the Advanced, Electronic Phase, Medical Equipment Maintenance Course (8-R-F12) has been changed to the Medical Equipment Maintenance Course (Supplementary and Refresher) and renumbered 8-N-F12. In addition, these three courses are now to be conducted for warrant officers as well as for enlisted personnel. The annual training capacities for the Medical Records and Reports Course (8-R-715.1) and the Medical Laboratory Procedures Course (8-R-931.1) have been increased from 150 to 300 students and from 528 to 768 students, respectively, to provide for the training of the additional personnel in these fields that will be needed in fiscal year 1961.

There has been an annual requirement to train approximately 5,000 active Army enlisted personnel as medical specialists (MOS 911.1), but the training capacity at the Army Medical Training Center was only 2,500. By allocation of additional funds and trainer personnel, the annual training capacity in this specialty will be increased, effective 1 July 1960, and nearly 4,500 are programmed to be trained during fiscal year 1961.

Several medical specialties do not lend themselves to formal service school courses, either because of the small number of personnel required in the specialty or because of the specialized facilities needed to conduct the training. Accordingly, on-the-job training was conducted at 7 Army general hospitals for 7 orthopedic brace specialists (MOS 451.3) and 20 orthopedic cast specialists (MOS 451.2) during the year. On-the-job training was also conducted at the U.S. Army Medical Optical and Maintenance Activity for seven optical laboratory specialists (MOS 453.1), and at the Fitzsimons General Hospital for one prosthetic eye technician (MOS 002.7). Arrangements have been made to provide on-the-job training during fiscal year 1961 for 36 veterinary specialists (MOS 084.1) at the Walter Reed Army Institute of Research and at the Army Medical Research Laboratory, and for 11 physical reconditioning specialists (MOS 922.1) and 16 occupational therapy specialists (MOS 923.1) at the Letterman and Valley Forge General Hospitals.

During the year, two enlisted men attended the Aeromedical Evacuation Technician Course conducted by the Air Force, and one attended the Pharmacy Technician Course presented by the Navy.

Training at civilian institutions.-The Surgeon General continued to sponsor the training of enlisted personnel at civilian educational institutions. Fourteen individuals continued the training they had started during the previous year under the Army's 2-year college program (AR 350-260), thirteen new personnel entered such training, and two individuals were eliminated from this training because of academic deficiencies. The Surgeon General has decided to limit his future

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sponsorship of training under the college training program for enlisted personnel to three major fields-medical laboratory technology, food technology, and nuclear physics-and to restrict the number entering this training to 20 per year. Nineteen enlisted men were trained at civilian institutions during the year in such short courses as allergy techniques, cytology screening, specialized crown and bridge work, and orthopedic fabrication. In addition, 26 enlisted men attended the courses in venereal disease control and communicable disease control conducted by the U.S. Public Health Service.

Classification and assignment.-The job description for each military occupational specialty monitored by The Surgeon General has been reviewed to determine if it is adequate and whether changes are necessary. As a result of this review, the specialty of medical laboratory helper (MOS 930.0) was eliminated, and the positions and individuals classified in this MOS were reclassified into medical laboratory specialists (MOS 931.1), pharmacy specialists (MOS 932.1), preventive medicine specialists (MOS 933.1), food inspection specialists (MOS 934.1), or X-ray specialists (MOS 935.1). This change was made because it would take longer to train a single individual as a helper qualified in all these fields than it would to train a technician skilled in any one of them.

The job description for the neuropsychiatric specialist (MOS 914) was revised to require additional skills and knowledge in accordance with the new techniques used in treating psychiatric patients. The revised MOS description has been approved and is now pending publication in Army Regulations.

The MOS for medical equipment repairman was revised to establish the requirement that personnel must complete the Advanced Medical Equipment Maintenance Course in order to qualify for MOS 208.2 and MOS's 208.6 through 208.8. This action was required to preclude the awarding of this highly technical MOS to personnel who have not had adequate training and who cannot satisfactorily perform maintenance functions appropriate to their grade and specialty. It will be necessary to retrain 28 individuals who are now classified in the MOS but have not had the essential technical training for it. The revised MOS has been approved and will be published in Army Regulations.

Studies have been made and further studies are continuing in regard to revising the MOS for medical specialist and the related training programs. Since individuals classified in this MOS constitute nearly one-half of the AMEDS enlisted personnel requirement, extreme care is being taken to assure that the revised MOS description accurately reflects the job-skill requirements and the training needed to attain these skills. Pending revision of the MOS description, the awarding of the

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MOS has been restricted to personnel completing officially recognized courses to preclude its award to untrained personnel.

Because of the existing shortage of pharmacy specialists (MOS 932) and of the further shortages that are anticipated in this specialty, a newly established policy prohibits the assignment of these personnel to STRAF (U.S. Strategic Army Forces) medical units and decreases the number assigned to STRAC units. This action temporarily reduces, by 56 men, the Army's requirement for enlisted personnel in MOS 932 and will result in better staffing of medical facilities with medical care and treatment missions.

Imbalance between noncommissioned officers and specialists.-The overages of noncommissioned officers and shortages of specialists-often in the same specialty-continues to present a serious problem in personnel utilization to the Army Medical Service as well as to the Army as a whole. The various changes in personnel policies, rapid promotions during World War II and the Korean War, and the high reenlistment rates for noncommissioned officers along with the low reenlistment rates for specialists have resulted in the Army's having considerably more noncommissioned officers than there are positions in some MOS's. Consequently, the noncommissioned officers must be utilized in positions that often are inappropriate to their grades. It is anticipated that the voluntary retirement of noncommissioned officers upon completion of 20 years of service will alleviate this situation considerably during the next 3 years. Meanwhile, those who are qualified for specialist-level MOS's in their current pay grades are being encouraged to accept reappointment to specialist status.

Implementation of E-8 and E-9 upgrading program.-Implementation of the two new top grades for enlisted personnel, which were authorized by the Military Pay Act of 1958 (Public Law 85-422, approved on 20 May 1958), have resulted in a worldwide AMEDS authorization of 486 enlisted personnel as master sergeants or first sergeants in grade E-8 and of 150 as sergeants major in grade E-9 in nine different MOSs. By the end of the fiscal year, there were 312 in grade E-8 and 70 in grade E-9. Most of those in grade E-8 and all of those in grade E-9 were classified as medical specialists (MOS 911). Table 16 shows the numbers authorized and the actual strengths in the two grades.

Proficiency tests.-A system for testing enlisted personnel to determine and evaluate their proficiency in their various specialties was instituted on an Army-wide basis during the previous year. These proficiency tests were continued in fiscal year 1960 when personnel in the following MOS's monitored by The Surgeon General were tested: Dental laboratory, medical, medical laboratory (second testing), pharmacy,

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and X-ray specialists. Proficiency tests for personnel in 20 AMEDS MOS's have been scheduled during fiscal years 1961 and 1962.

Proficiency testing provides the Army with two significant scores for each individual tested. One score indicates the individual's actual score on the written test pertaining to the skills and knowledge required in his specialty. The other score combines the written-test score with the scored evaluation report submitted by the individual's supervisor. Although these test scores have been used only for the purpose of awarding MOS proficiency pay, it is anticipated that they will be

TABLE 16.-Authorizations and actual strength of noncommissioned officers in the two newtop enlisted grades

Title and MOS	Authorized strength		Actual strength
Title and MOS	E-8¹	E-9²	E-8¹	E-9²
Medical equipment maintenance specialist (208)	6	---	5	...
Dental laboratory specialist (452)	5	---	3	---
Optical laboratory specialist (453)	2	---	3	---
General supply specialist (768)	58	---	28	---
Medical specialist (911)	365	150	234	70
Dental assistant (917)	28	---	13	---
Medical laboratory specialist (931)	11	---	10	---
Preventive medicine specialist (933)	1	---	3	---
Food inspection specialist (934)	10	---	13	---
Total	486	150	312	70

¹Master sergeants or first sergeants.
²Sergeants major.

utilized to determine the individual's qualifications for retention in an MOS and his eligibility for promotion.

Proficiency pay.-An additional $30 per month, which was authorized by the Military Pay Act of 1958 as an incentive to enlisted personnel who are outstandingly proficient in their specialties, was awarded during the year to 6,400 medical specialists. Similar awards were made to several hundred dental laboratory, medical laboratory, pharmacy, and X-ray specialists. Beginning in July 1960, medical laboratory specialists will be awarded proficiency pay in the amount of $60 per month.

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