History

Medical Science Publication No. 4, Volume II

MONDAY AFTERNOON SESSION
26 April 1954

MODERATOR
LIEUTENANT COLONEL DOUGLAS LINDSEY, MC

TRAINING PROGRAM IN THEATER AND ARMY AREA*

LIEUTENANT COLONELDOUGLAS LINDSEY, MC

Ad bellum, pace parati is the motto of the Army's famed Commandand General Staff College. Drawing liberally from the few Latin words weare enjoined to utilize the period of peace to get ready for the time ofwar. Defining period of peace nowadays is a rather difficult thing to do,but the injunction still serves us well. In every lull in actual battle,and at all times in cold war we must be bettering our position to meetwhat may come next.

The need for interminable cycles of training, regardless of the scopeor quality of the initial education, is perhaps more evident to the medicalprofession than any other. None of us regard the M. D. degree, or the completedinternship and state licensure, or board certification as appropriate pointsfor medical education to stop.

The Need for Training in Military Medicine

Besides these general incentives to training, there are other reasonsmore indurate and more tangible why we will always be in the training businessin the Army Medical Service, overseas as well as at home.

First, there is no pool of trained manpower to fill most of the jobsin the Military. The myth that Americans need only to hear the call toarms, and will rush in ready to fight, should have disappeared shortlyafter the Battle of Lexington. We have only the semblance of an organizedand trained reserve. And the distribution of civilian skills does not matchmilitary needs. There are, for example, few legitimate civilian occupationswhich offer significant academic credit toward graduation as a qualifiedrifleman. The services can never use as many lawyers and pharmacists aswill be caught in the draft. And there patently is no pool of young mentrained and ready to go out as aidmen and resuscitate the seriously wounded.

Second, extensive re-training or supplemental training is usually required,even for those with a useful professional or technical civilian background.The company aidman is not just doing Boy Scout first aid on the field ofbattle. The excess pharmacists and college graduates in biology make goodlaboratory technicians, but not just at

*Presented 26 April 1954, to the Course on Recent Advances in Medicine and Surgery, Army Medical Service Graduate School, Walter Reed Army Medical Center, Washington,
D. C.

the stroke of a personnel officer's pen; it takes training. The MedicalCorps employs personnel in jobs more comparable to their civilian occupationthan almost any other major branch of the Army, yet few people disagreethat it is necessary to train the new medical officer in certain aspectsof the military environment in which he works. And whether we admit itopenly or not, the fact remains that many of our newly commissioned medicalofficers are not ready professionally to strike out on their ownin the practice of military medicine. The practice and administration ofpsychiatry was the smoothest professional operation we had in Korea, andthis I attribute to the fact that many of our psychiatrists were trainedas psychiatrists in a military school, and virtually all of ourpsychiatrist replacements received a short orientation course at the EighthArmy psychiatric center before going out to their jobs with divisions.

Third, our military schools and training centers do not turn out a finishedproduct. They do not claim to. They do not intend to. They cannot do itin the time allowed. In time of relative peace the pressure of time isthe necessity of getting a useful period of duty out of a rapid turnoverof short-term soldiers. In time of war it is the urgency of mobilization-toget men out to the units as fast as possible. The unit receiving the trainingcenter or service school product must be prepared to develop it further,by on-the-job training or a formal training program.

Fourth, there are the varying requirements of what we may call facilityand utility. Cadres must be organized, trained and kept current. Unforeseenchanges in mission, equipment and organization must be met with personnelresources at hand. A two-shift operation may have to be worked up froma single-shift allocation of personnel. The vacancies created by illness,emergency and death must be filled more rapidly than the time it takesto process a new personnel requisition. All these things require a degreeof flexibility and versatility which in turn depends on supplemental training.

Last, but certainly as material as the other four reasons, is the factthat the replacement pipeline, and in fact all elements of the personnelmachine, does not operate at or near 100 percent efficiency. Excludingeven relative efficiency, it is hard to believe at the receivingend of the line that anything near the gross quantity that enters at oneend comes out at the other. There is no doubt at either end thatthe qualitative distribution is undependable. At one time thereis an excess of dental laboratory men; at another time these are scarce,and we are loaded with neuropsychiatric technicians. In the Medical CorpsI have become resigned to the fact that the supply, by MOS, bears utterlyno relation to the demand. Even in the versatile Medical Service Corps,tailor-made and specially procured for delimited

military duties, the same discrepancy has existed. At one time in EighthArmy we had psychiatric social workers in foolishly lush numbers, yet wewere having to get officers for medical supply-a key career field for theMedical Service Corps-by training completely raw second lieutenants onthe job, while they were filling supply positions of great responsibility.

All this brings to mind a lecture in one of the service schools, inwhich the organization of the infantry regiment was described as including"3,800-odd men, hardy, intelligent, trained specialists, armed, equipped,and trained to fulfill their mission." If one ever finds a battle-testedinfantry regiment in a combat theater with a full strength of 3,800 men,it will probably be because it has just had several hundred odd,confused, ill-equipped, mal-assigned, poorly motivated and physically questionablenew basics, pardoned prisoners, and hospital returnees dumped on it asreplacements.

For these reasons, and more, we will always have organized training,all the time, and everywhere, in the Army-in fixed installations in theZone of Interior, and throughout the theaters of operations.

By title, the scope of my presentation on this subject embraces thewhole of the Far East Command, for the entire period 1950-53. But implicationfrom the criteria for the selection of speakers-on the basis of first-handknowledge-exempts me from much of this. My actual experience in the theateroutside of Korea is nil. My experience in Korea is confined to the latterhalf of the war. But my interest in the training of medical personnel forcombat has led me to keep contact with that which I did not actually see.

Medical Training in Japan

The medical training in Japan during this period I choose to divideinto three categories: in-service training, specialist training, and basicmedical training. I do not think you are interested in the routine trainingof field medical units in Japan, or the few hours a week of mandatory commonsubjects training which was carried out in all the fixed medical installationsin Japan.

The in-service training programs of which I have some knowledgewere well planned, well organized, and well run. They did not contributedirectly to the operation in Korea or, more strictly, to the level of trainingin Korea. They did contribute to the efficiency of the hospitals supportingEighth Army from Japan. On the average only 60 percent of the techniciansof these hospitals were school-trained, but unit and on-the-job trainingkept 95 percent of the technicians qualified for their jobs.

Of the specialist training in Japan, much of it was informalor individual in-service training in hospitals and other medical units.

Of the organized training, examples are the course for nurse anesthetistsat Tokyo Army Hospital and the 279th General Hospital; the training ofphysical therapy technicians in the hospital at Kyoto; and the basic medicalequipment maintenance course at the Japan Medical Depot. About half ofthe output of this last course went to Korea. Although the graduates werenot polished technicians and did not hold the 1229 MOS, they did much toease the stress of the perpetual, severe shortage of medical maintenancepersonnel.

The Far East Medical Service Specialist School at Shinodayama Barrackstrained enlisted men in the most frequently used specialities: medicaltechnician, surgical technician, x-ray technician, laboratory technician,and pharmacy technician. Most of the students came from hospitals and separatemedical units in Japan; few or none from pipeline. This school closed inJune 1952, and its medical work was carried on, along with various coursesby the other technical services, in a consolidated institution: the EtaJima Specialist School. The medical branch at Eta Jima was the direct successorof the specialist school at Shinodayama, but the slant of the program changed,from specialist training to what amounted to medical basic-the trainingof medical aidmen.

Trainees came almost entirely from pipeline. Basic soldiers were tappedoff from the stream, sent to Eta Jima for technical training, and thenreturned to pipeline for movement to Korea. Although the individual end-productof the school might not be highly skilled, the net result was to deliverto Eighth Army a replacement package more nearly resembling what it hadrequisitioned than did a cross-section of the raw stream as it arrivedin Japan from the United States. The effect of the Eta Jima school wasnot widely known in Korea, but its sudden absence would have brought asharp increase in conscious appreciation. So long as a man came into Koreabearing a needed MOS, and performed reasonably well in it, few people thoughtto ask him where he was trained. The fact that so few people were awareof the Eta Jima school is a credit to the quality of its graduates-theywere successful.

The training period at Eta Jima for medical aidmen was 4 weeks. Sinceall the students had completed 16 weeks of training of some sort in theZone of Interior, all training time could be devoted to technical or branchmaterial subjects, and the scope of the course was then the approximateequivalent of 8 weeks' advanced individual medical training in the UnitedStates. Branch training was on a simple level, as is the case in the trainingof medical aidmen (MOS 1666) and medical corpsmen (MOS 5657) in medicalreplacement training centers in the Zone of Interior. The medical instructionat Eta Jima was even more closely limited to subjects directly perti-

nent to the company aidman and litter bearer, omitting most of the hospitaland attendant technics, even the simplest bed-pan maneuvers that are currentlygiven in our lowest level of medical replacements.

Graduating aidmen were shipped out to Korea where many of them neverserved in their newly-acquired specialty. Receiving commanders often putthem back in their original MOS, mostly as riflemen.

Medical Training in Korea

The medical training in Korea may be conveniently classified as follows:

1. On-the-job training and small unit schools.

2. Tactical training of medical units.

3. Societies; consultants; professional specialists.

4. Training of the Republic of Korea Army.

5. Bulk training.

a. Officers: replacement orientation, formal schooling.

b. Enlisted men: formal schooling.

The necessity for on-the-job training was generally acceptedas routine. A few commanders persisted in petulantly demanding the ready-made,fully qualified replacement to which they were admittedly entitled by Tablesof Organization, but in most cases as a key man, or any man with an individuallyidentifiable job was suddenly lost, or approached time for rotation, themost likely replacement locally available was moved over and trained inthe position. Technicians became sergeants major, ward men became laboratoryor x-ray technicians, and new replacements were trained in their specificclinical and technical duties.

Just as some aidmen were assigned as riflemen, we did get into medicalunits a number of riflemen to be made into medics. In divisions the mostcommon on-the-job training system, and a surprisingly effective one, wasto assign the new men to the collecting station or aid station to learnthere what they could before losses in forward units demanded that theygo out on their own. I have seen company men placed on the line after only2 or 3 hours of medical instruction. On one occasion I found that the senioraidman out of a group of five on the hill had received only 3 daysof instruction in the aid station before he went out. This is on-the-jobtraining with a vengeance.

Small unit schools were handicapped by lack of training material.Official field manuals and technical manuals were scarce in the theater.A few of the more ambitious or more cautious young medical officers broughtinstructional material with them from their course at the Medical FieldService School, and they found it priceless. The field medical man badlyneeds something that the infantryman has in the

Infantry School Quarterly and the Combat Forces Journal. Themedical service has nothing remotely comparable.

Under the heading of unit training I include the strictly "tactical"training of medical units, as well as training in the team performanceof the primary technical mission of the unit under field conditions.

How well we did in our training in the true tactical arts dependson what standard one measured it by. It was spotty, and certainly did notmeet the standards of the infantry, but in comparison with the past I thinkit safe to say that the medical units in Korea learned a great deal aboutjust plain soldiering. In most instances they furnished armed securityfor their own installations. And in accordance with training directivespromulgated by various headquarters they could put into the field, on shortnotice, effective squads and platoons for their own defense. This abilitydid not just arise by the automatic assimilation of a tactical atmosphere,but took deliberate training.

In their ability to act in simulation of normal operations in supportof active, moving warfare-to pack, load, and move; and to disperse, dig-in,black-out, operate and move again-our units varied widely. It is an oddstatement on the face of it, and I cannot document its proof, but I believethat in the latter half of the war the surgical hospitals and other fieldarmy medical units did better in this respect than did the medical battalionsof the divisions. These latter moved on line with their divisions, andthen sighed in relief and settled down, secure and satisfied in the knowledgethat they would stay put for 6 weeks or more. They were on line, and incombat and not inclined to train. Then after a few months the divisionwent into reserve, and the infantry battalions trained and maneuvered whilethe medical battalion sat in the center of the reserve area and operateda clinic and infirmary for the division.

The surgical hospitals, however, sat in one location during most ofthe latter half of the war. In and from that one location, in periods oflow flow of casualties, they could train for the future. Perhaps I soundtoo enthusiastic. It took some strong stimulation to make them train, andwe had a few major training exercises, but on these they did well. Twoof them, the 46th and 47th (formerly the 8225th and 8209th) Surgical Hospitalshad excellent movement plans and good movement training. They restoredmy own faith in the mobility of the surgical hospital, a principle I beganto doubt immediately on my arrival in Korea.

The field army medical units other than the hospitals were distinctlyragged in their training accomplishments. The absence of medical groupheadquarters and additional medical battalion headquarters was painfullynoticeable in the training field.

The question of the training function of medical societies, theutilization of visiting consultants for training, and the localproduction of professional specialists I would like to leave toColonel Salyer. With regard to the last of these I will say only that itis possible and practical to turn out commendably competent professionalspecialists through either organized schools or on-the-job training inan active combat zone. And for the societies and consultants a single sideremark: the combat medical officer's thirst for knowledge, and professionalcontacts is much emphasized, but I think exaggerated. It is not alone sufficientstimulus to assure a good attendance at a scientific meeting. They willsit in their tents and bunkers unless we propagandize and "beat thebushes" to get them out.

The whole vast project of training the Republic of Korea Army wasone of the most important operations of the entire war. In less than 3years' time, masses of rice-paddy laborers and the remanants of a constabularywere transformed into an organized field army, with dependable combat elements,and effective service support. The medical aspects of this operation areintriguing.

The Korean Military Advisory Group (KMAG) included a medical section.It was located in Taegu, and devoted most of its attention to The SurgeonGeneral's Office and the general hospitals and other base-type installationsof the Republic of Korea Army. A field grade medical service officer wasmaintained full time at the ROKA Medical Field Service School, which waspatterned very much like our own school at Fort Sam Houston. It gave bothofficer and enlisted courses, basic branch specialist. It went beyond ourschool in one respect, that of operating a complete school of nursing-fromprobationer, through graduate, to commissioned officer.

KMAG medical representation in forward units was notably lacking. Notuntil the last 6 months of the war, and then only after an arduous campaign,were medical officers assigned as advisors to forward ROKA units. It wasnecessary to place these officers on temporary duty with KMAG, countingthem against the already dangerously low manning level of U. S. medicalunits. The KMAG Table of Distribution never included more than a singleCaptain, MOS 3100, for each ROKA Corps KMAG detachment. This officer officiallywas there to furnish dispensary service for the combined U. S. advisorypersonnel of the corps and the divisions, but as the sole officer representativeof the U. S. Army Medical Service he naturally assumed advisory duties,and in effect became a consulting staff surgeon to an Army corps in combat.The effect on ROKA was sometimes questionable, but the arrangement undoubtedlyserved to give valuable training to the U. S. officers concerned. I recallone young lieutenant, obviously and completely without field experienceon his first assign-

ment in Eighth Army, who later was thrust by circumstance into one ofthese positions and was turned into a creditable corps surgeon.

The cultivation of the ROKA medical service was a continuous, gradualand sometimes tedious process, often with discouragingly long periods devoidof tangible progress. It involved improvement in the supply picture andin personnel status. Besides deliberate and recognizable training it requireda tricky mixture of stubborn force and painstaking tact. In spite of theirappearance of obsequity, the Koreans are a sincerely independent, and ahighly sensitive people. An idea indirectly planted, to germinate in hisown mind, and to be applied on his own authority, is far more valuableto a Korean officer and his unit than is any sweeping offer of technicalassistance or formal training. I found that a few words of halting Koreanwere often more effective in putting a point across than was the most lucidand forceful English-even when the Koreans concerned were wholly fluentin the English language. One really had to live with a Korean unit or staffa little while in order to find out what was going on.

Over and above the fundamental process of organizing, training, supervising,advising and coordinating the operating field medical service of the Republicof Korea Army, there were a great many training projects of a special nature,both official and organized, and personal or informal, in which we trainedthe Koreans to help themselves. An excellent neurosurgical team was builtfrom scratch. Individual officers were trained in psychiatry. SelectedKorean officers and enlisted men were trained in our depots in supply accountingand storage and issue procedures. Korean nurses were trained in our operatingrooms. Our medical societies were open to Korean personnel, and were wellattended by them. Special societies for Koreans were fostered in addition,since many of their key personnel did not comprehend English. Internshipswere established in the hospitals of the communications zone. And, thoughnot strictly pertinent to a discussion of training in a theater of operations,the training of certain senior Korean medical officers as "observers"in our hospitals here in the United States was strikingly effective inraising the quality of ROKA medical service.

I mentioned a moment ago the training of Koreans to "help themselves."We actually did a great deal of training of Koreans to help us. Theuse of KATUSA personnel (Korean Augmentation to U. S. Army) as riflemenin our squads was a measure hastily thrust upon us early in the war. Laterit became a highly organized big business. The use of KATUSA's in medicalunits was not prominent. The few that we had were mostly litter bearers.We did use a great many KSC's (Korean Service Corps-a quasi-military group)and directly hired civilians. These were used mostly in unskilled laborpositions,

but some of them were trained to a high degree of efficiency in technicalor clerical positions.

Late in the war the concept of Type B units was officially recognized.These were units with U. S. Army command and cadre, but with all the unskilledand most of the semi-skilled positions held by native personnel. Naturallythe U. S. cadre will in most instances have to train their own troops.In this the units in Korea did an outstanding job. It is absolutely amazingto see a half-pint Korean in his canvas shoes and baggy uniform, with amechanical background limited to the intricacies of a two-wheeled ox-cart,being trained in a few weeks to drive and maintain a U. S. Army ambulance.

The methodical training of medical personnel en masse was mostconspicuous right at the end of the war, but it was a significant featurefor a longer time, at least during the last 18 months of the campaign.

A systematic 2-day briefing of incoming officer replacements was instituted.It was more than just an orientation to the existing situation and organization.It actually amounted to a highly compressed postgraduate refresher coursein the medical support of a field army in combat. This briefing was greatlyexpanded at the end of the winter of 1952-53 when an acute Army-wide shortageof medical officers necessitated a drastic cut in pipeline time. Officerswere sent to Korea in the early months of 1953 after completion of onlyhalf of the Medical Field Service School basic courses, and even a fewarrived direct from civil life-in Korea with as little as 2 weeks of militaryservice behind them. For these groups a school was set up, and we wentso far as to graduate them with diplomas-clever imitations of the MFSScertificate, suitably modified in heraldry and inscribed "MedicalField Service School, Korean Branch."

Although this was admittedly an abnormal situation and a stopgap measure,the success of the school brought to light many advantages of trainingin a theater of operations. We might file these away to refer to againunder comparable circumstances.

First, these officers, although untrained, furnished the Army Surgeonan immediately available reserve of personnel for emergency use.This advantage is offset by the fact that the "pipeline time"for training is then charged against the theater rather than against theZone of Interior. Instead of getting 18 months duty from these officerswe got 17 months, after subtracting the month of training.

Second, the interest of the students was high. There was no longerany doubt in their mind as to whether they would go overseas, or whetherthey might beat the Far East and get Europe. They could see clearly thepertinence of the instruction. Their performance on the pistol range, forexample, indicated that they appreciated the applicability of even thenon-medical phases of the course.

Third, our training could be more specific. We did not restrictthe scope of the instruction to Korea and the Eighth Army. We could havedone so if the press of time had demanded. We could, and did, emphasizelocal conditions, such as hemorrhagic fever, and specific procedures inthe evacuation system of Eighth Army.

Fourth, our training was realistic. Instead of lice in a Petridish we had lousy personnel to show, and we could demonstrate delousingon the spot. Instead of describing the organization and equipment of divisionartillery we could actually show to these men its disposition on the ground,and they stood in the gun pits while missions were fired. They observedinfantry companies and battalions on training problems while in reserveareas. And some few of them received unscheduled instruction in the distinctdifference between outgoing and incoming rounds.

Fifth, to our pleasure we found that this training strongly stimulatedinterest in and respect for field medicine. From each class we gotmore applicants for battalion surgeons' jobs than we had vacancies tofill. We had more men asking for a command, of any size, than we couldaccommodate between the vacancies existing and the dates of rank of thepersonnel involved.

As for the bulk training of enlisted men we had nothing similarto the briefing we gave the officers. Enlisted replacements were assignedto divisions and separate medical units direct from the replacement depotin Japan. Not until the very last, with the organization of the 30th MedicalGroup, and the consolidation of separate Army medical units under it, couldthere be any centralized orientation of enlisted personnel. The qualityand scope of the orientation and processing by the individual medical unitswas quite variable.

The need for formal training of medical technical and clerical personnelwithin Eighth Army was recognized early, but our tight troop ceiling precludedthe establishment of a separate school. Such of this training as was donewas carried on in selected units which continued operating in their primaryrole while carrying on training at the same time. Other technical servicesdid much the same, except that Ordnance was able to set up a provisionalschool battalion well before the end of the war.

An example of formal training given within an operating unit was theextensive course for laboratory technicians given for several cycles atthe 1st Medical Field Laboratory. We had a number of courses for medicalrecords clerks, given in several different units.

Not until the end of the war were we able to divert units and personneland spaces to the full-time operation of a school center. This center includedthe 34th Medical Battalion, plus a separate clearing company and an ambulancecompany. In addition to the medical offi-

cers occupying T/O positions in the clearing company the professionalpersonnel on the faculty included two attached nurses. They proved to beinvaluable additions.

The success of the school is measured by the fact that liberal quotaswere set; quotas were not mandatory, but all quotas were met, often withdemand for an increase in the capacity of the school. The school servedboth divisional and non-divisional units and offered the following courses:

Course	MOS	Duration
Medical corpsman	5657	3 weeks
Medical technician	1123	4 weeks
Medical records and reports	None	3 weeks
Medical equipment maintenance	None	2 weeks
Operating room technician	1861	8 weeks
Medical aidman	1666	4 weeks
Leadership (medical NCO)	None	4 weeks

These courses were developed to meet the actual and anticipated requirementsof Eighth Army for medical personnel which were not set by training installationsin the United States and Japan. From this standpoint it was soon evidentthat the medical aidman training should be carried on at two more levelsof instruction-the lowest level to meet quantative deficiencies in basicmedical replacements, the higher levels to provide for advancement of aidmenbasically qualified, and already assigned.

As long as we have units and personnel to do the job, I believe thatsuch a school could always be used to good profit in the field army, evenin a moving situation. It could bounce along in the army rear at aboutthe same pace as the larger depots and replacement installations. It woulddo much to cushion the deficiencies that we will always have in the replacementsystem.

Medical Training in Zone of Interior

I cannot help but mention training in the Zone of Interior, at leastinsofar as it affects the necessity for or the scope of the training programin a theater of operations.

I question the effectiveness of our military residency program. In theselection of residents, the orientation of the training, and the assignmentof the end product I personally am skeptical that the taxpayer is gettinghis dollar's worth, or that the U. S. Army Medical Service is utilizingthe program to the best advantage. The program is still deeply tinged withan element of inducement for procurement of officers, to some detrimentof the over-all training of career rnedical service personnel. It doesnot help us in procuring officers interested in true military medicine,the people we need most as Regular officers, and the people most likelyto stay on after their period of

obligated service. The training appears to me to be so heavily slantedtoward the attainment of specialty board certification, and so imitativelypatterned after university hospital residencies, that it assiduously avoidsall military attributes, and the military applications and implications.

Unfortunately I can quote little specific evidence of the qualificationsand defects of Army-trained general surgeons in Korea. There were too pitifullyfew of them. The Regular Corps stayed away from Korea in conspicuous droves.A few residents were on temporary duty in Japan when the war broke out,and they served admirably in Korea. There was a strenuous effort to getthem back to the States into their residencies, as if the moral obligationto continue their training was the most important consideration. Therewas just as strenuous an effort to keep residency training going thereafteruninterrupted and almost unabated, as if the residency program was a shiningexample of the culture we fight wars to defend. What are we training militaryresidents for if not for medicine in support of any army at war? Why notpull residents out of training for 12 to 18 months of duty in Korea?What better training could a military surgeon get than a year or so ofcombat surgery sandwiched in between the years of his formal training?

I have seen little indication that our surgical residents reach boardeligibility knowing any more about débridement than does a residentat New Haven. Actually the senior resident in surgery in an Army hospitalshould be a past master of the theory, and basically qualified in the technic.Our general hospitals see little acute trauma, but some arrangement couldbe made for tours of residents at station hospitals. What training arewe giving in our obstetrical and orthopedic residencies to qualify thesespecialists to function as general military surgeons in the combat zone?No, of course it will not count for their boards, but surely we do notintend to keep all these officers back in the Zone of Interior in a majorwar, and I cannot see that we need all of them in their primary specialtyoverseas. What orientation are we giving our residents as to the why andhow of the administrative processes they rub up against in military hospitals,to prepare them for future assignments as chiefs of service, or hospitalcommanders?

The answers to all these questions are discouraging.

In the field of enlisted training in the Zone of Interior the problemsare different. On the simple question of what is the quality of our enlistedtechnicians-are they good or bad-there are discrepant opinions. Dr. Scottintensively studied a limited number of aidmen, and feels that they aredeficient. Major Mallory had broader contacts with a larger number, andfeels that we may possibly be over-

training them. General Ginn left his position as Surgeon of Eighth Armyand moved to command of the Medical Replacement Training Center just intime to receive a formal complaint, long in channels from Eighth Army,that the MRTC product had been found lacking. I feel that all of us areaccurately appraising the quality of the current aidman, but we differin our estimates and opinions of the theoretical standard. What do we expectof him? What is the ideal? I am inclined to concur with Dr. Scott thatthe field medical technicians should be men of judgment and dependabilitybeyond what we are likely to find in the men we are getting into the jobat present. Judgment, and the background on which to found the versatilitynecessary to assure a dependable result-both of these require experience,and experience is not offered in the medical personnel replacement schemenow operating.

Under the present program recruits are processed and then given a standard8 weeks of basic combat training, designed to qualify them as soldiersno matter what their future assignment in the Army. After basic, some ofthem go to advanced medical training, others to ordnance, engineer or othertechnical training. The infantrymen, artillerymen and tankers continueon in training divisions for their advanced phase.

Medical trainees are split three ways. After 2 weeks of advanced trainingthe men who are already classified as specialists on the basis of civilianexperience (such as pharmacists and laboratory technicians) go directlyout to assignments in the United States. Also at the end of 2 weeks certainmen, varying in number with school quotas, are pulled out of advanced trainingand sent to the Medical Field Service School for special technical training,in courses such as physical therapy, preventive medicine or electroencephalography.These school courses, with one exception, make no provision for a significantlylong applicatory phase. Men are sent out from the school direct to assignmentsin the United States and overseas. In spite of the fact that they may cometo their jobs in a theater with all schooling and no experience I am notworried about them. All of them go to positions where they work under supervision.Not so with the aidman.

The men who do not go directly to schools, and who are to complete thefull 8 weeks of advanced medical training, are divided into two groupswith an approximate 40/60 split. Those with physical or mental limitationsare trained for the lowest medical job; Medical Corpsman, MOS 5657. Thelarger number, with the best physical and mental qualifications, are trainedfor the job of Medical Aidman, MOS 1666. Following this training both groupsare assigned to units, overseas or in the United States.

This selection of the best men, and the most intensive training we cangive them in the time allowed, still does not assure that the 1666 graduatecan do the job we expect of him without prior experience in the actualhandling of sick and injured human beings. The job of company aidman isa position vacancy for a sergeant, five grades up the enlisted ladder fromrecruit. Yet our system puts privates in the job. I feel that arrangementsmust be made for the assignment of technicians to duty as company aidmenonly after appreciable experience and demonstrated ability in a hospitalor dispensary job.

Several times in this presentation I have hinted at the fact that theArmy Medical Service does not have control over medical enlisted personnel.Nothing prohibits the replacement depot from reclassifying a medic, andmaking him an engineer. An infantry regimental commander can, and readilydoes, make an aggressive (or even a reluctant) medical private into a rifleman,or he can move an astute medical sergeant into headquarters or into theheavy mortar company. This distinctly magnifies our training problem, particularlyin the matter of developing medical men for greater responsibility in thehigher grades.

Although this discussion was set up to be a panoramic presentation ofthe actual experience with medical training overseas during the KoreanWar, leaving the moralizing to the later discussants, I would like in closingto make three points, not in summary exactly, since I have not so pointedlyexpressed them thus far:

1. The Army Medical Service needs better control of its enlisted personnel.

2. We need to re-orient our pattern of training, for both officers andenlisted men, toward a military medical career.

3. We must send the best men forward.

Even so, there will always be a need for a training program in the theaterof operations.