History

CHAPTER I

Preparations for World War II

TRAINING BETWEEN THE WARS

Training facilities of the U.S. Army Medical Department in 1939 reflectedadaptation to peacetime medical requirements. From a World War I peak ofover 340,000, the Medical Department's strength had been reduced to a littleover 11,500 officers and enlisted men by June 1939. Enlisted personnelhad been reduced by the National Defense Act, as amended in 1920, froma wartime concentration of nearly 10 percent of the Army's enlisted strengthto a statutory maximum of only 5 percent. Because all but a fraction ofthe enlisted strength was needed to care for the garrison army, field traininghad been neglected. The five Medical Department field units that existedwere either understrength or skeleton organizations; trained enlisted cadrecould not have been provided in case of mobilization. Without enlistedpersonnel to man units, officer training could be little more than theoretical.¹

Peacetime Components of the Medical Department

Under the National Defense Act, as amended in 1920, the Army was dividedinto three components: the Regular Army, the Reserves, and the NationalGuard.² The Regular Army consisted of officers and enlistedpersonnel who were continuously on active duty. The Reserves were designedto meet immediate needs for manpower in the initial stages of mobilization,and the National Guard was a state organization intended for use in anemergency or in actual hostilities. The Medical Department was dividedby function into seven basic components: the Medical, Dental, Veterinary,Sanitary, and Medical Administrative Corps, composed of officers of commissionedrank; the Army Nurse Corps, whose members held relative rank; and the enlistedpersonnel necessary to support the professional staff. These medical elementswere represented in each of the Army's Reserve and Regular components,with the exception of the Sanitary Corps, which was found only in the Reserves,and the Army Nurse Corps, which was not organized in the National Guard.³

In the peacetime Medical Department, technical duties were performedby a variety of personnel, including commissioned and enlisted membersof the Regular

¹(1) Committee to Study the Medical Department,1942, Testimony, pp. 1-2. (2) Smith, Clarence McKittrick: The Medical Department:Hospitalization and Evacuation, Zone of Interior. United States Army inWorld War II. The Technical Services. Washington: U.S. Government PrintingOffice, 1956. (3) Medical Department, United States Army. Personnel inWorld War II. Washington: U.S. Government Printing Office, 1963. (4) 41Stat. 766.
²41 Stat. 759.
³See footnote 1 (3).

Army, members of the Army Nurse Corps, and civilian specialists employedeither under civil service regulations or by The Surgeon General underspecial contract. The commissioned Regular Army personnel consisted ofphysicians assigned to the Medical Corps, dentists assigned to the DentalCorps, veterinarians assigned to the Veterinary Corps, and nonprofessionaladministrative officers, who were assigned to the Medical AdministrativeCorps. Regular Army enlisted men were not assigned to corps but were utilizedin administrative, clerical, training, and technical capacities for whichthey were qualified by civilian experience or Medical Department training.Civilians were employed at various installations, including hospitals,laboratories, supply depots, and offices, in a variety of positions, rangingfrom laborers and trained artisans to highly skilled technicians, therapists,and dietitians. The Surgeon General also employed a small number of doctorsunder special contract, usually for part-time duty at small posts.

To supplement these personnel in an emergency, the Army maintained aMedical Department Reserve. Commissioned members of the Medical DepartmentReserve were assigned to five Reserve corps: the Medical, Dental, Veterinary,Medical Administrative, and Sanitary Corps. Reserve officers in the firstfour of these corps had the same professional qualifications as officersin the corresponding corps of the Regular Army, and those in the firstthree corps were usually commissioned upon completion of the Reserve Officers'Training Corps program at civilian medical schools. The Sanitary CorpsReserve consisted of men with experience and college training in technicalfields allied to medicine, such as chemistry, sanitary engineering, orhospital architecture. The Medical Administrative Corps Reserve consistedlargely of World War I officers with administrative experience who continuedin the Reserves after the war, senior active-duty noncommissioned officerswho also held Reserve commissions, and, after 1936, graduates of accreditedpharmacy schools who applied for Reserve commissions. The number of enlistedreservists was negligible. Reserve officers were required by law to attendperiodic meetings, and the law permitted the Government to call them toactive duty for 2 weeks each year. War Department policy, however, wasto call them for such duty only upon their own application. Reserve officerswere also required to complete a limited number of Army extension courses.⁴

In contrast to the Medical Department Reserve, which emphasized thetraining of individual officers, the Medical Department of the NationalGuard had a high level of enlisted strength and emphasized the trainingof field units (table 1). In addition to providing organic medical supportfor regiments and smaller units, the National Guard possessed a numberof independent medical units designed to be attached to larger units. Theseincluded 19 regimental headquarters, 12 battalion headquarters, 20 collectingcompanies, 45 motorized ambulance companies, 29 hospital companies, anda number of veterinary and service companies. Taken together, they possesseda far greater capability for providing field medical service than did unitsof the Regular Army. In 1939, The Surgeon General reported that the NationalGuard had achieved the highest level of training in its history. Becauseof

⁴The Army of The United States, Senate DocumentNo. 91, 76th Congress, 1st Session. Washington: U.S. Govern ment PrintingOffice, 1940.

TABLE 1.-Approximate strengthof peacetime components of the U.S. Army Medical Department, 1939

Component	Regular Army	Reserves	National Guard
Medical Corps	1,098	15,198	1,085
Dental Corps	221	5,063	234
Veterinary Corps	126	1,381	66
Medical Administrative Corps	64	1,243	145
Sanitary Corps	------	454	------
Army Nurse Corps	672	------	------
Enlisted personnel	8,643	16	12,500
Total	10,824	23,355	14,030

Source: (1) Annual Reports of The Surgeon General, U.S.Army. Washington: U.S. Government Printing Office, 1940 and 1941. (2) TheArmy of the United States, Senate Document No. 91, 76th Congress, 1st Session.Washington: U.S. Government Printing Office, 1940, p. 117.

their low professional strength, however, National Guard units werethought to be better qualified in tactical training than in caring forthe sick and wounded in the field. Members of the National Guard were underthe jurisdiction of corps area commanders for training and were requiredto participate in weekly exercises, as well as 2 weeks of summer exercises.⁵

Training Responsibility

Full control over the training of Medical Department personnel was notvested in any single office. All training was under the technical supervisionof The Surgeon General, but not all of it was under the same degree ofcontrol. In common with the other technical services, the Medical Departmentwas an element of the War Department Special Staff, and The Surgeon Generalhad direct access to the Chief of Staff. The Chief of Staff and the GeneralStaff were responsible for coordinating the separate arms and services.Each of the chiefs of the arms and services acted as the immediate adviserto the General Staff in technical areas peculiar to his arm or service.Thus, The Surgeon General advised G-3, Operations and Training Division,on the technical training of Medical Department personnel and preparedmaster program guides, manuals, and instructional aids. In sum, The SurgeonGeneral established the basic "doctrine" under which MedicalDepartment troops were trained, regardless of their location or level oftechnical skill.

The degree of control exercised by The Surgeon General over the trainingof a particular body of Medical Department troops, however, was determinedboth by geographic location and by level of technical skill. The SurgeonGeneral controlled the basic, advanced, and professional training of officers,the advanced technical training of enlisted men, and the routine trainingof enlisted personnel at the limited number of installations, known asexempted stations, under his direct control. The most important of these,from the standpoint of training, were the Medical Field

⁵ Annual Report of The Surgeon General, U.S.Army, 1939. Washington: U.S. Government Printing Office, 1940.

FIGURE 1.-Carlisle Barracks,Pa., home of the Medical Field Service School, about 1939.

Service School of Carlisle Barracks, Pa. (fig. 1), and the ProfessionalService Schools at the Army Medical Center, Washington, D.C. At the professionalschools in Washington, officers and enlisted technicians were trained inmedical specialties and in the military aspects of medical, dental, andveterinary service. The Medical Field Service School trained enlisted menand officers of all corps in the field aspects and administration of theMedical Department. The routine and basic technical training of other troopswas under the control of corps area commanders, except at the schools andthe named general hospitals classified as exempted stations.

Medical Department officers and men assigned to medical installationsand field units at posts, camps, and stations under corps area jurisdictionwere no less a part of the Medical Department than those assigned to exemptedstations, but they were isolated from the Medical Department by severallevels of command and administration. Their numbers far exceeded thoseat exempted stations. Training at corps area level was the responsibilityof the area commander, who usually delegated the responsibility to thecorps area surgeon. The surgeon, in his dual capacity as a local staffofficer and technical representative of The Surgeon General, was then responsibleto the corps area commander for conducting training according toWar Departmentpolicies and to The Surgeon General for the technical content of instruction.The same command relationship existed on a lower level at posts, camps,and stations. Except for about 2 percent of the Reserve officers, who wereassigned to The Surgeon General in event of mobilization, both the Reservesand the National Guard were under corps area control. In peacetime, thetendency of corps

and station commanders not to interfere in medical matters allowed localsurgeons a considerable degree of autonomy.⁶

Officer Training

The peacetime pattern for training Medical Department officers was designedto meet the dual need for professional medical personnel capable of performingcommand and staff functions in the operation of military medical installationsand for supplementing civilian professional training with instruction inspecialties having a different emphasis in military medicine. As a resultof problems encountered during World War I, training facilities were establishedto meet each of these needs. In 1920, the Medical Field Service Schoolwas established at Carlisle Barracks to conduct a program of instructiondesigned to transform civilian doctors, dentists, and veterinarians intomedical officers trained to assume command in medical installations andunits. Three years later, the Army Medical Center was established in Washington,D.C., to conduct a postgraduate program of instruction in the militaryaspects of medicine, dentistry, and veterinary service.

The Army Medical Center was a multiple institution whose componentsfunctioned as separate installations before 1923. These included the WalterReed General Hospital, the Army Medical School, the Army Dental School,and the Army Veterinary School. The three schools, usually referred toas the Medical Department Professional Service Schools, had conducted trainingprograms of their own long before the center was established. Indeed, theArmy Medical School had been created as early as 1893. But the establishmentof the Medical Field Service School in 1920, and the Army Medical Centerin 1923, marked the beginning of a two-phase program designed to give comprehensivetraining to Medical Department officers in both military and technicalaspects of their profession. Facilities at the Army Medical Center werenot usually available to officers of the National Guard and Reserve, butthe Medical Field Service School offered special courses for their instruction.⁷

Regular Army officers.-The Medical Department basic trainingprogram for Regular Army officers provided an academic year of postgraduatestudy in the professional and military aspects of military medicine. Beginningin late August or early September each year, 4-month courses known as "BasicGraduate Courses" were offered at each of the three service schoolsat the Army Medical Center. These programs were "basic" in thatthey presented essential professional knowledge required for the militarypractice of medicine, dentistry, or veterinary service, as distinguishedfrom the same practices in civilian life, and "graduate" in thatstudents in the classes had degrees in their professional fields and wereprepared to cope with subject matter presented in a manner characteristicof graduate schools at

⁶(1) See footnote 1 (2), p. 1. (2) MedicalDepartment, United States Army. Organization and Administration in WorldWar II. Washington: U.S. Government Printing Office, 1963.
⁷(1) Annual Report of The Surgeon General, U.S. Army, 1922.Washington: U.S. Government Printing Office, 1922. (2) Annual Report ofThe Surgeon General, U.S. Army, 1924. Washington: U.S. Government PrintingOffice, 1924. (3) Hume, E. E.: Training of Medical Officers for War Duty.War Med., vol. I, September 1941.

civilian institutions. When these professional courses were completedin December, students transferred to the Medical Field Service School fora 5-month course of military indoctrination. This course, which emphasizedtactics, logistics, administration, field sanitation, and instructionalmethods, was designated the "Medical Department Officers Basic Course,"to distinguish it from the basic graduate courses at the Army Medical Center.After 9 months of intensive training, the officer was considered readyto assume duties as a member of the Regular Army Medical Department.⁸Unfortunately, peacetime requirements for professional personnel made itimpossible for each newly commissioned medical officer to participate inthe basic training program, and the program was too cumbersome for useduring mobilization.

In addition to basic officer training, the Medical Department offeredopportunities for continuing education. A program of "Advanced GraduateCourses" at the Army Medical Center allowed medical officers to receive4 months of training in technical subjects. More intensive training couldbe pursued through "Professional Specialists Courses," individualcourses in medical specialties corresponding to residency at civilian hospitals,that varied in length from 2 to 4 years. Because of the administrativeburden of formal reports required by regulations, the professional specialistscourses were not formally offered in the closing years of the interwarperiod.⁹ The program was carried on the books to comply withregulations, but in practice, students were ordered to the Army MedicalCenter and became in fact, if not in name, regular duty officers at WalterReed General Hospital, where they received informal training. Through theseprograms, the Medical Department attempted not only to keep its personnelabreast of developments in medical science but also to provide the specialistsnecessary for complex medical installations. At the Medical Field ServiceSchool, field grade officers were provided with additional training incommand techniques by a 3-month "Advanced Course."

To supplement training available through formal courses at the ArmyMedical Center and the Medical Field Service School, the Medical Departmentoffered extension courses and subsidized study at civilian institutions.Correspondence courses covering military and administrative subjects wereprepared by the Department of Extension Courses of the Medical Field ServiceSchool. Regular Army officers were allowed to enroll in a series of basicextension courses designed for officers in Reserve components. The numberof Regular Army officers taking such courses was always small, totalingonly 59 in the 5-year period preceding 1940.¹⁰ During the sameperiod, 369 Regular Army officers completed the "Special ExtensionCourse for Medical Department Officers, Regular Army" for field grade

⁸Annual Report of The Surgeon General, U.S.Army, 1936. Washington: U.S. Government Printing Office, 1936.
⁹(1) Memorandum, Lt. Col. Charles B. Spruit, MC, Training Subdivision,Planning and Training Division, OTSG, for Col. Albert G. Love, MC, Chief,Planning and Training Division, OTSG, 16 Apr. 1940, subject: Schedule ofCourses for Medical Department Special Service Schools, School Year 1940-41.(2) Annual Report of The Surgeon General, U.S. Army, 1940. Washington:U.S. Government Printing Office, 194l. (3) See footnote 7 (3), p. 5.
¹⁰(1) Annual Report of The Surgeon General, U.S. Army, 1935.Washington: U.S. Government Printing Office, 1935. (2) Annual Report ofThe Surgeon General, U.S. Army, 1937. Washington: U.S. Government PrintingOffice, 1937. (3) Annual Report of The Surgeon General, U.S. Army, 1938.Washington: U.S. Government Printing Office, 1939.

officers seeking promotion to grades of lieutenant colonel or colonel.¹¹Completion of this special extension course exempted officers from theportion of their promotional examination consisting of a medicomilitaryproblem, which probably accounts for the high level of participation. Inaddition, the National Defense Act, as amended in 1920, allowed up to 2percent of the officers of the Regular Army to enroll in courses at civilianinstitutions in subjects not taught at service schools but essential tothe efficient conduct of their duties. The number enrolled for such studyvaried from year to year, as did the subjects, length of courses, and institutionsinvolved. In the 5-year period preceding 1940, 150 Medical Department officersparticipated in this program.¹² Finally, a limited number ofMedical Department officers were enrolled in service schools operated byother Army agencies, such as the Army War College and the Army IndustrialCollege, Washington, D.C., the Infantry School, Fort Benning, Ga., theCommand and General Staff School, Fort Leavenworth, Kans., the ChemicalWarfare School, Edgewood Arsenal, Md., and the School of Aviation Medicine,Randolph Field, Tex. Most of these officers were being groomed for high-levelcommand positions, and the number was always small.

Other facilities for special training were offered by the School ofAviation Medicine which had been established as a Special Service Schoolin 1921. In name and function a Medical Department school, it was fundedby the Air Corps and, exempted from corps area control, was under the commandof the Chief of the Air Corps. Courses were offered to qualify membersof the Medical Corps assigned to the Air Corps as flight examiners andflight surgeons and to train enlisted men as flight surgeon's assistants.The special school was formally justified by the need for special physicalstandards for flight personnel and the need for special methods to controldisease in a highly mobile command. In common with other Special ServicesSchools, the School of Aviation Medicine offered extension courses forofficers in Reserve components.¹³

Medical Administrative Corps officers in the Regular Army had neitherthe need nor the background for the professional courses offered by theMedical Department Professional Service Schools at the Army Medical Center.Commissioned and appointed to perform nonprofessional administrative duties,these officers were at first drawn exclusively from the enlisted ranksafter at least 5 years of service, and after 1936, from graduates of recognizedpharmacy schools. Once they had been commissioned, they were eligible toattend the basic course at the Medical Field Service School.¹⁴

National Guard and Organized Reserve Corps officers.-Reserveand National Guard officers were qualified for appointment through a varietyof programs. For the Medical Department, the most important of these wasthe Reserve Officers' Training Corps, which had medical units in operationat the professional schools of colleges and universities. To qualify forcommissions in the Medical Department, students were required to completea 2-year basic course, a 2-year ad-

¹¹See footnotes 5, p. 3; and 8 and 10, p. 6.
¹²41 Stat. 786.
¹³See footnote 7 (2), p. 5.
¹⁴41 Stat. 767.

vanced course consisting of 5 hours of weekly instruction in militarysubjects, and a 6-week summer encampment, as well as their professionaltraining. Summer camp training for students in Medical Department ReserveOfficers' Training Corps was held at the Medical Field Service School andincluded indoctrination in sanitation and the administration and deploymentof medical field units, as well as basic military instruction. Upon graduation,candidates were eligible for Reserve commissions or to compete for appointmentto the Regular Army and were required to complete 5 years of Reserve duty.Another opportunity for commissioning was offered by Citizens' MilitaryTraining Camps. By attending four successive summer camps, each 1 monthin length, interested civilians could also qualify for Reserve commissions.Others, who had no previous military service, or who had not attended militaryacademies or colleges with Reserve Officers' Training Corps units, couldqualify for National Guard commissions by successfully attending officertraining camps.¹⁵

Once commissioned, Reserve and National Guard officers could participatein a variety of training programs, in addition to regular drills. Insteadof the 5-month basic course for Regular Army officers at the Medical FieldService School, the basic training of officers in the Reserve componentsof the Medical Department was accomplished through a combination of summercamps and correspondence courses. A 2-week program, known as the BasicSummer Training Camp for Reserve Officers, was conducted for junior officerseach June. Approximately 200 officers enrolled annually for instructionin basic military subjects, administration, field sanitation, and the operationof medical detachments. In July, a 2-week program designated the "UnitTraining Camp for Reserve Officers" was held for officers assignedto medical regiments, squadrons, battalions, general hospitals, field hospitals,and evacuation centers. Approximately 350 officers of the Reserve componentsattended annually. To supplement camp training, the Medical Departmentoffered a series of extension courses in the fundamentals of military scienceand tactics. With the retention of commissions and promotion providingincentives, these correspondence courses played a major role in the basictraining of Reserve and National Guard officers. In 1939, for example,7,445 officers of Medical Department components completed 15,848 subcoursesof the extension courses, representing a total of 223,121 hours of work.

Advanced training for field grade officers and senior captains of Reservecomponents paralleled that of Regular Army officers. When authorized, theMedical Field Service School conducted a 6-week counterpart to the 3-monthadvanced course for Regular Army officers, known as the National Guardand Reserve Officers Course, that was designed to develop commanding officers,executive officers, and planning and training officers for medical fieldunits. Eighteen officers were authorized to attend the session held inthe fall of 1939. Extension courses were also a part of the advanced trainingof officers in Medical Department Reserve components, and promotion depended,in part, upon the completion of successive series of subcourses.

Opportunities for professional training for officers in Reserve componentswere

¹⁵(1) See footnotes 5, p. 3; and 7 (3), p.5. (2) 41 Stat. 781.

much less extensive than those in military subjects. A course in forageinspection was open to National Guard officers at the Army Veterinary School,and inactive duty training could be pursued at civilian medical centersunder the "Skinner Plan." Under this plan, medicomilitary courseswere offered by various institutions, in the interest of national defense,at no expense to the Government or the officers attending. Reserve officerswere not ordered to active duty while attending these courses and did notreceive pay. They were, however, given credit for course completion. Thepattern for inactive duty training was set by the Mayo Clinic, Rochester,Minn., which offered two courses annually: one of 4 to 6 weeks' durationin the spring, and another of 2 weeks, in the fall. During the morninghours, student officers studied purely medical subjects, and during theafternoon, attention was devoted to military subjects. The success of theprogram, both in keeping physicians abreast of current medical developments,and in creating interest in military medicine, encouraged the program'sexpansion. By 1939, similar courses were offered by medical groups in Cincinnati,Ohio, Cleveland, Ohio, St. Louis, Mo., Boston, Mass., Kansas City, Mo.,Chicago, Ill., New Orleans, La., and Nashville, Tenn.¹⁶

Regular Army Enlisted Personnel

Training programs for enlisted personnel of the Medical Department reflectedthe critical shortage of personnel. To use personnel efficiently, the MedicalDepartment neglected routine military and field training and relied onthe specialization and division of labor, supplemented by on-the-job training.Limited by statute to a 5-percent strength allocation, barely adequateto provide routine medical care for a garrison army, the Medical Departmentfound itself progressively squeezed between the need for technicians tosupport the increasing tendency toward specialization in medicine and thegrowing demands for medical service. In a number of installations, menserved 12-hour shifts, and the rotation of duties was suspended.¹⁷

Enlisted soldiers in the Medical Department performed a wide varietyof duties, in installations ranging in size and function from hospitalsto dispensaries, laboratories, and medical supply agencies. Regardlessof their assignment, all Medical Department enlisted personnel were requiredto engage in training basic to the trade of soldiering, such as dismounteddrill, physical conditioning, military courtesy, and army administration.In addition, the medical soldier required instruction in the functionsof the Medical Department and, depending upon his assigned duties, technicaltraining in skills ranging from simple emergency medical treatment to complicatedlaboratory technique. Medical soldiers as a group required all the skillsnecessary for supplementing the professional services of a functioningmedical installation. Responsibility for training the enlisted personnelof any medical detachment or installation, regardless of its size or specificmission, fell on the commanding officer.

¹⁶Patterson, R. U.: The Medical Reserve Corpsof the Army. Mil. Surg. 74 (5): 256-258, May 1934.
¹⁷See footnotes 5, p. 3; and 9 and 10, p. 6.

Skills were developed through on-the-job training. Training scheduleswere established for drill and physical exercise periods and for lecturesand demonstrations on military courtesy, military law, and technical subjects.The degree to which such schedules were followed, however, depended uponthe demands which routine care of the sick and injured made upon the timeof instructors and students. Because these demands were usually heavy,more technical training was accomplished in wards, dispensaries, and operatingrooms, where men could learn by "seeing and doing," than in classrooms.Since the length of peacetime enlistment was 3 years, and many men remainedin the service for more than one term of enlistment, the more enterprisingoften became highly skilled specialists through on-the-job training. Thosewho desired technical ratings had to pass Armywide promotional examinationsin both technical and military subjects.¹⁸

A limited number of courses for enlisted men were offered by the MedicalField Service School, the Army Medical Center, and the School of AviationMedicine. The Medical Field Service School initiated an annual NoncommissionedOfficers Course in 1924 designed "to teach noncommissioned officerscorrect and effective methods of instruction and the art of handling andtraining Medical Department troops of the components of the Army of theUnited States."¹⁹ This 8-week course included instructionin company administration, leadership techniques, logistics, tactics, mapreading, sanitation, control of communicable diseases, first aid, and teachingmethodology. It was particularly valuable to experienced enlisted men preparingfor annual promotional examinations, although it was not a prerequisite.Between 1935 and 1940, numbers enrolled ranged between 41 and 100. Extensioncourses were offered to enlisted personnel through the Medical Field ServiceSchool also, but the number of participants was always small.²⁰

In addition to the Noncommissioned Officers Course, four technical courseswere conducted by the Professional Service Schools at the Army MedicalCenter. These included the X-ray Technicians Course and the LaboratoryTechnicians Course at the Army Medical School, the Dental Technicians Courseat the Army Dental School, and the Veterinary Technicians Course at theArmy Veterinary School. All were courses of long standing, establishedbefore the organization of the Army Medical Center, and army regulationsrequired that they be offered annually. The courses were 4 months in lengthand could be offered twice yearly if enrollment requests warranted.²¹In 1939, all courses, except the Veterinary Technicians Course, were lengthenedto 12 months, and 12-month courses for pharmacy technicians and orthopedicappliance technicians were added to the program. Such courses were designedto contribute to the quality of Army medical service and to be of personalvalue to students who anticipated taking promotional examinations for advancedtechnical ratings. They were not prerequisites for examination, and between1935 and 1939, enrollments were low. In no course did enrollments exceed33, and in most, enrollments were below 12.²²

¹⁸Army Regulations No. 615-15, 25 May 1937.
¹⁹Army Regulations No. 350-1030, 30 Dec. 1926.
²⁰See footnotes 5, p. 3; and 8, 9, and 10, p. 6.
²¹See footnote 7 (2), p. 5.
²²See footnotes 5, p. 3; and 10, p. 6.

The School of Aviation Medicine conducted a 3-month "Flight SurgeonsAssistants Course." Offered twice annually, the course was designedto train students not only to prepare instruments used in examining applicantsfor flight duty but also to assist in examinations by taking pulse counts,blood pressure readings, and similar measurements. Enrollments were small,reaching a peak of 44 in 1939.

Field Training

At the close of the interwar period, tactical training continued tobe the Medical Department's most striking training deficiency. With theexception of the men assigned to existing understrength field units, fewmedical soldiers received actual training in tactical medical operations.These units, consisting of the 1st Medical Regiment, which was used fordemonstrations at Carlisle Barracks (fig. 2), the 2d Medical Regiment atFort Sam Houston, Tex., the skeleton 1st Medical Squadron (Cavalry) atFort Bliss, Tex., and the 11th and 12th Medical Regiments,

FIGURE 2.-Members of the 1st MedicalRegiment at the Medical Field Service School, Carlisle Barracks, Pa., loadsimulated patients on an ambulance at an ambulance loading post set upby the collecting company of the regiment during a field problem.

FIGURE 3.-Four-mule ambulancessuch as these were used in the training of Medical Department personnelat the Medical Field Service School, Carlisle Barracks, Pa., before WorldWar II.

in Hawaii and the Philippines, respectively, were the only units receivingwhat was deemed adequate field training. Yet, on the field of battle, themission of providing aid stations, collecting stations, and clearing stationsfor the first and second echelons in the chain of evacuation was basicto the Medical Department's combat mission.

Soldiers assigned to these units received tactical and field trainingthat could not be given to members of the Medical Department assigned toduty in dispensaries and hospitals. Their training included instructionin such subjects as emergency medical treatment, first aid, litter carrying,ambulance service, and the establishment, movement, and operation of medicalfacilities in the field (fig. 3).

Opportunities for practicing actual field support were limited. The1st Medical Regiment, in addition to its training program, acted as a demonstrationunit at the Medical Field Service School and for the training camps operatedat Carlisle Barracks for the Organized Reserves and Reserve Officers' TrainingCorps units. The 2d Medical Regiment, in addition to its routine activities,actively participated in 1938 and 1939 in the experimental exercises andmaneuvers of the newly streamlined infantry division in Texas. Shortagesof personnel handicapped the training of these units just as they handicappedthe training of personnel in dispensaries and hospitals; the four medicalregiments were maintained at "peacetime" strength, rather thanmobilization strength, and the medical squadron was usually described as"skeletonized." As late as 1939, The Surgeon General reportedthat the "lack of adequate enlisted strength from which to form therequired regimental medical detachments and Medical Department field unitsto be ready for use on M-day

presents a problem as yet unsolved, in furnishing adequate medical servicefor units in the protective mobilization plan." Units scheduledfor activation in fiscal year 1939 were deferred until the following yearbecause of manpower shortages. In a sudden mobilization, the Medical Departmentwould have been unable to care for combat troops and, at the same time,to provide cadres for an expanding medical field service.²³

Summary

Despite the effects of peace, disarmament, and depression on the machineryfor mobilization, some developments of the interwar period proved beneficial.The Medical Department developed techniques and programs to train officersfor their role in a technical service. In a like manner, programs wereset up for the advanced training of enlisted technicians and noncommissionedofficers. But, the Medical Department's training program was adapted tomeet the needs of a small garrison army and would have to be restructuredto function efficiently in a period of mass mobilization. Physical facilities,of course, would have to be expanded and, more important, tempo accelerated.The luxury of an academic year of training for newly commissioned officers,and a full year for enlisted technicians, would have to be abandoned totrain a service expanding more than proportionally with the Army and toprovide immediate medical care for mobilized troops. Skills acquired informallythrough on-the-job training, or by a gradual process of see-and-do, wouldhave to be taught by formal methods. Medical Administrative Corps officers,who previously acquired their training through long years of enlisted service,would have to be trained in great numbers to free the limited number ofavailable physicians from administrative duties. Had the Medical Departmentbeen confronted with mobilization in the summer of 1939, the problems ofcreating a functioning organization capable of providing both routine healthcare and field medical support might have proved insurmountable. The 2-yearperiod that intervened provided an opportunity to adjust the program forthe crisis that lay ahead.

PREPARATIONS FOR WAR

The gradual deterioration of international affairs between 1939 andthe attack on Pearl Harbor allowed the Nation to mobilize gradually. Publicopinion limited U.S. involvement in the wars of Europe and Asia, but defensivereaction to the deepening international crisis produced a continuous buildupof forces. By July 1941, the strength of the Army was comparable to thatprojected by mobilization planners for a point in time 8 months after adeclaration of war. Expanding the Army from approximately 189,000 on 1July 1939 to 1,461,000 on 1 July 1941,²⁴ required not only restylingto adjust the training program for volume but also adjusting for

²³See footnote 6 (2), p. 5.
²⁴(1) Annual Report of the Secretary of War to the President,1939. Washington: U.S. Government Printing Office, 1939. (2) Annual Reportof the Secretary of War to the President, 1941. Washington: U.S. GovernmentPrinting Office, 1941.

the changing quality of new soldiers. In the Medical Department of theArmy, as in the entire Defense Establishment, piecemeal response to thedeterioration of world affairs provided a cushion against sudden mobilization,but the buildup was a mixed blessing.

Staff mobilization planning continued unabated throughout the interwarperiod. Annual revisions of basic plans were required as a part of normalstaff procedure, and periodic reassessments of basic planning were requiredby the growing obsolescence of stockpiles, the aging of men who servedin World War I, and the changes in strength and diplomatic posture of foreignnations. Frequently, basic changes in mobilization planning coincided withthe appointment of a new Chief of Staff. Following the disarmament conferencesof the 1920's, staff planning was little more than an academic exercise.By the mid-1930's, growing international tensions and the obvious degenerationof U.S. military power focused staff attention on the need for more realisticplanning.

The Protective Mobilization Plan of 1939

It was at this point that Gen. Malin Craig replaced Gen. (later Generalof the Army) Douglas MacArthur as Chief of Staff in October 1935. Lesspublicized than his predecessor, General Craig assumed command in a periodof moderate economic recovery and slowly reviving concern about nationaldefense. Distressed at commanding an Army ranking 18th among the world'spowers, General Craig directed his staff to begin work on a new ProtectiveMobilization Plan in December 1936. General Craig's anxieties, which herevealed in subsequent statements, focused on the time necessary to trainand equip men to fight increasingly technological warfare. He later wroteas follows:

* * * This is an immensely rich nation,but all of its wealth, all of its industrial capacity, all of its intelligentmanpower, is helpless before the inexorable demands of time in manufactureand training. The period has long passed when ineffectively armed or insufficientlytrained men can succeed in war. We know to a day the time necessary toproduce every item of armament and equipment-the time it takes to trainour military specialists. As an instance, the sums appropriated this lastyear will not be fully transformed into military power for 2 years. Thisfact, that it takes years to resolve the will of the people into efficientlyhandled munitions of war, must be remembered. The same persons who nowstate that they see no threat to the peace of the United States would hesitateto make the same forecast through a 2-year period.²⁵

As a result of staff efforts, a new Protective Mobilization Plan wasformulated, revised, and approved as the Protective Mobilization Plan of1939, in December 1938.²⁶

The Protective Mobilization Plan of 1939 was designed to mobilize abalanced Army of moderate size, consistent with limitations on the procurementof men and materiel. At the beginning of hostilities, or on receipt ofmobilization orders, the plan anticipated creation of a defensive Armyof 400,000 men, designated the "Initial

²⁵Annual Report of the Chief of Staff to theSecretary of War. In Annual Report of the Secretary of War to thePresident, 1939. Washington: U.S. Government Printing Office, 1939.
²⁶Kreidberg, Marvin A., and Henry, Merton G.: History of MilitaryMobilization in the United States Army, 1775-1945. Washington: U.S. GovernmentPrinting Office, 1955. (DA Pamphlet 20-212.)

Protective Force," consisting of the Regular Army, the Reserve,the National Guard, and a corps of volunteers who would act as fillers.Thirty days after the onset of mobilization, this force of four RegularArmy and 18 National Guard divisions was to be ready to protect U.S. soilfrom attack. Once the Initial Protective Force had been prepared for action,the Protective Mobilization Plan called for a second phase of troop activationdesigned to bring the U.S. Army to a strength of approximately one millionenlisted men, and the officer strength necessary to command them. Assumingthat Selective Service would be functioning by the second month of mobilization,draftees and volunteers were to be inducted as rapidly as equipment couldbe supplied, and then trained by selected Regular Army or Reserve cadreseither as fillers for existing understrength units or as new units. Materialshortages limited the induction of personnel for new units to approximately150,000 per month, although an additional number of fillers requiring onlythe issue of personal equipment could also be trained. A serious handicapto the program's success was the shortage of Regulars and Reservists tofill cadre positions and command the Initial Protective Force. Once thesecond phase was completed, some 8 months after M-day, it was assumed thatsuperior trainees could be utilized as cadre, and the process could beeither continued or expanded until manpower requirements for the particularemergency were satisfied.

To provide for the induction and training of new troops, the ProtectiveMobilization Plan specified the location of reception centers, enlistedreplacement training centers, and unit training centers, and the locationat which each unit would begin and complete its training. Under the program,recruits were first assigned to a corps area reception center, where theywould be processed, classified, and issued basic clothing and equipment.Those assigned as fillers to understrength units would then report directlyto their units for additional training. Others would be sent to enlistedreplacement training centers for a vigorous 90-day training cycle. Aftera period of training, these men would be shipped overseas as fillers, sentto new units in training, or assigned for technical training at serviceschools or civilian trade schools. In general, troops were to be trainedin the traditional military manner, beginning with the broad general problemsof physical conditioning and discipline, and progressing gradually to morespecialized subjects.

Officer training was to proceed along different lines. At the onsetof mobilization, the Army War College and the Army Industrial College wereto be closed, but the Command and General Staff School would offer specialcourses shortened to 3 months. Special service schools, such as the InfantrySchool and the Medical Field Service School, would offer short coursesto refresh Reserve officers called to active duty, and give specialisttraining. If the emergency continued for more than 2 months, Officer CandidateSchools would be inaugurated at both special service schools and at othernecessary locations.²⁷

The Protective Mobilization Plan had many flaws. In spite of the realizationthat enlisted replacement training centers would not have enough RegularArmy or prior service personnel to man them, no attempt was made to providecadres for

²⁷(1) See footnote 26, p. 14. (2) Watson, MarkSkinner: Chief of Staff: Prewar Plans and Operations. United States Armyin World War II. The War Department. Washington: U.S. Government PrintingOffice, 1950.

these centers. Operating under the assumption that troops would be hurriedlytrained in the South and shipped overseas for final training in a mannersimilar to that used by the American Expeditionary Forces in World WarI, the plan did not provide for the construction of adequate housing. Plansfor reservations large enough for division and corps maneuvers were neglected.Designed primarily for the mobilization of combat elements of field armies,provisions for the training of technical and support elements were admittedlyinadequate. Plans for Zone of Interior hospitalization were inadequate,and War Department planners made no provision for the use of affiliatedunits, which had made important contributions to medical care in WorldWar I. Despite these defects, the program outlined in the Protective MobilizationPlan of 1939 was more realistic than any offered before the war.

The Surgeon General's Protective Mobilization Plan, 1939

The plan issued by the War Department was brief but specific and designedto be supplemented by army regulations, mobilization regulations, and theprogressively more detailed plans of subordinate units. Plans preparedby subordinate agencies, such as the Medical Department, followed a formatparallel to that of the War Department and were more detailed only in providinggeneral outlines for their specific areas of responsibility. Formulatingplans for implementing the details of these general outlines was the responsibilityof specific commands within the agency.

The War Department mobilization plan, within which Medical Departmentplans had to be framed, severely limited the scope for discretionary action.The sites of replacement training centers and unit training centers werespecified, as well as the sites for unit activation, and the length andsize of training cycles for both basic and technical training. Cycle lengthwas standardized at 90 days throughout the Army. The Surgeon General'sProtective Mobilization Plan, issued on 15 December 1939, reflected thesestrictures.

Providing for the routine health care of an expanding army and creatingthe support units for combat medical duty placed heavy burdens on the MedicalDepartment. Within 120 days after receiving mobilization orders, the MedicalDepartment was required to expand more than tenfold to a strength of over140,000 officers and enlisted men, and this figure did not include membersof the Air Corps and those assigned overseas. To achieve this strength,it was necessary to strain facilities to the limit and, in some instances,to omit the luxury of formal training and to rely on the assumption thatmen with suitable skills could be channeled directly into their militaryoccupations by induction centers. Other new members of the Medical Departmentwould be channeled through training programs.²⁸

Officer training.-To meet requirements for officers, both forWar Department overhead and for medical command, the Medical Departmentrelied heavily

²⁸The Surgeon General's Protective MobilizationPlan, 1939, with annexes.

on the Reserves. Because of prewar neglect of field training, effortswere concentrated on preparing officers for field medical service. Thoseofficers required for units mobilized before the 30th day of mobilizationwere to receive only refresher course training in the troop schools ofthe unit to which they were assigned. Officers required by units afterthat time were to attend a 1-month refresher course at Carlisle Barracks,and other installations, designed to prepare them for duty in field medicalunits. Because officer candidate schools could be activated only with WarDepartment approval, and the selection of officer candidates was a corpsarea responsibility, no formal plans were announced. The Medical FieldService School, however, was charged with the responsibility for preparinga 3-month training program in the event of such authorization. The peakloadof trainees for both of these programs was estimated at 2,000 by the 60thday of mobilization.

Officers destined for duty outside field medical service units wereto be trained by a variety of techniques. The Army Medical Center, chargedwith concentrating available facilities on the training of enlisted specialists,made no provision for the continuing training of incoming professionalofficers. General hospitals were charged with the responsibility of trainingkey administrative officers for general, surgical, and evacuation hospitals.Medical supply depots were required to train officer replacements for similardepots destined for both the Zone of Interior and theaters of operations.Any officer not attending one of these facilities was to receive refreshertraining "in the troop schools of the units concerned." Enrollmentand classification of nurses, dietitians, and highly trained technicianswere responsibilities of the American Red Cross, and these people wereto be given only routine training. Recruitment of nurses was a responsibilityof the commanders of corps areas.²⁹

Affiliated units.-The most serious defect of the War DepartmentProtective Mobilization Plan, from the viewpoint of the Medical Department,was its failure to provide adequately for the creation of hospital professionalstaffs. On paper, the Medical Department was required simply to mobilize32 general, 17 evacuation, and 13 surgical hospitals, in addition to theunits required by corps, army, and General Headquarters Reserve, but inpractice, the creation of a hospital required more than the simple assignmentof professional personnel and the allocation of equipment according totables of authorization. To carry out their mission, both mobile and fixedhospitals were required to be completely integrated units, with a harmoniousstaff of competent physicians and surgeons who could function as a team.During World War I, the use of affiliated units, hospital staffs drawnfrom a single parent civilian medical institution, demonstrated its valuein allowing the Medical Department to avoid the time-consuming problemof solving the complicated equation of professional skills required bya medical team. After the war, the close relation between The Surgeon Generaland civilian institutions had continued, but in 1924, as a result of WarDepartment policies requiring the decentralization of Reserve affairs,affiliated hospitals were transferred to corps area control, and in 1928,the Medical Department lost control of personnel assignments to these organizations.Between 1928 and 1939, age and frustration with the obstacles created

²⁹See footnote 28, p. 16.

by corps area administration caused many key officers to resign or allowtheir commissions to lapse and many of the affiliated units disintegrated.³⁰

The Surgeon General was convinced that the only possibility of developinga properly integrated peacetime reserve of medical units, particularlyevacuation, surgical, station, and general hospitals, suitable for mobilizationunder the War Department Protective Mobilization Plan lay in the revitalizationof affiliated units. Despite the failure of that plan to specifically includesuch units, authority for their utilization existed in a War Departmentpublication, MR (Mobilization Regulations) 1-1, dated 14 August 1938, whichstipulated that: "Procurement of entire organizations, where advantageousto expedite their formation with trained personnel or for other appropriatereasons, may be utilized for elements requiring a relatively large numberof occupational specialists, as in the case of certain engineer, signal,and medical units. When corps area commanders desire to provide such procurement,they will request the authority of the War Department in each such case."

In March 1939, The Surgeon General recommended to the War Departmentthat selected medical institutions be invited to create or maintain affiliatedorganizations. By October, after a lengthy struggle over personnel policies,the War Department authorized The Surgeon General to organize affiliatedhospitals from a list of selected institutions and to appoint personnel.Planning for the organization of affiliated units was still not completedby the end of 1939, when The Surgeon General's Protective MobilizationPlan was issued. At that time, activation of units was a corps area responsibilitywhen directed by the War Department, while the Medical Department retainedcontrol over organization and promotion. Few formal plans were made fortraining after activation, because the period between activation and utilizationwould be so short that performance depended heavily on the proper priorselection personnel.³¹

Enlisted personnel.-Training enlisted men to perform the dutiesof the Medical Department in a mobilized Army presented serious problems.For practical purposes, there was no reserve pool of skilled manpower comparableto that existing for Medical Department officers. The enlisted strengthof National Guard medical units was inadequate for the support of mobilizedNational Guard divisions, and the Enlisted Reserve did not exist in meaningfulnumbers. But enlisted men were required for supporting duties ranging fromthe common specialties of truck driving, cooking, and litter bearing, tothe technical specialties of X-ray technician, surgical technician, anddental assistant.

Under the prevailing system of War Department control, The Surgeon Generalwas directly responsible for the activation of named general hospitalsand installations classified as exempted stations. The activation and administrationof other medical units, as well as the establishment of Medical Department,Unit Training Centers and Enlisted Replacement Training Centers, were corpsarea responsibilities. The Medical Department was responsible only forthe technical supervision

³⁰Letter, The Surgeon General to The AdjutantGeneral, 17 Mar. 1939, subject: Affiliation of Medical Department Unitswith Civil Institutions, and Appointment and Promotion in Medical CorpsReserve.
³¹See footnotes 1 (3), p. 1; and 28, p. 16.

of training at these installations for the preparation and issue oftraining programs. Enlisted training in the Medical Department followedlines laid down by the War Department for the entire Army. After a shortperiod at corps reception centers, devoted to discipline and physical conditioning,recruits were to be selected and sent to branch replacement centers forinitial training. Both Enlisted Training Centers and Unit Training Centersfor the Medical Department were to be opened at Fort George G. Meade, Md.,Fort Oglethorpe, Ga., and Fort Warren, Wyo., during the first 30 days ofmobilization. Medical Department enlisted training was restricted to basicsubjects and military discipline, on the principle that success lay "notin the actual technical training given the soldier, but in having suitablemen for such training properly selected from those with similar civilianvocational training." Unit training centers, responsible for the trainingof nondivisional units, and divisional units activated after the 30th dayof mobilization, were to be activated under similar controls.

Anticipating a shortage of critical technical skills, plans called forthe activation of training facilities for nonprofessional enlisted specialists.Courses were to be offered to qualify men as X-ray, medical, surgical,pharmacy, dental, sanitary, and laboratory technicians. Installations chargedwith the responsibility for providing facilities included the Medical FieldService School, the Army Medical Center, and named general hospitals underThe Surgeon General's direct control. Each installation was to be preparedto begin training on 10 days' notice and to draft programs of instructionto be incorporated in its own mobilization plan.

Mobilization cadres.-In addition to other requirements, the necessityof providing cadres for newly activated units placed a serious strain onthe Medical Department's limited resources. During the first 30 days ofmobilization, planners had to rely heavily on the expedient of drainingtrained manpower from existing units and installations. Three exemptedinstallations alone-Army Medical Center, Fitzsimons General Hospital, andArmy and Navy General Hospital-were to furnish 44 officers, 20 nurses,and 27 enlisted men during the first 30 days of mobilization. Other exemptedinstallations and those under corps area command were to provide corpsarea commanders with 2,201 officers and 829 enlisted men for cadre dutyduring the same period. The following month, 1,070 officers and 1,122 enlistedmen would be required, but it was hoped that these could be selected fromless experienced personnel who could receive additional training at UnitTraining Centers before being assigned to newly activated units. Afterthis initial drainage, staff planners expected to draw cadre from officersin training and enlisted graduates of the replacement training centers.

The precipitous mobilization envisioned by staff planners would haveseverely strained the manpower and facilities of the Medical Department.Unlike a fighting arm, which could usually count on an indefinite periodafter basic training and unit training to improve its skill before beingcommitted to combat, the Medical Department had to care for the healthof an expanding Army and simultaneously prepare for its role in combatmedical support. Peacetime experience had proved that over 80 percent ofthe Medical Department's statutory allocation of 5 percent of the enlistedstrength of the Army was required in routine health care. But

mobilization plans called for the use of over 20 percent of the Department'sstrength for cadre duty alone, with an unspecified force required for WarDepartment overhead and training at special service schools. Fortunately,the precipitous mobilization envisioned by staff planners never occurred.

Negro troops.-The use of Negro troops presented a complex problemfor War Department planners. Failure to achieve racial balance in mobilizationfor World War I had resulted in bitter criticism, and top level plannerswere determined to avoid repeating the mistake of discriminatory recruitmentduring the enlistment period and the subsequent disproportionate draftingof Negroes required to restore racial balance in later phases of mobilization.But, at the same time, fear that public endorsement of policies favoringracial balance would result in criticism of the disproportionately whitepeacetime Army led the War Department to keep its policies secret fromall but a few top level planners. It was not until 1937 that new plansfor the utilization of Negro troops were incorporated into mobilizationregulations, which were then in the process of revision. This step resultedin only a limited dissemination of policies because access to mobilizationregulations was restricted to a few headquarters, including corps areacommanders and the chiefs of the arms and services. And even then, lagtime in printing and the practice of issuing revisions in segments resultedin an unabsorbed and unfamiliar body of doctrine.

In theory, policies revealed in the revision of 1937 provided for thecreation of a racially balanced, segregated Army. Negroes and whites wereto be regarded as separate, but almost equal. Negro manpower was to beincorporated into mobilization plans in a ratio equal to their proportionof population of military age, and corps areas were to provide manpoweraccording to manpower ratios in their respective geographical areas. Negroesand whites were to be utilized in representative proportions in both thearms and the services. Negro units could be commanded by either Negro orwhite officers, preferably Negroes when qualified officers were available.No decision was made concerning the level of command at which separateunits would be organized.

On the eve of Pearl Harbor, the U.S. Army had failed to fully implementthe policies of 1937. Negro manpower was well below the 9-percent levelregarded as a representative proportion, and Negroes were distributed unevenlywithin the arms and services. Three-fifths of the entire number were almostequally divided between infantry, engineer, and quartermaster units. Inthe Air Corps, Medical Department, and Signal Corps, less than 2 percentof all enlisted men were Negroes.³²

Within the Medical Department, plans for the utilization of Negro manpowerwere limited. Citing mobilization regulations, The Surgeon General's ProtectiveMobilization Plan provided that the percentage of Negro manpower in installationsunder his direct control would be at least equal to the percentage of Negroesin the total male population of military age. Specific provision for themobilization of Negroes at exempted installations was not incorporatedinto the plan, and openings for Negroes in activities under corps areacommand, over which The Surgeon General had only indirect control, werefar below population ratios.³³

³²Lee, Ulysses: The Employment of Negro Troops.United States Army in World War II. Special Studies. Washington: U.S. GovernmentPrinting Office, 1966.
³³See footnote 28, p.16.

It was not until 1940 that the Medical Department began to make plansfor utilization of its share of Negro manpower. In October 1940, Negrowards were established at certain hospitals in the United States, and TheSurgeon General recommended the establishment of a new type of unit toabsorb most of the Negro increment of enlisted personnel. In November 1940,this "sanitary company" was authorized for the performance ofunspecified general duties. At the same time, it was clearly stated thatthe Medical Department would not willingly create mixed detachments unlesssuch a policy was adopted by both the arms and the services. Because TheSurgeon General would not willingly adopt a policy which forced white soldiersto accept treatment by Negro physicians and personnel, further decisionson the size and type of Negro units had to be postponed until the War Departmentannounced the size and type of Negro units the Medical Department wouldbe servicing.³⁴

The Limited Emergency

Within months after the publication of the War Department ProtectiveMobilization Plan, and even before The Surgeon General was able to issuethe Medical Department's subordinate plan, events were set in motion thatbegan to transform U.S. mobilization from the anticipated crash programto a gradual buildup of forces. The U.S. responses to the degenerationof world affairs in the late 1930's had been cautious, and even after theoutbreak of hostilities in Europe, U.S. response was limited. Between 3September 1939, when Britain and France declared war on Germany, and theJapanese attack on Pearl Harbor, U.S. mobilization was carried out notas a result of planning but in sporadic response to a gradually deepeningworld crisis. On 8 September 1939, 7 days after the beginning of WorldWar II in Europe, President Roosevelt responded with the declaration ofa limited national emergency, the meaning of which was not entirely clear.In the same proclamation, the President authorized an increase in the enlistedstrength of the Army from 210,000 to 227,000, and an increase of NationalGuard strength to 235,000 men. Despite the disappointment of Army planners,who had hoped for authorization to increase the Army to its full peacetimeenlisted strength of 280,000, the emergency proclamation and the 17,000increase in troop strength were not without benefits. Limited emergencypowers allowed the War Department to increase the number of National Guardarmory drills from 48 to 60 per year and to increase the length of theirsummer camps to 3 weeks. Immediately following the President's declaration,Gen. (later General of the Army) George C. Marshall, Chief of Staff, issuedorders reorganizing the Army from its three square divisions, consistingof four regiments, to five new triangular divisions of three regimentseach. The new divisions, together with the troop increase, allowed thecreation of corps and army headquarters to give higher commanders an opportunityto gain experience in the techniques of large-scale field operations. Latein the spring of 1940,

³⁴See footnote 1 (3), p. 1.

some 70,000 Regular Army troops were assembled for the first corps andarmy maneuvers since 1918.³⁵

In the months following the fall of Poland, fiscal caution and the fearthat increased strength would lead to U.S. involvement in a European warled Congress to adopt a noncommittal attitude toward further military expansion.It was not until the German armies began the campaign on 10 May 1940 thatby 22 June had forced evacuation of the British Expeditionary Force andthe surrender of France that Congress was spurred to action. Within weeksof the renewal of the German offensive, Congress surpassed Presidentialrecommendations in two separate bills that brought the total authorizedArmy troop strength to 375,000 and increased War Department appropriationsto nearly $3 billion. Two months later, when threatening German attitudesand the uncertain future of the French Fleet raised the possibility thatmost of the Regular Army would have to be dispatched to Latin America,leaving the Nation defended solely by raw recruits without adequate cadreto train them, Congress again took the bit in its teeth. Despite both Executiveand General Staff restraint, Congress passed a joint resolution on 27 Augustauthorizing the President to call the National Guard and Reserves to activeduty for 1 year, and on 16 September, it passed the Burke-Wadsworth bill,authorizing Selective Service for 1 year. By two acts, Congress had, ineffect, authorized the strength of the Army to be temporarily increasedto 1.4 million men.³⁶

Saddled with a massive expansion, the Army turned its full attentionto inducting, training, equipping, quartering, and organizing its expandedforces. During the next year, the Army managed to overcome difficultiesthat have since become legend and organized a ground force consisting offour armies of nine army corps and 29 divisions, and an armored force offour divisions, including support troops. By staggering inductions andthe activation of National Guard units, the Army was expanded sixfold during1941. Even before expansion was completed, however, the General Staff facedthe threat of demobilization when the authorization for Selective Serviceand National Guard activation expired. In Congress, a more relaxed nationalattitude toward the war, prompted by the persistence of British defensesand the diversion of German offensive forces against Russia, weakened thehand of interventionists and threatened the continuation of mobilizationefforts. It was only at the last moment, and by a narrow margin, that Congress,on 12 August 1941, extended the service of men on active duty for 1 yearand voted to continue Selective Service.³⁷

By December 1941, when Japanese attacks ended debates over U.S. commitment,the Army was more thoroughly prepared for the outbreak of war than everbefore in its history. Troop strength projected for the third phase ofthe Protective Mobilization Plan of 1939 had already been reached, and36 divisions, with their support troops, had been activated. Many of theseunits were admittedly understrength, poorly equipped, and manned by recruitswith limited training. It would

³⁵(1) Biennial Report of the Chief of Staffof the United States Army to the Secretary of War, 1 July 1939 to 30 June1941. Washington: U.S. Government Printing Office, 1941.
(2) See footnote 26, p.14. (3) Weigley, Russell F.: History of The UnitedStates Army. New York: The Macmillan Co., 1967.
³⁶See footnotes 26, p. 14; and 35 (1) and (3).
³⁷See footnote 35 (3).

be many months before the Nation could do more than assume the defensiveand minimize the loss of outlying possessions but, at the same time, industryhad begun its retooling, supplies had been ordered, the machinery for inductionand training had been established, and the cadre for expansion was beingcreated. As inadequate as these preparations would appear, once war hadbegun, mobilization was accomplished less painfully than it could havebeen from the troop base of 1939.

In the months preceding Pearl Harbor, the Medical Department expandedeven more rapidly than the Army as a whole, sharing in common its problemsand growing pains. Between June 1939 and December 1941, Medical Departmentenlisted strength grew from less than 10,000 to over 107,000, increasingproportionally from less than 5 percent to 6.4 percent of the strengthof the entire army. Officer strength increased similarly from 6.1 percentto over 7.7 percent of the strength of the officer corps. This more thanproportional expansion, made necessary by the requirement to create fieldmedical units as well as administer routine medical care, began in 1940,when Congress lifted the statutory strength limitation of the Medical Departmentfrom 5 to 7 percent, and authorized the President to make further increasesin the event of hostilities.³⁸ By June 1941, all tactical unitsattached or assigned to field forces had been activated at table-of-organizationstrength, including the organic medical units below division level; 34divisional medical battalions, regiments, and squadrons; nine corps levelmedical battalions; and seven army level medical regiments.

The activation of so many new units would have been a difficult task,even had a large number of field medical units existed from which trainedcadres might have been drawn. As it was, hospitals assigned to the fieldforces had to be activated on the basis of one-half enlisted and nominalofficer strength. Numbered general hospitals, for example, were activatedwith five officers and 250 enlisted men, when their table of organizationentitled them to 73 officers, 120 nurses, and 500 enlisted men. These units,including 22 station hospitals, 22 general hospitals, 17 evacuation hospitals,and eight surgical hospitals, were activated in the belief that their limitedstrength would provide a trained nucleus of enlisted personnel for theactivation of affiliated units if and when called to duty and to trainthe cadre for additional units. Finally, a number of Medical Departmentinstallations, including nine named general hospitals (750-2,000 bed),10 supply depots, eight corps area laboratories, and 175 station hospitals(50-2,000 bed) were fully staffed, equipped, and placed in operation. Thestrain placed on the Medical Department, even by the comparatively gradualexpansion of 1940-41, stretched its facilities to the limit and pointedup the need for having medical facilities available before mobilizationbegan.³⁹

Training the Expanding Army, 1939-41

With the passage of time, the problems of training the Army createdbetween 1939 and 1941 have become legendary. Ideally, an army should bebuilt from the

³⁸See footnote 1 (3), p. 1.
³⁹(1) Annual Report of The Surgeon General, U.S. Army, 1941.Washington: U.S. Government Printing Office, 1941. (2) Wakeman, F. B.:Medical Department Training. Army M. Bull. 57: 46-49, July 1941.

bottom up, beginning with the conditioning and training of the basicsoldier, and progressing through unit tactics from the lowest to the highestlevel of field organization, in order to weld individuals into seasoned,efficient combat teams and to develop the command leadership and stafftechniques necessary for managing large units on the battlefield. Withthe activation of the National Guard and the passage of Selective Servicelegislation, manpower became immediately available. But the timelag requiredbetween appropriations and the procurement of equipment and facilities,in combination with the drainage of critical material through lend-lease,forced the implementation of less than ideal training procedures.

During the year between the President's declaration of a limited emergencyand passage of the Selective Training and Service Act, training programscentered on integrating the additional troops authorized in 1939 into theArmy's new triangular divisions and field testing these divisions in large-scalemaneuvers. During September and October, armory drills for the NationalGuard were increased by 12, and 7 additional days of summer field trainingwere authorized. Five complete Regular Army divisions and one cavalry divisionwere assembled for intensive field training, and corps area commanderswere ordered to assemble their nondivisional troops for similar training.In January 1940, the 3d Division, assembled at Fort Lewis, Wash., participatedin amphibious exercises near Monterey, Calif. In April 1940, 3 weeks ofcorps maneuvers were held at Fort Benning, Ga. During the same period,division and corps troops maneuvered in eastern Texas, followed by 3 weeksof corps against corps maneuvers in the Sabine River area of Louisiana.The spring maneuvers of 1940 focused attention on the training weaknessesof the Army: lack of equipment, poor minor tactics, lack of basic leadershipin many units, and some inept command leadership by senior officers. Suchweaknesses could be corrected only by the tedious process of basic, smallunit training. Maneuvers reinforced the idea that training must begin atthe bottom and provide uniform and standardized instruction focused onthe fundamentals of soldiering.⁴⁰

Little could be done to correct deficiencies without additional appropriations.Shortages of equipment and facilities were aggravated by the sudden decisionto federalize the National Guard and to inaugurate Selective Service. Theoriginal request for National Guard federalization had been made in May,not only to gain control of its manpower and equipment, but also to utilizesummer camps while preparing winter quarters. The prolonged debate thatfollowed consumed most of the summer, and resulted in the activation ofthe National Guard, Selective Service, and the prospect of having to givebasic training to a large number of raw recruits. In contrast to WorldWar I, in which newly activated units were given basic training and shippedoverseas, the Army now faced the unanticipated problem of housing its expandedtroop strength for a protracted period, and providing large unit trainingareas. Supply bottlenecks and the onset of winter forced planners to placethe rate of induction and activation below planned schedules and to pursueless than ideal training programs.

Until replacement training centers could be completed, selectees wereassigned

⁴⁰See footnote 26, p. 14; 27 (2), p. 15; and35 (1) and (3), p. 22.

directly to Regular Army and National Guard units, where basic trainingand advanced unit training were conducted concurrently. Although the replacementtraining center program was initiated immediately and 21 centers openedas rapidly as construction could be completed, the majority did not beginoperating until March and April 1941 and did not reach maximum capacityuntil June. In the meantime, an annual training cycle was prescribed thatdivided the year into three 4-month periods: The first devoted to individualand small unit training; the second, to progressive combined arms training;and the third, to corps and army training. After replacement training facilitiesbecame available, selectees and recruits were subjected to basic trainingin their arm or service for a period of 13 weeks before being assignedto their units. The unit training centers called for in the ProtectiveMobilization Plan were never activated. When Pearl Harbor thrust new demandson the Army, the machinery for enlisted training was functioning. Testsconducted during the fall maneuvers in 1941 did not produce entirely satisfactoryresults, but the performance of units was well above that demonstratedin the spring of 1940.

Service schools.-During the initial phases of mobilization, serviceschools followed the policies laid down in the Protective MobilizationPlan and mobilization regulations. The Army War College and the Army IndustrialCollege suspended operations in June 1940, and the Command and GeneralStaff School shifted to a short course program in November 1940. Specialservice schools discontinued peacetime courses in June 1940, and initiatedshort courses designed to give refresher and specialist training to thoseReserve and National Guard officers who could be spared to attend. In mostinstances, refresher courses were designed not only to provide basic instructionfor company grade officers but also to teach them in such a manner thatthey would become capable instructors.

Because the pool of National Guard and Reserve officers was adequatefor the mobilization of an army of 1.4 million, the officer candidate programwas postponed through the 1940 phase of mobilization. Opposition to activatingthe officer candidate program was based on the fear that it would createa surplus of officers who would become a personnel problem for the Army.After General Marshall became convinced that the opportunity to earn commissionwould improve the morale of selectees, the officer candidate program wasactivated on a limited basis in July 1941. By the end of the year, officercandidate schools had graduated only 1,389 officers. Mass training wasdelayed until after Pearl Harbor. Had the program been delayed much longer,the time consumed in establishing programs and facilities might have produceda critical shortage of officers.

Doctrinal publications and training aids.-Among the lessons learnedfrom mass mobilization for World War I had been the need for training literature.Following the war, both the General Staff and the Army War College conductedextensive studies on its preparation and use. By 1930, four types of WarDepartment training publications were being issued-training regulations,technical regulations, training manuals, and field manuals. In practice,field manuals were most frequently used in military instruction. Duringthe 1930's, the volume of training literature was expanded by the publicationof new manuals and regulations designed to explain the use of new weaponsand organizations. Finally, in

1938, the existing training literature was simplified by eliminatingtraining regulations and replacing them with revised and expanded fieldmanuals. Such revision became necessary, in any event, when the far-reachingorganizational changes of 1939-40 and the new weapons and materiel beingfurnished under the rearmament program made nearly all field manuals obsolete.Revision of the old manuals was well underway by the end of 1941, but formost of the emergency period, training facilities had to either dependon obsolete manuals or create their own materials.

Responsibility for the revision of training literature was not vestedin a single agency but was distributed among the service schools and specialboards. Directives for the revision of field manuals made it clear thatsimplicity was as important an objective as bringing the material up todate; lecture-style writing, duplication, and complexity were to be eliminatedat all costs. Most of the actual writing was done by the faculties of theCommand and General Staff School and the service schools, in the beliefthat people who were experienced in teaching and instructional methodswould be able to write better training manuals than specialists in a givensubject. Despite dissatisfaction at the slowness of the work, and the difficultyof coordinating the work of different service schools to avoid duplicationand contradiction, the policy of decentralized preparation continued throughoutthe war.

Supplementing written manuals and doctrinal publications were a widevariety of training aids. After World War I, Army service schools had developedan increasing number of devices, including charts, films, filmstrips, tables,mockups, and models, and other aids to add depth to ideas created by writtenand spoken words. Instructors in service schools had come to depend heavilyon such devices, but with manuals, they were often not readily availablein the early stages of expansion. When funds became available in increasingamounts after 1940, the training aids program was expanded, and by themiddle of the war, maps, films, and filmstrips were available in ever increasingquantities. Eventually, the resources and experience of the motion pictureindustry were harnessed to the production of training aids. Throughoutthe war, however, many of the auxiliary tools of training were producedby small units, either for special purposes or because of individual inspirationon the part of unit commander, in training aids shops that were establisheddown at least as far as the regimental level.

Before 1940, training schedules did not conform to any rigid pattern.Small units at company level and above usually prepared a master schedulefor the entire year that included mandatory training subjects, but thesequence and hours allotted to them were left to the discretion of theunit commander and were subject to the availability of time and facilities.The Protective Mobilization Plan, however, included in its subsidiary plansa provision for mobilization training programs, which prescribed time allotmentsfor training subjects in a desired sequence. The mobilization trainingprograms, which were issued for each arm and service late in 1940, wererigid training schedules, allowing only such changes as were made necessaryby local conditions. Experiences of the war were reflected by successivechanges of the mobilization training programs and by changes in the lengthof the training period. The overall length of the replacement trainingprogram, for instance, varied from 13 weeks to 17, to 8, to 14, back to13, and again to 17, usually to meet

a heavy demand for replacements in theaters of operations. The mobilizationtraining programs standardized training and were useful to inexperiencedofficers. At times, however, they were not flexible enough to allow experiencedofficers to take advantage of their ingenuity and professional skill.

As teaching programs, mobilization training programs were in turn supplementedby subject schedules, which were, in effect, a syllabus for subjects specifiedin mobilization training programs. Prepared by the branch schools, theseschedules consisted of an outline of the subject, instructions on how itwas to be taught, and lists of required training aids and equipment necessaryor desirable for a particular lesson. Training programs were also supplementedby a variety of devices by which higher commanders could influence theconduct of training. War Department training circulars were used to institutechanges in training manuals until a given manual could be revised, andsimilar directives were published by subordinate commands. Many of thesecommunications established broad training policies, emphasized currentdeficiencies, and prescribed special training. In sum, a body of regulationswas created that not only outlined the training to be given but also specifiedits conduct and content.

Although mobilization made on-the-job training impractical, the Armycontinued to emphasize "learning by doing" in its training programs,disguised by the cumbersome phrase "applicatory training." Inpractice, methods of instruction emphasized five basic principles: preparation,explanation, demonstration, application, and examination. The techniquewas efficient for mass transmission of a limited body of knowledge butwas often limited by the availability of equipment and training aids, particularlyin the early stages of mobilization. To overcome this handicap, trainingcenters frequently had to pool resources and utilize training committeescomposed of officers and noncommissioned officers specially trained forsome phase of instruction. Testing, at all stages of instruction, was usedto measure the effects of training.

The Administration of Training

Until the fall of France, the Army within the continental United Stateswas administered through nine geographic divisions known as corps areas.Commanders of corps areas not only controlled the "housekeeping"functions of the Army in the Zone of Interior but also were responsiblefor the training programs of the arms and services, except for those activitiesdirectly under branch control. In theory, a framework of four army areaswas superimposed on this structure, which, in case of hostilities, wouldbecome responsible for tactical training and operations. In the event ofmobilization, plans called for the activation of a General Headquartersto command the field forces in army areas.

The headquarters envisioned by Army planners was created and injectedinto the Army command structure on 26 July 1940. When activated, GeneralHeadquarters consisted of a Chief of Staff and a small group of officersselected to perform its initial function-the supervision and training oftactical ground forces in the continental United States. On 3 August 1940,Brig. Gen. (later Lt. Gen.) Lesley J.

McNair was appointed to command General Headquarters. A second steptoward a wartime organization was taken in October 1940, when command ofthe four field armies was separated from that of the corps areas.

In theory, responsibility for the several phases of training was clearlydelineated in the General Headquarters concept. Commanders of corps areasand the chiefs of the arms and services continued to exercise their preemergencycontrol of the basic training of personnel in their spheres of responsibilityand in the newly activated replacement training centers. General Headquarterswas designed to take over when these commanders had completed their responsibilityand to train the units filled by graduates of replacement training centers.In garrison, troops remained under the jurisdiction of corps area and postcommand, but in the field, command and support became the responsibilityof General Headquarters. Ideally, the system should have created four independentfield armies capable of prompt and effective tactical movement, but inpractice, the ideal was never achieved. Army commanders were never fullyliberated from the responsibility for post command, the delegation of trainingresponsibility remained incomplete, and General Headquarters remained subjectto War Department General Staff, G-4, in matters of supply. Until March1941, when replacement training centers began to function, newly activatedunits of the forces under General Headquarters command were filled withselectees directly from civilian life. Much of General Headquarters energywas consumed in training raw recruits, tactics, discipline, and the useof weapons, instead of the advanced unit training for which it was intended.

The duties of General Headquarters were, for the most part, of a generalnature. Seven officers were assigned to General Headquarters in August1940, and as late as June 1941, as few as 23 were on its staff. GeneralMcNair's energy and ability enabled him to translate the Chief of Staff'sstrong views on the necessity of step-by-step training into action, aswell as the traditional Army view that training should begin from the groundup. But aside from these accomplishments, General Headquarters ambiguousposition and limited strength made it a difficulty to function as intended.When the addition of command and planning responsibilities in the summerof 1941 brought it into conflict with the War Plans Division, the War Departmentbegan to consider reorganization.⁴¹

The Reorganization of March 1942

The Army reorganization of March 1942, which served as the basis forZone of Interior administration throughout the war, was the product ofconflicts produced by overlapping responsibilities under the existing WarDepartment structure and the increasing administrative burden on the Chiefof Staff created by Army expansion. After a lengthy period of study, reorganizationwas effected by Executive order on 9 March 1942.⁴²

⁴¹(1) Greenfield, Kent Roberts, Palmer, RobertR., and Wiley, Bell I.: The Organization of Ground Combat Troops. UnitedStates Army in World War II. The Army Ground Forces. Washington: U.S. GovernmentPrinting Office, 1947. (2) Millett, John D.: The Organization and Roleof the Army Service Forces. United States Army in World War II. The ArmyService Forces. Washington: U.S. Government Printing Office, 1954.
⁴²See footnote 41 (2).

Under the new organization, only a limited number of officers had directaccess to the Chief of Staff, including the General Staff and the threechiefs of Zone of Interior administrative agencies. The General Staff wasto be composed of a small group of officers who would assist the Chiefof Staff in strategic planning and coordinate the activities of theatercommanders with Zone of Interior agencies. Zone of Interior administrationwould be accomplished through three commands reporting directly to theChief of Staff: Army Air Forces, Army Ground Forces, and Army Service Forces.The new air command had its own general and administrative staffs and theresponsibility for training and equipping air units both for independentoperations and for combined exercises. Army Ground Forces became responsiblefor organizing and training ground combat troops previously controlledby General Headquarters and absorbed most of the functions controlled bythe previously semiautonomous chiefs of the combat arms. Army Service Forceswas charged with relieving the fighting arms of the problems of supply,procurement, and housekeeping administration. Because the Chief of Staffwas determined that no more than three commands in the United States wouldreport to him, Army Service Forces assumed all responsibilities which didnot fit into the structure of Army Air Forces and Army Ground Forces, includingthe technical services. The Medical Department, as one of the technicalservices, now reported directly to the Commanding General, Army ServiceForces, instead of to the Chief of Staff.⁴³

In addition to its mission of supply and procurement, Army Service Forceswas charged with routine administrative and housekeeping duties, includingcertain Armywide functions, such as "premilitary training, manpowermobilization, and labor relations; operation of reception centers, replacementtraining centers, and training schools for the supply arms and services;technical training of individuals, basic training of service troops, andtechnical training of service units; and the furnishing of ASF personnelto the Army Air and Ground Forces, theaters of operations, and overseasforces * * * ."⁴⁴ To carry outthis mission, Army Service Forces was given control of those installationsresponsible for administrative and housekeeping duties, including the corpsareas, and many installations which had previously been under the controlof the chiefs of the arms and services. To emphasize this change, the titleof the corps areas was changed to Service Commands, Army Service Forces.To facilitate administrations, all Army field installations in the Zoneof Interior were placed under four categories of control. Those under thedirect control of Army Service Forces, including supply and training facilities,and all named general hospitals, except the Army Medical Center, were categorizedas class I installations and placed under the commanding generals of servicecommands. Class II installations were those where Army Ground Forces unitswere stationed, and Army Service Forces duties were confined to housekeepingand administration. Class III installations were those similarly occupiedby Army Air Forces units. Class IV installations were those that, becauseof their technical nature, remained under the direct command of a supplyor administrative service.

⁴³Initially called SOS (Services of Supply),the name of the command was changed to ASF (Army Service Forces) by WarDepartment General Orders No. 14, 12 Mar. 1943. It is best known by thisdesignation, which will be used hereafter.
⁴⁴See footnote 41 (2), p. 28.

In this redistribution of authority, The Surgeon General not only lostdirect control of most of the Medical Department's exempted installationsbut also lost a great deal of control over the activities of the Air Surgeonand the medical service he commanded.⁴⁵

The reorganization of 1942 placed a capstone on the structure of commandand control which had gradually been evolving since the introduction ofthe General Staff system. Throughout the interwar period, as part of thespecial staff, the chiefs of the technical services had acted as technicaladvisers to War Department General Staff, G-3, in matters of troop training.Well before 1939, The Surgeon General had become established as the finalsource of technical doctrine for the training of medical troops, and theWar Department had charged the Surgeon General's Office with the responsibilityfor developing programs for the individual and unit training of all medicaltroops, as well as preparing Medical Department training materials forpublication. The Surgeon General continued to be the ultimate source oftraining doctrine and official War Department training guides and materialsfor all medical soldiers throughout the war. The War Department reorganizationof March 1942, which reduced the staff level of the chiefs of technicalservices and placed them under the Commanding General of Army Service Forces,modified only administratively The Surgeon General's responsibility forthe formulation of Medical Department training doctrine, program guides,and instructional materials. Before the reorganization, The Surgeon Generaldischarged this responsibility as an agent of the War Department; afterthe reorganization, he discharged it as an agent of the Commanding General,Army Service Forces.⁴⁶

In contrast with the control of technical doctrine, The Surgeon General'scommand relationship to the staffs of installations training medical troopswas seriously modified by the reorganization of 1942. During the interwarperiod and the first 2 years of the emergency, direct command of the facilitiesand staff for training medical troops was divided between corps area commandersand The Surgeon General. Corps area commanders had immediate jurisdictionover the training of medical soldiers at all posts, camps, and stationsthat were not reserved for The Surgeon General by War Department directive.At the beginning of the limited emergency, the exempted stations consistedof the Medical Field Service School; Army Medical Center, including WalterReed General Hospital; the other four named general hospitals; and medicalsupply depots.⁴⁷Commanding officers of exempt installationswere directly responsible to The Surgeon General for all administrativeand supervisory activities affecting training. They were responsible tocorps area commanders in matters of supply, communication, courts-martial,and the discipline and military bearing of their troops. Because all serviceschool courses were conducted at either the Medical Field Service Schoolor the Army Medical Center, The Surgeon General had direct control overall such courses. Control of the basic training of recruits was sharedby The Surgeon General and the commanders of corps areas; recruits at exemptedstations were trained by their commanders, and

⁴⁵See footnote 6 (2), p. 5 .
⁴⁶Army Regulations No. 170-10, 10 Aug. 1942.
⁴⁷Army Regulations No. 170-10, 10 Oct. 1939.

others were trained under corps area jurisdiction. As the Army expandedto meet emergency and wartime needs, facilities for training medical troopswere dramatically expanded. Changes in the command authority over MedicalDepartment training facilities were so frequent and diverse that they mustbe reviewed by category to be meaningful.

Control of basic training.-In the interwar years, the initialtraining of a Medical Department recruit was usually accomplished on-the-jobat the dispensary or hospital to which he was assigned. Compared with basictraining during the war, little emphasis was placed on drill and fieldtraining. When Selective Service began to bring large numbers of new meninto the Medical Department, recruits were sent from reception centerseither to Medical Department field units, which were activated in increasingnumbers after July 1940, or to the Medical Replacement Training Centers,which began being activated in February 1941.⁴⁸

The Surgeon General's relationship to the Medical Replacement TrainingCenters had a checkered history. The first centers, established at CampLee and Camp Grant in January 1941 and at Camp Barkeley in November 1941,were corps area installations⁴⁹ even though plans for the centerswere developed in the Office of The Surgeon General. In December 1941,these centers were designated exempt stations and placed under commandof The Surgeon General.⁵⁰ Camp Joseph T. Robinson, Ark., establishedin January 1942, operated under a different command relationship to TheSurgeon General for a period of 8 months, being placed under the controlof the Chief of Infantry for administration and The Surgeon General fortraining.⁵¹

The War Department reorganization of March 1942 made no immediate changein The Surgeon General's relationship to the Medical Replacement TrainingCenters at Camps Lee, Grant, and Barkeley, which were exempted stations,but the center at Camp Robinson became an installation of the newly createdArmy Ground Forces when that command absorbed the functions of the Chiefof Infantry. In July 1942, the Surgeon General's Office requested thatthe center at Camp Robinson be placed on exempted status to eliminate the"long and circuitous procedure of securing concurrences before orderingpersonnel in and out of this center."⁵² The request wasnot approved, and Camp Robinson remained under the administrative controlof Army Ground Forces until August 1942, when it became a class I installationof Army Service Forces.⁵³ Meanwhile, in June, the Medical Replacement

⁴⁸See footnote 5, p. 3.
⁴⁹(1) Letter, The Adjutant General to Commanding Generals, Secondthru Ninth Corps Areas; Commanding General, GHQ, Air Force; CommandingOfficer, Edgewood Arsenal, Md.; and Commanding Officer, Aberdeen ProvingGrounds, Md., 13 Jan. 1941, subject: Replacement Centers. (2) Letter, TheAdjutant General to Commanding Generals, Seventh and Eighth Corps Areas;Chief Signal Officer; The Surgeon General; and Chief of Infantry, 23 Oct.1941, subject: Activation of Replacement Training Centers.
⁵⁰(1) Telegram, The Adjutant General to Commanding Generals,Medical Replacement Training Centers, Camp Grant, Ill., Camp Lee, Va.,and Camp Barkeley, Tex., 20 Dec. 1941. (2) See footnote 6 (2), p. 5.
⁵¹Letter, The Adjutant General to Commanding Generals, Third,Sixth, Seventh, and Eighth Corps Areas, Infantry Replacement Training Centers;Chief of Infantry; and The Surgeon General, 3 Jan. 1942, subject: Constitutionand Activation of Medical Replacement Training Center, Camp Joseph T. Robinson,Ark.
⁵²Memorandum, The Surgeon General for Director of Training,Services of Supply, 6 July 1942, subject: Exempted Status Medical ReplacementTraining Center, Camp Joseph T. Robinson, Ark.
⁵³Memorandum No. W170-1-42, The Adjutant General, 22 Aug. 1942,subject: Status of the Medical Replacement Training Center, Camp JosephT. Robinson, Ark.

Training Center at Camp Lee was transferred to Camp Pickett,⁵⁴and, in August, the exempted stations also became class I installationsunder the newly created service commands of Army Service Forces.⁵⁵

By this reorganization, the Medical Department lost direct command ofthe Medical Replacement Training Centers and was required to exert itsinfluence through channels. Throughout the war, the formulation of doctrineremained a prerogative of The Surgeon General, along with the authorityto draft training programs. Doctrine and training programs could be forwardedto the Medical Replacement Training Centers directly through the CommandingGeneral, Army Service Forces, who retained direct control over these areas.The selection, assignment, and relief of staff and faculty personnel weresimilarly retained by the headquarters of Army Service Forces, and in December1942, regulations were loosened to allow direct communication between thechiefs of technical services and training activities in matters of program,doctrine, and staff assignments. With the exception of the responsibilityfor faculty and staff assignment, which was transferred to service commandjurisdiction in April 1943, these policies remained in effect until afterthe end of the war.⁵⁶

Control of units in training.-At the beginning of the limitedemergency, only five medical field organizations were in existence. Ofthese, only the 1st Medical Regiment was under the direct command of TheSurgeon General, and that because it was assigned to the Medical FieldService School as a demonstration unit. The other four units were responsibleto the commanders of corps areas. Activation of new medical field unitsdid not get underway until the middle of 1940, following the callup ofNational Guard units and the inauguration of Selective Service. Becausethese units were attached or assigned to corps, armies, and divisions fortraining, they came under the control of General Headquarters. The exceptionsto this procedure were a few numbered general hospitals activated at fullstrength. Until the reorganization of 1942, The Surgeon General, as a memberof the War Department Special Staff, was as responsible for the trainingof a medical battalion or an evacuation hospital, which would later havebeen classified as an Army Ground Forces-type unit, as he was with thoselater classified as Army Service Forces-type units, such as numbered generalor station hospitals. The Surgeon General was frequently called upon forguidance by the commanders of both field and support units, and his representativesinspected both types of units.⁵⁷

The War Department reorganization of March 1942 radically modified thissupervision by placing certain types of medical units under Army GroundForces, others under Army Air Forces, and still others under Army ServiceForces for training.⁵⁸ Control was complicated by The SurgeonGeneral's new status, as far as

⁵⁴Radiogram, Commanding General, Medical ReplacementTraining Center, Camp Pickett, Va., to The Surgeon General, 21 June 1942.
⁵⁵See footnote 46, p. 30.
⁵⁶Army Regulations No. 170-10, 24 Dec. 1942.
⁵⁷(1) See footnotes 9 (2), p. 6; and 39 (1), p. 23. (2) Letter,The Adjutant General to Commanding Generals of all Armies, Army Corps,Divisions, Corps Areas, and Departments; Commanding General, GHQ Air Force;Chief of Staff, GHQ; Chiefs of Arms and Services; Chief of the ArmoredForce; and Commanding Officers of Exempted Stations, 14 Jan. 1941, subject:Organization, Training and Administration of Medical Units.
⁵⁸War Department Circular No. 59, 2 Mar. 1942.

unit training was concerned, as an agent of the Commanding General,Army Service Forces, and the elevation of the Ground Surgeon and the AirSurgeon to the same level of organizational hierarchy. Under the new system,the Office of The Surgeon General retained as much influence over thoseunits assigned to the Army Service Forces as it had in peacetime when theseunits were controlled through the War Department or General Headquartersand corps area commanders, but its relationship to the training of medicalunits assigned to Army Ground Forces or Army Air Forces became more remote.While The Surgeon General still formulated training doctrine and officialinstructional materials for all medical units, he no longer inspected unitsassigned to Army Ground Forces and Army Air Forces. The War Departmentreorganization of 1942 thus reduced the staff level on which The SurgeonGeneral functioned as a training agent, and, in so doing, removed fromhis control large numbers of medical troops during their unit's trainingperiod.

The division of control of unit training among the three major commandsdid not seriously affect The Surgeon General's control of the basic trainingof medical troops. Recruits and selectees assigned directly to MedicalDepartment field units between September 1940 and mid-1941, before theopening of replacement training centers, received all the basic trainingthey were likely to receive before the reorganization. Their training wasa responsibility of either exempted units under direct command of The SurgeonGeneral or field units under corps area command and General Headquarters.Although the Medical Replacement Training Center at Camp Robinson was underthe control of Army Ground Forces for a short period, it too was placedunder Army Service Forces for the duration of the war in August 1942. Exceptfor those men assigned directly to units in the initial stages of mobilization,all enlisted members of the Medical Department received basic trainingfrom training camps administered as class I installations of Army ServiceForces, whether they were ultimately destined for assignment to Army ServiceForces or Army Ground Forces.⁵⁹

Command of schools.-On 1 July 1939, only two Medical Departmentinstallations provided academic training: the Medical Field Service School,and the Medical Department Professional Service Schools, including theMedical, Dental, and Veterinary Schools at the Army Medical Center. Inthe course of the war, the number of schools was expanded heavily to meetrequirements for technically trained personnel. Throughout the war, MedicalField Service Schools and the three professional service schools at theArmy Medical Center remained under the direct command of The Surgeon General.Mobilization plans called for the establishment of enlisted training schoolsat exempted installations, which would have remained under direct control,and all but two of the 13 schools established between April 1941 and July1942 were, at their inception, directly administered by the Medical Department.The exceptions were the Enlisted Technician's School at Station Hospital,Fort Sam Houston, Tex., and the Army School of Roentgenology at the Universityof Tennessee College of Medicine, Memphis, Tenn., neither of which waslocated at an exempted station. In July 1942, the newly created servicecommands, which superseded the older corps area commands under the Army

⁵⁹Annual Report, Training Division, OperationsService, Office of The Surgeon General, fiscal year 1943.

Service Forces, absorbed most of the Medical Department's exempted stationsand removed all but the Medical Field Service School and the Army MedicalCenter from The Surgeon General's direct control. Following the reorganization,the Office of The Surgeon General continued to exercise direct controlover training programs and doctrine but was unable to exercise jurisdictionover personnel and administration at schools falling under the authorityof the service commands.

Activities of the Training Division, Office of The SurgeonGeneral

Within the Office of The Surgeon General, administrative authority overThe Surgeon General's training responsibilities was delegated to the TrainingDivision, which developed all Medical Department training programs; supervisedthe preparation of technical manuals, training films, and other trainingaids; formulated plans for Medical Department replacement centers and schools;supervised the activation of training installations; and inspected schools,units, and training centers for which The Surgeon General had supervisoryresponsibility. On 1 July 1939, the Training Division was actually a subdivisionof the Planning and Training Division, staffed by one officer, as it hadbeen since its creation in 1921. In spite of an increasing workload, growthof the subdivision was slow. It was not until January 1940 that the staffwas increased to two officers, and when the United States entered WorldWar II, the subdivision was staffed by only three officers. In February1942, the Training Subdivision achieved division status, but there wasno change in personnel until June 1942, when its staff was increased tofive officers.

In August 1942, the Training Division was reorganized to parallel thestructure of the Army Service Forces Training Division. Originally it hadconsisted of an Enlisted Branch, an Officer Branch, and a Publication Branch.Thereafter, it contained a Replacement Training Branch, a School Branch,a Training Doctrine Branch, and a Unit Training Branch. The ReplacementTraining Branch and the School Branch prepared plans for the inaugurationof Medical Replacement Training Centers and Medical Department schools,recommended overhead personnel allotments and changes in the staff, wroteappropriate mobilization training programs, and inspected the installationsinvolved. The Unit Training Branch was created to prepare programs forMedical Department communications zone installations, which were an ArmyService Forces responsibility, and, in addition, recommended officer personnelfor these units and evaluated their proficiency. The Training DoctrineBranch supervised the preparation of technical manuals, field manuals,training films, filmstrips, posters, and graphic training aids. In May1944, the Replacement Training Branch and the Unit Training Branch wererenamed the Regular Training Branch and the Readiness and RequirementsBranch to conform with terminology used in the Office of the Director ofMilitary Training, Army Service Forces, but the changes were in name only.The basic structure created by the reorganization of August 1942 remainedin effect throughout the war.⁶⁰

⁶⁰(1) See footnote 6 (2), p. 5. (2) AnnualReport, Training Division, Operations Service, Office of The Surgeon General,fiscal year 1944.

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