CHAPTER II
Medical, Dental, Veterinary, and Sanitary CorpsOfficers
World War II did not produce radical changes in the pattern of trainingMedical, Dental, Veterinary, and Sanitary Corps officers. Expanding activitiesincreased specialization and division of labor and intensified the specializationof training. Programs were divided into components that could be expandedinto separate courses; other courses were shortened, and the pace of trainingwas accelerated. New courses were added to provide officers with skillsthat had been traditionally acquired through informal training. Medicalspecialists required for the treatment of wounds and diseases uncommonin peacetime medical practice also required special training. When theincreasing demand for physicians resulted in a transfer of nontechnicalduties to MAC (Medical Administrative Corps) officers, some areas of trainingwere deleted from the program. Training facilities were expanded from theMedical Field Service School, Carlisle Barracks, Pa., and the Army MedicalCenter, Washington, D.C., to include general hospitals, medical depots,civilian institutions, replacement training centers, and officer replacementpools. Despite these changes, however, the division of training into tacticaland technical programs continued throughout the war; the addition of newfacilities and courses reflected the Medical Department's expansion, andnot a change in direction.
PERIOD OF FLUX: 1939-41
Continuing the Peacetime Program: September 1939-September1940
Regular Army training
Aside from increasing emphasis on field medical service, the first yearof the war in Europe produced few substantive changes in Medical Departmenttraining. The expansion of the Army that accompanied the limited emergencyproclamation, and the conversion to triangular divisions that followed,allowed the Medical Department to organize field medical detachments forfour divisions, four medical battalions, and an additional medical regiment.Activation of these units during the winter of 1939-40 was complicatedboth by the preponderance of recruits and by the relative inexperienceof many of the officers who had been detached from hospitals to commandthem. At best, their performance in the spring maneuvers of 1940 was describedas "creditable," and led to the observation: "The inexperiencein all echelons of command in the use of these units showed the necessityof having in
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being all of the tactical medical elements of mobile forces in orderthat all may be trained in respective responsibilities and cooperativeaction."1
To provide basic field training for newly commissioned officers, andto complete the basic training of Regular Army officers who had not yetattended the Medical Field Service School, the Officers' Basic Course wasshortened from 5 to 3 months, and offered twice annually. The change permitteda modest expansion: in contrast to the largest class in the preceding 5years, 81 officers who graduated in 1935, 111 student-officers completedthe basic course in 1940.2
An unusual opportunity to experiment with basic officer training developedin 1940, when the War Department directed the MFSS (Medical Field ServiceSchool) students to participate in the spring corps and army maneuvers.3To prepare the basic officers' class for maneuvers, Lt. Col. (later Brig.Gen.) Charles B. Spruit, MC, recommended altering the course schedule toconcentrate formal instruction in the month preceding maneuvers. "Iam firmly convinced that the experience these * * * officerswould obtain by actual participation in the greatest peacetime maneuverthe Army has ever had, will be of far greater value to the service andto them than the solution of any number of map problems or participationin the field exercises at Indiantown Gap."4
After an initial period of instruction at Carlisle Barracks, studentsfrom the Medical Field Service School participated in both corps and armyexercises. During the corps phase, at Fort Benning, Ga., half of the studentswere assigned to medical battalions, and half to regimental medical detachments.To give students a greater understanding in all echelons of support, assignmentswere reversed during the army phase of maneuvers, which were held in theSabine River area of Louisiana. Eight members of the faculty, assignedas special medical observers and control officers, accompanied the class.Although reports on the performance of MFSS students were enthusiastic,particularly when contrasted to that of medical unit officers who had receivedno formal training, the maneuvers produced conflicting recommendationsfor future training. The Surgeon General supported Colonel Spruit's opinionthat "the sending of these two classes to the Army maneuver was justified."5The Medical Field Service School, however, took the position that, despitethe value of the maneuvers, the time could have been better spent in independentmedical exercises at Indiantown Gap, Pa., within a reasonable distanceof Carlisle Barracks. Five weeks had been too short to prepare studentsfor field exercises, and the time
1Annual Report of The Surgeon General, U.S.Army, 1940. Washington: U.S. Government Printing Office, 1941.
2(1) Annual Report of The Surgeon General, U.S. Army. Washington:U.S. Government Printing Office, 1935. (2) See footnote 1.
3Letter, The Adjutant General, War Department, to The SurgeonGeneral, U.S. Army, 25 Mar. 1940, subject: Courses of Instruction at SpecialService Schools, 1940-41.
4Memorandum, Lt. Col. Charles B. Spruit, MC, Chief, TrainingSubdivision, Planning and Training Division, Office of The Surgeon General,for Col. Albert G. Love, MC, Chief, Planning and Training Division, Officeof The Surgeon General, 5 Jan. 1940, subject: Training at Carlisle as Affectedby Coming Course and Army Maneuvers in the South.
5(1) Letter, Lt. Col. Charles B. Spruit, MC, Chief, TrainingSubdivision, Planning and Training Division, Office of The Surgeon General,to The Surgeon General, U.S. Army, 14 June 1940, subject: Third U.S. ArmyManeuvers, Army Phase. (2) Annual Report of The Surgeon General, U.S. Army,1941. Washington: U.S. Government Printing Office, 1941.
37
spent on maneuvers was disproportionate.6 The school prevailed,and future maneuvers were confined to facilities adjacent to Carlisle Barracks.
Aside from these experiments with basic field training, few other changeswere introduced into the training program for Regular Army officers. Thebasic graduate courses at the Army Medical Center were shortened by a month,but the number of students remained constant. The advanced course at theMedical Field Service School was lengthened by a month to provide specialinstruction in training methods for senior officers. In December 1939,advanced graduate courses at the Army Medical Center, scheduled to beginin February 1940, were canceled because officers could not be spared toattend them.7 Revision of the MFSS extension courses, institutedin 1939 as a 4-year plan to concentrate efforts on preparing young Reserveand National Guard officers for service in-grade, eliminated the specialextension course for Regular Army officers preparing for promotion to lieutenantcolonel or colonel. More elementary courses were still open to them, butonly eight Regular Army officers enrolled.
National Guard and Reserve officers
The first year of the limited emergency produced as few changes in thetraining of Reserve and National Guard officers as it had in the RegularArmy program. Until both elements were called to active duty in the fallof 1940, summer training camps and correspondence courses continued toprovide the bulk of their training. In common with the Regular Army, Reservecomponents were trained with an increasing emphasis on field medical service.In addition to the usual basic- and unit-training camps held at the MedicalField Service School in the summer of 1939, summer camp training in fieldsanitation was conducted for 79 officers at newly constructed demonstrationareas at Jefferson Barracks, Mo.; Camp Bullis, Tex.; and Fort Ord, Calif.Previously, sanitary demonstration areas were available only at CarlisleBarracks. To school National Guard units in the problems of cold weatheroperations, supplemental field training was required between October 1939and January 1940. Basic- and unit-training camps were again held in thesummer of 1940. Field training was supplemented as usual by extension courses,which were still in the process of being revised, and more than 11,000officers of the Reserve and National Guard enrolled in them between June1939 and June 1940. During the same period, one National Guard officerenrolled in the Army Veterinary School course in forage inspection.
The program of extension courses for field grade officers, dropped fromthe Regular Army program, continued to be available to senior officersin Reserve components. The usual fall advanced course, offered between15 September and 28 October 1939, was attended by 25 officers. The followingMay, 14 officers in a special course for National Guard officers were unexpectedlygiven the opportunity to participate in the Third U.S. Army maneuvers inLouisiana, where they were able to gain practical experience as officersin various echelons of medical support.
6Technical Report of Activities of the MedicalField Service School, Carlisle Barracks, Pa., fiscal year 1940.
7Letter, Col. James E. Baylis, MC, Executive Officer, Officeof The Surgeon General, to The Adjutant General, War Department, 27 Nov.1939, subject: Advanced Course, Medical Department Professional ServiceSchools, School Year 1939-40.
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Schools outside the Medical Department
Between September 1939 and September 1940, two Medical Corps officersof the Regular Army attended the Army War College, Washington, D.C.; oneattended The Infantry School, Fort Benning, Ga.; three attended the ArmyIndustrial College, Washington, D.C.; and four attended the Command andGeneral Staff School, Fort Leavenworth, Kans. One VC (Veterinary Corps)officer, Regular Army, attended the Chemical Warfare School, Edgewood Arsenal,Md. The number of Regular Army MC (Medical Corps) officers attending theSchool of Aviation Medicine, Randolph Field, Tex., increased from 10 to17, reflecting the emphasis at the beginning of the limited emergency onexpanding the Air Corps. Eight MC Reserve officers also completed thiscourse, and an additional 51 qualified for entrance by completing a requiredextension course. Twenty-eight Regular Army officers attended a varietyof courses at 15 universities and foundations, and the Reserve officerscontinued to attend civilian institutions under the Skinner Plan.8
Growth and Transition: September 1940-September 1941
Activation of the Army's Reserve and National Guard components, andpassage of the Selective Training and Service Act, accelerated trainingin the Medical Department as well as throughout the Army. Between September1940 and the end of the summer of 1941, when the tours of men called toactive duty were extended for an additional year, attention focused onproviding maximum training within the additional year. Because a high proportionof Medical Department officers called to active duty had previous training,distinctions between programs for Regular Army, Reserve, and National Guardofficers were eliminated, and schools concentrated on refresher trainingdesigned to prepare them for special duties in the Army of the United States.Existing special service schools were expanded, and new schools were openedto provide specialized training. Officers completing resident courses ofinstruction in the special service schools of the Medical Department andMedical Corps officers completing courses of instruction at service schoolsother than Medical Department schools for fiscal year 1941 are shown inthe tabulation which follows:
Schools:1 | Number |
Special schools: | |
Medical Field Service School, Carlisle Barracks, PA | 2,119 |
Army Medical Center, Washington, D.C. | 247 |
Army and Navy General Hospital, Hot Springs, Ark | 62 |
Letterman General Hospital, San Francisco, Calif | 44 |
Fitzsimons General Hospital, Denver, Colo | 94 |
William Beaumont General Hospital, El Paso, Tex | 12 |
Station Hospital, Fort Sam Houston, Tex | 35 |
Veterinary Meat Inspection Course, Chicago Ill | 114 |
Total | 2,727 |
8See footnote 1, p. 36.
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Schools:1 (Continued) | Number |
Other schools: | |
School of Aviation Medicine, Randolph Field, Tex | 237 |
The Infantry School, Fort Benning, GA | 0 |
Army Industrial College, Washington, D.C. | 12 |
Command and General Staff School, Fort Leavenworth, Kans | 12 |
Total | 261 |
1Annual Report, Training Subdivision, Planningand Training Division, Office of The Surgeon General, fiscal year 1941,p. 16.
The expansion of medical officer strength, from approximately 2,000to more than 14,000 during the first year of partial mobilization, producedfar-reaching changes in Medical Department Special Service Schools. Basedon the assumption that previous training equipped officers from Reservecomponents for general duties, plans formulated by The Surgeon Generalcalled for establishment of refresher courses to prepare officers for theassumption of special duties. All officers assigned to tactical units wereto receive a 1-month refresher course at Carlisle Barracks. Those assignedfor duty at hospitals were to attend schools set up at general hospitals,under The Surgeon General's direct control, and the remainder were to beassigned to special courses offered at the Army Medical Center and otherinstallations.9
To provide basic training for newly commissioned medical officers, thelast 3-month basic course was offered at the Medical Field Service Schoolin the fall of 1940, and 73 officers were graduated.10 Beginningin December, a 1-month refresher course for Reserve and National Guardofficers was substituted for the regular basic-training program. Becauseofficers were needed to staff enlisted replacement training centers, emphasishad to be shifted from the tactical training planned for this course byThe Surgeon General's Protective Mobilization Plan of 1939, to preparingReserve officers to serve as instructors for the increasing numbers ofenlisted men being brought into the Army by selective service. Emphasison training instructors continued until April 1941, when the program wasreoriented to tactical training. During August, a special 1-month coursefor instructors was again offered, followed by a month-long course givenat the replacement training centers, to provide replacements for Reserveofficers who wished to be relieved or rotated from training assignmentsat the end of their year of active duty, and to provide instructors forthe expansion of training facilities. By shortening courses and expandingfacilities, the Medical Field Service School was able to increase its trainingcapacity
9(1) Letter, The Surgeon General, U.S. Army,to The Adjutant General, War Department, 6 Sept. 1940, subject: MedicalDepartment in Mobilization, inclosures thereto. (2) Letter, The AdjutantGeneral, War Department, to The Surgeon General, U.S. Army, 15 June 1940,subject: Courses at Special Service Schools. (3) Letter, Col. James E.Baylis, MC, Executive Officer, Office of The Surgeon General, U.S. Army,to The Adjutant General, U.S. Army, 24 June 1940, subject: Courses at MedicalDepartment Special Service Schools, inclosures thereto.
10Goodman, Samuel M.: History of Medical Department Training,U.S. Army, World War II. Volume III. A Report on the Training of MedicalOfficers, 1 July 1939-30 June 1944. [Official record.]
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by June 1941, from approximately 100 officers the previous year to morethan 500 officers each month.11
In addition to transforming the basic officer training program, activationof the Reserves and the National Guard produced other changes in the MFSSprogram. Special courses previously offered to officers of Reserve componentswere dropped from the program, including the advanced course offered forfield grade officers. Thereafter, officers of all components were eligiblefor the same courses. With the exception of the summer camp held for ROTC(Reserve Officers' Training Corps) students in June 1941, all summer campswere eliminated.12
During the first year of mobilization, modifications in the programsof the three Medical Department Professional Service Schools at the ArmyMedical Center to meet demands for increased training produced a transitionto the installation's wartime role as a center for technical training.The Army Medical School basic graduate course, which had been reduced from3 to 2 months the previous year, was shortened to a single month in thefall of 1940, and subsequently discontinued. The professional specialistcourses, which had long provided on-the-job training in clinical and laboratoryprocedures, were similarly eliminated after the last class of 20 graduated.The advanced graduate course, which had not been offered the previous year,was again suspended. These programs were replaced by a series of refreshercourses, ranging in length to a maximum of 3 months, in surgery, clinicalmedicine, ophthalmology and otorhinolaryngology, roentgenology, and photoroentgenology.The special graduate course at the Army Dental School was again offered.The Army Veterinary School conducted special graduate courses in clinicalpathology, and offered the usual courses in forage inspection. Both theArmy Medical and Dental Schools participated in the Medical Department'sadministrative refresher training program. By June 1941, the facilitiesof the Professional Service Schools at the Army Medical Center had beenexpanded from a capacity of 100 officers the previous year, to more than100 officers each month.13
Partial mobilization proved a mixed blessing for the Medical Department,simultaneously providing much needed manpower and increasing the demandfor medical services. As graduates of accredited professional schools,MC Reserve officers were considered qualified both by training and by experienceto care for the sick and injured, but few of those who entered the Army,after September 1940, had
11(1) The Surgeon General's Protective MobilizationPlan of 1939, with annexes. (2) Annual Report, Training Subdivision, Planningand Training Division, Office of The Surgeon General, fiscal year 1941.(3) Letter, Maj. E. D. Liston, MC, Acting Executive Officer, Office ofThe Surgeon General, U.S. Army, to The Adjutant General, War Department,23 June 1941, subject: Additional Officers at Replacement Training Centers,inclosures thereto. (4) Letter, The Adjutant General, War Department, toChief of Staff, General Headquarters; Commanding Generals, First, Second,Third, and Fourth U.S. Armies, 12 Dec. 1940, subject: Attendance at theMedical Field Service School, Carlisle, Pa. (5) Letter, Brig. Gen. AlbertG. Love, Assistant Chief, Planning and Training Division, Office of TheSurgeon General, to The Adjutant General, War Department, 22 Jan. 1941,subject: Training of Officer Cadres for Medical Replacement Centers, CampLee, Va. (6) Immediate Action Letter, Maj. E. D. Liston, MC, Acting ExecutiveOfficer, Office of The Surgeon General, U.S. Army, to The Adjutant General,War Department, 23 June 1941, subject: Additional Officers at ReplacementTraining Centers, inclosures thereto.
12(1) See footnote 5 (2), p. 36. (2) Special Report of the MedicalField Service School: Personnel Trained-Graduates of School Courses, 1921-41.
13(1) Annual Report of Technical Activities, Medical DepartmentProfessional Service Schools, Army Medical Center, Washington, D.C., fiscalyear 1940. (2) Letter, The Adjutant General, War Department, to The SurgeonGeneral, U.S. Army, 31 July 1940, subject: Courses at Special Service Schools.(3) Annual Report of the Training Subdivision, Planning and Training Division,Office of The Surgeon General, fiscal year 1941.
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any detailed knowledge of the administration of Army hospitals. Recognizingthe need for training Reserve officers in administrative procedures beforeassigning them to hospitals, The Surgeon General authorized the Army MedicalCenter (Dental and Medical Schools), each of the named general hospitals,including William Beaumont, El Paso, Tex.; Army and Navy, Hot Springs,Ark.; Fitzsimons, Denver, Colo.; and Letterman, San Francisco, Calif.;and Station Hospital, Fort Sam Houston, Tex., to conduct refresher coursesin hospital administration. Under this program, 50 officers could be assignedmonthly to each installation to understudy jobs to which they would subsequentlybe assigned. On-the-job training would thus be available to Reserve officersin positions ranging from forage inspector and mess officer to commandingofficer of a general hospital. Maximum capacity reached 300 per month whenthe program was placed in full operation on 1 April 1941, but sometimesfull utilization was not possible because officers could not be sparedfrom their duties to attend these schools.
By the end of June, about 340 officers, or slightly more than 1 month'scapacity, had graduated. The following year, facilities were expanded toinclude 14 named general hospitals, with a capacity of 700 officers permonth. Shortly thereafter, when the supply of Reserve officers had beenexhausted, the refresher courses became a part of the Officer Pool Programand were offered to newly commissioned officers. Even later, when MAC officersbegan to replace MC officers in administrative positions, many of themreceived pool training in administration. Despite its changing title, itsfunction remained the same, and a 30-day period of on-the-job trainingin hospital administration became a permanent feature of the World WarII program.14
Except for this increase in size, other facets of the training programfor MC officers remained unchanged. The program for revising extensioncourses continued, and 12,764 officers enrolled during the fiscal year.This was only a slight increase over the previous year's enrollment of12,645, but its size is significant in view of the number of Reserve andNational Guard officers who had been called to active duty during the year.At the same time, the facilities of civilian institutions continued tobe used for the advanced training of selected MC officers. Between July1940 and July 1941, 25 officers attended courses ranging in length from5 days to 1 year at 10 civilian institutions. As a result of priority placedon expansion of the Air Corps, attendance at the School of Aviation Medicineincreased more than tenfold in 1941. In contrast to the 17 officers whograduated as flight surgeons in 1940, 237 graduated in 1941. Attendanceat the Army Industrial College and the Command and General Staff Schoolalso expanded, and 12 Medical Department officers graduated from each school.15
14(1) Smith, Clarence McKittrick: The MedicalDepartment: Hospitalization and Evacuation, Zone of Interior. United StatesArmy in World War II. The Technical Services. Washington: U.S. GovernmentPrinting Office, 1956. (2) See footnote 5 (2), p. 36. (3) Annual Report,Training Division, Operations Service, Office of The Surgeon General, fiscalyear 1942. (4) Annual Report of Technical Activities, Medical DepartmentProfessional Service Schools, Army Medical Center, Washington, D.C., fiscalyear 1941. (5) Letter, Col. Larry B. McAfee, MC, Executive Officer, Officeof The Surgeon General, U.S. Army, to the Commanding General, LettermanGeneral Hospital, San Francisco, Calif., 7 Nov. 1940, subject: Trainingof Medical Department Personnel. (6) Letter, Col. Larry B. McAfee, MC,Executive Officer, Office of The Surgeon General, U.S. Army, to The AdjutantGeneral, War Department, 14 Dec. 1940, subject: Allocation of TrainingFacilities at Special Service Schools.
15See footnotes 1 and 5 (2), p. 36.
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Additional opportunities for training were provided for VC officersby the inauguration of a course in milk and dairy hygiene at the ChicagoQuartermaster Depot, Chicago, Ill. Veterinary officers had traditionallyinspected milk and meat purchased locally as part of their regular duties,but late in 1940, Quartermaster plans for the establishment of a marketcenter program to insure a steady flow of perishable foods and cushionthe impact of military demand on the market created a need for veterinaryofficers specializing in meat and dairy inspection. Following discussionsbetween Lt. Col. Will C. Griffin, VC, depot veterinarian at the ChicagoQuartermaster Depot, and Lt. Col. (later Brig. Gen.) Raymond A. Kelser,VC, Chief, Veterinary Corps, permission was obtained on 1 November 1940for the Veterinary Division to conduct classes at the depot.
Under the agreement, staff and equipment for the course were suppliedby the Medical Department, while classrooms and laboratory space were providedby the depot. The first class of 17 officers convened on 25 November 1940,and classes continued to be offered through 1946. By the end of 1946, theclass had been conducted 52 times, with 1,038 graduates, including morethan 100 officers of the Army Air Forces. Originally a 4-week program,it was extended to 5 1/2 weeks in June 1944. After the reorganization of1942, the school operated as a class IV installation of the QuartermasterCorps.16
THE WAR YEARS: 1941-45
When the United States entered World War II, the program for trainingmedical, dental, and veterinary officers was accelerated. Because of changesmade necessary by the near depletion of the pool of officers with previoustraining, and the decision to retain men called up after September 1940for an additional year of service, few discontinuities were produced bythe transition to war. Basic training was readjusted to prepare officersnewly commissioned from civilian practice for military service, and theofficer pool program was expanded. Advanced military instruction was providedby the addition of special cadre and medicomilitary courses. On the assumptionthat civilian physicians were technically competent to perform routinemedical duties, the basic and advanced graduate courses at the Army MedicalCenter, begun during the limited emergency, were suspended. In their stead,the facilities of the Army Medical Center and a number of civilian medicalschools were harnessed to retrain physicians with noncritical skills inspecialties essential to the war effort or to the rehabilitation of thewounded. Through the ASTP (Army Specialized Training Program), effortswere also made to expand the supply of physicians available for militaryservice by sending eligible enlisted men to medical school.
16(1) Medical Department, United States Army.United States Army Veterinary Service in World War II. Washington: U.S.Government Printing Office, 1961. (2) Risch, Erna, and Kieffer, ChesterL.: The Quartermaster Corps: Organization, Supply, and Services. VolumeI. United States Army in World War II. The Technical Services. Washington:U.S. Government Printing Office, 1953.
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Basic Military Training
War brought vast numbers of a new type of officer into the Medical Department.Before the war, Medical, Dental, and Veterinary corps officers were, inmost cases, career soldiers with varying lengths of service. Even afterSeptember 1940, when the reserve and National Guard were called to activeduty, members of these corps had some degree of military training. By late1941, the Medical Department's pool of trained reserves had been nearlyexhausted. Yet between December 1941 and August 1945, the Medical Corpsalone expanded from approximately 11,000 to nearly 47,000.17Those who were not drawn directly from civilian practices were recruitedupon the completion of their internships, and few, if any, had previousmilitary experience. As a result, the demand for basic-training facilitiesmushroomed.
The disproportionate concentration of the Army's wartime strength increasesin the first year of hostilities increased pressure on the Medical Department'sbasic-training facilities, and produced expedient measures that might havebeen avoided by more uniform growth. Estimates of the troop strength requiredto defeat the Axis, formulated immediately after Pearl Harbor, projecteda need for over 200 divisions, or more that 10 million men, by mid-1944.The troop basis for 1942, approved by the Secretary of War on 15 Januaryas a guide for the organization and activation of units, required by theArmy to bring its strength to 71 divisions with a total of 3.6 millionmen by 1 January 1943. By September, the 1942 troop basis had been increasedto an even 5 million men. Since estimates of total troop requirements werelater reduced, the troop basis of 1942 required well over half of the soldiersmobilized during World War II to be trained during the first year of thewar.18
As its share of the troop basis, the Medical Department was requiredto raise its strength from 16,219 officers in January 1942 to 39,894 by1 January 1943.19 By the end of 1942, the Medical Departmenthad narrowly missed meeting the goals set by the War Department. In theprocess, however, it was necessary to abandon the prewar pattern of sendingevery newly commissioned officer to the Medical Field Service School andto combine basic training with a variety of military specialty programsat many installations.
Where and how an individual MC, DC, VC, or SnC (Sanitary Corps) officerwas given basic training depended, in large measure, upon his ultimateassignment. Because of The Surgeon General's policy that, as far as possible,junior officers who had not acquired a medical specialty would be givenbasic tactical training and assigned to the field forces, the facilitiesof the Medical Field Service School were reserved for younger officers.Members of affiliated units, limited-service personnel, and older, morehighly specialized officers were usually trained at pools established atinstallations, ranging from general hospitals and Medical Replacement Training
17Medical Department, United States Army. Personnelin World War II. Washington: U.S. Government Printing Office, 1963.
18Kreidberg, 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.)
19Memorandum, Brig. Gen. Larry B. McAfee, Assistant to the SurgeonGeneral, U.S. Army, Chief, Operations Service, for the Director of Training,Services of Supply, 7 May 1942, subject: A Study in Preactivation Trainingof Commissioned Officers, inclosure thereto.
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Centers to supply depots, and under the control of headquarters rangingfrom ASF (Army Service Forces) service commands to AGF (Army Ground Forces)and AAF (Army Air Forces) commanders.
Training facilities at the Medical Field Service School and the ProfessionalService Schools were allocated by The Surgeon General, through the WarDepartment, to the Army Service, Ground, and Air Forces, which in turnassigned officers within their command.20 As a result, an MC,DC, VC, or SnC officer assigned to the Air, Service, or Ground Forces mightreceive his basic training at a medical pool within that command or, ifhe was considered eligible for duty in a tactical unit, at the MedicalField Service School. A medical officer assigned to the Army Air Forces,for example, might receive his initial training at either the Medical FieldService School or the pool established for medical units and installationsof the Air Forces at the Gulf Coast Air Corps Training Center, RandolphField, Tex. Thus, the basic military training given a Medical Departmentofficer included a standard body of military knowledge, but the locationand type of installation at which it was received were varied.
Medical Field Service School
Throughout the war, as in the prewar era, the Medical Field ServiceSchool provided basic training for the largest single number of officersin the Medical, Dental, Veterinary, and Sanitary Corps. Until the beginningof the limited emergency, the standard period of training in medical fieldservice and in the functions of the combat arms had been 5 months. To providemilitary training for the large number of officers on active duty, whohad previously been unable to attend the course, and to meet the requirementto train a small number of officers added to the Medical Department afterthe eruption of war in Europe, the course had been compressed to 3 months,and offered twice a year.
Following the activation of the Reserve and National Guard, the coursewas condensed to a single month of instruction, and facilities were expandedto offer "refresher" training to a large number of officers withprevious military training. Because of the exhaustion of reserve pools,refresher training was suspended after the graduation of the Seventh RefresherCourse, which was conducted between 4 and 29 August 1941, to train additionalofficers for duties at replacement training centers. Beginning in September1941, a 2-month course, designated simply as the "Officers' Course,"was introduced to train newly commissioned officers in the principles andmethods of medical field service.21
With variations in length, this condensed version of the 5-month, prewar"Basic Course" continued to be offered throughout the war. On6 July 1942, the course was shortened to a single month, to take advantageof June graduations and double the output of trained officers. The changewas not welcomed by authorities at the Medical Field Service School, whofelt that a minimum of 8 weeks was required for orientation to field medicine.Under a 4-week program, too much time
20A Report on the Status of Training in theMedical Department, U.S. Army, 24 Sept. 1942.
21Technical Report of Activities of the Medical Field ServiceSchool, Carlisle Barracks, Pa., fiscal year 1942.
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was spent in teaching subjects required by the War Department to standardizeinstruction at all special service schools. Six months later, when combinedpressure from the Air and Ground Forces for a greater share of the school'soutput resulted in its being expanded, the course was lengthened to 6 weeks.Beginning with the 19th class, on 3 January 1943, the program was revisedand quotas were rearranged to allow a new class of 500 to begin every 2weeks.
With three basic courses running concurrently, the capacity of the schoolwas increased to allow the graduation of 1,500 officers during every 6-weekperiod. By a series of expedients, which included closing the MAC OfficerCandidate School at Carlisle Barracks on 27 February 1943, to provide housingfor the expanded basic course, the Medical Department was able to providebasic training for most newly inducted officers, and to reduce the numberof those inducted in 1942 without benefit of MFSS training. Even then,one special 6-week class had to be authorized at the ASF Training Center,Camp Barkeley, Tex., in January 1944, when the demand for training exceededexisting facilities. Enrolled were 856 officers. With this exception, the6-week Officers' Basic Course continued to be offered at Carlisle Barracksuntil February 1945, when reduced demand for officers allowed the courselength to be restored to 8 weeks. Between December 1940 and 2 August 1945,when the 69th course was completed, slightly more than 25,000 officersgraduated. Graduates of the Medical Field Service School Officers' BasicCourse for fiscal years 1921-45 were as follows:22
Years | Number |
1921-40 | 1,369 |
1940-41 | 2,119 |
1941-42 | 1,692 |
1942-43 | 7,358 |
1943-44 | 9,298 |
1944-45 | 4,620 |
Officer pool training
The inability of Army Special Service Schools to provide basic trainingfor all officers in the event of mass mobilization, and the obvious needto reserve those facilities for officers qualified for tactical duties,had long been a matter of concern to War Department planners. Early in1941, the Medical Department arrived at a partial solution to the problemby activating refresher courses at general hospitals that allowed Reserveofficers, who had the equivalent of basic training when called to activeduty, to understudy their counterpart in a hospital's administrative structurefor a period of 1 month. Courses were offered at six hospitals, each witha
22(1) See footnotes 10, p. 39; 12 (2), p. 40;19, p. 43; and 21, p. 44. (2) Annual Report, Medical Field Service School,Carlisle Barracks, Pa., fiscal year 1943. (3) Memorandum, Lt. Col. F. B.Wakeman, MC, Chief, Training Division, Operations Service, Office of TheSurgeon General, for the Personnel Division, Surgeon General's Office,22 May 1942. (4) Letter, Col. John A. Rogers, MC, Executive Officer, Officeof The Surgeon General, to the Commanding General, Services of Supply,10 Apr. 1942, subject: Special Courses, Medical Field Service School. 1stindorsement thereto, dated 11 Apr. 1942. (5) Annual Report, Medical FieldService School, Carlisle Barracks, Pa., 1945. (6) Annual Report, Army ServiceForces Training Center, Camp Barkeley, Tex., fiscal year 1944. (7) AnnualReport of The Surgeon General, U.S. Army. Washington: U.S. Government PrintingOffice, 1922. (8) Technical Report of Activities of the Medical Field ServiceSchool, Carlisle Barracks, Pa., fiscal year 1944.
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capacity of 50 students per month, but because of the urgent demandfor the technical and tactical service of medical officers, the programwas never fully utilized.
Within a week after Pearl Harbor, however, the War Department turnedits attention to the problem of officer filler and loss replacement training.On 19 December 1941, orders were issued to the chief of each ground armand service to establish pool training for unassigned officers withoutdelay at special service schools, branch replacement training centers,and War Department overhead installations under the direct control of thechief of the arm or service. These pools were to be designed to provide"suitable preparatory training" to each individual before permanentassignment and to furnish a source of replacements for troop units andtraining centers.23
Early in 1942, plans were formulated by the Medical Department for theestablishment of officer replacement pools within the Zone of Interiorat a number of installations and under a variety of commands, includingall named general hospitals except Darnall, Danville, Ky., all medicalreplacement training centers, medical supply depots, medical sections ofgeneral depots, and the Gulf Coast Air Corps Training Center. Pools wereassigned the threefold mission of providing instruction to qualify officersfor their first permanent assignment, of furnishing officers qualifiedto attend courses training medical specialists at service schools and civilianinstitutions, and of acting as the primary source of officer filler andloss replacements. Officers destined for Medical Department tactical units(later designated "AGF type" units) were assigned to either poolat one of the medical replacement training centers, each of which had acapacity for 100 officers, or the Medical Field Service School, which wasauthorized a pool of 150 officers. Officers assigned to the Air Forceswere sent to the Gulf Coast Air Corps Training Center, which had a poolof 200 officers; those assigned to professional units of the field forcesor fixed Zone of Interior installations (later designated "ASF type"units) were trained in pools of 50 established at named general hospitals,which were the successors to the administrative refresher courses establishedfor Reserve officers in 1940. Pools for training 50 officers in medicalsupply and procurement were established at medical supply depots and themedical sections of general depots.
Early plans directed that officers would be assigned to pools for aminimum of 3 months, but these were soon changed to allow the period inpools to vary from an extremely short period up to 4 months. Formal courseoutlines were developed to give newly commissioned officers a basic knowledgeof the Army and military subjects, but most of the instruction was providedthrough on-the-job training. Programs varied with the type of installationat which a pool was located, and commanders were instructed to integratestudents in their commands and to train them so that they could furnisheither a qualified pool officer or a previously trained
23(1) Memorandum, Brig. Gen. Wade H. Haislip,Assistant Chief of Staff, War Department General Staff, for the Chief ofStaff, 15 Dec. 1941, subject: Pool of Officer Replacements, inclosuresthereto. (2) Letter, The Adjutant General, War Department, to Chief ofEach Ground Arm or Service; Chief of the Armored Force; and Chief of Staff,General Headquarters, 19 Dec. 1941, subject: Officer Filler and Loss Replacementsfor Ground Arms and Services. (3) See footnote 5 (2), p. 36.
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officer whom the student would replace within the command whenever afiller or replacement was requested.24
Full use of officer pools was not possible until after June 1942, whena large number of young officers who had graduated from medical schoolin 1941, and spent the intervening year in internships, were called toactive duty. By the time these officers became available, pools had beenestablished with a total capacity of 1,500 officers. Shortly after June1942, an additional pool was established at the New York Port of Embarkation.
With varying size and location, pool training continued to be conductedthroughout the war. Its importance as a primary source of basic trainingfor medical, dental, and veterinary officers declined late in the war,however, because of the decreasing numbers of such officers available formilitary service, the expanding capacity of the Medical Field Service School,and the increasing use of MAC officers to perform nonmedical duties. Thedecentralized agencies that administered pools frequently assigned officersfor indefinite and varying periods, sometimes assigned them there onlyfor administrative purposes, and often failed to distinguish between MCand MAC officers in annual reports; for these reasons, it is not possibleeven to estimate the numbers of MC, DC, VC, and SnC officers who receivedpool training. It is probable, however, that nearly every junior officerpassed through a pool at some time during World War II, and in two areas,supply and administration, it was the only source of training available.
The operation of pools is typified by the Medical Department ReplacementPool which began operations on 8 June 1942 at Camp Barkeley. Between thatdate and 30 June 1943, the 4-week refresher course was conducted for 528officers. After completing this course, 359 officers were assigned to temporaryduty in Medical Department training battalions at Camp Barkeley, pendingpermanent assignment.
The program of instruction in the 4-week pool course included a generalstudy of administration, field sanitation, and organization and operationof medical field units. Two officers of the Medical Replacement TrainingCenter cadre at Camp Barkeley were assigned to supervise the pool, prepareschedules, conduct classes, and make necessary reports. Regular classesconducted in the training battalions and in the Officer Candidate Schoolat the center were open to pool officers, whose schedules were arrangedto allow them to take advantage of the varied activities available at CampBarkeley. Special classes were also conducted for pool officers by instructorsat the camp. During their period of temporary duty with medical battalions,pool officers were given the opportunity to observe experienced instructors,and were assigned teaching duties. After June 1943, the number of officerspassing through the Camp Barkeley pool declined, as the supply of available
24(1) Memorandum, Maj. F. B. Wakeman, MC, Chief,Training Division, Operations Service, Office of The Surgeon General, forThe Surgeon General, 3 Jan. 1942, subject: Training of Officer Filler andLoss Replacements for Ground Arms and Services. (2) Letter, Lt. Col. JohnA. Rogers, MC, Executive Officer, Office of The Surgeon General, U.S. Army,to The Adjutant General, War Department, 15 Jan. 1942, subject: OfficerFiller and Loss Replacements in the Medical Department. 1st indorsernentthereto, dated 7 Feb. 1942. (3) Letter, Lt. Col. John A. Rogers, MC, ExecutiveOfficer, Office of The Surgeon General, U.S. Army, to Commanding Generals,All Medical Replacement Training Centers; Commanding Officers, All GeneralHospitals; and All Medical Supply Depots, 27 Feb. 1942, subject: OfficerFiller and Loss Replacements for the Ground and Air, Arms and Services.
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officers diminished. Only 99 officers received pool training, comparedwith 528 the previous year.25
An unusual curriculum, typifying the diversity of the officer pool program,was the course in medical supply procedures at the St. Louis Medical Depot,St. Louis, Mo. Between 1922 and 1924, the Medical Department had operateda separate Medical Supply Training School at the New York General Depot,New York, N.Y. Thereafter, medical supply officers were usually assignedto a 2-year tour at the New York General Depot, followed by a year in theSurgeon General's Office, and then completed their training with a 1-yearcourse at the Army Industrial College. During the 1920's, between threeand five officers completed this training each year, but during the 1930's,only two medical supply officers were enrolled annually.
In response to wartime demand for an increasing number of medical supplyofficers, a separate Medical Department school was reestablished in April1942. Initially, this course consisted of 2 weeks of informal, on-the-jobtraining, organized to give the student officer a few days' practical experiencein the supervision of each of the St. Louis Medical Depot's divisions andbranches. This drastic reduction in course length was based on the assumptionthat supply officers would be drawn from the ranks of civilians with medicalsupply experience, who would require only token orientation to militaryprocedures. Administration of the course was the responsibility of theOfficers' Orientation School, established at the St. Louis Medical Depotfor that purpose. In August 1942, the course was lengthened to 4 weeksand given permanent status.
As the war assumed global proportions, it became increasingly apparentthat officers in charge of supplies needed more thorough orientation tothe procedures involved in transferring supplies from the Zone of Interiorto combat areas. On 1 March 1943, the course was assimilated into ASF supplytraining programs reorganized to provide 3 months of training in threephases, and redesignated the "ASF Depot Course." The first phaseof this new program was conducted at the Quartermaster School, Camp Lee,Va., where officers received 30 days of orientation to Army supply procedures.The 1-month training program at the St. Louis Medical Depot became phaseII of the new program. Phase III consisted of 30 days of practical workat one of several medical supply depots within the Zone of Interior. Coursecapacity was expanded to 100 officers.
While these developments were taking place, other courses were establishedat the St. Louis Medical Depot for Medical Department enlisted personnel.On 3 June 1943, the administrative organization at the St. Louis MedicalDepot, responsible for supervising all of these courses, was formally designatedthe "Medical Supply Services School," and the Officers' OrientationSchool was absorbed as the Officers' Supply Division of the newly createdschool.26
Following this reorganization, the Medical Supply Services School continuedto provide training for the duration of the war without major changes inits curriculum.
25(1) Annual Report, Army Service Forces TrainingCenter, Camp Barkeley, Tex., fiscal year 1944. (2) Circular Letter No.48, Office of The Surgeon General, U.S. Army, 23 May 1942.
26(1) Annual Report, Training Division, Operations Service,Office of The Surgeon General, fiscal year 1943. (2) Annual Report, ArmyService Forces, Medical Supply Services School, St. Louis Medical Depot,St. Louis, Mo., fiscal year 1944. (3) Annual Report, Medical Supply ServicesSchool, St. Louis Medical Depot, St. Louis, Mo., fiscal year 1943. (4)Medical Department, United States Army. Medical Supply in World War II.Washington: U.S. Government Printing Office, 1968.
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The first class of officers to enroll in phase II of the new programentered the school on 5 April 1943, and before the end of June, a totalof 495 officers had completed this phase. Between June 1943 and June 1944,a total of 412 officers completed this phase of instruction and were sentto the medical sections of ASF depots for phase III of the ASF Depot Course.Thirty-eight officers completed courses in equipment maintenance, and ninecompleted courses in optical repair, which had been inaugurated at theschool. Between June and September 1944, when it was dropped from the program,four officers graduated from the 6-week course for supervisors of opticalrepair shops. By June 1945, 46 more officers had graduated from the 16-weekequipment maintenance course, and an additional 178 had graduated fromphase II of the depot course.27 The tabulation which followsshows the total number of male Medical, Dental, Veterinary, and SanitaryCorps officers graduating from service school courses from July 1939 toAugust 1945.
Training1 | Number |
Officers Basic Course | 25,972 |
Cadre Course (Special) | 526 |
Medical and Field Sanitary Inspectors | 888 |
Chemical Warefare Medical Dept. Officers Course | 1,836 |
Quartermaster School, ASF Depot Course, Phase I | 516 |
ASF Depot Course, Phase II (Med) | 1,195 |
ASF Depot Course, Phase III | 42 |
Equipment Maintenance | 93 |
Optical Repair | 13 |
Meat and Dairy Hygiene | 862 |
Clinical Pathology, Veterinary Officers (Special) | 14 |
Forage Inspection | 67 |
Tropical Medicine | 1,708 |
Anesthesiology | 292 |
Electroencephalography | 48 |
Maxillofacial Plastic Surgery | 233 |
Roentgenology | 802 |
Military Neuropsychiatry | 841 |
Operation of Red Cross Blood Donor Center | 46 |
Malariology | 260 |
Medical and Surgical Care of Battle Casualties in Forward Areas | 179 |
Adjutant General's School | 276 |
Army Industrial College | 15 |
Army War College | 2 |
Command and General Staff School | 246 |
Engineers School | 52 |
Ordnance School | 10 |
Food and Nutrition | 145 |
1(1) Training Division, Office of The SurgeonGeneral, 8 Jan. 1948. (2) Goodman, Samuel M.: History of Medical Department,Training U.S. Army World War II. Volume III. A Report of the Training ofMedical Officers, 1 July 1939-30 June 1944. [Official record.] A smallnumber of MAC officers may be included in some courses.
27(1) Annual Report Training Division, OperationsService, Office of The Surgeon General, fiscal year 1944. (2) Annual Report,School Branch, fiscal year 1945. In Annual Report, Training Division,Operations Service, Office of The Surgeon General, fiscal year 1945. (3)Memorandum, Maj. Walter H. Potter, SnC, Chief, Specialties Branch, SupplyPlanning and Specialties Division, Supply Service, Office of The SurgeonGeneral, for the Chief, Operations Service, Surgeon General's Office, 28July 1943, subject: Training of Opticians for Optical Repair Sections ofMedical Depot Companies. (4) Memorandum, Col. F. B. Wakeman, MC, Director,Training Division, Operations Service, Office of The Surgeon General, toCommandant, Medical Supply Services School, St. Louis Medical Depot, St.Louis, Mo., 13 Aug. 1943, subject: Training of Medical Department Officersin Maintenance of Medical Equipment.
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Pools also provided special instruction for groups which were difficultto fit into the regular program. Women, for example, were not commissionedin the prewar Army, and there were no programs for training female MedicalDepartment officers. After Congress authorized the commissioning of womendoctors in April 1943, 76 female physicians were commissioned in the MedicalCorps. About one-third of this group was placed on active duty withoutformal training. Beginning in October 1943, however, all newly commissionedwomen doctors were sent to the Medical Department Replacement Pool at LawsonGeneral Hospital, Atlanta, Ga., where they received an orientation to militarylife. Fifty-five women, or approximately two-thirds of all women acceptedin the Medical Corps, were trained at this pool. In addition to pool training,three women doctors were sent to the Tropical Medicine Course; four weresent to the School of Military Neuropsychiatry, at Lawson General Hospital;and six, to various courses in anesthesiology.28
A special pool for Negro officers was established at Fort Huachuca,Ariz., on 8 June 1943. This action was taken following publication of aWar Department policy, in January 1943, requiring Negro officers to beassigned in groups. Ostensibly, officers assigned to the pool were to continuetheir technical training "until such time as group assignment to aMedical Department unit or installation" became effective. Since thecommandant of the Medical Field Service School, Brig. Gen. Addison D. Davis,refused to allow more than 25 Negro officers to attend the school at onetime, the pool also proved useful for holding newly commissioned Negroofficers until they could be accepted under the quota.29
Extension courses
Throughout the interwar years, the Special Service School extensionprogram, administered through corps areas, was a major part of the Army'straining program for Reserve and National Guard officers. This series ofprogressive subcourses, designed to expand the officer's grasp of the fundamentalsof military knowledge and qualify him for promotion, was participated inby more Reserve and National Guard officers than any other form of training.Even after September 1940, when these officers were called to active duty,enrollment in extension courses offered through the Medical Field ServiceSchool continued unabated. Revision of the program to incorporate changesin doctrine and equipment, begun in the late 1930's and scheduled for completionin 1942, continued throughout 1941.
By the time the United States entered World War II, most of these revisionshad been completed, and the revised Army Extension Courses were thoughtto be
28(1) See footnote 17, p. 43. (2) Goodman,Samuel M.: History of the Training of Medical Department Female Personnel,1 July 1939 to 31 December 1944. [Official record.]
29(1) War Department Circular No. 132, 8 June 1943. (2) AnnualReport, Office of the Director, Medical Division, Fort Huachuca, Ariz.,1943. (3) Memorandum, Col. Frank B. Wakeman, MC, Director, Training Division,Operations Service, Office of The Surgeon General, to Director of Training,Services of Supply, 10 Mar. 1943, subject: Training Pool for Colored Medicaland Dental Officer Personnel. (4) Memorandum, Lt. Col. Durward G. Hall,MC, Assistant to Director, Reserve Division, Personnel Service, MilitaryPersonnel Division, Office of The Surgeon General, for Col. Howard T. M.C. Wickert, Chief, Planning Division, Operations Service, Office of TheSurgeon General, 20 Mar. 1943. (5) Memorandum, Maj. E. R. Whitehurst, MAC,Assistant to Director, Reserve Division, Personnel Service, Military PersonnelDivision, Office of The Surgeon General, to the Chief of Military Personnel,Surgeon General's Office, 16 Feb. 1943, subject: Assignment of ColoredMedical and Dental Personnel.
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the most up-to-date source of information on doctrine, tactics, technique,and procedure available. Because most Reserve and National Guard officerswere on active duty by the end of 1941, the War Department General Staff,G-3, Operations and Training, recommended, and received approval from theChief of Staff, that operation of corps area extension courses be suspendedand that extension course material be diverted to field force units foruse in unit troop schools. Orders for the suspension of corps area extensionschools for the duration of the war were issued early in February 1942,and all officers then enrolled in classes were required to complete themby 1 April. Special Service Schools were directed to continue their revisionsof course material.
By August, however, reports that unit troop schools were not using theextension courses because they were too cumbersome for the acceleratedpace of wartime training were confirmed by training inspections of fournewly activated divisions, and G-3 decided to relieve the service commandsfrom the burden of directed use. In the future, G-3 declared, the War Departmentwould handle extension courses as it handled other areas of training, confiningitself to announcing policies and outlines of broad objectives, and allowingthe commanding generals of the service commands to determine the mannerin which the objectives would be achieved. When a poll of the service commandsrevealed that only the Army Air Forces desired the continued preparationand revision of extension course material, the War Department directedthe Special Service Schools to suspend their revision of extension coursesfor the duration of the war. The service commands were directed to continuetheir distribution of extension material until stocks were exhausted, andto revise courses that might prove useful in training their respectivecommands.
By the end of 1942, the prewar extension program was decentralized and,for all practical purposes, suspended for the duration of the war.30
Specialized and Advanced Military Training
The program of basic training provided at the Medical Field ServiceSchool and replacement pools was supplemented by a variety of programs,either sponsored by, or available to, the Medical Department for trainingspecialists qualified to protect the health of the Army in the field, orqualified for duties requiring specialized military skills.
30(1) Letter, Lt. Col. John A. Rogers, MC,Executive Officer, for The Surgeon General, U.S. Army, to the Commandant,Medical Field Service School, Carlisle Barracks, Pa., 8 Oct. 1941, subject:Revision of Army Extension Courses for the 1942-43 School Year. (2) WarDepartment Training Circular No. 6, 2 Feb. 1942. (3) Letter, The AdjutantGeneral, War Department, to All Corps Area Commanders, 3 Feb. 1942, subject:Suspension of Corps Area Extension School. (4) War Department CircularNo. 198, 20 June 1942. (5) Letter, Col. C. H. Day, AGD, Assistant GroundAdjutant General, to Assistant Chief of Staff, G-3, 1 Aug. 1942, subject:Suspension of Preparation of Army Extension Courses. (6) Memorandum, Brig.Gen. I. H. Edwards, Assistant Chief of Staff, G-3, for the Commanding Generals:Army Ground Forces; Army Air Forces; and Services of Supply, 27 Aug. 1942,subject: Suspension of the Preparation of Army Extension Courses. (7) Memorandum,Brig. Gen. I. H. Edwards, Assistant Chief of Staff, G-3, for the CommandingGenerals: Army Air Forces; Army Ground Forces; and Services of Supply,29 Oct. 1942, subject: Suspension of the Preparation of Army ExtensionCourses. (8) Memorandum, Brig. Gen. I. H. Edwards, Assistant Chief of Staff,G-3, for The Adjutant General, 29 Oct. 1942, subject: Suspension of thePreparation of Army Extension Courses, inclosures thereto. (9) War DepartmentCircular No. 361, 31 Oct. 1942.
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Medical field and sanitary inspectors
Mass mobilization, accompanied by the rapid expansion of existing facilities,the creation of new military installations, and the induction of largenumbers of men unfamiliar with techniques for avoiding the potential hazardsof garrison and field life, produced threats to the health of the Army.By mid-1942, the problem was serious enough to prompt the War Departmentto call the attention of commanders of all grades to their responsibilityfor the enforcement of sanitary regulations, and to observe:31
* ** The incidence of food poisoning, diarrhea, and dysentery among troopslast year, both in camps and on maneuvers, and the recurrence of similaroutbreaks this year indicate that training in personal hygiene and sanitationhas been neglected and that well established measures for the control ofsuch diseases have not been intelligently enforced. Commanders of all grades,surgeons, and medical inspectors must realize that organizations whichhave difficulty controlling endemic intestinal diseases during trainingwill have greater difficulty in the field, and it follows that the combatvalue of such units will be substandard. The recurrence of these diseasesis indicative of inefficiency on the part of the responsible commandersand medical officers and lack of discipline in the units.
In response to War Department concern, a conference was held at theMedical Field Service School on 20 August 1942, between the commandantof the school, General Davis, and Lt. Col. (later Col.) Frank B. Wakeman,MC, the director of training at the Office of The Surgeon General, andtheir assistants, to discuss methods for improving sanitation in the Army.As a result of this conference, recommendations were sent to the War Departmentcalling for the expansion of division cadres and post staffs to includea medical inspector, and the establishment of a special training programfor such officers at the Medical Field Service School. The request fora special training program was argued on the grounds that a majority ofMedical Corps officers were new to the service and not thoroughly trainedin the requirements of military sanitation. The block of instruction includedin the basic orientation course could not be expanded to qualify officersfor duties as medical inspectors without hampering their training in othermilitary subjects. The course proposed by the committee was to be 1 monthin length, with a capacity of 50 officers each month, preferably seniorcaptains of the Medical Corps, to begin in November 1942. In response tothese recommendations, the Medical and Field Inspectors' Course was authorizedon 9 September 1942, and classes began on 2 November.32
In general, the course established in the fall of 1942 followed theoutlines suggested by the Wakeman-Davis Committee. Of 192 hours of coursework, 102 were devoted to military sanitation, including such diverse subjectsas barracks sanitation, insectborne diseases, food inspection, waste andrubbish disposal, water
31War Department Circular No. 277, 20 Aug.1942.
32(1) Letter, Brig. Gen. Addison D. Davis, Commandant, MedicalField Service School, Carlisle Barracks, Pa., to The Surgeon General, U.S.Army. Attention: Plans and Training Division, 29 Aug. 1942, subject: MedicalInspectors' Course, Medical Field Service School, Carlisle Barracks, Pa.(2) Memorandum, Col. John A. Rogers, MC, Executive Officer to The SurgeonGeneral, U.S. Army, for the Director of Training, Services of Supply, 4Sept. 1942, subject: Course of Instruction for Medical Inspectors. (3)Memorandum, Brig. Gen. C. R. Huebner, GSC, Director of Training, Servicesof Supply, for The Surgeon General, U.S. Army, 9 Sept. 1942, subject: Courseof Instruction for Medical Inspectors.
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and sewage treatment, and venereal disease control. The balance wasdevoted to studying tactics and administration related to the duties ofa medical inspector. Quotas were distributed among the service commands,defense commands, and Air and Ground Forces. Courses continued to be offeredthroughout the war, with few changes in content.
Standards of admission, however, were gradually eroded by the growingshortage of physicians. Originally, only senior captains in the MedicalCorps, who had completed the MFSS Officers' Basic Course, were to be admitted,but in time, the regulations were rewritten by authorities outside theMedical Department's control, and lieutenants, newly commissioned captains,SnC officers, and MAC officers were sent to the course. In August 1943,the course was lengthened to 5 weeks to allow a greater amount of basictraining and field experience. Reports from the field indicated that SnCand MAC officers were being successfully utilized as medical inspectors.By June 1945, at the completion of the 24th class, 892 officers had graduated.33
Chemical Warfare School
The development of a formal course of instruction in chemical warfarewas one of the few radical innovations in the Medical Department officertraining program. Before the war, a few officers had been sent to EdgewoodArsenal for training each year, but for most officers, knowledge of defenseagainst chemical agents was confined to a few hours of cursory instructionreceived in the MFSS Officers' Basic Course.
Early in 1941, The Surgeon General instructed the Medical Research Divisionat Edgewood Arsenal to prepare tables of organization and equipment fora gas medical battalion that was to be activated to care for gas casualties.Seizing this opportunity, the chief of the Medical Research Division, Lt.Col. (later Col.) William D. Fleming, MC, reported that such a battalionwould be of little use unless its medical personnel received more instructionin chemical warfare and chemical warfare medicine than was currently available,and submitted one of the Medical Research Division's periodic recommendationsfor the establishment of a formal course of instruction.34 Workon a course and text began, and almost a year later, the course outlinewas submitted to the Office of The Surgeon General. In August 1942, theMedical Corps Officers' Course, to be given at the Chemical Warfare School,was approved by the War Department, and classes began in September.
33(1) See footnotes 22 (2) and (5), p. 45.(2) Essential Technical Medical Data, U.S. Army Forces, South Atlantic,for April 1944, dated 4 May 1944. (3) War Department Circular No. 99, 9Mar. 1944. (4) Letter, Col. R. W. Bliss, MC, Assistant to The Surgeon General,U.S. Army, as Chief, Operations Service, to the Director of Military Training,Army Service Forces, 3 Aug. 1943, subject: Training of Medical and FieldSanitary Inspectors. 1st indorsement thereto, dated 8 Aug. 1943. (5) Letter,Brig. Gen. Addison D. Davis, Commanding General, Medical Field ServiceSchool, Carlisle Barracks, Pa., to The Surgeon General, U.S. Army. Attention:Col. F. B. Wakeman, MC, Training Division, 28 Apr. 1943, subject: SixthMedical Inspectors' Course, Medical Field Service School, Carlisle Barracks,Pa., inclosures thereto.
34(1) Letter, Lt. Col. William D. Fleming, MC, Chief, MedicalResearch Division, Chemical Warfare Service, Edgewood Arsenal, Md., toThe Surgeon General, War Department, 25 Mar. 1942, subject: Special Trainingin Treatment of Chemical Casualties, inclosure thereto. (2) Letter, Lt.Col. William D. Fleming, MC, Chief, Medical Research Division, ChemicalWarfare Service, Edgewood Arsenal, Md., to The Surgeon General, War Department,31 Mar. 1942, subject: Instruction of Medical Officers in Care of Gas Casualties.
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This course of instruction to train Medical Department officers in theidentification of chemical warfare agents, in decontamination, and in preventionand care of chemical warfare casualties covered a 4-week period. Originally,plans called for five classes of 100 officers each, to begin on 7 September1942, but before the fifth class had graduated, the course was extendedindefinitely. Officers attending the course were selected from the ArmyService, Air, and Ground Forces, and from the Office of The Surgeon General.
The teaching staff of the Chemical Warfare School provided technicalintruction in agents, materiel, and weather factors, while members of theMedical Research Division presented courses in the physiological effectsof agents, pathology, treatment, and medical service. Veterinary Corpsofficers enrolled in the course were offered an alternate program in theprotection, care, and treatment of animal casualties, and the contaminationand decontamination of food. A similar adjustment in content was made inMay 1943 for SnC officers, who were given special instruction on the decontaminationof water. In July 1944, the course was shortened to 3 weeks by the eliminationof many hours devoted to basic military subjects. Before the course wasdiscontinued at the end of the 29th class in December 1944, approximately2,000 officers received instruction at the Chemical Warfare School. A majoritywere MC officers, but the Sanitary and Veterinary Corps were well represented,and in 1944, the course was even attended by 48 naval officers.35
Special Cadre Course for divisional officers
Providing qualified officers with the ability to organize, activate,and train new divisions was a major problem for all of the arms and services.Prewar planners had counted on being able to strip installations of theirRegular Army personnel to provide cadre for the first 8 months of mobilization.At the end of 8 months, it was assumed they would be able to select cadrefor future activations from among superior trainees. During the limitedmobilization following passage of selective service, unit activations followedthis pattern. It was not until after the outbreak of war that formal trainingwas provided for Medical Department officers by the inauguration of theSpecial Cadre Course for divisional officers at the Medical Field ServiceSchool. Under this program, it was planned that, approximately 2 monthsbefore the activation of a division, a maximum of 13 medical officers assignedto the medical battalion and medical detachments supporting the divisionwould be enrolled in the Special Cadre Course for 4 weeks of intensivetraining. The course
35(1) Cochran, Rexmond C.: History of Researchand Development of the Chemical Warfare Service in World War II. Volume30. Medical Research in Chemical Warfare. Historical Branch, Chemical CorpsSchool, Edgewood Arsenal, Md, 1 Mar. 1947. [Official record. Office ofthe Chief of Military History.] (2) Annual Report, School Branch, fiscalyear 1945. In Annual Report, Training Division, Operations Service,Office of The Surgeon General, fiscal year 1945. (3) Memorandum, Brig.Gen. Alexander Wilson, C.W.S., Chief, Field Service, Chemical Warfare Service,to the Commanding General, Services of Supply, 20 July 1942, subject: ChemicalWarfare School, Medical Corps Officers' Course. (4) Letter, The AdjutantGeneral, War Department, to The Surgeon General, U.S. Army, 4 Aug. 1942,subject: Chemical Warfare School, Medical Corps Officers' Course. (5) AnnualReport, Training Division, Operations Service, Office of The Surgeon General,fiscal year 1943. (6) Memorandum, Lt. Col. Charles H. Moseley, MC, DeputyDirector, Training Division, Office of The Surgeon General, for Lt. Col.John R. Wood, Medical Research Laboratory, Edgewood Arsenal, Md., 10 May1943. (7) Memorandum, Col. John A. Rogers, MC, Executive Officer to TheSurgeon General, U.S. Army, for Director of Training, Services of Supply,29 Sept. 1942, subject: Chemical Warfare School, Medical Corps Officers'Course.
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was designed to instruct them in methods of training and administration,and in the principles of first- and second-echelon medical support, toallow them to function efficiently in their newly activated divisions andinform them of duties during unit activation. The first Special Cadre Coursebegan on 26 January 1942, and by the end of June, 138 officers, representing11 divisions, had graduated.
Included in this total were 22 newly commissioned Negro officers assignedto the 93d (Negro) Infantry Division, and to the Station Hospital, FortHuachuca, who did not participate in the regular program of instruction.A special outline of instruction was designed for these officers, who attendedthe Medical Field Service School between 9 March and 4 April 1942.36The curriculum prepared for these officers contained a greater concentrationon basic military subjects than that prepared for regular cadre courses,a procedure which was probably not necessary for the Reserve officers assignedto the 93d (Negro) Infantry Division, but was essential for the trainingof the cadre of the Negro station hospital, a group of handpicked Negrophysicians, which had already become the subject of national controversy.
The controversy arose out of a series of conferences held between representativesof the Office of The Surgeon General and the Negro counterpart of the AmericanMedical Association, the National Medical Association, beginning on 14October 1940, as a result of pressure by Negro professional and politicalorganizations for integration and greater participation in the war effort.At this time, patients at fixed Army hospitals were completely integrated,but professional service in these installations was the exclusive prerogativeof white physicians. Negro physicians were confined to field installationsproviding first- and second-echelon medical service for Negro units.
Among the demands of the National Medical Association was the completeintegration of professional staffs, to relieve a greater number of Negrophysicians from duty as regimental surgeons (unflatteringly characterizedas "first aid surgeons" by the National Medical Association).Members of the association demanded an equal opportunity to enhance theircareers by participating in advanced training programs and to gain thespecialized medical and administrative experience available to physiciansassigned to station and general hospitals.37 While sympatheticto demands for increased participation in higher echelon medical service,Maj. Gen. James C. Magee opposed any integration of professional servicesuntil integration of the Army became a War Department policy, because professionalintegration of military hospitals would result in white patients beingforced to accept treatment by Negro physicians.38
No minutes were kept of the first meeting, but representatives of theOffice of The Surgeon General emerged believing that the National MedicalAssociation
36See footnote 21, p. 44.
37(1) Press release, National Medical Association Incorporated,"Reply of the National Medical Association to the Purported PressRelease of the Honorable Secretary of War, USA, 20 Feb. 1942." (2)Letter, Eleanor Roosevelt to Maj. Gen. James C. Magee, The Surgeon General,U.S. Army, dated 1 Mar. 1943, inclosure thereto. (3) Memorandum, Col. AlbertG. Love, MC, Chief, Planning and Training Division, Office of The SurgeonGeneral, to Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, 14Oct. 1940. 38Minutes, Meeting, Re Use of Negro Doctors, Nurses,and Dentists by Medical Department, 7 Mar. 1941.
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agreed that the use of Negro physicians in mixed wards was impracticable,and that a satisfactory substitute for professional integration could beprovided by establishing segregated Negro wards in hospitals with a largenumber of Negro patients, or possibly, a hospital devoted exclusively toNegro patients.39 Following the conference, the Office of TheSurgeon General began to consider establishing separate Negro hospitalsat Fort Huachuca; Savannah Ordnance Depot, Savannah, Ga.; and the WilmingtonAnti-Aircraft Firing Center, Wilmington, Del. Separate Negro wards wereestablished at Fort Bragg, N.C., and Fort Livingstone, La. The generalplan of segregating Negro patients for the benefit of Negro physiciansreceived War Department approval.40
Late in December 1940, Judge William H. Hastie, the dean of the HowardUniversity Law School, Washington, D.C., who had recently been appointedCivilian Aide to the Secretary of War on Negro Affairs, was given the powerto comment or concur before final decision, on all matters of policy pertainingto Negroes.41 Establishment of an all-Negro hospital was postponeduntil it could be justified by the concentration of sufficient numbersof Negro personnel; in the interim, members of the National Medical Associationbegan to express discontent with plans for Negro medical service.
At a conference in March 1941, attended, among others, by Judge Hastieand Dr. (later Colonel, MC) Midian O. Bousfield, a leading member of theNational Medical Association, Judge Hastie took issue with a member ofthe National Medical Association, who insisted that the association hadnot accepted the Medical Department's plan. As Judge Hastie explained it,the National Medical Association was willing to concede the necessity ofsegregated wards in the South, where local customs would be hostile tothe integration of a professional staff, but felt it would be unfortunateif the practice were extended to other areas. Dr. Bousfield expressed theopinion that anything short of complete integration would be inconsistentwith the concept of democracy.42
When plans for an all-Negro hospital were revived early in 1942, however,and Dr. Bousfield was recommended by the Procurement and Assignment Service,a civilian agency, as the most qualified member of the National MedicalAssociation to recruit a hospital staff, he accepted the responsibility.When his name was urged upon the Medical Department by Judge Hastie's office,he also accepted command of the new hospital.43 In a letterto members of the National Medical Association,
39(1) See footnote 37(3), p. 55. (2) Letter,Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, to Dr. A. N.Vaughn, President, National Medical Association, 18 Oct. 1940.
40(1) Letter, Col. Larry B. McAfee, MC, Executive Officer toThe Surgeon General, to The Adjutant General, War Department, 25 Oct. 1940,subject: Plan for Utilization of Negro Officers, Nurses, and Enlisted Menin the Medical Department's 1940-41 Military Program. 1st indorsernentthereto, dated 15 Nov. 1940. (2) See footnote 38, p. 55.
41Letter, The Adjutant General, War Department, to the Chiefsof Arms and Services, and Divisions of War Department General Staff, 18Dec. 1940, subject: Policies Pertaining to Negroes.
42(1) See footnote 38, p. 55. (2) Memorandum, William H. Hastie,Civilian Aide to the Secretary of War, to The Surgeon General, U.S. Army,17 Mar. 1941, inclosure thereto.
43(1) Memorandum, Lt. Col. Howard T. Wickert, MC, AssistantChief, Planning Division, Operations Service, Office of The Surgeon General,for General McAfee, Chief, Operations Service, Office of The Surgeon General,16 Jan. 1942. (2) 2d indorsement, Brig. Gen. Larry B. McAfee, Assistantto The Surgeon General, Chief, Operations Service, Office of The SurgeonGeneral, to The Adjutant General, War Department, 19 Jan. 1942. (3) InformalAction Sheet, Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General,Chief, Operations Service, Office of The Surgeon General, to The AdjutantGeneral, War Department, 1 May 1942.
57
Dr. Bousfield announced :44
* * * I have just returned from a conference in the Surgeon General's Officein Washington. A station hospital of 672 beds is to be organized immediatelyat Camp Huachuca, Ariz., with a complete complement of Negro doctors. Exceptfor being a completely segregated unit, it is a victory for the protestagainst the exclusion of Negro doctors. Much more important, it gives protectionto our best physicians in two ways: It prevents them from being draftedinto the ranks, and gives great protection by being assigned to a stationhospital, which will not be disturbed unless the country is bombed or successfullyinvaded. The men will likely not see active service with the fighting forces.A complete division is to be trained at Huachuca.
* ***** *
An immediate response willindicate the interest of the members of the National Medical Associationin the control of an opportunities [sic] of additional training to be obtainedin this large hospital, as well as in this successful issue of our protests.
Neither the establishment of an all-Negro hospital nor Dr. Bousfield'sletter was long in drawing hostile fire. An announcement by Secretary ofWar, Henry L. Stimson, that the Fort Huachuca hospital was to be established,purportedly at the request of the National Medical Association, was immediatelyrepudiated by that organization. In its formal reply to the Secretary'spress release, the association stated that Dr. A. N. Vaughn, presidentof the National Medical Association, refused to endorse the plan, and thatthey would not subscribe to any form of racial segregation.45 TheMedical Department responded by informing the Secretary of War, throughThe Adjutant General:46
* * * The point at issue appears to be the purported statement that theNegro association officials specifically requested the present arrangementfor the utilization of Negroes in the Medical Service. Actually they haveconsistently insisted on integration of Negro doctors with white doctors.This had not been done. War Department policy for their use does not contemplateit. However, through patient segregation it has been possible to broadenthe Negro doctors' service in the Medical Department, and it has been theimpression that the manner in which it was being done, that is, separatedepartments in these hospitals in which the Negro patient population wouldjustify it and complete Negro staffed hospitals for Negro cantonments,was most satisfactory to the association officials, short of complete integration.
Despite the National Medical Association's protests, it appears thatthe Medical Department, limited by War Department policy on integration,had acted in good faith to expand the professional activities of Negrophysicians, even though it meant changing previous policies of separatingpatients by disease and substituting segregation by race. Dr. Vaughn hadbeen informed of this policy immediately following the conference of October1940, and Judge Hastie had endorsed the policy of segregated wards forthe benefit of physicians, at least in the South, in March 1940.47
44Letter, Dr. M. O. Bousfield, Chairman, NationalMedical Association Procurement and Assignment Service, to All State andLocal Societies of the National Medical Association, 12 Mar. 1942.
45See footnote 37 (1), p. 55.
46(1) Memorandum, Brig. Gen. Larry B. McAfee, Assistant to TheSurgeon General, U.S. Army, Chief, Operations Service, Office of The SurgeonGeneral, to The Adjutant General, War Department, 16 Mar. 1942, subject:Secretary of War's Press Conference on Use of Negro Doctors. (2) 2d indorsement,Brig. Gen. Larry B. McAfee, Assistant to The Surgeon General, U.S. Army,Chief, Operations Division, Office of The Surgeon General, to The AdjutantGeneral, War Department, 9 Mar. 1942.
47See footnote 39 (2), p. 55.
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Subsequently, both Judge Hastie and Dr. Bousfield, an outspoken opponentof hospital segregation, collaborated with the Medical Department in establishingthe Fort Huachuca Station Hospital. Dr. Bousfield was later censured bythe National Medical Association for his part in the affair, and his inappropriaterecruiting effort also drew expressions of resentment. Others expressedthe fear that Dr. Bousfield's geographic origin would result in the choiceof too many physicians from the Middle West.48 In any event,the special course for the cadre of the 93d (Negro) Infantry Division andthe Fort Huachuca Station Hospital began on a sour note. Preparation ofa special outline was justified by the lack of prior experience and trainingon the part of officers selected for the hospital. Apparently, the courseproceeded without incident, and all 22 officers were graduated with satisfactoryratings. No further segregated Special Cadre Courses were held.49
Special Cadre Courses continued to be offered regularly until July 1943,when the program was terminated. In April 1943, the capacity of the programwas expanded from 50 to 100, to allow cadres from nondivisional units toattend. During its more than 2 years of operation, 560 officers graduatedfrom the course.50
Schools outside the Medical Department
In addition to courses already discussed at the Chicago QuartermasterDepot and the Edgewood Arsenal Chemical Warfare School, a number of courseswere available at Army schools not controlled by the Medical Department.Between July 1941 and July 1942, 46 Medical Department officers were sentto the Command and General Staff School. Twelve MAC officers and threeMC officers graduated from the Adjutant General's School, Fort Washington,Md., and a few attended the 2-week Camouflage Course at Fort Belvoir, Va.The following year, 132 completed courses at the Command and General StaffSchool, 81 completed courses at the Adjutant General's School, 43 completedthe Camouflage Course, and four completed the Ordnance Automotive MaintenanceCourse at the Ordnance School, Atlanta, Ga. Between July 1943 and the endof June 1944, 52 officers graduated from the Command and General StaffSchool, 180 graduated from the Adjutant General's School, four completedthe Camouflage Course, and six completed the Ordnance Automotive MaintenanceCourse. After June 1944, no officers were reported attending these courses.51
48(1) Letter, Brig. Gen. Larry B. McAfee, Assistantto The Surgeon General, U.S. Army, Chief, Operations Service, Office ofThe Surgeon General, to Dr. S. H. Freeman, Secretary, Board of Trustees,National Medical Association, Inc., 7 May 1942. (2) Letter, Dr. W. HaroldBranch to The Surgeon General, U.S. Army, 6 Apr. 1942. (3) Letter, Brig.Gen. Larry B. McAfee, Assistant to The Surgeon General, U.S. Army, Chief,Operations Service, Office of The Surgeon General, to Dr. W. Harold Branch,22 Apr. 1942. (4) Letter, Maj. Gen. J. A. Ulio, The Adjutant General, toDr. R. M. Hedrick, Chairman, Board of Trustees, National Medical Association,Inc., 9 Mar. 1942.
49(1) Letter, Maj. E. R. Whitehurst, MAC, Assistant to Director,Reserve Division, Personnel Service, Military Personnel Division, Officeof The Surgeon General, to the Commandant, Medical Field Service School,Carlisle Barracks, Pa., 25 Nov. 1942, subject: Training of Negro (sic)Medical Officers. 1st indorsement thereto, dated 30 Nov. 1942. (2) Letter,Brig. Gen. Addison D. Davis, Commandant, Medical Field Service School,to The Adjutant General, U.S. Army, 8 Apr. 1942, subject: Special SchoolReport, Special (93d (Negro) Infantry Division) Course 1942, inclosurethereto.
50See footnote 22 (2) and (8), p. 45.
51See footnote 14 (3), p. 41; 26 (1), p. 48; and 27 (1), p.49.
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Specialized Technical Training
Training officers for tactical and administrative duties was a seriousproblem, but equally important was the task of providing physicians, dentists,and veterinarians with the specialized technical training required formedical support of an army of 8 million, employed in a global war. Thedistribution of technical skills in prewar medicine, geared to diseasescommon to the continental United States and a small number of industrialaccidents, was inadequate to provide medical service for an army besetwith combat casualties and exotic diseases, and a civilian population whoseindustrial activities were accelerated.
Within the American medical profession, only a handful of men had anyfamiliarity with tropical medicine, and the number of thoracic surgeons,neurosurgeons, and similar specialists was small compared to the numberrequired for the rehabilitation of war casualties. At the same time, suchspecialists as general surgeons, obstetricians, and pediatricians wereavailable in numbers greater than the Army could use. To produce the specialistsit needed, the Medical Department instituted a series of technical coursesdesigned to retain physicians with redundant skills. Facilities for thesecourses were provided by expanding existing programs, establishing newservice schools, and harnessing civilian institutions. In sum, the redistributionof technical skills to meet wartime requirements was one of the largestand most significant training problems encountered by the Medical Departmentin World War II.
Civilian institutions
The Medical Department had used the facilities of civilian institutionsto provide specialized training for selected officers since 1920. Throughoutthe interwar years, the Medical Corps officers sent annually for specializedtraining had proved invaluable in keeping the Medical Department in contactwith professional trends. Faced with the problem of training large numbersof officers in professional specialties at the beginning of the war, theMedical Department again turned to civilian institutions for assistance.
On 23 January 1942, the Office of The Surgeon General asked the Divisionof Medical Sciences of the National Research Council to recommend medicalcolleges equipped to provide instruction in general surgery, orthopedicsurgery, thoracic surgery, maxillofacial plastic surgery, neurosurgery,clinical pathology, roentgenology, and anesthesiology.52 Thecouncil was also asked to recommend the length of each course, and to draftoutlines of instruction. On 11 April 1942, the Office of The Surgeon Generalrequested that epidemiology, venereal disease control, tropical medicine,and sanitary engineering be added to the list.53
52(1) Informal Memorandum, Maj. F. B. Wakeman,MC, Assistant to The Surgeon General, Chief, Training Division, OperationsService, Office of The Surgeon General, to Lt. Col. Joseph R. Darnall,MC, Professional Service, Surgeon General's Office, 23 Jan. 1942. (2) Letter,Maj. Robert G. Prentiss, Jr., MC, Director, Technical Division, OperationsService, Office of The Surgeon General, to Dr. Lewis H. Weed, Chairman,Division of Medical Sciences, National Research Council, 23 Jan. 1942.(3) 41 Stat. 786.
53Letter, Lt. Col. Roger G. Prentiss, Jr., MC, Director, TechnicalDivision, Operations Service, Office of The Surgeon General, to Dr. LewisH. Weed, Chairman, Division of Medical Sciences, National Research Council,11 Apr. 1942.
60
Working in cooperation with the Office of The Surgeon General, committeesof the National Research Council accepted the project and estimated thenumber of officers required in each specialty. The project was approvedby the Army Service Forces in June 1942, and before the end of the month,facilities were available at 22 civilian institutions for courses in eightspecialties. Classes could not begin until September 1942, however, becauseof a shortage of officers available to attend them.54 In theinterim, 57 officers were sent to the Mayo Foundation, Rochester, Minn.,and to The Johns Hopkins University, Baltimore, Md., for specialized training.55
By September 1942, the supply of officers had increased sufficientlyso that it was possible to begin most of the courses planned earlier inthe year. On 28 September 1942, courses were opened in 12 specialties at15 civilian institutions. On 2 January 1943, the program was expanded toinclude seven additional institutions. By June 1943, 2,067 officers hadenrolled, and 2,014 had graduated.56
In the fall of 1943, most of the courses at civilian institutions werecanceled. By June 1944, training was confined to a basic course in neurosurgeryat the University of Pennsylvania, Philadelphia, Pa., and to courses inanesthesiology, general surgery, internal medicine, physical therapy, androentgenology at the Mayo Foundation. Between June 1943 and June 1944,the number of officers completing courses in civilian institutions wasreduced to 944.57 The following year, enrollment in civilianinstitutions was reduced even further. In March 1945, the courses in generalsurgery and internal medicine were canceled. Twelve-week courses in neuropsychiatryat Columbia and New York Universities, located in New York, N.Y., wereused to supplement training at the Army School of Military Neuropsychiatry,Mason General Hospital, Long Island, N.Y. A total of 381 officers completedcourses between June 1944 and June 1945.58
A variety of factors were responsible for the abrupt reduction of trainingat civilian institutions in the fall of 1943. Chief among these were arenewed shortage of medical officers and a change in policies governingthe use of civilian facilities. In September, The Surgeon General reportedthat he did not have enough physicians in the Army Service Forces to manhospital units scheduled for overseas movement the following January, andthe Medical Department began to study the possibility of a wider use ofMAC officers in a semiprofessional capacity.
The movement of hospitals to the overseas theaters dramatically reducedthe pool of officers available for advanced technical training. Coupledwith this development was a change in policies governing the use of civilianinstitutions. Early in 1943, the War Department began to insist on themaximum utilization of existing
54(1) See footnotes 14 (3), p. 41; and 26 (1), p. 48.(2) Memorandum, Brig. Gen. Larry B. McAfee, Acting The Surgeon General,for the Commanding General, Sixth Service Command, 22 Feb. 1943, subject:Medical Department Training Facilities in the Sixth Service Command. (3)Letter, Col. John A. Rogers, MC, Executive Officer to The Surgeon General,U.S. Army, to Dr. Lewis H. Weed, Chairman, Division of Medical Sciences,National Research Council, 18 May 1942. (4) Memorandum, Col. John A. Rogers,MC, Executive Officer to The Surgeon General, U.S. Army, for the Directorof Training, Services of Supply, 22 May 1942, subject: Attendance of MilitaryPersonnel at Civilian Educational Institutions. 1st indorsement thereto,3 June 1942.
55See footnote 14 (3), p. 41.
56See footnote 26 (1), p. 48.
57See footnote 27 (1), p. 49.
58See footnote 35 (2), p. 54.
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schools, and the Medical Department began to emphasize the use of militaryfacilities. Officers in the Training Division were unhappy about this policy,but they began to transfer programs to facilities under military jurisdiction.59The Army School of Malariology at Fort Clayton, C.Z., is a case in point:one of the purposes of establishing this school was to bring instructioncompletely under Army control. Similarly, the course in anesthesiologywas terminated at all civilian institutions except the Mayo Foundation,and transferred to named general hospitals.60 The only new coursesat civilian institutions after September 1943 were added because the urgentrequirement for military neuropsychiatrists overtaxed the facilities ofthe School of Military Neuropsychiatry at Mason General Hospital. Columbiaand New York Universities were therefore selected to conduct a 3-monthcourse beginning in April 1944. The course was not repeated.61
General hospitals
To supplement courses developed along National Research Council guidelinesat civilian institutions, special courses in anesthesiology and neurosurgerywere established at a number of general hospitals. Five general hospitalsbegan to offer a 3-month course in anesthesiology in January 1943. Becausethese courses were intended merely to increase the total number of specialistsbeing trained, they essentially duplicated those being offered at civilianschools.62 The neurosurgical program, however, was designedto supersede the original civilian course. Dissatisfaction with the programsat civilian institutions, particularly those at the University of Illinois,Chicago, Ill., and the Columbia University Neurological Institute, resultedin the restructuring of the entire program.63
The new two-phase course was established on 26 April 1943. Phase I ofthe program consisted of 4 weeks of instruction at Columbia University,in the anatomy and physiology of the nervous system, with emphasis on surgicalapplication. During the second phase, students were assigned, singly orin pairs, to neurosurgical centers throughout the country for 60-day periodsof practical training. In contrast with the previous program, the practicalphase was conducted entirely at military hospitals, where apprentice neurosurgeonssaw cases typical of those they would encounter in military practice. On17 January 1944, the theoretical phase of instruction was shifted to theUniversity of Pennsylvania. It remained there until suspended early in1945, after the supply of general surgeons available for special traininghad been
59See footnotes 14 (1), p. 41; and 17, p. 43.
60(1) Annual Report, Army School of Malariology, Fort Clayton,C.Z., fiscal year 1944. (2) Letter, Col. F. B. Wakeman, MC, Director, TrainingDivision, Operations Service, Office of The Surgeon General, to the Directorof Military Training, Army Service Forces, 26 Nov. 1943, subject: Coursesin Anesthesiology.
61(1) Memorandum, Col. F. B. Wakeman, MC, Director, TrainingDivision, Operations Service, Office of The Surgeon General, for Directorof Military Training, Army Service Forces, 9 Mar. 1944, subject: Trainingof Neuropsychiatrists. (2) Memorandum, Brig. Gen. R. W. Bliss, Chief, OperationsService, Office of The Surgeon General, for Commanding General, Army ServiceForces, 21 Mar. 1944, subject: Training of Neuropsychiatrists.
62(1) Memorandum, Col. F. B. Wakeman, MC, Director, TrainingDivision, Operations Service, Office of The Surgeon General, to Directorof Training, Services of Supply, 13 Nov. 1942, subject: Courses in Anesthesiology.(2) Letter, Maj. Gen. James C. Magee, The Surgeon General, U.S. Army, tothe Commanding Officer, Tilton General Hospital, Fort Dix, N. J., 20 Nov.1942, subject: Training in Anesthesiology.
63Personal Diary, Lt. Col. R. Glen Spurling, MC, Chief, NeurosurgicalSection, Walter Reed General Hospital, Washington, D.C., entry dated 15Mar. 1943.
62
exhausted and the needs of the Medical Department had been met. Approximately245 neurosurgeons were trained during the war, about half through the 3-monthprogram at civilian institutions, and half under the joint military-civilianprogram.64
Army schools
Tropical and military medicine.-Before World War II, graduatesof American medical schools were seldom trained to cope with tropical diseases.Recognizing this deficiency, the Subcommittee on Tropical Diseases of theNational Research Council recommended, on 9 May 1941, that the Army andthe Navy develop programs in tropical medicine. Specifically, they recommendedthat the services send officers to the Tropics for special training, andthat they utilize the facilities of the Tulane University School of Medicine,New Orleans, La., and the School of Tropical Medicine, San Juan, P.R. Thesubcommittee stood ready to assist the services in developing facilities,and in preparing programs of instruction.65
Following a meeting between representatives of The Surgeon General andthe Subcommittee on Tropical Diseases on 15 May 1941, the Medical Departmentagreed to draw up an outline for a course to be offered at the Army MedicalCenter and to explore the possibility of conducting a course at TulaneUniversity, and another in the Tropics.66 Recommendations forthe course at the Army Medical Center were approved in June 1941, and classesbegan in August. The first classes were of 4 weeks' duration, but by theend of the year, course length was extended to 8 weeks to permit the additionof basic subjects in military medicine, including clinical and surgicalmedicine, preventive medicine, ophthalmology, otolaryngology, roentgenology,dentistry, and veterinary medicine. The title of the course was changedto Tropical and Military Medicine, and the course became, in effect, asubstitute for the suspended advanced graduate course, with a heavy emphasison tropical diseases.67 The Surgeon General justified thesechanges on the basis of "insistent requests of station, corps, andarmy surgeons that some basic instruction other than that in tropical medicinebe given to the officers who had the opportunity to attend the school."68
Courses were designed to provide both lectures and laboratory instructionin tropical and parasitic diseases. Content was adjusted from time to timeto prepare officers for current or future areas of operation. Instructorswere Medical Department officers from the Army Medical School, Walter ReedGeneral Hospital, Washington, D.C., and The Surgeon General's office, aswell as specialists from other Government and civilian institutions. Lecturerswere provided by the
64Medical Department, United States Army. Surgeryin World War II. Neurosurgery. Volume I. Washington: U.S. Government PrintingOffice, 1958.
65Minutes, Meeting, Subcommittee on Tropical Diseases, Divisionof Medical Sciences, National Research Council, 9 May 1941.
66Minutes, Meeting, Re Special Training in Tropical Diseases,15 May 1941. [Between representatives of The Surgeon General and the Subcommitteeon Tropical Diseases, Division of Medical Sciences, National Research Counsil.]
67See footnote 10, p. 39.
68Letter, Maj. Gen. James C. Magee, The Surgeon General, U.S.Army, to Lt. Col. Leon A. Fox, MC, Office of the Division Engineer, CaribbeanDivision, New York, N.Y., 14 Oct. 1941.
63
Department of Agriculture, the U.S. Public Health Service, the U.S.Navy, the Rockefeller Foundation, and several universities.
Beginning with the 11th course, in January 1943, staff members of medicalschools in the United States and Canada were enrolled in the course underthe sponsorship of the American Association of Medical Colleges and financedby a grant from the John and Mary R. Markle Foundation. Seventy-two facultymembers of colleges, graduates of this program, were prepared to presentinstruction to students who might subsequently enter the armed services.
The course was originally designed for a maximum of 30 students. ByJuly 1942, the demand for officers with a background in tropical medicinewas intense, and by November, enrollment had increased to 106 students.Peak enrollment of 222 was reached in January 1943. Courses continued throughoutthe war, ending with the graduation of the 23d class in September 1945.A final course of 4 weeks was given in October 1945, with special emphasison tropical diseases in the Far East. During the war, 1,882 students graduated.Of these, 1,741 were Medical Corps officers, 25 were Sanitary Corps officers,and one was a Women's Army Corps officer. Other graduates included 16 fromthe U.S. Public Health Service, six from other U.S. Government services,and 83 officers from Allied Nations.69
To adjust to the requirements of global war, the course in tropicaland military medicine was supplemented by programs emphasizing the controlof tropical diseases. During 1942, while the use of civilian institutionsfor teaching medicomilitary subjects was still in the planning stages,steps were taken to insure a more adequate emphasis on the control of tropicaldiseases. The course for medical and field sanitary inspectors was inauguratedat the Medical Field Service School, and a course in tropical medicineat Tulane University similar to the one conducted at the Army Medical Centerwas incorporated into plans for the utilization of civilian institutions.Instruction on tropical diseases was incorporated into the courses in clinicallaboratory and in epidemiology that were to be part of the program at civilianmedical schools.70
In June 1942, members of the Office of The Surgeon General and its civilianconsultants began to discuss the possibility of having the Tennessee ValleyAuthority conduct a 2-week field course in malaria control at Wilson Dam,Ala.71 Finally, in December 1942, plans were developed for sendingsmall groups of Medical Department officers to hospitals, stations, anddispensaries along the Pan American Highway in Costa Rica, for 1 to 4 monthsof practical experience in control of tropical diseases.72
Late in 1942, these plans began to be translated into programs. On 10August
69Annual Report, Technical Activities, MedicalDepartment Professional Service Schools, Army Medical Center, Washington,D.C., fiscal year 1946.
70(1) See footnote 26 (1), p. 48. (2) Letter, The Adjutant General,War Department, to Commanding General, Caribbean Defense Command, 19 Aug.1943, subject: Army School of Malariology, Fort Clayton, C.Z., indorsementsthereto.
71Letter, Lt. Col. Paul F. Russell, MC, Chief, Tropical Diseasesand Malaria Control Section, Epidemiology Division, Preventive MedicineService, Office of The Surgeon General, to Dr. W. A. Sawyer, Director,International Health Division, the Rockefeller Foundation, 9 July 1942.
72Memorandum, Col. F. B. Wakeman, MC, Director, Training Division,Operations Service, Office of The Surgeon General, to the Director of Training,Services of Supply, 29 Dec. 1942, subject: Applicatory Training in TropicalDiseases.
64
1942, the field course in malariology was inaugurated at the TennesseeValley Authority. This course was conducted until 31 October 1942, whenit was replaced by a similar course of 3 weeks' duration, conducted bythe Florida State Board of Health, in cooperation with the InternationalHealth Service of the Rockefeller Foundation, at Pensacola, Fla. By June1943, 207 officers had graduated from these field courses. Courses in epidemiologyand in clinical laboratory began operation in September 1942. In February1943, the course in tropical medicine at Tulane University was opened,and by June, it had graduated 42 officers. In March 1943, four officerswere sent to Costa Rica for field work in malariology along the Pan AmericanHighway.73
By mid-1943, it had become obvious that field programs in tropical diseases,particularly malariology, were too widely scattered for efficient controland that no site in the United States was completely satisfactory for fieldwork in malariology.74 In September, the Office of The SurgeonGeneral proposed the establishment of a service school to provide instructionin malariology on the Pacific side of the Canal Zone. The site was chosenbecause all types of malaria control were used in the area
FIGURE 4.-Army School ofMalariology, Fort Clayton, C.Z.
73(1) Report of the Activities of the EpidemiologyBranch for 1942. In Annual Report of Activities of Preventive MedicineDivision for 1942. (2) Annual Report, Tropical Disease Control Division,Preventive Medicine Division, 1943. (3) See footnote 26 (1), p. 48. (4)Medical Department, United States Army. Preventive Medicine in World WarII. Volume VI. Communicable Diseases. Washington: U.S. Government PrintingOffice, 1963, pp. 22-24.
74See footnote 73 (4).
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and because it was close to such agencies as the Canal Zone Health Departmentand the Gorgas Institute.75
The Office of The Surgeon General recommended that the Army School ofMalariology be activated on 1 January 1944, but the opening was postponeduntil late in the month because of construction delays and difficultiesin acquiring personnel. The 4-week course conducted by the school includedinstruction in survey and reconnaissance, epidemiology, parasitology, entomology,engineering principles of malaria control, larvicides and insecticides,malaria discipline and individual protective measures, clinical malaria,and antimalarial drugs. Between January and June 1944, 70 students graduated,and the following year, the course was completed by 172 students. The fieldcourse in Florida was terminated when the Army School of Malariology opened(fig. 4).76
The Army School of Roentgenology.-Before the war, the subjectof roentgenology was included in several programs at the Army Medical Center.After many of these programs were suspended in 1940 and 1941, roentgenologywas elevated to the status of a formal course. The new 4-week course, designedto prepare junior grade MC officers to operate X-ray equipment, began on5 January 1942. Course capacity was 50 students each month.77
To make room at the Army Medical Center for an expansion of the coursein tropical and military medicine, the roentgenology course was transferredto facilities leased in Memphis from the University of Tennessee, and establishedas the Army School of Roentgenology in December 1942. The first class atthe new location enrolled early in January 1943. Class length was extendedto 6 weeks, and course capacity was increased to 100. The course continuedto be conducted throughout the war. Peak enrollment was reached in 1943,and gradually declined in following years. Course length increased as enrollmentfell off, reaching 12 weeks by April 1944, and members of the staff devotedmore time to research. Between January 1942 and June 1945, approximately857 officers graduated.78
The School of Military Neuropsychiatry.-Psychiatry became a permanentpart of the practice of military medicine during World War I, but in commonwith other medical specialties, it fell victim to the attrition of peaceand depression. In 1940, only 35 officers of the Regular Army Medical Corpswere assigned to psychiatric positions, and only four of these were certifiedby the American Board of Psychiatry and Neurology.79 Mobilizationand war, however, produced a constantly growing demand for specialiststo screen inductees and treat the psychiatric casualties of training andcombat. It was not until 6 months after the beginning of the war, in theface of mounting patient loads, that the Neuropsychiatry Branch (laterthe Psychiatry Consultants Division) of the Surgeon General's Office becameaware of the national shortage of
75See footnote 70 (2), p. 63.
76See footnote 35 (2), p. 54; and 60 (1), p. 61.
77(1) Medical Department, United States Army. Radiology in WorldWar II. Washington: U.S. Government Printing Office, 1966. (2) See footnote14 (3), p. 41.
78(1) Annual Report, Army School of Roentgenology, Memphis,Tenn., fiscal year 1944. (2) Annual Report, Army School of Roentgenology,Memphis, Tenn., fiscal year 1945. (3) See footnote 77 (1).
79Medical Department, United States Army. Neuropsychiatry inWorld War II. Volume I. Zone of Interior. Washington: U.S. Government PrintingOffice, 1966.
66
trained psychiatrists, and the need for an intensive training program.Many MC officers assigned to the psychiatric sections of hospitals hadhad no contact with psychiatric patients since their internship, and evenqualified psychiatrists required specialized training to cope with theadministrative aspects of military neuropsychiatry. All officers had tobe acquainted with Army regulations governing psychiatry, disposition procedures,and testimony before boards and courts-martial. Most had to be preparedfor practice under field conditions and the problems of forward areas.80
Early in September 1942, the Neuropsychiatry Branch recommended theestablishment of a training program, and on 9 October, the Office of TheSurgeon General officially requested the authorization for a 4-week coursein military neuropsychiatry. Lawson General Hospital was suggested as thesite because of its large psychiatric service. The request was approvedon 27 October 1942, and on 2 January 1943, the new service school beganoperation.81
The School of Military Neuropsychiatry, Lawson General Hospital, beganwith a staff of four MC officers in existing hospital buildings. The program,consisting of 187 hours of instruction, was designed to orient psychiatriststo the military aspects of their speciality. About two-thirds of the programwas devoted to lectures, seminars, and clinical presentations in neurologyand psychiatry, and the balance was devoted to administration and militaryorientation. A total of 308 students graduated from the 11 courses conductedat Lawson General Hospital.82
In October 1943, the school was moved to Mason General Hospital, whichhad been designated as a specialized treatment hospital for neuropsychiatriccasualties. In the spring of 1944, it became apparent that the shortageof trained psychiatrists would continue indefinitely, and the program wasredesigned to provide 12 weeks of intensive training for medical officerswho had no previous psychiatric experience. With the exception of two "fillin" courses, all subsequent classes were subjected to a total of 600hours of instruction with a heavy emphasis on orienting physicians to psychiatry.It was at this time that the program temporarily expanded to include coursesat Columbia and New York Universities. Both of these universities conductedthree such courses, and 227 officers graduated. The School of MilitaryNeuropsychiatry continued to offer classes until 22 December 1945, graduating692 officers. The total graduates for the military school at both of itslocations were exactly 1,000, about two-thirds of whom had no previousbackground in psychiatry.83
The Professional Service Schools at the Army Medical Center.-Beforethe war, Medical Department technical training was conducted almost exclusively
80See footnote 79, p. 65.
81(1) Menninger, Brig. Gen. William C.: Education and Trainingin Neuropsychiatry. [Official record.] (2) Memorandum, Col. John A. Rogers,MC, Executive Officer, Office of The Surgeon General, U.S. Army, for Directorof Training, Services of Supply, 9 Oct. 1942, subject: Intensive Courseof Instruction in Military Neuropsychiatry. (3) Memorandum, Brig. Gen.C. R. Huebner, GSC, Director of Training, Services of Supply, for the CommandingGeneral, Fourth Service Command, 27 Oct. 1942, subject: Establishment ofa School for Military Neuropsychiatry.
82(1) Annual Report, School of Military Neuropsychiatry, LawsonGeneral Hospital, Atlanta, Ga., fiscal year 1943. (2) Annual Report, Schoolof Military Neuropsychiatry, Mason General Hospital, Long Island, N.Y.,fiscal year 1944.
83See footnote 79, p. 65.
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at the Professional Service Schools at the Army Medical Center. Manycourses were suspended at the beginning of the war, and others, such asthe course in roentgenology, were transferred to make room for expansionof the course in tropical medicine. The few that remained throughout thewar were usually conducted by either the Army Dental School or the ArmyVeterinary School.
In the prewar era, training in plastic and maxillofacial plastic surgerywas provided by the Army Medical School through its professional specialistscourses. In August 1941, after these courses had been suspended, the ArmyMedical School and the Army Dental School joined in cooperative effortsto organize a 4-week course to prepare medical and dental officers to serveon maxillofacial surgical teams. The new course opened on 1 September 1941,and continued to be offered until September 1943, graduating 209 officers.Late in 1942, the length of the course was extended to 6 weeks. BetweenSeptember 1942 and August 1944, training in maxillofacial plastic surgerywas also conducted at civilian institutions.84
A new 4-week course in the preparation of blood plasma and the operationof plasma centers was inaugurated at the Army Medical Center in April 1942.The program provided on-the-job training in laboratory techniques and theoperation of donor centers. The course continued to be given to a smallnumber of officers throughout the war.85
In 1941, the Army Veterinary School reported that some instruction inmeat and dairy hygiene was being given to officers of the Sanitary Corpsundergoing training for duty as nutrition officers. The program was designedto orient officers to the production, preparation, and distribution ofmeat for military use. Instruction was informal, consisting of 6 weeksof conferences and demonstrations. Because of space limitations, the Foodand Nutrition Course was transferred to the Army Medical School on 10 June1942, where it remained until February 1945 when it was transferred tothe Medical Nutrition Laboratory in Chicago. The number of officers attendingthe course was always small and was not consistently reported. By the endof the war, course length had been extended to 9 weeks, and the capacitywas six officers.86
The course in forage inspection, described earlier, was one of the fewpeacetime courses that continued for the duration of the war. The 1-monthRefresher Course in Forage Inspection was authorized on 31 July 1940, asa substitute for the National Guard officers' course and a partial substitutefor the Basic Graduate Course for VC officers. Temporarily suspended inJune 1942, it was reestablished in March 1943 and continued until afterV-J Day. It was conducted 21 times, and 66 officers graduated.87
In June 1940, the Veterinary Division of the Surgeon General's Officerecommended the establishment of a course in clinical pathology for officersassigned to Medical Department laboratories. A few months later, a 3-monthcourse designated
84(1) Annual Report, Technical Activities,Medical Department Professional Service School, Army Medical Center, Washington,D.C., fiscal year 1942. (2) See footnotes 26 (1), p. 48; and 27 (1), p.49. (3) Medical Department, United States Army. United States Army DentalService in World War II. Washington: U.S. Government Printing Office, 1955.
85See footnote 10, p. 39.
86See footnotes 35 (2), p. 54, and 84 (1).
87See footnote 16 (1), p. 42.
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as the Special Graduate Course in Clinical Pathology was established.The course included 454 hours of instruction and laboratory experiencein bacteriology, parasitology, serology, and food chemistry.88
On-the-job training for specialized teams.-Early in 1942, theMedical Department formally recognized the need to prepare specializedteams to operate at medical field installations. Small groups such as surgicalteams, composed of an operating surgeon and his assistant, an anesthetist,a nurse, and a surgical technician, required practice to integrate theirskills and function efficiently. Other specialties in which the teams wererequired included treatment of shock, splinting, thoracic surgery, maxillofacialplastic surgery, and neurosurgery. On 27 February 1942, all hospitals witha capacity of 500 or more beds were directed to establish team trainingprograms before 1 April.89 Formal course outlines were not required,and instruction was to be integrated with the routine duties of personnelat the hospitals. Once the program was established, it became a continuousfeature of hospital-level training, although statistics were not reportedby the Medical Department.90
The School of Aviation Medicine.91-The priority placedon air defense during the initial phases of the limited emergency broughtwith it an early expansion and acceleration of the training program atthe School of Aviation Medicine. In May 1940, Gen. H. H. Arnold, chiefof the Army Air Corps, estimated that during the next year 50,000 physicalexaminations, in addition to routine examinations, would be required toscreen the trainees needed for Air Corps expansion. To train physiciansto conduct examinations, he recommended, through The Surgeon General, thatthe training program for the School of Aviation Medicine under the ProtectiveMobilization Plan be put into effect on 15 July 1940. His recommendationwas approved, and in mid-1940, the basic course at the school was shortenedfrom 3 months to 6 weeks.
During the year it remained in effect, the accelerated course had mixedresults. Designed to train Army medical officers as aviation medical examiners,the program was confined to theoretical and clinical instruction in medicalspecialties, and training time was increased from 43 to 50 hours a week.Between 1 July 1940 and 1 July 1941, approximately 240 medical examinersgraduated. That number was adequate, but instructors at the school believedthat 6 weeks was not enough time to provide thorough training, and reportsfrom the field confirmed this opinion. At the end of the year, class lengthwas restored to 12 weeks, and the capacity of the school was expanded.
Beginning in April 1942, the course was split into two phases of 6 weekseach. During the first phase, students attended conferences, lectures,demonstrations, and
88(1) See footnote 84 (1), p. 67. (2) Letter,Lt. Col. Ralph B. Stewart, VC, Director, Army Veterinary School, Army MedicalCenter, Washington, D.C., to the Assistant Commandant, Army Medical Center,Washington, D.C., 3 Aug. 1940, subject: Special Course of Instruction inVeterinary Laboratory Procedure, attachment thereto.
89Letter, The Adjutant General, War Department, to the CommandingGenerals of All Corps Areas, Chief of the Air Force, and the CommandingOfficers of All Named General Hospitals, 27 Feb. 1942, subject: Trainingof Auxiliary Surgical Groups.
90See footnote 10, p. 39.
91This section is based on Link, Mae Mills, and Coleman, HubertA.: Department of the Air Force. Medical Support of the Army Air Forcesin World War II.Washington: U.S. Government Printing Office, 1955.
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clinics at the School of Aviation Medicine. In the second phase, theywere sent to special branch schools established at Aviation Cadet ClassificationCenters for practical training. By assigning students to other stationsfor half of the course, authorities at the school hoped to double its capacity,and to use students to conduct physical examinations during half of theirtraining. During this period, classes expanded from a capacity of 100 toapproximately 320.
Since the classification centers at which the second phase of the medicalexaminers' course was conducted were initially designed for the examinationof cadets, they were not ideally equipped for classes in medical, administrative,and tactical procedures. Training was further complicated by a lack ofuniformity in branch school programs. One school, for example, conducteda 3-week course in hospital administration similar to the refresher andpool courses at ASF hospitals. To overcome these difficulties, the AirSurgeon directed a committee to study the training and to recommend a standardizedprogram of instruction, in mid-September 1942. The committee decided thatthe second phase should be divided into three subcourses of 2 weeks each.During one period, the student was to be assigned to conduct physical examinationson the examining line, and rotated from station to station in the lineso that he performed each part of the examination on aircrew applicants.In the second period, he was to conduct psychological studies of aviationcadets, and during the third, he was to be assigned to the station hospitalto study medical subjects. The schedule was put into effect in November1942, but as late as April 1943, branch schools had failed to achieve thedesired level of standardization.
On 7 October 1943, the Aviation Medical Examiners' Course was shortenedfrom 12 to 9 weeks, and the branch schools were closed. Between May 1942and October 1943, 1,020 students had graduated from the San Antonio, Tex.,branch school, 666 from the Santa Ana, Calif., branch, and 1,092 from theNashville, Tenn., branch. After October 1943, all training for aviationmedical examiners was conducted at the School of Aviation Medicine. On31 July 1944, the course was lengthened to 11 weeks to permit the reestablishmentof flight training, expand the time devoted to medical studies, and providestudents with a free afternoon each week.
During the course of World War II, the School of Aviation Medicine expandedits curriculum to embrace many subjects which had previously been confinedto schools under the direct control of The Surgeon General. Traditionally,medical officers assigned to the Army Air Corps had received their trainingin military medicine, tactics, and administration at the Medical FieldService School, and then attended the School of Aviation Medicine to betrained as aviation medical examiners and eventually become flight surgeons.92During 1941, when the course was compressed into 6 weeks of intensive training,main emphasis was placed on conducting physical examinations at classificationcenters and on related subjects, such as cardiology and physical diagnosis.After December 1941, mounting criticism of the officers graduating fromthe course brought a shift in emphasis
92Aviation medical examiners became qualifiedas flight surgeons after a specified period of time, usually 1 year, onduty with the Army Air Forces. The period needed to qualify varied duringthe war and could be modified by the amount of flight time accumulatedby an officer.
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toward military medicine and administration. By March 1942, the commandantof the school was able to report:
* * * The course at the School of Aviation Medicine has materially changedsince October, as we are stressing the practical aspects of field dutymore and more and the physical examination is only of material interestto those who are assigned to classification centers and replacement centers.To be sure 64 examinations are made but they are few and far apart exceptat the centers mentioned. We have added tropical medicine, field sanitationand hygiene, first aid, shock treatment, low pressure chamber work andother features to our curriculum. Furthermore, some compulsory exerciseand drill have been added.93
In November 1942, a Department of Military Medicine was added to theschool and made responsible for instruction in the organization and functionsof the Army Air Forces, field sanitation and hygiene, chemical warfare,supply and administration, and field exercises. By October 1943, a 6-daybivouac had been added. During the same period, training in medical specialtieswas increased, and beginning in April 1944, a policy of sending all MCofficers assigned to the Army Air Forces to the School of Aviation Medicinewas adopted. Finally, after July 1944, officers eligible for service intheaters of operations were assigned to the Tactical Unit Surgeon's Courseat the AAF School of Applied Tactics, Orlando, Fla., to be trained in tactics,military aspects of medicine, and administration.
The trend toward incorporating tactical, medicomilitary, and administrativesubjects into the curriculum of the School of Aviation Medicine paralleleddevelopments in Special Service Schools and other ASF training programs.The course in tropical medicine, for example, integrated administrativeand tactical subjects into the technical curriculum early in the war. Similardevelopments took place at the Medical Field Service School itself, inthe course for medical field and sanitary inspectors, and in pools establishedat medical installations. The underlying cause of this duplication of effortslay in the inability of the Medical Field Service School to provide basictraining for all Medical Department officers as soon as they reported forduty.
Programs for Negro flight surgeons were also a problem. During the firstyear of the war, the School of Aviation Medicine was able to keep Negroesfrom attending by enrolling them in extension courses. Three Negro officersenrolled in the extension course graduated in February 1943. When thispolicy was brought to the attention of the Secretary of War by Judge Hastiein January 1943, the policy was changed to provide equal standards foradmission. The first Negro officers graduated from the course in March1943.
Mid-War Additions to the Medical Department Program
By late 1943, the pace of unit activations had slowed and training effortswere reduced in the main to providing replacements. At this point, plannersbegan to turn their attention to adjustments in the training process, specialcourses for special situations, and eventually, to planning for the cessationof hostilities. During the last 2 years of the war, a series of courseswas added to the program whose only common denominator was being establishedto meet special needs.
93 See footnote 91, p. 68.
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Anesthesiology for portable surgical hospitals.-A special coursein anesthesiology for portable surgical hospitals was conducted from 7August to 4 September 1943. The object of this special course was to providepersonnel trained to use the limited anesthetic equipment allotted to portablesurgical hospitals. The 7 course was conducted at Halloran General Hospital,Staten Island, N.Y., Nichols General Hospital, Louisville, Ky., and thestation hospitals at Fort Bragg and Camp Breckinridge, Morganfield, Ky.A total of 12 officers graduated.94
The Army Ground Forces refresher course.-In December 1943, thecommanding general of the Army Ground Forces requested that the MedicalDepartment establish a refresher course in medical and surgical treatmentof battle casualties in forward areas for officers assigned to medicaldetachments and divisional medical battalions. In response, the Officeof The Surgeon General developed a 4-week program of on-the-job trainingat named general hospitals. Forty eight hours' training time was devotedto each of four subject areas: Amputations and fractures, neurosurgeryand anesthesiology, neuropsychiatry and medicine, and roentgenology andchest and abdominal surgery. The training consisted of reviewing the casehistories of battle casualties, making ward rounds with the chiefs of hospitalservices, and participating in the weekly clinical conferences of staffsections and the general staff of hospitals.
The first 4-week AGF Refresher Course in First and Second Echelon Medicaland Surgical Care was initiated on 29 April 1944 at the following generalhospitals: Bushnell, Brigham City, Utah; Percy Jones, Battle Creek, Mich.;Walter Reed; Brooke, San Antonio, Tex.; and McCloskey, Temple, Tex. Coursescontinued until November 1944, when the program was discontinued.95
Electroencephalography.-In July 1944, a 4-week course was establishedat Walter Reed and Mason General Hospitals to train officers in the operationand interpretation of electroencephalographs. Each course had a capacityof four students. Subsequently, similar courses were established at BrookeGeneral Hospital and DeWitt General Hospital, Auburn, Calif. By the endof June 1945, a total of 35 students had graduated.96
Orientation for female SnC officers.-In November 1944, a 2-weekcourse was established at Billings General Hospital, Indianapolis, Ind.,for newly commissioned members of the Women's Army Corps (detailed to theSanitary Corps) as bacteriologists, biochemists, or serologists. By thetime the course was terminated in March 1945, 31 officers had graduated.
94(1) Letter, Col. Charles H. Moseley, MC,Deputy Director, Training Division, Operations Service, Office of The SurgeonGeneral, U.S. Army, to the Director of Military Training, Army ServiceForces, 21 July 1943, subject: Special Course in Anesthesiology. (2) Seefootnote 27 (1), p. 49. (3) Letter, The Surgeon General, U.S. Army, tothe Commanding Officer, Nichols General Hospital, Louisville, Ky., 28 July1943, subject: Special Training Course in Anesthesiology.
95(1) Letter, Commanding General, Army Ground Forces, to CommandingGeneral, Army Service Forces, 4 Dec. 1943, subject: Course of Instructionfor Medical Officers, indorsements and inclosure thereto. (2) Memorandum,Col. Floyd L. Wergeland, MC, Director, Training Division, Operations Service,Office of The Surgeon General, U.S. Army, for Director of Military Training,Army Service Forces, 13 Apr. 1944, subject: Refresher Course for MedicalCorps Officers of the Army Ground Forces, indorsement and inclosure thereto.(3) See footnote 35 (2), p. 54.
96Memorandum, Lt. Col. Chas. H. Moseley, MC, Deputy Director,Training Division, Operations Service, Office of The Surgeon General, U.S.Army, to Director of Military Training, Army Service Forces, 26 June 1944,subject: Applicatory Training of Medical Corps Officers in Electroencephalography.
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Refresher courses for Medical Department officers.-At the beginningof World War II, many Regular Army officers had been transferred from professionalduties to administrative posts, where their administrative skills and experiencecould be used to guide the Medical Department's expansion. By late 1944,large numbers of medical, dental, and veterinary officers had already servedlong periods in administrative or semiprofessional assignments. When peacereturned and the Army was demobilized, many would be returned to clinicalduties.
Plans for refresher training to bring Medical Department officers upto date with developments in their specialties were approved in the fallof 1944, and on 17 November, a "Guide for the Professional RefresherTraining of Medical Corps Officers" was approved. This guide was usedas background material for 12 weeks of on-the-job refresher training forMC officers in general medicine and general surgery. By early 1945, 48general hospitals were participating in the program. By June 1945, 176MC officers had completed the refresher course. In April and May 1945,guides for refresher training were approved for DC and SnC officers, andcourses were established for them at general hospitals.
THE ARMY SPECIALIZED TRAINING PROGRAM97
Between 1943 and 1945, 29,730 enlisted men were assigned to ASTP (ArmySpecialized Training Program) units at civilian schools to be trained asphysicians, dentists, and veterinarians, and approximately 4,900 enlistedmen were assigned to ASTP units at colleges and universities for preprofessionaltraining. Before the program was terminated in July 1946, 16,429 enlistedmen graduated from professional schools and became available for appointmentas officers in the Medical Department.98
World War I Precedents
The World War II Army Specialized Training Program had antecedents inWorld War I. Following the passage of the Selective Service Act of 1917,medical schools sought to have students exempted from induction on theground that their value to the Armed Forces would be greater if their educationwere continued through graduation. A prolonged war might even produce aserious shortage of physicians. Medical students were not exempted, butby the end of August 1917, the Army had made it possible for full-timemedical, dental, and veterinary students entering the service to be assignedto the Medical Enlisted Reserve Corps in an inactive status to continuestudies at their own expense. Students could retain their inactive statusthrough residency if their academic progress was satisfactory. The programwas placed under the supervision of The Surgeon General.99
97Except as otherwise noted, this section isbased on Fitts, Francis M.: Training in Medicine, Dentistry, and VeterinaryMedicine, and in Preparation Therefor, Under the Army Specialized TrainingProgram, 1 May 1943 to 31 Dec. 1945. [Official record.]
98See footnote 17, p. 43.
99The Medical Department of the United States Army in the WorldWar. Washington: Government Printing Office, 1923, vol. I.
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By March 1918, 60 percent of the medical students in recognized schoolsof medicine had entered the Enlisted Reserve Corps. Those not under militaryjurisdiction consisted of aliens, the physically disqualified, registrantsdeferred because of dependents, overage students, and those who had notreached age 21. Statistics are not available for dental and veterinarystudents. In August 1918, enlistments and transfers to the Enlisted ReserveCorps were discontinued because SATC (Students' Army Training Corps) wasestablished. That fall, all members of the Enlisted Reserve except thoseserving hospital internships were called to active duty and transferredto SATC units established at the schools in which they were enrolled. Sincethese trainees were discharged shortly after the armistice, little informationon this experiment is available. Despite provisions for the voluntary continuationof professional studies, the eagerness of that generation to participatein the war effort resulted in a serious reduction of the number enteringor continuing their studies.
Neither program made specific provisions for preprofessional students.Those preparing for medical, dental, and veterinary schools had no protectionbeyond general enrollment in the Students' Army Training Corps. Since theage of induction was not lowered from 21 to 18 until 31 August 1918, failureto assure a continuous flow of students into professional schools createdno serious military problems. Had the war continued for several years,however, a shortage of physicians, dentists, and veterinarians might havedeveloped.
National Emergency Programs
Between wars, little thought appears to have been given to providinguninterrupted training for professional and preprofessional students. Itwas not until after the declaration of a limited national emergency in1939, when educators became concerned that medical students who had earnedReserve commissions outside the Medical Department as undergraduates mightbe mobilized as line officers, that the question received formal consideration.100
In April 1940, as a result of a study of medical officer procurement,the War Department made it possible to transfer full-time medical, veterinary,and dental students with Reserve commissions to the MAC Officers' Reserveduring mobilization. On 28 August 1940, the day after Congress authorizedlimited mobilization, the transfer was put into effect by War Departmentdirective.101
Under the Selective Training and Service Act of September 1940, studentswere exempted from the draft until July 1941, but residents and internswere required to seek occupational deferments from their local boards.While such
100Letter, The Adjutant General, War Department,to Each Corps Area and Department Commander; Each Chief of Arm or Service,17 Apr. 1940, subject: Special Mobilization Procedures for Procurementof Medical Department Reserve Officers Who Are Students in Approved MedicalSchools.
101(1) Letter, Col. James E. Baylis, MC, Executive Officer toThe Surgeon General, to The Adjutant General, War Department, 9 Aug. 1940,subject: Special Mobililization Procedures for Procurement of Medical DepartmentReserve Officers Who Are Students in Approved Medical Schools. 1st indorsementthereto, 3 Sept. 1940. (2) Letter, The Adjutant General, War Department,to Each Corps Area and Department Commander; Each Chief of Arm or Service,28 Aug. 1940, subject: Special Mobilization Procedures for Procurementof Medical Department Reserve Officers Who Are Students in Approved MedicalSchools. (3) See footnote 100.
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deferments were usually granted, they could not be guaranteed. In Mayand June 1941, the War Department authorized the appointment of full-timejuniors and seniors in approved schools of medicine to the Medical AdministrativeCorps, and postponement of their call to active duty. A year later, similarappointments were authorized for students in the two lower classes andfor students who had been accepted for the next entering class. After completingtheir studies, these officers were to be transferred to either the Medical,Dental, or Veterinary Corps.
By February 1943, when the program was discontinued, commissions inthe Medical Administrative Corps were held by 13,108 medical, 5,838 dental,and 1,116 veterinary students. The Navy provided a similar program, andby March 1943 when the National Selective Service recommended that localboards defer full-time students in these fields, there were few physicallyqualified male students who had not enrolled in the wartime Reserve. Thischange in policy by the Selective Service proved of value, however, forit also extended deferments to preprofessional students who were acceptedfor approved professional studies and would complete their undergraduatework within 24 months.102
Students in other fields had less extensive opportunities to continuetheir education. In May 1942, the War Department authorized the voluntaryenlistment of college students in the Enlisted Reserve Corps, with theunderstanding that they were to be exempted from active service as longas the military situation permitted. Medical, dental, and veterinary studentscould not participate in this program, but preprofessional students whohad not yet been accepted by a professional school were able to take fulladvantage of it.103
The War Department Program104
The decision to initiate the military college training program grewout of the War Department's recognition that lowering the selective serviceage to 18 would cut off the supply of college-trained men. The armed servicescould not afford the luxury of allowing a large proportion of the Nation'smilitary manpower to spend 4 years engaged in studies not necessarily vitalto the war effort, but neither could they afford to destroy their sourceof college-trained men who could serve as officers and technicians. Plannersalso had to consider the impact of reducing the draft age to 18 on theNation's colleges and universities.
In January 1942, and again in July, representatives of the Nation'scolleges met at conferences sponsored by the American Council on Education,to discuss the effect of war on higher education. In both instances, statementswere issued urging the Government to make maximum use of college facilities,to grant Federal aid to accelerate training, and to draft plans for usingthe resources of educational institutions in the war effort. Anticipatingthat both industry and educators would
102See footnote 17, p. 43.
103Letter, The Adjutant General, War Department, to Corps Areaand Similar Commanders, 25 May 1942, subject: Preinduction Training inColleges and Universities, inclosures thereto.
104This section is based on "History of Military Training,Army Specialized Training Program, Army Service Forces, From Its Beginningto 31 Dec. 1944, With Supplement to 30 June 1945." [Official record.]
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oppose reducing the draft age to 18, the War Department began to makeplans for an Army-Navy college training program.
On 25 September 1942, the Commanding General, ASF, was directed to preparea detailed plan for an Army college training program. On 13 November, thePresident signed an amendment to the Selective Service Act, reducing thedraft age to18, and on 17 December, the Secretaries of the War and NavyDepartments announced an Army-Navy college training program. The programsannounced by the two secretaries became the Army Specialized Training Programand the Navy College Training Program commonly known as the V-12.
Basic policies guiding ASF planning for the Army Specialized TrainingProgram were developed during a series of conferences between representativesof the War Department and American colleges and universities. Guidelinesfor the program were incorporated into the memorandum of 25 September 1942,directing the Commanding General, ASF, to develop detailed plans for theArmy Specialized Training Program. The number of men to be trained, andtheir fields of specialization, were to be determined by the Army's needs.Trainees were to be selected from the Army at large, on the basis of previousacademic training, the results of scholastic aptitude and achievement tests,and the qualities of leadership demonstrated during military service. Selectionwas to be preceded by basic military training. During their college training,men assigned to the program were to be on an active-duty status, organized,administered, and disciplined under a cadet system. The curriculum, theduration of training, and the number of men in each course were to be determinedby the Army.
In exceptional cases, cadets who were selected for service in nonmilitaryactivities were to be transferred to the Reserve, for employment in civilianstatus, subject to recall to active duty. Recommendations were also includedfor the kinds and levels of instruction, the acceleration of academic training,and the selection of trainees. The detailed plan based on these guidelineswas developed by the Personnel Division, ASF, after further conferences.
The final plan for the Army Specialized Training Program, released bythe Secretaries of War and Navy on 17 December 1942, modified many of theguidelines in the memorandum of 25 September. Medical and dental students,and members of the Enlisted Reserve Corps, were exempted from basic militarytraining. Selection was placed under the control of the War Departmentand was to follow the general guidelines for selecting officer candidates.Enlisted men over the age of 22 were eligible only for advanced training.Trainees were to be privates, seventh grade, and given military trainingunder a cadet system, concurrent with their academic training. Academicstandards were to be formulated after consultation with the U.S. Officeof Education and the American Council on Education. Men in training wereto undergo continuous screening, and failing trainees were to be promptlyrelieved and reassigned.
Graduates of the program were to be selected for further training atan officer candidate school, recommended for ratings as technical noncommissionedofficers, or returned to troops. Responsibility for the operation of theprogram was assigned to the Army Service Forces. A memorandum from theSecretaries, submitting the
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plan for the President's approval on 3 December 1942, stipulated thatnot more than 150,000 men would be trained by the Army at any one time,of whom 40,000 would be medical, dental, veterinary, premedical, and predentalstudents.
Special provisions were included for members of the Enlisted ReserveCorps and the Reserve Officers' Training Corps, and medical, dental, andveterinary students who held Reserve commissions in the Medical AdministrativeCorps, to insure that their previous training would be utilized, and thatthere would be no discrimination against them. It was considered discriminatoryto deprive them of opportunities for further training, or to require themto continue at their own expense. Premedical and predental students inthe Enlisted Reserve Corps were to be called to active duty at the endof the first full term beginning in 1943, and detailed to continue theirstudies. Medical, veterinary, or dental students commissioned in the MedicalAdministrative Corps were given the opportunity to resign their commissionsand enlist as privates to continue their studies at Government expense.Premedical students not in the Enlisted Reserve Corps, if inducted throughselective service, were to be placed on inactive duty until the end ofthe first full term beginning in 1943, and were then to be called to activeduty. Thereafter, they could be assigned to the Army Specialized TrainingProgram for further medical or premedical training, or to other militaryduties.
Between its establishment late in 1942, and its termination in 1946,the Army Specialized Training Program underwent continuous change. Of majorimportance were fluctuations in the program's size. At the beginning, ceilingstrength was set at 150,000. By September 1943, the Army Specialized TrainingProgram had reached a strength of approximately 124,000 trainees and wasstill growing. On 16 September, however, the War Department let it be knownthat the program would probably be reduced, and on 1 November 1943, theSecretary of War directed that total enrollment be reduced to 95,000 by30 June 1944, and to 40,000 by the end of December. The program reacheda peak strength of 140,000 in January 1944, when plans for reduction toprescribed ceilings were put into effect. On 10 February 1944, the Chiefof Staff, War Department General Staff, sent a strongly worded memorandumto the Secretary of War, recommending a drastic reduction of ceilings toa maximum of 30,000. On 16 February, the War Department General Staff,G-1, Personnel, informed the Commanding General, ASF, that a ceiling of30,000 ASTP trainees would become effective on 1 April. Those remainingin the program would consist entirely of advanced technical, preprofessional,and professional trainees.
In response to this directive, a plan, submitted on 25 February 1944,recommended that 25,000 professional and preprofessional medical, dental,and veterinary trainees be retained in the program, and that an additional1,000 vacancies be reserved for soldiers who held acceptances from professionalschools but were not yet enrolled in the Army Specialized Training Program.It also recommended that the Army Specialized Training Program include2,000 foreign area and language trainees, 3,000 advanced engineering trainees,and a small group of men in other programs. Under this plan, total enrollmentwould have been reduced to 34,100. With revisions that reduced it to 30,000trainees, the Secretary of War approved the plan on 28 February 1944. Asa result of these decisions, medical, dental, and
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TABLE 2.-Summary of ArmySpecialized Training Program demands, by arms and services, January 1943-July1944
Arms and Services | 1943 | 1944 | |||||
January | April | July | October | January | April | July | |
Army Air Forces | ----- | ----- | 43,997 | 10,197 | 12,790 | 100 | 100 |
Army Ground Forces | ----- | 46,995 | 55,985 | 40,520 | 40,520 | 2,350 | 2,350 |
Classified | ----- | ----- | 3,156 | 3,156 | 3,156 | 955 | 955 |
Corps of Engineers | 6,633 | 6,633 | 3,000 | 3,000 | 4,500 | 1,700 | 1,700 |
Chemical Warfare Service | 1,683 | 1,683 | 500 | 500 | 500 | 50 | 50 |
Ordnance | 1,650 | 1,650 | ----- | 900 | 900 | 645 | 645 |
Signal Corps | 4,925 | 4,925 | 13,707 | 13,707 | 13,234 | 3,001 | 3,001 |
Transportation Corps | ----- | ----- | 50 | 50 | ----- | ----- | ----- |
Surgeon General | 5,630 | 5,630 | 5,630 | 5,630 | 5,630 | 5,665 | 5,665 |
Adjutant General's Office | 1,170 | 1,170 | 1,100 | 1,100 | ----- | ----- | ----- |
Provost Marshal General | 1,595 | 1,595 | 1,600 | ----- | ----- | ----- | ----- |
Total | 23,286 | 70,281 | 128,725 | 78,760 | 81,230 | 14,466 | 14,466 |
Source: History of Military Training, Army SpecializedTraining Program, Army Service Forces, From Its Beginning to 31 December1944, With Supplement to June 1945. [Official record.]
veterinary students were the largest single group of Army SpecializedTraining Program trainees after April 1944 as reflected in table 2.
Medical, Dental, and Veterinary Training
Army specialized training in medicine, dentistry, and veterinary medicinediffered from other Army specialized training in a variety of ways.105Because study in these fields led to professional degrees, the programwas longer and followed the regular curriculum of professional schools.Instead of adopting the standard 12-week ASTP cycle, many schools remainedon the quarter or the semester. Provisions for physical and military trainingwere different, and because most medical, dental, and veterinary studentswere on commutation of quarters and rations, there were differences inlocal administrative problems. Since most students in these fields hadbegun their professional or preprofessional training before the establishmentof the Army Specialized Training Program, most of them were selected underother than ASTP procedures; and, while Medical Department officers connectedwith the program were fond of repeatedly saying that trainees were not"students in uniform" but "soldiers in college," thedifferences between standard Army specialized training and the Army SpecializedTraining Program in medical specialties was so marked that, in May 1943,a representative of the Army Specialized Training Division told participantsat an ASF conference that contracts with medical schools fell into a separatecategory from standard ASTP contracts because
"* * * we are putting professional students intouniform, we are not
105 See footnote 97, p. 72.
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putting soldiers into medical colleges. * * * mostof these boys have had no military training at all; we are merely goingto put a uniform on them and let them keep right on doing what they havebeen doing all the time."106
The program in operation.-During the spring and summer of 1943,all members of the Enlisted Reserve Corps, who had reached age 18, werecalled for active duty. Upon completion of basic military training, they,and all other enlisted men in the Zone of Interior (except loss replacementsand those in alerted units), were eligible for selection for the Army SpecializedTraining Program. Medical, dental, and veterinary students in approvedschools, who were called to active duty as members of the Enlisted ReserveCorps or inducted through the Selective Service System, were not requiredto receive basic military training before assignment, but were processedthrough reception centers and immediately returned to the schools in whichthey were enrolled as members of the school's ASTU (Army Specialized TrainingUnit). Members of the Enlisted Reserve Corps who had been accepted foradmission to a 1943 or 1944 professional school freshman class were alsoexempted from basic training and were granted the option of remaining oninactive status to complete prerequisites for admission. Those who didnot elect to remain on inactive status were processed at reception centersand sent to a STAR (Specialized Training and Reassignment) unit for verificationof their admission to professional schools, and for evaluation of theirprogress toward completing entrance requirements.
This information was forwarded to the Army Service Forces, which orderedthe trainee to an Army Specialized Training Unit to complete his preprofessionaltraining. Enlisted men with 1943 and 1944 acceptances, who had finishedbasic military training without completing their preprofessional training,were also sent to STAR units for classification and assignment. In short,the War Department did everything possible not to interrupt the professionaland preprofessional training of potential physicians, dentists, and veterinarians.
Enlisted men who had completed their preprofessional training and beenaccepted by a professional school were assigned interim duties until theycould be enrolled in a freshmen class. Such duties were performed on an"attached-unassigned" status at Medical Department installationswithin the service command in which the professional school was located,or in which the trainee was then stationed. The period of interim dutiesvaried from 1 to 8 months.
By honoring the commitments of individual schools during 1943 and 1944,the War Department, in effect, delegated responsibility for selecting traineesto accredited medical, dental, and veterinary colleges. A major factorin this decision was the presence in the Army of a large number of enlistedmen with premedical or predental training who had either failed to applyfor acceptance at a professional school, or failed to gain admission. Toavoid selecting these men at the expense of those already admitted, theArmy agreed to accept the admissions of individual schools for freshmanclasses beginning in 1943 and 1944.
106Remarks of Lt. Col. Blake R. Van Leer, MC,at Army Service Forces Conference on Negotiation and Renegotiation Procedurefor Training Unit Contracts for Securing Services and Facilities of Non-FederalEducation Institutions, Omaha, Neb., 28 May 1943.
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The number of men accepted by individual schools for classes beginningin 1943 and 1944 was estimated to be adequate to meet the Medical Department's1946 and 1947 demand schedules. However, demand schedules for subsequentyears could be met only by selecting and assigning enlisted men for trainingin medicine and dentistry. Satisfaction of the Medical Department's annualdemand schedule for 4,200 physicians, 1,100 dentists, and 150 veterinariansrequired the reservation of 3,600 freshman medical school and 825 dentalschool vacancies in each 9-month cycle. Because of the disproportionatelylarge number of enlisted men in veterinary training, additional trainingin this field was not required. To guarantee these vacancies, the War Departmententered contracts with medical and dental schools to reserve 55 percentof the freshman medical capacity and 35 percent of the freshman dentalcapacity in each class beginning after 1 January 1945. The schools wereadvised that vacancies in 1945 freshman classes would no longer be filledby honoring the selections of individual institutions. Instead, representativesof medical and dental education would participate in the selection of enlistedmen to fill Army-reserved freshman vacancies.
To fill its reserved vacancies, the Army was required to provide anaverage of 400 medical and 100 dental trainees each month. This level ofenrollment could be maintained only by selecting trainees from those whohad demonstrated their academic competence by completing two or three termsof the basic ASTP curriculum. Courses required for admission to medicalor dental school could then be completed in three additional terms-a totalperiod of 60 weeks. Assuming a loss in these three terms of only 15 percent,a monthly input of 625 trainees into term 3 of the preprofessional curriculumwas necessary to meet the contract obligations for the utilization of freshmanvacancies. While it was assumed that a number of potential candidates mightbe discovered in the Army at large, their numbers and qualifications wereso uncertain that they could not be counted upon to furnish a continuousflow of trainees. Thus, plans for professional training after 1944 requiredcontinuation of the basic phase of the Army Specialized Training Programat a level sufficient to provide a choice of candidates for preprofessionaltraining.
The basic phase of the Army Specialized Training Program was discontinuedon 1 April 1944, and approximately 42,000 trainees enrolled in the basicprogram were assigned other military duties. Only those who had been selectedfrom basic ASTP cycles ending in December, January, and February were transferredto the preprofessional program. On 18 April, ASF headquarters announcedthat the Army's share of classes entering medical schools during 1945 wouldbe cut from 55 percent to 28 percent, and for dental schools, from 25 percentto 18 percent; no commitments were to be made for classes starting in 1946.107
Meanwhile, the question of reducing the dental Army Specialized TrainingProgram became involved with that of discharging dentists already in theservice. In March 1944, the Dental Corps had reached its ceiling strengthand was faced with the prospect of having more graduates than it needed.On 18 July, the War
107Memorandum, Brig. Gen. W. L. Weible, GSC,Director of Military Training, Army Service Forces, for The Surgeon General,18 Apr. 1944, subject: War Department Policy Governing Training in Medicineand Dentistry under Army Specialized Training Program.
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Department announced that training would be terminated. Only those whowere seniors in July were able to continue, and the dental Army SpecializedTraining Program came to an end when they graduated in April 1945.
In May 1944, The Surgeon General approved the termination of the veterinaryphase of the Army Specialized Training Program. Apparently, the VeterinaryDivision considered the program no longer necessary, since the VeterinaryCorps was near its authorized strength, and having little difficulty inrecruiting veterinarians from civilian practice.108
The future of the medical phase of the Army Specialized Training Programwas a matter of more concern to The Surgeon General. The collapse of Japanraised the problem of whether the Army should continue the program to meetcivilian needs for doctors. Some War Department authorities feared theArmy would be criticized for the lack of medical training during the war,while others believed that training should be confined to meeting the futureneeds of the Army. Maj. Gen. (later Gen.) Brehon B. Somervell, CommandingGeneral, ASF, believed that the Army could not justify continuing expendituresand recommended that medical courses be terminated during the academicyear 1945-46. The Surgeon General believed that young medical officerswho had received their education at Government expense should be orderedto active duty as replacements for older medical officers with long periodsof service.109
Two months after the defeat of Japan, the Medical Department recommendedthat the program be continued as a source of replacements. In light ofpast difficulties in recruiting physicians for the Regular Army, it tooka dim view of the loss of 5,000 medical officers that would result fromterminating the program in June 1946. The Chief of Staff did not agree,and in November 1945, the War Department announced that the program wouldbe terminated on 1 July 1946. With specified exceptions, those scheduledto graduate before 1 July 1946 were to be retained for service. Those scheduledfor graduation after that date were to be separated from the program inMarch 1946. Upon separation, they were transferred to the Enlisted ReserveCorps in an inactive status and subject to recall if they failed to completetheir studies. Those who were unable to continue their studies were transferredto other duties and discharged when they became eligible. The medical phaseof Army Specialized Training Program came to an end a year after the dentaland veterinary phases and permitted the Army to solve many of its postwarpersonnel problems. Total enrollment in professional courses, and theiroutput, as a result of the Army Specialized Training Program, are summarizedin table 3.
Peak enrollment was reached in March 1944, when 21,581 enlisted menwere in training: 14,042 in medicine, 6,143 in dentistry, and 1,396 inveterinary medicine. Peak enrollment in preprofessional training was reachedin April of the same year, when 4,093 enlisted men were enrolled. Precisefigures for total enrollment in
108See footnote 17, p. 43.
109(1) Letter, Maj. Gen. I. H. Edwards, GSC Assistant Chiefof Staff, G-3, to Prof. Philip Lawrence Harrison, Bucknell University,Lewisburg, Pa., 23 Aug. 1945. (2) Memorandum, Gen. Brehon B. Somervell,Commanding General, Army Service Forces, for Chief of Staff, U.S. Army,4 Sept. 1945, subject: Future of Army Specialized Training Program. (3)Letter, Maj. Gen. Norman T. Kirk, The Surgeon General, U.S. Army, to theHonorable L. Mendel Rivers, House of Representatives, 16 Oct. 1945.
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TABLE 3.-The Army SpecializedTraining Program: Students of medicine, dentistry, and veterinary medicineassigned, separated, discharged, and transferred through curtailment ofthe program
Student Status | Medicine | Dentistry | Veterinary medicine |
Assigned | 20,336 | 7,734 | 1,660 |
Separated | 15,216 | 3,031 | 679 |
By graduation | (13,373) | (2,458) | (598) |
By failure | (1,045) | (472) | (41) |
For other reasons | (798) | (101) | (40) |
Curtailment | 5,120 | 4,703 | 981 |
Discharged | (5,120) | (4,651) | (940) |
Transferred | ----- | (52) | (41) |
NOTE.-Figures in parentheses are subtotals.
Source: (1) Fitts, Francis M.: Training in Medicine, Dentistry, and VeterinaryMedicine, and in Preparation Therefor, Under the Army Specialized TrainingProgram, 1 May 1943 to 31 December 1945. [Official record.] (2) Letter,Col. Francis M. Fitts, MC (Ret.), to Col. John B. Coates, Jr., MC, Director,Historical Unit, U.S. Army Medical Service, 15 Nov. 1955.
preprofessional courses throughout the life of the program are not available,but approximately 3,500 were assigned to premedical, about 1,400 to predental,and an unknown number to preveterinary studies.110
Curriculum.-The curriculum adopted for enlisted men in engineeringand in area language studies was designed to meet specific requirementsof the arms and services. Many traditional college courses, oriented towardscientific or liberal arts degrees, were modified in content, duration,or emphasis to provide soldiers with special skills in the shortest possibletime. College credits and academic degrees were secondary and had littlemilitary value. ASTP curriculums for medical, dental, and veterinary studentswere the exception because graduation from a professional school approvedby the War Department was a prerequisite for commissioning. Since theseschools had accelerated their programs by eliminating long vacations andholidays before the establishment of the Army Specialized Training Program,it was not even necessary to shorten the length of their programs. Contracts,therefore, merely stipulated that the ASTP trainees at these institutionswould follow the contractor's standard curriculum under the acceleratedprogram recommended by the national professional association of which itwas a member. Schools were unofficially requested to remain in session48 weeks of each calendar year, since no more than 30 days annual leavecould be routinely granted to Army trainees.
Since the Army had accepted the standards of professional schools forgraduation, it had little choice but to accept their standards for admission.Success of the preprofessional program, and in the long run, the professionalprogram, depended upon graduates being acceptable for advanced training.Despite these limitations, the Army was able to make significant changesthrough standardization and acceleration. Standards for admission to accreditedmedical, dental, and veterinary
110See footnote 17, p. 43.
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schools had been formulated by professional associations, college accreditingassociations, and the schools themselves, long before the establishmentof the Army Specialized Training Program. The requirement for admissionto medical schools was a minimum of 2 years of college work that includedcourses in English, physics, biology, and general and organic chemistry.Three years of college were recommended, and a number of medical schoolsrequired 4 years. A few required the degree of bachelor of arts or science.Schools were free to expand these requirements, and beyond meeting minimumstandards, professional school admission requirements varied widely. Requirementsfor admission to schools of dentistry and of veterinary medicine were lower,but since only one preparatory curriculum could be adopted for the ArmySpecialized Training Program, the program had to meet medical school standards.
By the time the Army Specialized Training Program was established, collegeassociations had already paved the way for standardization and accelerationby recommending that professional schools contribute to the war effortby accepting applicants who satisfied minimum requirements for admission.At the request of the Director, Army Specialized Training Division, TheSurgeon General invited selected representatives of medical, dental, andveterinary education to a conference in January 1943. This committee recommendedthat the professional program consist of 30 term hours of required basiccourses, and 60 term hours of electives. Required courses were to include8 term hours of general chemistry, 4 term hours of organic chemistry, and6 term hours each in English, physics, and biology. Electives were to berestricted to courses in qualitative and quantitative analysis, physicalchemistry, comparative anatomy and embryology, psychology, economics, publicadministration, and a modern foreign language. Completion of the programrequired six ASTP terms, or a total of 72 weeks.111 The recommendationsof this committee were accepted by The Surgeon General and were adoptedby the Army Specialized Training Division with only minor changes. Thelength of the program was reduced to five terms, and basic course requirementswere increased to 8 hours in each subject.112
The War Department's decision to compress premedical training into aperiod of 60 weeks (five ASTP terms) was controversial. The Associationof American Colleges contended that the curriculum was overaccelerated;it would result in physical and mental exhaustion, and enter trainees inprofessional programs before they had matured. Since the program couldbe completed in five terms if preprofessional students followed schedulescomparable to those adopted for other ASTP trainees however, the War Departmentdid not feel that it could justify adding a sixth term. Sixty weeks ofASTP instruction was considered to be the equivalent of at least 64 weeks(2 academic years) of peacetime college work.
The sequence of courses under the Army Specialized Training Programwas a marked departure from traditional patterns of training. Customarily,students in
111In Letter, Brig. Gen. Larry B. McAfee, ActingThe Surgeon General, to Officer in Charge of Army Specialized TrainingProgram, 2 Jan. 1943, subject: Pre-Medical and Medical Education, inclosurethereto. Report of Advisory Committee on Medical Sciences Part of the ArmySpecialized Training Program.
112Army Service Forces Manual M 108, Catalog of Curricula andCourses, Army Specialized Training Program, March 1945.
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preprofessional programs began specializing as early as their freshmanyear, with no assurance that they would eventually be admitted to a schoolof medicine or dentistry. There was no way to coordinate the number ofpreprofessional students with the number of vacancies in professional schools,and as a result, large numbers of students who had completed premedicalprograms annually competed for a limited number of medical school vacancies.The training of unsuccessful candidates was either wasted or adapted toother fields.
The Army attempted to avoid wasting talent and manpower by assigningall trainees to a common curriculum in which they studied English, physics,and general chemistry. Candidates for preprofessional training were thenselected from among those who had proved their academic competence by completingthe first two or three terms of the ASTP basic curriculum, or a year ofcollege before entering the service.113 The number of traineesselected to complete the remaining course in the preprofessional curriculumwas limited by the number of professional school vacancies reserved forthe Army, with an allowance for dropouts and failures. Those who were notselected for preprofessional training were allowed to continue in otherphases of the Army Specialized Training Program.
Selection of schools.-Selecting schools to participate in themedical phases of the Army Specialized Training Program was never a majorproblem, because the choice was limited to those accredited by the AmericanMedical Association.114 By the time the Army Specialized TrainingProgram was established, members of the Officers' Reserve Corps, the MedicalAdministrative Corps Reserve, and the Enlisted Reserve Corps were attendingall of these schools except the Woman's Medical College of Pennsylvania,Philadelphia, Pa. Since the problems involved in transferring the academiccredits of these men to a few select institutions were considered insurmountable,the Army chose to make arrangements for contract instruction at all approvedmedical, dental, and veterinary schools.
Race and religion presented special problems. Because of its policyof honoring the admissions of schools which had accepted students for classesbeginning in 1943 and 1944, the Army was unable to reject Negroes who hadbeen accepted by predominately white schools. This could be done only whenthe Army had full control of freshman vacancies. At the same time, manyschools were worried that Army control of vacancies, and the Army procedureof assigning students by number instead of by name, would lead to unwantedintegration. Col. Francis M. Fitts, MC, Director of Military Training,ASF, explained these problems and their solution at The Surgeon General'sconference with chiefs of the medical branches of the service commandsin mid-1943:115
*** Negro trainees now accepted by Chicago or Harvard will besent to those schools by which they had been accepted. When Chicago andHarvard reserve for the Army a certain percentage of vacancies we willnot send Negro trainees there. That has been the point which has givensome concern to some schools and is one which you cannot decide absolutelyor say that an order will not be made; but if it is made, it will be rectified.
113War Department Memorandum No. W350-112-43,Army Specialized Training Program Professional and Preprofessional TrainingGeneral Information and Procedures for Selection of Personnel, 29 Apr.1943.
114See footnote 17, p. 43.
115Report of The Surgeon General's Conference with Chiefs, MedicalBranch of Service Commands, Washington, D.C., 14-17 June 1943.
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As a result of these policies, enrollment in medicine and dentistryat Howard University and Meharry College, Nashville, Tenn., was limitedexclusively to Negroes, and Negroes were not selected for other collegesunless they had already been admitted by the individual school. In anycase, enrollment of Negroes was to be limited, because the Medical Departmentdid not plan to expand its use of these officers, and needed only about40 replacements a year for those already on active duty. With about 380Negro medical students already enrolled in the Medical Administrative Corps,the Medical Department had a 10-year supply of replacements and believedit could not justify extensive training of this racial group. A small groupof trainees were sent to Negro colleges late in 1944, but reservationsfor 1945 were canceled. Enrollment at the College of Medical Evangelists,Loma Linda, Calif., a Seventh-Day Adventist School, was similarly limitedto members of that faith.116
The selection of colleges for preprofessional programs was more complicated.Reports compiled by the Association of American Medical Colleges, on theperformance of freshman medical students admitted from more than 500 collegesand universities between 1931 and 1941, served as a basis for evaluation.The names of schools whose past performance and capacity indicated thatthey were capable of acceptably training a class of at least 50 preprofessional.students were then submitted for clearance to the Joint Army-Navy ManpowerCommission Committee for the Selection of Non-Federal Institutions. Finalselection for participation in the preprofessional program required thattotal ASTP enrollment at the school, in all programs, be sufficient toallow the formation of an Army specialized training unit with a strengthof 200 to 250 trainees.
The number of schools at which preprofessional programs could be establishedwas limited by the number of students assigned to the program. Initialestimates called for the enrollment of 8,000 students, and the selectionof 90 institutions for possible contracts. This estimate, however, wasbased on the assumption that enlisted men would be enrolled for preprofessionalstudies during their first term. The decision to enroll all ASTP traineesin a common program until the end of their second term reduced the numberof men to be classified as preprofessional trainees to 5,400. This levelof enrollment, which would have been reached in September 1944, allowedthe establishment of preprofessional programs at 52 institutions.
Contracts.-Government contracts with colleges and universitiesfor ASTP professional and preprofessional programs were negotiated throughthe service commands. In contracts with medical and dental colleges, theGovernment agreed to allow schools to continue training ASTP and Reservestudents who were already enrolled, or who had been accepted for enrollmentin classes beginning before 1945. In each class beginning in 1945 and subsequentyears, the schools agreed to reserve a specified number of vacancies forArmy trainees. By an agreement with the War Manpower Commission, the combinedenrollment of ASTP and V-12 trainees after 1944 was limited to 80 percentof incoming freshman classes: 55 percent to the Army and 25 percent tothe Navy. The remaining 20 percent was reserved for
116See footnote 115, p. 83.
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women and men who were not eligible for military service. Thirty-fivepercent of the capacity of dental schools was allocated to the Army, and25 percent to the Navy. No contracts were made for the reservation of freshmanvacancies in veterinary schools. The Army was required to give 60 days'notice if it was unable to fill reserved vacancies.
In April 1944, when the basic phase of the Army Specialized TrainingProgram was discontinued, it became apparent that the Army would be unableto fill the freshman vacancies it had reserved. The number of men selectedfor professional training was only adequate to fill half of the vacanciesreserved for 1945, and there would be no new trainees in subsequent years.Contracts were therefore revised to reserve only 28 percent of the capacityof medical schools, and 18 percent of the freshman dental capacity. Thenumber of institutions under contract remained unchanged.
To compensate the school for the staff, facilities, equipment, and suppliesit provided, the Government agreed to pay the equivalent of nonresidenttuition for each trainee enrolled. Special provisions were made for a smallgroup of schools whose normal tuition was significantly below the nationalnonresident average. The Army also agreed to pay incidental fees normallypaid by students. No payment was made for registration fees, enrollmentfees, and "good-faith" deposits. The textbooks, instruments,and supplies required by trainees were purchased by the Government andissued, or reissued, to trainees on receipt. Textbooks issued to freshmantrainees remained in their possession until the completion of training.Instruments which could be obtained on a rental basis, such as microscopes,were not purchased. Instructional supplies and equipment which were notstandard throughout the program were purchased for the Government throughthe contracting school, which was allowed a small handling charge.
The average monthly cost of professional training per trainee is shownin table 4.
Contracts for preprofessional training were similar to those for otherASTP programs. Payment was made on a cost basis computed for the rentaland maintenance of facilities (classrooms, laboratories, dormitories, andmesshalls) and for proportional salaries of faculty members actually engagedin the instruction of Army trainees. All contracts were subject to renegotiationeach term.
The average monthly cost per trainee for instruction under the preprofessionalcurriculum was $52.31.
Item | Medical | Dental | Veterinary medicine |
Tuition and instructional fees | $51.00 | $38.00 | $26.70 |
Textbooks and instruments | $7.15 | $4.84 | $4.40 |
Instrument rental | $4.32 | $18.26 | $2.40 |
Total | $62.47 | $61.10 | $33.50 |
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Preprofessional trainees were housed and messed by the contracting institution.In most medical, dental, and veterinary medicine schools, however, grouphousing and messing facilities could not be provided. Many medical anddental schools had no university housing and were located in densely populatedmetropolitan areas where common housing and messing were impractical. Atother schools, the wide dispersion of trainees for clinical training duringtheir junior and senior years made it undesirable. As a result, most ASTPmedical, dental, and veterinary trainees were paid commutation allowancesfor quarters and rations. At schools in which group housing and facilitieswere available, many regulations, including restrictions on late study,had to be relaxed.117
Academic standards.-When the program was established, the Armyaccepted all enlisted men then enrolled in approved professional schools.It similarly accepted enlisted men who had been admitted to freshman classesentering approved schools in 1943 and 1944. Thus, for the first 2 yearsof the program, standards for selection were set by individual schools.Many of these students could not have been accepted under Army standards.The AGCT (Army General Classification Test) was given to all enlisted menwhen they came on active duty. A minimum AGCT score of 115, plus graduationfrom high school, were the prerequisites for assignment to the Army SpecializedTraining Program. When members of the Enlisted Reserve Corps and MedicalAdministrative Corps Reserve enrolled or accepted by medical, dental, andveterinary schools were called to active duty in mid-1943, nearly 9 percentof the Army trainees in medical schools, 22 percent in dental schools,and 18 percent in veterinary schools failed to achieve the AGCT score of115. These percentages did not include students accepted by the two accreditedNegro schools, where 35 percent of the medical students and over 60 percentof the dental students failed to achieve a qualifying score.118Because of the Army's commitments, students accepted by individual schoolsfor classes beginning in 1943 and 1944 had to be exempted from basic ASTPstandards. Enlisted men assigned for preprofessional or for professionaltraining by the Army, however, were required to meet minimum standards.
To remain in the professional program, trainees were required to meetthe individual school's standards for continuation and graduation. Studentswere permitted to repeat courses only if failure was explained by illness,injury, or official Army orders. Failure in any subject, not satisfactorilyexplained by extenuating circumstances, resulted in separation from theprogram. Trainees so separated were ineligible for reassignment to theArmy Specialized Training Program. The majority of the medical, dental,and veterinary trainees separated from the program, other than by graduation,were assigned to the Medical Department for further training and for serviceas medical soldiers.119 In setting standards for the preprofessionalprogram, the Army accepted the policy established at a majority of theaccredited professional schools and required an overall "C" average.
117Army Service Forces Manual M 105, Army SpecializedTraining Programs, 3 Apr. 1944.
118Compilation of the number of ASTP students at various universitieswho fell below the Army General Classification Test passing score of 115by Medical Section, Curricula and Standards Branch, Army Specialized TrainingDivision, 3 Sept. 1943.
119See footnote 117.
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The selection of the enlisted men for assignment to vacancies reservedby the War Department in classes beginning after 1944 required more elaborateprocedures. In general, candidates were chosen from trainees completingterm 2 and term 3 of the basic ASTP curriculum (B-1), who were then transferredto the preprofessional curriculum for the completion of their premedicaltraining. Applicants for admission to the preprofessional program wererequired to pass a preliminary screening test known as the Aptitude Testfor Medical Professions before they could be sent to unit classificationboards for interviews.120
The Aptitude Test for Medical Professions was prepared for the War Departmentby Drs. Fred A. Moss and Thelma Hunt under the direction of a committeeof the Association of American Medical Colleges. Dr. Moss and this committeehad previously designed and administered the Scholastic Aptitude Test forMedical Colleges (Medical Aptitude Test) which was used by the admissionscommittees of a majority of medical schools. The applicant's score on theMedical Aptitude Test had served as a basis for admission in conjunctionwith academic records, letters from professors, and personal interviews.The test had not been used extensively in the selection of dental students.
In the Army Specialized Training Program, the Aptitude Test for MedicalProfessions was used primarily to limit the number of candidates who wouldbe presented to unit classification boards for interviews. Usually, minimumscores were set at a point that required boards to interview three timesthe number of candidates they would ultimately select. Representativesof contracting medical and dental schools within each service command servedas consultants, and conducted ASTP classification board interviews to determinewhether candidates were qualified and acceptable. After being interviewed,candidates were assigned to one of four categories: fully qualified andacceptable; acceptable, but not of the highest qualifications; acceptable;or not satisfactory and not acceptable. As far as possible, units wereassigned from candidates classified as fully acceptable. Reports of qualifiedcandidates in excess of unit quotas were forwarded to the Army SpecializedTraining Division.
Since preprofessional trainees were selected before they had taken coursesin biology and in organic chemistry, a second screening was required inthe final term (term 5) of the preprofessional curriculum. This secondscreening resulted in an elimination from the program of 173 enlisted men,or 7.2 percent of the 2,401 previously selected for training in medicine.
Because of the abrupt termination of all but a few special purpose programsin early 1944, only four groups of candidates were able to take the AptitudeTest for Medical Professions. Trainees in the first three groups testedwere screened and selected for professional training by routine procedures.Since it was impossible to interview members of the group tested on 16February 1944, before the basic program was brought to a conclusion, the500 candidates with the highest scores were arbitrarily transferred andinterviewed during their first term in the preprofessional program. Thosefound unacceptable for medical or dental training were offered the opportunityto study Japanese.
120 Herge, Henry C.: Wartime College TrainingPrograms of the Armed Services. Washington: American Council on Education,1948.
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Trainees who graduated in medicine and were commissioned in the MedicalCorps, AUS, or the Medical Corps Reserve, were not called to active dutyuntil they had completed their civilian hospital training. This training,in an inactive-duty status, consisted of 9 months of hospital internshipfor all, an additional 9 months as assistant residents for a maximum ofone-third, and a further period of 9 months as residents for one-sixthof the original group. When called to active duty, they were assigned for6 weeks' intensive field training at the Medical Field Service School,Carlisle Barracks, and 6 weeks of training in Army hospital proceduresand administration in general hospitals in the Zone of Interior.
In 1945, The Surgeon General recommended that, effective on 1 April1946, all medical officers still in an inactive status be called to activeduty from previously authorized civilian hospital residencies and assistantresidencies, and that those serving hospital internships be activated uponthe completion of 12 months of intern training. This change in existingprocedures was adopted, with the concurrence of the War Manpower Commission,to allow these positions to be filled by veterans whose hospital traininghad been interrupted.
Military and physical training.-All ASTP trainees, except thosein medicine, dentistry, and veterinary medicine, were required to participatein 6 hours of military training and 5 hours of physical training. For menin the professional program, the military training requirement was reducedto 3 hours, and physical training was eliminated. These exemptions weregranted because it was difficult to crowd an extra 9 hours of traininginto the accelerated programs of professional schools without using timeneeded by trainees for their studies. Moreover, almost every medical, dental,and veterinary school lacked the gymnasiums and athletic fields requiredfor a physical training program. In units where such facilities were available,trainees were encouraged to engage in physical exercise. Military instructionoutside the classroom was usually conducted in streets, vacant lots, andparks.
At first, military instruction was based on the program previously usedby medical units of the Reserve Officers' Training Corps. Later, it wasmodified to be used both for enlisted men who had completed basic trainingand by those who had been assigned directly to the Army Specialized TrainingProgram. In July 1944, a program of branch immaterial training was establishedto allow students to be trained by nonmedical officers.121 Underthis program, branch training was given to students in a 6-week courseat the Medical Field Service School, followed by 6 weeks of training ata Zone of Interior hospital after they had been commissioned and servedtheir hospital internship.
EDUCATIONAL TECHNIQUES AND PROBLEMS
Despite their number and variety, Medical Department training programsshared many common techniques and problems. Facilities and equipment hadto be
121(1) Army Service Forces Manual M 107, MilitaryTraining Program for ASTP Trainees and ASTRP Students, 2 June 1944. ChangeNo. 1, dated 17 July 1944. (2) See footnote 117, p. 86.
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provided, instructors had to be selected and trained, and educationaltechniques had to be geared to an accelerated program.
Facilities and Equipment
The expansion and acceleration of officer training programs createda corresponding need for an expansion of training facilities. At CarlisleBarracks, extensive construction was required to prepare the Medical FieldService School for its role in training commissioned and noncommissionedofficers. During the first half of 1940, barracks were built to house 125men, and the school received an appropriation of $375,000 for the constructionof a new permanent school building.122 The training area wasexpanded to include 220 tent platforms, 14 lavatories, a 400-man messhall,and buildings for storage and administration. The following year, constructionbegan on 18 barracks (63-man), two temporary classroom buildings, and avariety of overhead buildings. Most of these were intended for use by officercandidates, but were eventually used for student officers as well.123At the Army Medical Center, construction was limited to two new officers'barracks.124
While helpful, this construction in no way prepared the service schoolsfor the expansion that lay ahead. By mid-1941, the Medical Field ServiceSchool had been required to increase its capacity from approximately 100officers to 6,000, and that of the Army Medical Center increased from approximately100 to 1,200.125 Construction did not expand space. To increasethe output of schools, courses were shortened, classes were staggered atintervals of as little as 2 weeks, and year-round use was made of existingfacilities. During 1941, for example, classes at the Medical Field ServiceSchool were conducted in the gymnasium while the new school was under construction.126Both schools found it difficult to house their expanded enrollment, andstudents were encouraged or required to live off-post.127
Construction undertaken in 1940 and 1941 solved many of these problems,but others persisted throughout the war. By mid-1942, the Medical FieldService School was able to report that existing facilities were adequatefor its program,128 but continued, even after 1942, to resortto expedients. The new classroom building, for example, was designed tohold only 200 students at a time, and it was necessary to continue usingthe gymnasium as a classroom and auditorium.129 Both the ArmyMedical Center and the Medical Field Service School had to terminate programsto allow the expansion of others.130 In some instances, it wasnecessary to establish new special service schools, which usually encountereddifficulties similar to those experienced by the parent schools.
122See footnote 1, p. 36.
123See footnotes 6, p. 37; and 21, p. 44.
124Annual Report, Headquarters, Army Medical Center, Washington,D.C., calendar year 1940.
125See footnote 5 (2), p. 36.
126See footnote 21, p. 44.
127(1) See footnote 10, p. 39. (2) Annual Report, CommandingGeneral, Headquarters, Army Medical Center, Washington, D.C., 1942.
128See footnote 22 (2), p. 45.
129See footnote 50 (2), p, 58.
130(1) See footnote 77 (1), p. 65. (2) Annual Report of TheSurgeon General of the Army for the Commanding General, Army Service Forces,fiscal year 1943.
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Instructional Staff131
Instructors in the Medical Department officer training program can bedivided into two categories: those concerned with the military aspectsof medicine, and those concerned with the technical phases of medicine,dentistry, veterinary medicine, and related sciences. Instructors in thefirst category were necessarily graduates of the courses they taught, whilethose in the second were usually men who had become specialists throughextensive study at civilian institutions. Each was selected by differentprocedures.
Instructors in military subjects.-With minor variations, thepattern of selecting and training instructors for military subjects atthe Medical Field Service School was typical of all military programs.Until a supply of officers returning from overseas became available, instructorswere selected from among candidates who had demonstrated leadership abilityduring their own training. Responsibility for recognizing potential instructorsamong trainees at the school rested upon individual department heads, whointerviewed promising candidates and selected those who would remain atthe school for further training. As overseas returnees became available,fewer students were retained for teaching assignments, and officers withcombat experience were selected for faculty assignments.
Until 1944, the training of new instructors was almost exclusively adepartmental responsibility. Candidates were oriented through conferenceswith veteran members of their department, by studying materials used bythe department, and by observing other instructors in the classroom andin the field. New teachers were required to present lectures in front ofexperienced instructors before being allowed in the classroom. When itwas considered necessary to give them experience in handling troops, theywere temporarily attached to the demonstration battalion at Carlisle Barracks.
In 1944, departmental indoctrination of new teachers was supplementedby an instructor guidance course conducted by the Training Department.This course, established at all ASF training centers, was designed to familiarizenew or potential instructors with approved teaching techniques, and withprocedures for selecting materials and making lesson plans. At the MedicalField Service School, the establishment of an instructor guidance programdid little more than elevate existing procedures to the status of formalrequirements.
At the Medical Field Service School, as at other military training facilities,the major staff problem was not selection and training, but retention.Between June 1942 and June 1944, for example, the annual rate of replacementat the school exceeded 40 percent. This lack of stability in instructorassignments created a need for constant selection and training of new personnel.132
Instructors in technical subjects.-Vacancies in technical teachingpositions could not be filled through on-the-job training, or intensiveshort courses. The specialized skills required for these positions couldbe acquired only through extensive study or experience. Neurosurgery, forexample, could be taught only by
131See footnote 10, p. 39.
132See footnotes 22 (2) and (8), p. 45.
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a qualified neurosurgeon, and the parasitology of tropical diseasescould be taught only by an expert in the field. Instructors in technicalsubjects had to be selected in much the same manner as instructors at civiliancolleges. Instructors were selected by the Military Personnel Divisionof the Office of The Surgeon General according to the specific requirementsfor each position. In some instances, the commandants of schools were ableto request specific individuals who had gained reputations in a field ascivilians, and preference was given to men who had been college instructorsbefore being commissioned. Once hired or assigned to a position, instructorswere indoctrinated through conferences with veteran members of the staffat each school.
Each technical course or school had different requirements, and filledits staff from different sources. At the Medical Supply Services School,for example, key instructors in the Officers' Supply Division were staffofficers at the St. Louis Medical Supply Depot. Instructors in the Maintenanceand Repair Division were civilians who had been sent to the depot by largemanufacturing firms and were later commissioned and formally assigned tothe staff. Instructors in the Optical Division were opticians. Most ofthe instructors at the Army Medical Center were staff officers who wereassigned additional duties as teachers. As a result, the Army Medical Centeralso experienced difficulties in staff retention.133
Educational Techniques
In training officers to perform the varied duties of the Medical Department,a wide variety of techniques were employed. Courses designed to providetrainees with military skills usually employed standard military techniques.Those designed to impart technical skills varied as widely as the skillsthemselves.
Class organization.-Class organization varied according to thenumber of trainees enrolled, and the degree to which drill, road marches,and field problems were part of the curriculum. In a course such as theOfficers' Basic Course at the Medical Field Service School, drill and fieldproblems played a large role, and classes were organized into battalions,companies, and platoons. Faculty members selected for their military abilitywere assigned as platoon leaders, class directors, and battalion commanders.These officers usually supplemented the technical instruction given bythe school's academic departments with training in military subjects andwere responsible for details such as messing, housing, and supplying unitsunder their command.134
In courses involving purely technical subjects, class organization differedlittle from that of typical civilian colleges. At the Army Medical Center,for example, selected students were appointed as "monitors" andmade responsible for details such as keeping attendance records. Becauseof the relatively small numbers attending such courses, formal organizationinto companies and battalions was not considered practical.135
133(1) Annual Report, Technical Activities,Medical Department Professional Service Schools, Army Medical Center, Washington,D.C., fiscal year 1941. (2) See footnotes 21, p. 44, and 22 (2), p. 45.
134See footnote 21, p. 44.
135See footnote 10, p. 39.
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Teaching methods.-Service schools conducting courses for MedicalDepartment officers followed approved military teaching techniques as closelyas possible. In general, these consisted of the lecture, the conference,the demonstration, and the practical exercise. The frequency with whichany one method of presentation was utilized varied with the content ofthe course.
Courses such as the Officers' Basic Course, the Special Cadre Course,and the National Guard and Reserve Officers' Course used much the sametechniques as those employed by the MAC Officer Candidate School, and areport by one of these schools best illustrates their application. Coursesemphasizing principles of command, organization, and administration reliedheavily upon conferences, demonstrations, and practical exercises. Conferencesand lectures were used solely to introduce and develop subject matter,but practical exercises which emphasized learning by doing rather thanby listening were the preferred technique. Whenever possible, demonstrationsand practical exercises were used exclusively. The Medical Field ServiceSchool, for example, had utilized demonstration troops since 1921.136The 1st Medical Regiment was assigned to Carlisle Barracks as a demonstrationunit until 1940, when it was replaced by the 32d Medical Battalion. Thebattalion was used to demonstrate the operation of medical field installationsand the employment of specialized equipment used in emergency medical treatmentand field sanitation.137
In highly technical courses, lectures and conferences were used in conjunctionwith practical exercises; such as, working in laboratories, participatingin hospital rounds, and assisting in operations. In neurosurgery, for example,academic reviews of the anatomy of the nervous system were followed byneurological examination of patients. In thoracic surgery, lectures anddemonstrations on the fundamentals of surgery were balanced by experiencein assisting at operations and anatomical dissections of the thorax. Insurgery of the extremities, cadaver surgery was practiced, with specialemphasis on the surgical approaches to the treatment of fractures. Thecourse in anesthesiology consisted almost entirely of applied work138
The courses at the Medical Supply Services School, although differentin content, were conducted along similar lines. In the Officers' SupplyDivision, lectures and conferences on Medical Department supply functionswere followed by practical exercises on the methods of handling supplies.Instruction in the Maintenance and Repair Division of the school consistedlargely of on-the-job experience with X-ray equipment, sterilizers, gasanesthesia apparatus, oxygen therapy appliances, and other technical equipment.In the Optical Division, courses were essentially designed to provide experiencein the operation of optical repair equipment.139
In sum, courses for Medical Department officers were designed to providethem with skills that had immediate application in the operation of fieldmedical
136See footnote 22 (7), p. 45.
137Hume, E. E.: Training of Medical Officers for War Duty. WarMed. 1: 642-643, September 1941.
138Memorandum, Lt. Col. Sanford V. Larkey, MC, Chief, SchoolBranch, Training Division, Office of The Surgeon General, U.S. Army, toCol. Frank B. Wakeman, MC, Director, Training Division, Office of The SurgeonGeneral, U.S. Army, 12 Mar. 1943, subject: Report of Inspection of TrainingCourses for Medical Department Officers at Civilian Institutions.
139See footnote 26 (2), p. 48.
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installations. Courses stressed application, rather than theory, andwere designed to provide a maximum of practical work.140
Training aids.-Training aids played a major role in convertingtheory into applicable knowledge. Items classified as training aids rangedfrom pictures, films, and demonstration units to areas set aside for demonstratingfield sanitary equipment, and infiltration courses. Drill fields, obstaclecourses, and bivouac areas fell into this category, as well as rubber moulagesof wounds, scale model compasses, and other devices used to provide visualassistance.141
In military courses, audiovisual aids were used extensively. These includedWar Department filmstrips, film bulletins, and training films. Most serviceschools operated auxiliary film libraries, to make them continuously available.142Charts, diagrams, and posters were prepared for use in lectures and conferences.Some, such as graphic portfolios on first aid and map reading, were preparedat higher echelons for distribution to all schools. Others were preparedat the schools for use in specific lessons. The Medical Field Service Schoolmaintained an art department, and the operations officer was made responsiblefor scheduling the use of aids, for having aids on display, and for trainingand supplying projectionists.143 Field manuals, training manuals,and other War Department publications were used almost exclusively as textsin military subjects.
Since technical courses covered a broad range of subjects, the trainingaids and equipment used in each course were different. Just as sanitaryareas and obstacle courses were considered training aids in military courses,the laboratories, operating rooms, and medical and surgical wards usedto enhance training were considered training aids for technical courses.The same definition was frequently applied to cadavers used in surgicalcourses, and patients treated in medical courses. In the Maintenance andRepair Course at the Medical Supply Services School, the equipment usedand items repaired fell into the same category. Visual aids used in technicalcourses included anatomical charts and diagrams and pictures projectedon photographic screens.144
Standard medical textbooks were assigned in most technical courses,but in a few a combination of War Department publications and special textswas used. The Maintenance and Repair Division and the Optical Divisionof the Medical Supply Services School used special texts prepared by theinstructors in these divisions to supplement material in War Departmentpublications. The special textbook issued for the Maintenance and RepairCourse was issued in three volumes totaling 2,200 pages, and the textbookfor the Optical Course was a volume of approximately 300 pages.145These special textbooks were used for enlisted men, as well as forofficers, and were similar to those prepared in schools for enlisted technicians.
Tests and critiques.-Written examinations were used as measuresof student achievement, as instructional devices, and as a means of checkingthe effec-
140See footnote 138, p. 92.
141See footnote 22 (8), p. 45.
142See footnote 26 (2), p. 48.
143See footnote 10, p. 39.
144See footnote 138, p. 92.
145See footnote 26 (2), p. 48.
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tiveness of instruction. At most schools, the construction of testswas a departmental responsibility. At the Medical Field Service School,test questions, prepared by the instructors who presented the materialin a given class, were submitted to department directors for approval ormodification before being incorporated into an examination. Schools reliedalmost exclusively on objective examinations, consisting of true-false,multiple choice, and completion questions. The same tests were often usedfor succeeding classes and, therefore, were not returned to the studentfor study and analysis. Instead, tests were reviewed in class, and doubtfulpoints were clarified. Students who failed were scheduled for conferenceson their individual problems. When an unusually high number of studentsfailed, the test was reevaluated.
Supervision and inspection of instruction.-To insure a continuingquality of instruction, department heads or officers corresponding to departmentheads were charged with responsibility for supervising the performanceof instructors on their staff.146 The most widely used techniqueof supervision and evaluation was a personal visit to the classroom. Therewas no set schedule for observing instructors, and periodic reports werenot required on instructors doing satisfactory work. New instructors werefrequently visited, and reports on those whose performance was inadequatewere forwarded to the assistant commandant of the school. When necessary,instructors were relieved. From time to time, officers senior to the departmenthead visited classes to check on his evaluations.
Representatives of higher echelons periodically inspected special serviceschools and civilian schools employed by the Medical Department. Inspectionreports included comments on the school's facilities, teaching staff, methodsof instruction, training aids, and trainees, and enabled higher echelonsto compare schools and maintain an Army-wide standard of training.147
Trainee Quality
Schools conducting courses for medical, dental, and veterinary officershad the good fortune of receiving trainees of consistently high quality.While marked differences in background and ability existed between trainees,all were graduates of approved professional colleges. Schools for suchofficers had to cope with few of the problems confronting training centersestablished for other categories of personnel.
Among medical, dental, and veterinary officers, attrition rates werelow. Samples taken during the first 2 years of the war revealed a grossattrition rate of 5.6 percent in professional courses and 4.9 percent inmilitary courses. Studies of these rates are incomplete, but availabledata indicate that at least half of the trainees who failed in technicalcourses, and approximately 25 percent of those who failed military courses,failed because they were recalled to their units before they could completeenough work to be credited with passing the course.
146See footnote 10, p. 39.
147Army Service Forces Manual M 4, Military Training, 20 Sept.1944.
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In most other instances, age and inadequate background seem to accountfor failure. A study conducted in the Tropical Medicine Course revealedthat students over 40 years of age, who represented only 14 percent ofthe trainees enrolled, accounted for 64 percent of the failures in thecourse. Older students, long removed from intensive study, seemed to havefound it more difficult to assimilate the material presented in acceleratedprograms. A second study of this program uncovered a high incidence offailures among graduates of less prestigious medical schools.148Graduates of these schools frequently lacked skill in laboratory techniquesand the background to absorb highly technical subjects. Studies of failuresin military courses are less complete and do not isolate groups with ahigh incidence of failure.
Although the principles of medicine and surgery are the same in militaryand civilian life, the conditions under which they are practiced are radicallydifferent. The military physician and surgeon must be able to deal withmass casualties, often under combat conditions. To perform on the fieldof battle, the surgeon requires an understanding of evacuation procedures,the medical equipment and treatment available at each stage in the chainof evacuation, and the limitations of field medicine and surgery. He mustalso understand the relationship of field medical service to the combatarm it serves, the tactical employment of medical units, and the principlesof medical supply. Administrative and tactical courses conducted at theMedical Field Service School, and other service schools, were designedto provide the Army physician with the basic knowledge required for fieldservice. Other more technical courses were designed to provide him withthe skills needed to engage in restorative treatment of battle casualtiesin rear echelons, or to combat the diseases which have traditionally ravagedarmies in garrison and in the field.
Three facts testify to the caliber of service provided by the MedicalDepartment in World War II: The recovery of 97 percent of all hospitalizedbattle casualties, the control of a number of diseases which had causedhigh rates of noneffectiveness in past wars, and the absence of major epidemics.149
An important factor in the improvement of surgical care was the developmentof new facilities and procedures for evacuation of casualties, and a knowledgeof how to use them. Similarly, improved approaches to the treatment ofneuropsychiatric breakdowns and increased attention to reconditioning casualtiesreturned many men to duty who would have been lost to the Army in earlierwars. Improved immunizing agents, and techniques for controlling disease-bearinginsects, were applied with marked effect against such diseases as denguefever, typhus, typhoid fever, and malaria. These successes cannot be attributedsolely to training; advances in medical science and education played amajor role. But it was training in military procedures that allowed membersof the Medical, Dental, Veterinary, and Sanitary Corps to apply their knowledgeto military problems.
148See footnote 10, p. 39.
149Medical Department, United States Army. Surgery in WorldWar II. Thoracic Surgery. Volume I. Washington: U.S. Government PrintingOffice, 1963.
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