History

CHAPTER XII

Rank, Promotion, and Pay

The Surgeon General was keenly aware of the morale factorsinvolved in problems of rank, promotion, and pay. He understood, also, that insuch matters he could not hope to win the approval of everybody in the MedicalDepartment. Policies concerning rank and promotion necessarily varied somewhatfrom corps to corps. The way in which these policies were applied or took effectmight also vary to a certain extent from one command to another. Personnel inoversea areas, for example, did not always fare the same in matters of promotionas did their opposite numbers in the Zone of Interior. Pay increased with lengthof service, and extra compensation came to be given for service overseas. Butfor the most part, pay followed rank, and promotion therefore was of vitalinterest to Army personnel not only because of the added prestige but because ofthe higher pay that went with it.

ZONE OF INTERIOR

Emergency Period

Officers

In the early part of the emergency period, whenselective service had not yet been introduced, and even reservists could not becompelled to accept active duty, many physicians resigned from the Reserve, thereason given being the disparity between civilian income and Army pay. It mustbe assumed, too, that some resigned for other reasons, notably an unwillingnessto accept active duty, but gave the insufficiency of pay and allowances as anexcuse. Whatever their real reasons, in the year ending on 30 June 1941, 1,937Medical Corps Reserve officers resigned.¹ Noraise in base pay was granted until 1942, and even then only second lieutenantsand enlisted personnel received an increase. Since doctors entered the Army asfirst lieutenants or higher, the increase did not affect them.

The commissioning of men in the Reserve directly fromcivilian life in the same grade or even higher than that held by members who hadbelonged to the Reserve for a period of time did not sit very well with theReserve officers, particularly those on active duty. Men had spent time andeffort in the Reserve during peacetime expecting that in an emergency or warthey would receive higher recognition than those who were newcomers. The Gen-

¹Annual Report of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1941.

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eral Staff resisted any change in the existing system on theground that it was protecting the interest of reservists. The MedicalDepartment, therefore, had to point out that there was then a need for moreprofessional specialists than were available from the Reserve or National Guardand as most of those in civilian life had advanced themselves professionally bypostgraduate study, in order to obtain their services, it was necessary to offerthe inducement of higher rank. The General Staff acquiesced in this lineof reasoning so far as to permit a certain number of appointments of the kinddesired, but it was not until after Pearl Harbor that a sizable group ofcivilians was brought in with advanced rank.²That these new men were specialists (most of them members of affiliatedunits) did not lessen the dissatisfaction of other reservists.³

It would also appear that promotions came more readily toNational Guard officers in Federal service than to medical officers in theRegular Army. Objections to this policy were expressed by Reserve officers, whowere being called to active duty without a comparable promotion policy.

Meanwhile, a promotion had been authorized in 1940 forReserve officers who had been on active duty for a year, but only the relativelysmall number who had been placed on active duty in 1939 were affected. In August1941, the Secretary of War listed certain temporary promotions, but again, aswith the promotion of 1940, relatively few benefited from this action. Theauthority covered Reserve officers with at least a year`s service ending notlater than 1 August 1941, and on the date nearest the beginning of that periodfor which figures are available (30 August 1940), only 646 Reserve officers ofthe Medical Department were either on active duty or had had orders requestedfor them by The Surgeon General. Of these, 450 were in the Medical, 121 in theDental, 52 in the Veterinary, 17 in the Medical Administrative, and 6 in theSanitary Corps. By 30 June 1941, however, a month before the authority becameeffective, 11,477 were on active duty,⁴ andundoubtedly, the number was larger by 1 August 1941.

After careful consideration, the Secretary of War on 26December 1941 directed The Surgeon General to submit a list of not to exceed 360captains and 1,620 first lieutenants of the Medical Corps, without regard tocomponent, whom The Surgeon General recommended for a temporary, one-gradepromotion.⁵ On this basis, TheSurgeon General recommended and the General Staff approved the promotion of 351captains and 1,277 first lieutenants.⁶

²(1) Committee to Study the Medical Department, 1942. (2) Letter, The Surgeon General, to The Adjutant General, 24 Aug. 1940, subject: Appointment in Medical Department Reserve, with 1st endorsement thereto, 9 Sept. 1940.
³Letter, Lt. Col. Laurence Mickel, to Executive Officer, Ohio Military Area, 25 Mar. 1941, subject: Medical Reserve Officers.
⁴See footnote 1, p. 451.
⁵Disposition Slip, G-1, to The Surgeon General, 26 Dec. 1941, subject: Promotion of Captains and First Lieutenants of Medical Corps.
⁶Memorandum, Lt. Col. Paul A. Paden, Military Personnel Division, Office of The Surgeon General, for Col. A. G. Love, Director, Historical Division, Office of The Surgeon General, 14 Mar. 1944.

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Since by that time new regulations had been issued,conferring on local commanders the right to promote, The Surgeon Generalsuggested that these authorities handle further promotions.

The Surgeon General had not recommended, nor did theSecretary of War grant, the authority to promote officers other than those ofthe Medical Corps. The advent of war somewhat dulled the edge of the question,but the War Department`s new policies after Pearl Harbor did not change thefeeling of many physicians, that they were not receiving their due.Nevertheless, this action began a process of removing restrictions on promotionthat had had the effect of lowering morale among Medical Corps officers.

Nurses

During the emergency period, Army pay was no greaterinducement for Reserve nurses to go on active duty than it was for many doctors.At this time, those in the grade of "nurse," which included thegreat majority of reservists, were paid only $840 a year plus maintenance.Although nurses who had served 3 or more years on active duty received more, fewof those brought on duty beginning in 1940 could have qualified for the higherrates, as there had been little or no opportunity for active duty in thepreceding years. The low pay of nurses was emphasized by a War Department planto use male nurses with noncommissioned rank in theater of operations hospitalsduring wartime. These men were to be paid substantially more than female nurseswere receiving in 1941. The Surgeon General called attention to this inequality,even though no action on the plan was taken.⁷

On 13 June 1941, in answer to a letter of complaint from anurse on active duty, The Surgeon General stated that he had recommended to theWar Department an increase in nurses` pay "on several occasions."⁸The following day, he repeated the recommendation.⁹A representative of the Surgeon General`s Office reported that in manyArmy hospitals "third-rate civilian ward employees" were receiving $85a month as against the Army nurse`s $70.¹⁰The Superintendent of the Army Nurse Corps believed that personnel requirementscould not be met without an increase in pay.¹¹But efforts to secure an increase did not succeed until June 1942 when Congressapproved an upward revision for all members of the Armed Forces.¹²

⁷Letter, The Surgeon General, to Hon. Charles A. Clason, U.S. House of Representatives (Mass.), 23 June 1941.
⁸Letter, The Surgeon General, to 2d Lt. Birdie B. Daigle, ANC, 13 June 1941.
⁹Memorandum, The Surgeon General, for The Adjutant General, 14 June 1941.
¹⁰Report, Perrin Long, M.D., of Visit to Station Hospital No. 3, Fort Bragg, N.C., 30 Aug. 1941.
¹¹Memorandum, Maj. Julia O. Flikke, Superintendent, Army Nurse Corps, for The Surgeon General, 2 Dec. 1941. Cited by Blanchfield, Florence A., and Standlee, Mary W.: Organized Nursing and the Army in Three Wars. [Official record.]
¹²56 Stat. 359.

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Early War Years, 1941-43

Officers

The outbreak of war brought with it a need for temporarypromotions in the Army of the United States for all officers, medical andotherwise. Hence, an Army regulation, dated 1 January 1942, one of the basicorders affecting promotion that were issued during the war, suspended mostpeacetime promotion regulations; advancement was thereafter based on (1)completion of a minimum of 6 months in grade except for second lieutenants, whocould be promoted sooner; (2) recommendations from superiors, attesting to theofficer`s qualifications; and (3) existence of a vacancy in the desired grade.The regulation stipulated that "normally" no officer except a secondlieutenant would be recommended for promotion until he had been assigned to aposition calling for the higher grade and had actually performed the duties ofthe higher grade for a period of at least 6 months. This regulation, applying toofficers of the Army of the United States, governed temporary promotions only;Regular Army Medical Department officers continued throughout the war to receivetheir permanent promotions in the Regular Army under conditions laid down inpeacetime. As promotion in the Army of the United States was more rapid than inits Regular component, the vast majority of Regular officers held two differentgrades throughout the war and for some time afterward-a temporary one in theArmy of the United States (the higher one) and a permanent one in the RegularArmy. They wore the insignia, had the command powers and duties, and drew thepay of the higher grade. National Guard and Reserve officers did not receivepermanent promotions in those components during the war.

This January 1942 regulation gave the power to recommendpromotions for personnel under their command to the commanding generals ofarmies, defense commands, corps areas, chiefs of services, and similar majorelements of the Army. The Surgeon General thereby lost the power to controlpromotions of all Medical Department officers except those (relatively few) whowere serving in one of the installations under his command.¹³At that time, these included the named general hospitals, the Army MedicalCenter, the Medical Field Service School, and medical replacement trainingcenters. He later lost command of the medical replacement training centers andthe general hospitals, except Walter Reed, which was part of the Army MedicalCenter. This order was one of the first if not the very first of many thatdecentralized the control of personnel, taking much of it from The SurgeonGeneral and giving it to the corps area, army, and defense command commanders.¹⁴

¹³A similar measure affecting the promotion of enlisted men deprived The Surgeon General of all power to make such promotions, vesting it in local medical authorities (War Department Circular No. 17, 22 Jan. 1942). A year earlier, his power in that respect had already been limited to promotions in the two highest noncommissioned grades (War Department Circular No. 5, 7 Jan. 1941).
¹⁴(1) War Department Circular No. 1, 1942. (2) See footnote 6, p. 452.

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Meanwhile, in July 1942, Congress raised the limit of rank inthe Medical Administrative Corps from that of captain to temporary ranks as highas colonel.¹⁵ During the war, at least oneofficer of this corps-Edward Reynolds, chief of The Surgeon General`s SupplyService-was appointed a brigadier general. Before the law was passed, a fewMedical Administrative Corps officers had received temporary promotions to thegrade of major, although they were not permitted to draw a major`s pay untilthe passage of the act, which made this pay retroactive to 9 September 1940.

In March 1943, at the suggestion of The Surgeon General, theDeputy Chief of Staff issued an order revising the tables of organization whichincreased the possibility of promoting members of the Medical and Dental Corpsfrom first lieutenant to captain.¹⁶ Thisprovided an opportunity to promote approximately 8,082 medical and dentallieutenants then authorized; the troop basis for the remainder of 1943 calledfor an additional 4,065 first lieutenant positions in the two corps which werethereupon changed to captain or first lieutenant positions. The Surgeon Generalmeanwhile had proposed extending the policy to all medical units anddetachments. At the same time, he recommended that all first lieutenants of theMedical and Dental Corps be promoted to the rank of captain upon the completionof 6 months` satisfactory service. The Army Service Forces, without rejectingthese ideas entirely, postponed consideration of them until promotions had beenmade under the policy already adopted.¹⁷

An extension of this policy to all table-of-allotment units¹⁸took place 2 months later (July 1943).¹⁹First lieutenants of the Veterinary Corps in table-of-organization units orin table-of-allotment or manning-table organizations were given the sameopportunity for promotion later in the war.²⁰

The effect of this new policy on table-of-organization unitswas immediate, but some difficulty seems to have been encountered ininstallations working under manning tables or tables of allotment since servicecommands were restricted to certain numbers of officers in each grade, and theyhesitated to advance Medical Department officers when such action would preventpromotions desired for qualified officers of other branches of service.²¹

The new policy gave members of the Medical and Dental (andlater the Veterinary) Corps a better chance of promotion to the grade of captainthan

¹⁵56 Stat. 663.
¹⁶Memorandum, Deputy Chief of Staff, for Commanding General, Services of Supply, 10 Mar. 1943, subject: Availability of Physicians.
¹⁷(1) Memorandum, The Surgeon General, for General Somervell, 22 Apr. 1943. (2) Memorandum, Army Service Forces, for The Surgeon General, 10 May 1943, subject: Promotion for Medical Corps and Dental Corps Officers.
¹⁸Since all or nearly all units and activities were operating under either a table of organization, a table of allotment, or a manning table, these two orders made all but a negligible percentage of Medical and Dental Corps lieutenants eligible for promotion.
¹⁹War Department Circular No. 169, 24 July 1943.
²⁰Army Regulations No. 605-12, 3 Feb. 1944.
²¹Medical Department, United States Army. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955.

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that possessed by officers of other corps. But officers inthe grade of captain or higher in many table-of-organization units still foundthemselves blocked from promotion. Whenever the table of organization was filledand all officers had the maximum grade allowed by it, there could be no furtherpromotion without transfer to a new unit in which an opportunity for promotionexisted. Transfer could and did solve the problem for some officers. Forexample, the Chief of Personnel in the Surgeon General`s Office was able toarrange a number of promotions for Medical Corps officers, particularly in thegrades of lieutenant colonel and colonel by permitting the Surgeon, Army GroundForces, to suggest commanding officers for new units being activated. Byselecting competent and deserving officers whose rank was lower than that calledfor by the new position, a promotion could be effected. Thus, many able men whocame to the Army Ground Forces as division surgeons and organic medicalbattalion commanders, and were frozen in the grade of lieutenant colonel inconsequence, achieved their colonelcies by being named hospital commanders.

Aside from inequalities in the promotion policy so far as itaffected individuals, there was a lack of uniformity, if not of equity, in thedistribution of rank among the several Medical Department corps (table 61).

The percentage distribution of field grades in the Medicaland Veterinary Corps differed markedly from that in the Dental Corps. In each ofthese three grades (colonel, lieutenant colonel, and major), the Medical andVeterinary Corps had a much higher percentage of officers than the Dental Corps.Possibly, the high percentage of Veterinary Corps officers in field grades isaccounted for by their holding a staff position in numerous headquarters. Ateach headquarters, as one might expect, a Medical Corps officer served as thesenior Medical Department representative in that headquarters. Commanders ofmost Medical Department units and installations were also Medical Corpsofficers.

The distribution of general officers in the expanding MedicalDepartment was also heavily weighted in favor of the Medical Corps. As of 30June 1942, The Surgeon General was the only major general in the Department, andthe three brigadier generals included the chiefs of the Dental and VeterinaryCorps. A year later, there was still only 1 major general, and only the 2nonmedical brigadier generals, but the number of Medical Corps brigadiers hadjumped from 1 to 33. The chief of the Dental Corps won an additional star inSeptember 1943, but by 30 June 1944, there were eight additional Medical Corpsmajor generals and three more brigadier generals, including in the lattercategory an Assistant Surgeon General of the U.S. Public Health Service. Therewere thus altogether 47 general officers in the Medical Department as of 30 June1944, an increase of 43, or more than 1,000 percent in 2 years.²²

²²(1) Annual Report, Commissioned and Enlisted Division, Personnel Service, Office of The Surgeon General, U.S. Army, 1942. (2) Annual Report, Military Personnel Division, Personnel Service, Office of The Surgeon General, U.S. Army, 1944.

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TABLE 61.-Rank of Medical Departmentofficers, 1939-45¹

Date	Colonel		Lieutenant colonel		Major		Captain		First lieutenant		Second lieutenant
Date	Number	Percentage of component	Number	Percentage of component	Number	Percentage of component	Number	Percentage of component	Number	Percentage of component	Number	Percentage of component
30 June 1939²
Total Army:
Male	793	6.12	1,605	12.38	2,858	22.04	4,094	31.57	2,146	16.55	1,471	11.34
Female	---	---	---	---	---	---	---	---	---	---	---	---
Medical Department:
Male	126	8.38	556	36.97	91	6.05	502	33.38	205	13.63	24	1.60
Medical Corps	109	9.96	384	35.10	68	6.22	402	36.75	131	11.97	---	---
Dental Corps	13	5.91	99	45.00	14	6.36	42	19.09	52	23.64	---	---
Veterinary Corps	4	3.17	73	57.94	9	7.14	35	27.78	5	3.97	---	---
Medical Administrative Corps	---	---	---	---	---	---	23	35.94	17	26.56	24	37.50
Female	---	---	---	---	---	---	---	---	---	---	---	---
Army Nurse Corps	---	---	---	---	---	---	---	---	---	---	---	---
30 November 1941³
Total Army:
Male	2,380	1.98	5,712	4.75	9,680	8.04	21,194	17.61	40,033	33.26	41,373	34.37
Female	---	---	---	---	1	.01	35	.50	365	5.18	6,642	94.31
Medical Department:
Male	234	1.41	712	4.29	1,214	7.31	4,341	26.14	9,611	57.87	495	2.98
Medical Corps	183	1.62	536	4.73	897	7.92	2,910	25.69	6,801	60.04	---	---
Dental Corps	30	.97	106	3.42	226	7.29	872	28.12	1,867	60.21	---	---
Veterinary Corps	20	2.89	62	8.95	52	7.50	153	22.08	406	58.59	---	---
Sanitary Corps	1	.44	8	3.54	21	9.29	70	30.97	126	55.75	---	---
Medical Administrative Corps	---	---	---	---	18	1.43	336	26.67	411	32.62	495	39.29
Female	---	---	---	---	1	.01	35	.50	365	5.18	6,642	94.31
Army Nurse Corps	---	---	---	---	1	.01	35	.50	365	5.18	6,642	94.31
28 February 1943
Total Army:
Male	6,553	1.55	13,895	3.29	31,628	7.49	78,629	18.62	117,068	27.73	174,417	41.31
Female⁴	2	.007	1	.004	9	.03	182	.64	1,528	5.35	26,833	93.97
Medical Department:
Male	765	1.38	1,803	3.24	6,796	12.22	18,059	32.48	22,765	40.95	5,408	9.73
Medical Corps	603	1.73	1,459	4.18	5,325	15.27	13,903	39.87	13,557	38.94	---	---
Dental Corps	112	1.14	234	2.39	920	9.40	2,442	24.94	6,082	62.12	---	---
Veterinary Corps	48	3.27	59	4.02	223	15.18	414	28.18	725	49.35	---	---
Sanitary Corps	2	.17	26	2.20	116	9.82	357	30.23	680	57.58	---	---
Medical Administrative Corps	0	0	25	.30	212	2.56	943	11.38	1,701	20.52	5,408	65.24
Female	1	.004	1	.004	9	.035	90	.35	1,048	4.02	24,905	95.59
Army Nurse Corps⁴	1	.004	1	.004	7	.027	90	.35	1,048	4.13	24,250	95.48
Physical Therapists⁴	0	0	0	0	1	.48	0	0	0	0	208	99.52
Hospital Dietitians⁴	0	0	0	0	1	.22	0	0	0	0	447	99.78
30 September 1943
Total Army:
Male	7,681	1.31	17,569	3.00	42,086	7.20	110,925	18.97	161,625	27.64	244,784	41.87
Female	2	.005	18	.047	75	.2	567	1.48	2,734	7.12	34,997	91.15
Medical Department:
Male	900	1.28	2,374	3.38	8,648	12.30	26,785	38.09	23,268	33.09	8,350	11.87
Medical Corps	734	1.84	1,967	4.94	6,811	17.11	19,171	48.15	11,130	27.96	---	---
Dental Corps	102	.78	262	2.00	1,049	8.02	4,910	37.56	6,750	51.63	---	---
Veterinary Corps	59	3.18	66	3.56	288	15.53	566	30.53	875	47.20	---	---
Sanitary Corps	4	.20	37	1.84	163	8.09	657	32.62	794	39.42	359	17.82
Pharmacy Corps	1	2.94	12	35.29	18	52.94	3	8.82	---	---	---	---
Medical Administrative Corps	---	---	30	.22	319	2.36	1,478	10.92	3,719	27.47	7,991	59.03
Female	1	.003	18	05	48	.14	202	.58	1,736	4.95	33,069	94.28
Army Nurse Corps⁵	1	.003	18	.05	46	.14	195	.58	1,551	4.59	31,945	94.64
Physical Therapists⁶	---	---	---	---	1	.23	4	.92	73	16.74	358	82.11
Hospital Dietitians⁶	---	---	---	---	1	.11	3	.34	112	12.70	766	86.85
31 December 1943
Total Army:
Male	7,861	1.27	19,076	3.08	46,752	7.54	124,963	20.16	175,069	28.24	246,148	39.71
Female	2	.005	22	.05	101	.23	712	1.65	3,670	8.52	38,555	89.53
Medical Department:
Male	951	1.30	2,566	3.50	9,511	12.98	30,842	42.08	21,076	28.76	8,340	11.38
Medical Corps	770	1.91	2,129	5.28	7,405	18.38	21,310	52.90	8,673	21.53	---	---
Dental Corps	113	.80	290	2.06	1,215	8.63	6,338	45.03	6,118	43.47	---	---
Veterinary Corps	61	3.15	61	3.15	305	15.77	652	33.71	855	44.21	---	---
Sanitary Corps	5	.23	38	1.73	191	8.70	763	34.76	738	33.62	460	20.96
Pharmacy Corps	2	3.08	21	32.31	33	50.77	4	6.15	2	3.08	3	4.62
Medical Administrative Corps	---	---	27	.18	362	2.46	1,775	12.05	4,690	31.84	7,877	53.47
Female	1	.003	22	.06	56	.15	222	.60	2,320	6.24	34,585	92.96
Army Nurse Corps	1	.003	22	.06	54	.15	215	.60	2,056	5.76	33,363	93.42
Physical Therapists	---	---	---	---	1	.20	4	.80	109	21.80	386	77.20
Hospital Dietitians	---	---	---	---	1	.10	3	.30	155	15.58	836	84.02
31 May 1944
Total Army:
Male	8,405	1.25	21,952	3.26	54,273	8.06	147,925	21.97	193,529	28.74	247,368	36.73
Female	2	.004	46	.10	176	.37	1,223	2.59	7,499	15.88	38,286	81.06
Medical Department:
Male	1,066	1.37	3,188	4.09	10,938	14.02	36,814	47.18	18,958	24.30	7,041	9.03
Medical Corps	876	2.01	2,673	6.12	8,609	19.70	24,270	55.55	7,262	16.62	---	---
Dental Corps	114	.76	346	2.31	1,305	8.72	8,479	56.64	4,727	31.57	---	---
Veterinary Corps	66	3.31	69	3.46	333	16.71	786	39.44	739	37.08	---	---
Sanitary Corps	7	.31	45	1.97	212	9.27	879	38.42	643	28.10	502	21.94
Pharmacy Corps	2	3.77	19	35.85	28	52.83	3	5.66	---	---	1	1.89
Medical Administrative Corps	1	.01	36	.24	451	3.00	2,397	15.97	5,587	37.22	6,538	43.56
Female	1	.003	38	.09	117	.28	607	1.47	5,573	13.47	35,045	84.69
Army Nurse Corps	1	.003	38	.10	115	.29	596	1.51	5,133	12.98	33,659	85.12
Physical Therapists	---	---	---	---	1	.16	5	.78	171	26.64	465	72.43
Hospital Dietitians	---	---	---	---	1	.08	6	.50	269	22.47	921	76.93
31 December 1944
Total Army:
Male	9,690	1.32	25,534	3.47	63,947	8.69	174,327	23.69	238,172	32.37	224,158	30.46
Female	2	.003	68	.13	281	.56	1,899	3.76	13,128	25.97	35,178	69.58
Medical Department:
Male	1,224	1.47	3,647	4.37	12,209	14.64	40,924	49.06	18,633	22.34	6,781	8.13
Medical Corps	1,017	2.18	3,058	6.54	9,501	20.32	25,703	54.98	7,468	15.98	---	---
Dental Corps	124	.82	372	2.46	1,439	9.52	9,815	64.96	3,360	22.24	---	---
Veterinary Corps	73	3.58	73	3.58	355	17.42	1,018	49.95	519	25.47	---	---
Sanitary Corps	5	.21	43	1.80	198	8.30	919	38.52	591	24.77	630	26.40
Pharmacy Corps	2	3.03	22	33.33	26	39.40	4	6.06	2	3.03	10	15.15
Medical Administrative Corps	3	.02	79	.46	690	4.04	3,465	20.30	6,693	39.21	6,141	35.97
Female	1	.002	58	.13	168	.38	1,045	2.34	10,449	23.49	32,928	73.67
Army Nurse Corps	1	.002	58	.14	166	.39	1,014	2.40	9,871	23.37	31,138	73.70
Physical Therapists	---	---	---	---	1	.10	11	1.11	245	24.75	733	74.04
Hospital Dietitians	---	---	---	---	1	.07	20	1.37	383	26.21	1,057	72.35
31 August 1945
Total Army:
Male	11,027	1.42	29,356	3.79	70,958	9.16	197,495	25.49	305,989	39.49	159,958	20.64
Female	3	.005	116	.18	463	.73	2,933	4.63	33,884	53.46	25,980	40.99
Medical Department:
Male	1,404	1.62	4,256	4.90	13,818	15.92	43,483	50.09	18,002	20.74	5,842	6.73
Medical Corps	1,186	2.48	3,547	7.41	10,662	22.21	26,597	55.60	5,882	12.30	---	---
Dental Corps	131	.91	426	2.97	1,618	11.26	10,167	70.75	2,028	14.11	---	---
Veterinary Corps	69	3.26	84	3.97	397	18.76	1,169	55.25	397	18.76	---	---
Sanitary Corps	9	.37	52	2.12	269	10.95	1,010	41.12	708	28.83	408	16.61
Pharmacy Corps	4	5.88	22	32.35	24	35.30	4	5.88	3	4.41	11	16.18
Medical Administrative Corps	5	.02	125	.63	888	4.45	4,536	22.72	8,984	45.01	5,423	27.17
Female	1	.002	96	.17	301	.52	1,803	3.13	30,175	52.36	25,251	43.82
Army Nurse Corps	1	.002	96	.18	299	.55	1,704	3.11	28,695	52.38	23,984	43.78
Physical Therapists	---	---	---	---	1	.08	41	3.23	550	43.38	676	53.31
Hospital Dietitians	---	---	---	---	1	.06	58	3.67	930	58.86	591	37.41

¹Unless otherwise specified, basic data are fromissues of "Strength of the Army" corresponding to the dates shown.Percentage distributions by rank therefore are based on The Adjutant General`sfigures rather than those of The Surgeon General (table 1). In accordance withthe principles governing the preparation of these tables, general officers arenot covered by any of the figures presented here. Figures for male officersinclude the female members of the Medical Corps, whose distribution by rank was:

Date	Colonel		Lieutenant colonel		Major		Captain		First lieutenant
Date	Number of women	Percent of doctors	Number of women	Percent of doctors	Number of women	Percent of doctors	Number of women	Percent of doctors	Number of women	Percent of doctors
31 December 1943	0	0	0	0	3	7.14	18	42.86	21	50.00
31 May 1944	0	0	0	0	3	5.88	26	50.98	22	43.14
31 December 1944	0	0	0	0	5	6.67	38	50.67	32	42.67
31 August 1945	0	0	1	1.39	4	5.56	51	70.83	16	22.22

²Basic data on Medical Department ranks from AnnualReport of The Surgeon General, U.S. Army, 1939. Basic data on rank of maleofficers in general are from Annual Report of the Secretary of War, 1939. OnlyRegular Army personnel are covered in either figure.
³Approximate date. Basic data for the entire Army and for nurses arefor 31 December 1941 and were provided by Statistics and Accounting Branch,Statistics Section, Office of The Adjutant General, on 21 February 1958. Basicdata on Medical Department male officers cover Regular Army and Reservepersonnel on active duty as of 5 December 1941 and Army of the United States andNational Guard personnel as of 1 November 1941. Memorandum, F. M. Fitts, forColonel Lull, 29 Oct. 1942, subject: Status of Medical Department Officers as of7 Dec. 1941, addendum to History of Military Personnel Division, PersonnelService, 1939-April 1944.
⁴Figures for 31 March 1943, from "Strength of the Army," 1Feb. 1947.
⁵Basic data from Annual Report, Nursing Branch, Military PersonnelDivision, Office of The Surgeon General, 1944.
⁶"Strength of the Army," 1 Feb. 1947.

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Nurses

In the Nurse Corps, the percentage of personnel in thegrade of second lieutenant was far higher than in either of the male officercorps having members in that grade-the Medical Administrative Corps and theSanitary Corps; of these three corps, the percentage was lowest in the SanitaryCorps (table 61). Up to December 1942, the grades of colonel, lieutenantcolonel, and major in the Nurse Corps were not authorized as a general rule,although exception had been made in the cases of the superintendent and herchief assistant, who had been granted the grade of colonel and lieutenantcolonel, respectively. In December 1942, Public Law 828 authorized appointmentsin the grades of lieutenant colonel and major. During the remainder of the war,however, no appreciable percentage reached a higher rank than that of captain.

After Congress had granted the dietitians and physicaltherapists relative rank (December 1942), the War Department on therecommendation of The Surgeon General established the following table of gradedistribution for each group: In addition to one major, the number of captainswas not to exceed 1 percent; the number of first lieutenants not to exceed 15percent; the remainder were to be second lieutenants.²³During therest of the war, each group possessed an actual percentage in the grade of firstlieutenant much larger than that authorized; during most of the period, thepercentage in the grade of captain was also larger (table 61).

In the early war years, Congress increased the pay of mostmembers of the Armed Forces, and male personnel of the Medical Departmentreceived the same increases, rank for rank, that were simultaneously accordedto those in other branches of the Army. In March 1942, Congress passed a lawwhich included, among other provisions, extra compensation for oversea or seaduty amounting to 10 percent of base pay for commissioned officers and 20percent for warrant officers, enlisted men, and female nurses.²⁴ Anotherlaw, enacted in June 1942, raised the pay of all enlisted men; privates, forexample, whose base pay had been increased from $21 to $30 a month by theSelective Training and Service Act of 1940,²⁵ received a further increase to$50. The base pay of warrant officers was also raised.

The new scale for commissioned officers involved partly a readjustment of base pay and partly added compensation for subsistence and rental of quarters. In the case of most Medical, Dental, and Veterinary Corps officers, the increase took the form of higher allowances for subsistence and quarters. In no case did the increase accorded Army officers amount to more than a few hundred dollars a year,²⁶ an addition which, so far as doctors in particu-

²³Letter, Col. Emma E. Vogel, USA (Ret.), to Col. C. H. Goddard, Office of The Surgeon General, 5 June 1952.
²⁴56 Stat. 143.
²⁵54 Stat. 885.
²⁶56 Stat. 359.

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lar were concerned, did little or nothing to close the gapbetween Army pay and income from civilian practice.

Members of the Army Nurse Corps, although their compensationwas gradually increased, did not achieve the full pay and allowances of Armyofficers until they attained full commissioned rank. Nevertheless, theircompensation was high enough so that the majority of nurses were not reluctantto accept it until the establishment of the more highly paid Women`sAuxiliary Army Corps in May 1942.²⁷

As nurses entered the Army or were induced by higher wages totake nonnursing jobs in industry, fewer remained in civilian practice, so thatwages rose there too (until they were frozen in 1942). A slight rise in pay forArmy nurses came from the Pay Readjustment Act of 1942, effective on 1 June1942. Nurses also received monthly quarters and subsistence allowances equal tothose of a second lieutenant, but unlike male officers, they did not receiveincreased allowances as their rank increased.²⁸ In spite ofimprovements, the pay still seemed inequitable, for the same act set enlistedmen`s pay rates at such levels that an intelligent soldier with little or nocivilian training might in the course of a year be earning as much as a nursewho had spent 3 years in nursing school.²⁹

The increase in pay did not satisfy all Army nurses orcivilian nurses who considered entering the service. To add to theirbelief that the Army was not only underpaying but actually discriminatingagainst nurses were the provisions in the act creating the Women`s AuxiliaryArmy Corps in May 1942 which fixed a generally more liberal pay scale.³⁰When questioned by members of the Committee to Study the Medical Department inthe fall of 1952, the Superintendent of Nurses answered that the nurses werenot properly paid, and mentioned the salary of the Women`s Auxiliary ArmyCorps as a "hindrance," presumably to the procurement of nurses.

The dissatisfaction of the nurses, coupled with support bytheir friends outside the corps, was partly responsible for furtherimprovements in the position of Army nurses. These³¹included a payincrease in December 1942, which gave nurses a remuneration substantially equalto that of commissioned officers.³² By its terms, nurses receivedthe same military base- and longevity-pay and allowances for subsistence,rental of quarters, mileage and other travel allowances as commissionedofficers were receiving. Subsistence and quarters allowances increasedaccording to rank, and they henceforth received only a 10-percent increase inbase pay (not 20 as previously) for oversea or sea duty, the same increase asthat given to commissioned officers. Thus, although

²⁷Memorandum, Colonel Blanchfield (Ret.), for Col. C. H.Goddard, Office of The Surgeon General, 14 July 1952, subject: Medical Department History inWorld War II.
²⁸See footnote 26, p. 462.
²⁹Memorandum, Chief, Military Personnel Division, Office ofThe Surgeon General, for Colonel Nugent, G-1, 6 Oct. 1942.
³⁰56 Stat. 278.
³¹For other concessions to the nurses at this time,see chapter VIII, pp. 247-266.
³²56 Stat. 1072.

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they held only relative rank, Army nurses had now attainedthe same pay schedule as commissioned officers, except for the allowance fordependents. They received that allowance and other privileges when in June 1944they were accorded full commissioned rank in the Army of the United States.

Dietitians and physical therapists

The act of December 1942 raising the pay of Army nurses,"militarized" two other groups of women, the hospital dietitians andthe physical therapists, giving them, along with "relative rank," thesame pay as nurses. Before they were given military status, women in these twogroups received a salary of $1,800 to $2,300 a year, while the twosuperintendents each received $3,200.³³

As before the war, the pay of civilian employees of theMedical Department conformed to the wage scales of all employees of the FederalGovernment, except that for a time certain Medical Department civilian personneldid not receive the higher pay for overtime work which, after 1940, some ofthose scales had allowed.³⁴ The reason was that, since not allclasses of civilian workers were entitled to such a rate, the commanders ofhospitals, in order to avoid a morale problem and also because only a fewmembers of their civilian staffs were entitled to it, did not request this ratefor them. In May 1943, however, Congress granted almost all Federal employeeshigher pay in lieu of specific pay for overtime work.³⁵

Later War Years, 1943-45

Officers

Inequalities (or inequities) in the system of promotion andin the distribution of rank among Medical Department officers caused concern andcriticism during the later war years. At the same time, some progress was madetoward removing the basis for complaint.

As regards promotion, there was a tendency to restrict it atthis period, both by lengthening the time an officer must spend in his currentrank and by preventing his promotion above the rank authorized for his job. TheWar Department in 1942 made officers` promotions to each grade possible after6 months had been spent in the lower grade; the only exception was in favor ofsecond lieutenants, who could be promoted in less than 6 months. Thisregulation applied throughout the Army, as did succeeding regulations during1943-46 which increased the waiting time in all grades. It will be observedthat the increases in waiting time struck the higher grades first and weregreater in them than in the lower grades. In July 1944, however, the

³³Memorandum, Maj. Helen B. Gearin, for Col. C. H.Goddard, Office of The Surgeon General, 23 June 1952, subject: Draft ofMaterial To Be Included in History of World War II.
³⁴(1) 54 Stat. 1205. (2) 55 Stat. 241.
³⁵57 Stat. 75.

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War Department granted extra credit to all officers overseas;it stipulated that for time-in-grade purposes, service outside the United Stateswould be counted as time and a half.³⁶

Working within the confines of these Army-wide policies, ArmyService Forces likewise tended to restrict promotions, particularly in thehigher grades, within its own domain. On 26 February 1944, Army Service Forcesheadquarters, under whose jurisdiction fell a large percentage of MedicalDepartment officers stationed in the United States, published Circular No. 59which showed its desire to prevent indiscriminate promotions of officers. Itstated at that time that the two principal considerations in promoting anofficer were the importance of the position and the merits of the individual.The promotion of any group or individual at a rate faster than was prevalentthroughout the Army, especially in combat units, could be justified only inthe most exceptional circumstances. Medical Department authorities believed thatexisting regulations did not give medical and dental officers enoughopportunities for promotion, and during the later war years, they succeeded inhaving special instructions issued to favor members of those corps.³⁷

In June 1945, the General Staff declared its desire andintent to be that all first lieutenants of the Medical, Dental, Veterinary (andChaplains) Corps occupying positions established for an officer of theseservices in the grade of captain or first lieutenant should be promoted tocaptain-providing, of course, that the officer was qualified for anddeserving of promotion and had served the required time in grade and position.For this purpose, the order authorized each command concerned a larger numberof captains` ratings in each of the corps just mentioned-a number equal tothe combined total of hitherto authorized captains` and first lieutenants`ratings in the corps. The order applied to ratings established both by tablesof organization and from bulk allotment sources.³⁸

Surgeon General Kirk had already complained that thepromotion of medical officers of higher as well as lower rank had not keptpace with their responsibilities, as indicated by the growing patientload. Many outstanding specialists from civilian life who were chiefs ofservices in general hospitals, he declared, were only majors or lieutenantcolonels. Many officers had been in company grade for 2 or 3 years withoutpromotion. Pointing out the amount of time that medical, dental, and veterinaryofficers had spent in getting their education, he said that many of these menafter 3 years of Army service were still in the grade of lieutenant, despitethe provisions of Army regulations. Actually, although changes in regulationshad made lieutenants

³⁶Army Regulations No. 605-12, 3 Feb. 1944, with ChangesNo. 1, 24 July 1944.
³⁷(1) Memorandum, Surgeon General Kirk, for General Styer,Army Service Forces, 24 Nov. 1943, subject: Failure to Promote 1st Lieutenants of the Medical and Dental Corps. (2) The Surgeon General`s ConferenceWith Service Command Surgeons, commencing 10 Dec. 1943. (3) Army Regulations No. 695-12, 17 Aug. 1944.
³⁸Letter, The Adjutant General, to Commanding General, ArmyService Forces, 30 June 1945, subject: Temporary Promotions in the Army of the United States of 1st Lieutenants, Medical, Dental, Veterinary, and ChaplainsCorps.

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eligible for promotion to captain, they had not made suchpromotions mandatory, and presumably not all commanding officers had recommendedtheir Medical and Dental Corps lieutenants for these promotions.³⁹

Shortly afterward, The Surgeon General initiated a move tohave the chiefs of services and sections of Zone of Interior general hospitalspromoted. Stating that these officers had a big workload and grave responsibilities,he pointed out that if the chiefs of services in hospitals having a capacity of1,500 beds or more had been so assigned in table-of-organization hospitals ofthe same size they would, without exception, have been authorized to hold therank of colonel. He showed that only 29 chiefs of medical and surgical servicesin these Zone of Interior hospitals were colonels, whereas 87 were lieutenantcolonels, and 16 were only majors. (At the end of April 1945, a few monthsbefore The Surgeon General furnished this information, only about 6 of the 65general hospitals in this country had capacities of less than 1,500 beds.)Moreover, a table showing the grade of chiefs of sections in such hospitalslisted 3 colonels, 66 lieutenant colonels, 114 majors, 35 captains, and 5 firstlieutenants. The chiefs of the larger sections, such as laboratory,neuropsychiatry, X-ray, and eye, ear, nose, and throat would rank, he asserted(presumably referring again to table-of-organization general hospitals), eitheras majors or lieutenant colonels, depending upon the workload of the hospital.Somewhat later, he submitted a list of officers who were chiefs of services inZone of Interior general hospitals and urged that they be promoted as rapidlyas possible to a grade commensurate with their professional assignments.⁴⁰

In this effort, The Surgeon General, besides invoking justicefor these highly trained officers, was endeavoring to correct a situationwhich, he stated, would inevitably result in hard feelings toward the Army inthe future on the part of individuals whose work was not rewarded. Undoubtedly,many of those concerned wielded considerable influence in the medicalprofession, and he may have feared the effects of their criticism based on theMedical Department`s failure to obtain promotions for them. The War Departmentfinally granted his request. General Kirk was then able to recommend a one-gradepromotion for many of the medical officers who were serving as chiefs ofservices and sections in Zone of Interior hospitals.⁴¹He did not securethis authorization, however, until after the end of hostilities, and by thattime,

³⁹Army Service Forces Seventh Semiannual ServiceCommand Conference, 28-30 June 1945.
⁴⁰(1) Memorandum, Surgeon General Kirk, for GeneralSomervell, Commanding General, Army Service Forces, 4 July 1945. (2)Memorandum, Chief, Personnel Service, Office of The Surgeon General, forCommanding General, Army Service Forces (attention: Director, MilitaryPersonnel Division), 10 July 1945, subject: Promotions of Chiefs of Servicesin Zone of Interior Hospitals. (3) Memorandum, Deputy Surgeon General, forDirector, Military Personnel Division, Army Service Forces, 16 Oct. 1945,subject: Promotion of Chiefs of Services in Zone of Interior GeneralHospitals.
⁴¹(1) Memorandum, Surgeon General Kirk, for G-1, 28 Feb.1946, subject: Promotion of Selected Officers. (2) Letter, Office of The Surgeon General (Col.H. W. Doan), to Commanding General, Army Service Forces (attention: Military Personnel Division), 19 Apr. 1946, subject: Promotion of Certain Medical Officers.

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undoubtedly, some of the officers for whose promotion he had workedso diligently had returned to civilian life.

In November 1945, The Surgeon General recommended that about100 specialists needed in hospitals in this country be retained on active dutyregardless of their eligibility for separation from the Army and that all ofthem who were not already colonels be given a one-grade promotion. These menwere promoted.⁴²

Nurses

Some complaints were made about the delay or lack ofpromotion not only for male Medical Department officers but also for nurses-inthe case of the latter, promotions from second to first lieutenant inparticular. Pressure originated from nurses` families, from nursing and alliedorganizations, and from the press. The critics alleged that nurses weredispirited at their own lack of promotion in comparison to the rise of at leastsome members of the Women`s Army Corps, of whom less formal training wasrequired than of nurses; that some nurses served long periods overseas in thesame grades as recent graduates or remained second lieutenants while othersat home were promoted.

Partly, no doubt, in order to placate so many critics, theMedical Department increased its exertion, in the later war years, to gethigher grades for its nurses. In November 1943, revisions of many tables oforganization for various kinds of hospitals and for certain other types ofmedical units raised the number of nurse first lieutenants in those unitswhile lowering the number of second lieutenants.⁴³ Aswith otherregulations concerning rank or promotion, this one did not make the newproportions of grades mandatory, and it is possible that for one reason oranother many of the first lieutenant vacancies created by it were filledslowly, if at all. In any case, as late as November 1944, 31,116 nurses-75percent of the total Nurse Corps strength-were still in the grade ofsecond lieutenant.⁴⁴

A move to increase the opportunity for promotion of secondlieutenants, not only of the Army Nurse Corps but of all other components of theArmy, took shape at the end of 1944. In December of that year, the WarDepartment announced that any second lieutenant who had completed 18 months ofservice in that grade might be promoted to the grade of first lieutenantwithout table-of-organization or table-of-allotment vacancies in that grade,provided he (or she) was qualified for and worthy of promotion. This authorizationwas not to be used for the automatic promotion of all second lieutenants who had served 18 months in that grade, but was reserved for those denied

⁴²(1) Information from Military Personnel Division, Officeof The Surgeon General, 17 Mar. 1947. (2) Letter, Acting Chief, Personnel Service, Office of TheSurgeon General (Col. Francis F. Mintz), to Commanding Officer, Valley ForgeGeneral Hospital, Pa., 11 Dec. 1945, subject: Promotion of Officers.
⁴³War Department Circular No. 306, 22 Nov. 1943.
⁴⁴Strength of the Army, 1 Dec. 1944. Prepared for WarDepartment General Staff by Machine Records Branch, Office of The AdjutantGeneral, under direction of Statistical Branch.

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TABLE 62.-Army Nurse Corps firstlieutenants and second lieutenants: Numbers in grade and numbers of promotions,September 1944-August 1945

Date	Second lieutenants¹	First lieutenents¹	Promotions to grade of first lieutenant²
1944
September	31,468	7,753	213
October	31,653	8,565	636
November	31,116	9,276	622
December	31,138	9,871	632
1945
January	30,810	10,790	973
February	29,601	13,752	2,350
March	30,871	16,528	3,126
April	30,870	19,490	3,670
May	29,497	22,826	3,723
June	26,013	26,330	4,369
July	25,629	28,028	1,914
August	23,984	28,695	1,388

¹"Strength of the Army"for dates approximate to those shown.
²"Strength of the Army," 1 Sept. 1945.

merited advance solely because they were not in positionsestablished for the higher grade.⁴⁵ In the Medical Department, thedirective applied to all officer components except the three which contained nosecond lieutenants-that is, the Medical, Dental, and Veterinary Corps. Itmeant ultimate promotion for large numbers of nurses, dietitians, physicaltherapists, and Medical Administrative Corps officers, and for smaller numbersof the Sanitary and Pharmacy Corps. By the early part of 1945, the change ofpolicy was beginning to stimulate the promotion of sizable numbers of Army-nursesecond lieutenants (table 62).

Dental Corps

At the urgent recommendation of the American DentalAssociation, and of the dental profession generally, The Surgeon General agreedin September 1943 to promote the chief of his Dental Division from brigadiergeneral

⁴⁵(1) Army Regulations 605-12, 17 Aug. 1944, with ChangesNo. 1, 9 Dec. 1944. The same regulations also permitted a promotionwithout regard to position vacancies for officers returned to the United States froma status of missing in action, evading capture in enemy controlled territory, internee,or prisoner of war, provided the officer`s case presented unusuallymeritorious or exceptional circumstances justifying waiver of the normalrequirements for promotion. This permitted one-grade promotion of the 66nurses, 3 dietitians, and 1 physical therapist who had been prisoners of the Japanesein the Philippine Islands and who were returned to this country in early 1945after their recovery by the forces under General MacArthur. (2) History ofNursing Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1 Jan.-31May 1945. (3) Quarterly History of Medical DepartmentDietitians, Military Personnel Division, Office of The Surgeon General, U.S.Army, 1 Mar.-3l Mar. 1945. (4) Quarterly History of Physical Therapy Branch,Military Personnel Division, Office of The Surgeon General, U.S. Army, 1Apr.-31 May 1945.

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to major general, and to consider recommending theappointment of one or more brigadier generals in the Dental Corps. Only one wasactually appointed, in February 1945; and he was reduced to the rank of colonelsome months after the end of the war. There was also some improvement in rank sofar as the mass of dental officers was concerned, as a comparison of thesituation in late 1943 with that in 1945 (table 61) will show. Nevertheless,their position continued to lag behind that of Medical Corps officers.⁴⁶

Medical Corps

In the Medical Corps, a problem of rank was sometimesinvolved when an officer had as his subordinate a man of lower rank but ofhigher proficiency rating, and therefore presumably of greater professionalability, in the specialty to which both were assigned. By virtue of his rank,the man of higher grade could give orders in technical as well asadministrative matters to his subordinate and could either accept or refuse hisadvice. In cases such as these, it would have been better from the professionalstandpoint if the positions had been reversed, but under existing Armypractices, there was no way this could be accomplished. Sometimes the purposewas achieved, however, in the case of specialists when the ranking officeraccepted his subordinate`s advice or permitted him virtually to issue theorders. If this was not done voluntarily, informal means were occasionally usedto overcome the difficulty; ranking officers were asked to accept orders andadvice from subordinates of superior competence. The Surgeon General`sMilitary Personnel Division reported at the end of the war that success hadoccurred only in cases where the ranking officers recognized that the ability ofthose under them completely surpassed their own.⁴⁷ The problem mightalso have been solved by relieving certain ranking officers from active duty,but since the procurement of medical officers was still going on, the WarDepartment did not permit such action.

Sanitary Corps

During the war, members of the sanitary engineeringprofession exerted great pressure on The Surgeon General to promote members ofthe corps to rank commensurate with their experience. In June 1943, a bill wasintroduced in Congress providing for an Assistant to The Surgeon General in theperson of a Sanitary Corps officer with the rank of brigadier general. TheSecretary of War, however, contended that such a promotion should be made onlywhen the War Department considered the duties and responsibilities of a SanitaryCorps officer justified it. He furthermore stated that permanent

⁴⁶For a detailed discussion of the reasons for thisdiscrepancy, see publication cited in footnote 21, p. 455.
⁴⁷Report, Military Personnel Division, Office of The SurgeonGeneral, to Historical Division, autumn 1945, subject: Medical DepartmentPersonnel.

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legislation affecting the peacetime Army should not beenacted in time of war.⁴⁸ The bill did not pass.

Enlisted personnel

Late in the war, the War Department took steps to promoteprivates-Medical Department as well as others-who through no fault oftheir own had not received a promotion-just as it did second lieutenants. InMay 1945, regulations provided that commanding officers who were authorizedto appoint privates, first class, might waive the requirement of an authorizedvacancy to appoint enlisted men or women to that grade if they had completed oneyear of satisfactory service or had served outside the United States (a fewexceptions were listed in the latter case). The War Departmentadmonished that this authority was not to be used for the automatic promotion ofall privates in those categories but was to be reserved for those who werequalified for promotion but were denied it because of lack of positionvacancies. At the same time, oversea commanders and the commanding generals ofthe Army Air Forces, Army Ground Forces, and Army Service Forces were authorizedto waive the requirements of an authorized vacancy to appoint to the next highergrade any persons below the grade of first or master sergeant who was returnedto U.S. military control after having evaded capture by the enemy or afterhaving been missing in action, interned, or taken prisoner. Such promotions werelimited, however, to those who presumably would have been promoted except fortheir absence from the Army.⁴⁹

PROMOTION OVERSEAS

Officers

During the early part of the war, the rank held byMedical Department officers⁵⁰ overseas was the rank they had acquiredbefore leaving the Zone of Interior. For one thing, the oversea theaters werelimited as to the number of high-ranking positions they could set up. Thetheatersthroughout the war lacked the function of supervising the worldwidemedical service

⁴⁸(1) Letter, Arthur D. Weston, Chief Sanitary Engineer,Department of Public Health, Boston, Mass., to Abel Wolman, Professor of Sanitary Engineering,The Johns Hopkins University, 22 Apr. 1943. (2) Letter, Deputy Surgeon General, to Abel Wolman, 30June 1943. (3) Letter, Secretary of War, to Robert R. Reynolds, Chairman, Committee on MilitaryAffairs, U.S. Senate, 31 May 1944.
⁴⁹Army Regulations No. 615-5, Changes No. 6, 23 May 1945.
⁵⁰In the section which follows, the term "MedicalDepartment officers," unless qualified, includes nurses. On the other hand,officers above the rank of colonel are not included in the term. Probably notmore than 20 general officers of the Medical Department were overseas at anytime. Sixteen (3 major generals and 13 brigadier generals) are listed in"The Surgeon General`s Notebook," vol. I, under date of 28 July1945.

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that characterized the Surgeon General`s Office, nor didthey have the responsibility to the same degree of definitiveness, of providingspecialized treatment, as did medical facilities in the continental UnitedStates. Both of these functions formed the basis for positions with the highestranks. Thus, it was only on rare occasions that any Medical Department corps hada percentage of its oversea strength in the rank of colonel equal to or greaterthan that which it possessed in the Zone of Interior (table 63). In the DentalCorps, this inherent advantage of the Zone of Interior extended down into ranksas low as that of major, for the concentrations of dental officers necessitated by a large amount of remedial work on new recruits was lacking inoversea areas.⁵¹

However, even had the higher positions existed, thepossibilities of promotion into them would have been few and far between in the earlier years. Promotions at the time were greatly dependent upon theexistence of vacancies. Conditions overseas, however, were not such as togive rise to a great many vacancies that could be filled by promotion. In theZone of Interior, until the middle of the war, units were constantly activatedwith personnel recently drawn from civilian life; fresh jobs werecontinuously established, and many of the new posts could be filled bypromotion. In the theaters, on the other hand, such organizations as wereactivated generally were staffed with the personnel of units that had beendisbanded or reorganized, and the total number of jobs remained substantiallyunchanged. Nor did the establishment of non-table-of-organization unitsprovide many vacancies to be filled by promotion since many casuals arrived fromthe Zone of Interior with grades appropriate to the positions which arose inthis fashion. Casuals also could be used to replace losses which, moreover,were fairly low particularly because the U.S. Forces were not yet fullycommitted to combat. Finally, transfers between units often were carried out ona grade-for-grade basis. Though promotions as a rule depended on the existenceof vacancies, a possibility of advancement also existed when a man held aposition for which the table of organization of his unit authorized a higherrank than the one he possessed. Overseas, as in the Zone of Interior, however, some commanders both in the line as well asin the MedicalDepartment, who had spent many years in the military service withoutadvancement in grade, frequently were unwilling to accord their juniors rapidpromotion.⁵²

⁵¹(1) Letter, Brig. Gen. L. H. Tingay, DC, Brooke ArmyMedical Center, to Col. C. H. Goddard, Office of The Surgeon General, 20 Sept.1952. (2) As late as 31 May 1944, no hospital dietitian or physicaltherapist was serving abroad in any grade above that of first lieutenant(table 63).
⁵²(1) Report, Maj. John B. West, 14 Apr. 1944, on MedicalDepartment Activities in Liberia. (2) King, Arthur G.: Medical History ofEspiritu Santo (New Hebrides) Service Command, pp. 55-56. [Official record.](3) Letter, Brig. Gen. Robert P. Williams, to Col. John B. Coates, Jr., MC,Director, Historical Unit, U.S. Army Medical Service, 22 Dec. 1955. (4)Information from Col. Florence A. Blanchfield, USA (Ret.), 13 Mar. 1952.

472-475

TABLE 63.-Rank of Medical Departmentofficers overseas (excluding general officers), 31 July 1941-31 May 1944¹

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It is true that Regular Army promotions continued, and it canbe assumed that in this respect the oversea areas had an advantage owing to thefact that they had a greater proportion of regulars in their officer strengththan did the Zone of Interior (table 41). When special regulations to permitpromotions in the Army of the United States were issued, the oversea areas alsohad an advantage in view of the greater seniority of their officers. Suchregulations, however, were of extremely limited scope in the emergency andespecially in the early war period.

Thus it is that the arrival of large numbers of secondlieutenants from the Zone of Interior in 1942 caused the first significantwartime alteration in the distribution of rank among Medical Departmentofficers overseas; that is, a general lowering of the level of grades. Most ofthe second lieutenants who came were members of the Army Nurse Corps, whosenumbers overseas increased tenfold between Pearl Harbor and 30 September1942, while those of male Medical Department officers grew less than seventimes. A considerable increment of Medical Administrative Corps officersalso helped to account for the increase in the proportion of second lieutenants(tables 32 and 64). Whereas the proportion of the oversea membership ofthis corps in the lowest rank had been less than 20 percent in November 1941, itwas 43.55 percent in September 1942. The change was of such proportions that itreversed the relationship with regard to the grade of second lieutenant thathad prevailed prior to Pearl Harbor between Medical Department officers andofficers in general. The Medical Department overseas now had, and continued tohave until at least May 1944, a ratio of second lieutenants that was larger thanthat possessed by the entire Army abroad. Among male Medical Department officersalone, the proportion of second lieutenants also increased, but it is clear thatoverseas as at home the proportion continued to be smaller than was the caseamong the other male officers until the end of the war. The fact that the Medical Corps, Dental Corps, and Veterinary Corps had no members in thegrade of second lieutenant accounts for this situation.

A similar process was taking place in the Zone of Interior.Intensive commissioning of Medical Administrative Corps officers beginning in1942 and heavy recruiting of the professional corps during the sameperiod accounts for the substantially greater proportions of worldwide strength insecond and first lieutenants as compared with oversea strength.

The latter part of the war witnessed a very markedimprovement in promotion rates among oversea Medical Department officers. Thisdevelopment began to manifest itself among the male components of the grouptoward the middle of 1943. During 1944, the pace slackened, but in 1945 rateswere attained which surpassed the levels reached in 1943 (table 65).Although

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pressure by Surgeon General Kirk upon oversea authorities in mid-1944 gave some impetus to promotions of members oftheArmy Nurse Corps, the monthly rate of these promotions abroad even during thethird quarter of that year was 0.1 per 1,000, whereas the worldwide ratewas 3.4 (table 65).⁵³

In 1945, however, great promotion activity was manifestedamong the members of the female components in the Medical Departmentoverseas. The most important factors in the improvement of the promotion ratesof Medical Department officers were the special regulations making possibleadvancements in grade regardless of the existence of vacancies. However, adirective of October 1943 authorizing promotion of second lieutenants of the Nurse Corps to the rank offirst lieutenant irrespective of openingsin the higher grade was of little influence at least until the invasion ofNormandy since they were applicable only to personnel serving with combatforces engaged in foreign areas.⁵⁴

Promotions through the creation of vacancies also increasedin the later war period. Higher attrition rates, rotations, arrival of unitsfrom the Zone of Interior without qualified incumbents in highlyspecialized jobs, and changes in tables of organization to permit replacementof medical officer`s by members of the Medical Administrative Corps allswelled the number of vacancies in oversea areas, although in many casesobstacles were raised to filling these vacancies by promotion. Among suchobstacles was the requirement that an officer rotated to the Zoneof Interior be replaced by an officer from that area holding the samerank. In the North African theater, regulations issued in August 1944provided that a replacement for a Medical Department officer berequisitioned in the same grade as the individual to be replaced and that whena vacancy was to be filled by promotion no action to that effect be takenuntil a replacement was obtained for the officer to be promoted. In theSouthwest Pacific, medical officers transferred to headquarters in orderto serve as consultants, remained on the rolls of their parent units, thusblocking promotion opportunities in such units.⁵⁵

⁵³(1) Letter, Maj. Gen. Kirk, to Maj. Gen. M.C. Stayer,Chief Surgeon, North African Theater of Operations, U.S. Army, 30 Nov. 1944. (2) Letter, Maj. Gen. Kirk, to Maj. Gen. P. R. Hawley, Chief Surgeon, EuropeanTheater of Operations, U.S. Army, 30 May 1944.
⁵⁴Promotions under the regulation were subject todemonstration of the fitness of the subject for advancement. She must alsohave served at least 6 months as a second lieutenant, no less than 3 monthsof this being in a theater of operations. Moreover, the number of firstlieutenants in a table-of-organization unit might not exceed 50 percentof all lieutenants in the unit. Finally, the authorization applied only tospecified theaters. Memorandum, The Adjutant General, to CommandingGeneral, Army Ground Forces, 2 Oct. 1943, subject: Promotions of SecondLieutenants, Army Nurse Corps, in Active Theaters. Also Annual Report, Surgeon,U.S. Army Services of Supply, 1943.
⁵⁵(1) Annual Report, Surgeon, Mediterranean Theater ofOperations, U.S. Army, 1944. (2) Memorandum, Brig. Gen. G. B. Denit, Chief Surgeon, Headquarters, U.S. Army Forces, Far East, forColonel Pincoffs, 22 May 1945.

478-479

TABLE 64.-Temporary promotions of MedicalDepartment officers, worldwide and overseas, January 1943-September 1945

480-481

TABLE 65.-Temporary promotions of MedicalDepartment officers by rank,¹ by corps, and by other components, worldwide andoverseas, November 1944 to June 1945, inclusive

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Some commanders also retained their prejudice against rapidpromotions. On the other hand, in Esp?ritu Santo and probably in many otherplaces there were commanders who, upon hearing reports of high initial ranksbeing granted to men entering the medical service in the United States, went tothe opposite extreme and tried, although perhaps with not much success, to fillall vacancies by promotion even before they had an opportunity to observe thebeneficiaries in action. For similar reasons, commanders were more willing thanformerly to permit individuals to attain the rank authorized for their jobs bytables of organization.

In spite of obstacles, at least 19.4 percent of all MedicalDepartment promotions during the period from November 1944 to June 1945,inclusive, resulted from assignments to vacancies or from advancement toauthorized rank. In each of the Medical Department`s male officer corps, thepercentage was much higher (table 65).

In the latter part of the war, promotion rates of MedicalDepartment officers overseas at times exceeded the corresponding worldwiderates. There were several reasons for this. The special regulations favoringpromotion had their initial application in the Zone of Interior and attainedtheir peak effect overseas when their influence at home was waning. Certainregulations, such as the time-and-a-half credit for service abroad, quiterightly favored oversea personnel. Promotion requirements in the continentalUnited States became more stringent. Finally, few new units were beingactivated in the Zone of Interior, and in those that were activated, the newjobs were given more and more to the former members of disbanded or reorganizedestablishments or to men who had been rotated home from overseas who alreadyhad ranks appropriate to the vacancies created.

Although the rate of promotion of oversea MedicalDepartment officers increased, it exceeded the rate of all officers in thetheaters only during the second quarter of 1945. The reason for this generallylower rate was the fact that attrition was a much greater influence in the Armyin general than it was in the Medical Department. The contrast is betterillustrated when male officers alone are compared. At no time did the promotionrate of male Medical Department officers overseas even closely approach thatof the corresponding group in the Army as a whole despite the increasedmedical losses experienced in 1945 and all the other aids to promotion activity.Indeed, promotion rates of the two groups were closer together in 1943 than theywere at later dates.

Even though promotions overseas increased during the latterpart of the war, it can be assumed that only about half of all Medical Corpsofficers who served overseas prior to the end of hostilities received promotionsthere. Many officers, of course, received promotions before going abroad, butthe fact nevertheless remains that considerable numbers of medical officerswho

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saw service overseas never were promoted at all or not untillate in their Army careers.⁵⁶

Decentralization of promotions

Decentralization of promotion in wartime had many advantages.It obviated heaping upon a central headquarters the vast amount of paperworknecessary to the promotion of officers, both of high and of low rank. Inremoving the necessity of sending all recommendations for promotions throughmilitary channels to a central headquarters (for the Medical Department thiswas the Surgeon General`s Office), decentralization speeded promotionsgreatly. This acceleration tended to foster officers` morale.Undoubtedly, The Surgeon General was content to have others promote officers inthe lower grades. Lack of attention in certain instances to qualifications whenpromoting officers to the grade of colonel overseas, however, posed seriousproblems for him when men who lacked either the professional or the militaryexperience to justify that rank for assignment to any type of job werereturned to the Zone of Interior. Often, particularly in the later war years, he had difficulty in persuading commanding generals of service commands andothers to accept young, inexperienced or ineffectual men who held that rank. Acentralized control over promotions to the rank of colonel, in the hands of TheSurgeon General, might possibly have tended to eliminate such difficulties.⁵⁷But this procedure was unthinkable. Theater commanders had the authorityto promote up to and including the rank of colonel. This was based on therecommendations of major commanders and availability of TOE vacancies and theproved competence of the individual concerned.

Enlisted Personnel

Between 31 July 1941 and the end of May 1944, thepercentage of Medical Department enlisted men who were in grades above that ofprivate increased from 49 to 68, and above the grade of private, firstclass, from 19 to 45 percent. Even in ranks above that of corporal, theincrease was substantial, being from 15 to 21 percent (table 66). In terms ofpay, however, these improvements were less significant than they seem to be.Prior to June 1942, certain Medical Department enlisted men in the grades ofprivate and private, first class, had specialist ratings which made their payequal to that of soldiers in higher ranks. What proportion of the number ineach of these grades they constituted is unknown, but it seems probable thatthey comprised more than 31 percent of all Medical Department enlisted men

⁵⁶Letters, to Col. C. H. Goddard, Office of The SurgeonGeneral, from (1) T. L. Badger, M.D., 3 Sept. 1952; (2) Col. E. G. Billings, 23 Sept. 1952; (3)Col. H. L. Blumgart, 7 Aug. 1952; (4) Col. G. G. Duncan, 19 Aug. 1952; (5) C. S. Drayer, M.D., 3 Sept. 1952; (6) G. H. Gowen, M.D., 10 Sept. 1952; and (7) Col. George G. Finney, 2 Sept. 1952.
⁵⁷Letter, Col. Paul A. Paden, Percy Jones Army Hospital, toCol. C. H. Goddard, Office of The Surgeon General, 9 June 1952.

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TABLE 66.-Rank of Medical Departmentenlisted men overseas, 31 July 1941-31 May 1944¹

Date	Master sergeant		First sergeant		Technical sergeant		Staff sergeant²		Sergeant³		Corporal⁴		Private, first class		Private
Date	Number	Percent of strength in rank	Number	Percent of strength in rank	Number	Percent of strength in rank	Number	Percent of strength in rank	Number	Percent of strength in rank	Number	Percent of strength in rank	Number	Percent of strength in rank	Number	Percent of strength in rank
31 July 1941
Total Army	961	0.77	874	0.70	1,762	1.40	4,220	3.36	9,665	7.71	11,554	9.21	33,399	26.63	62,999	50.22
Medical Department	26	.60	9	.21	75	1.74	188	4.37	328	7.63	202	4.70	1,271	29.56	2,201	51.19
30 November 1941
Total Army	1,136	.74	1,098	.71	1,969	1.28	5,415	3.52	12,637	8.21	14,777	9.60	40,858	26.56	75,962	49.37
Medical Department	45	.68	25	.38	97	1.47	248	3.77	494	7.51	386	5.87	1,888	28.69	3,397	51.63
30 September 1942
Total Army	4,990	.65	4,115	.54	10,195	1.33	34,261	4.46	82,638	10.76	124,311	16.19	171,803	22.37	335,738	43.71
Medical Department	168	.35	216	.44	533	1.10	2,480	5.11	4,213	8.68	7,391	15.22	11,880	24.47	21,666	44.63
31 January 1943
Total Army	7,252	.70	5,527	.53	16,175	1.56	55,478	5.35	120,156	11.59	193,408	18.66	236,881	22.86	401,452	38.74
Medical Department	244	.34	319	.44	797	1.10	3,105	4.30	7,409	10.25	13,647	18.89	17,733	24.54	29,005	40.11
31 December 1943
Total Army	19,536	.81	13,200	.55	48,100	2.00	55,747	6.49	320,695	13.37	517,470	21.57	551,328	22.98	773,383	32.23
Medical Department	673	.37	725	.40	2,174	1.20	10,178	5.60	22,515	12.39	41,440	22.80	43,893	24.15	60,164	33.10
31 May 1944
Total Army	29,549	.87	18,731	.55	80,443	2.36	246,654	7.22	466,609	13.67	721,718	21.14	796,861	23.34	1,053,584	30.86
Medical Department	1,033	.40	1,065	.41	3,105	1.20	16,565	6.43	33,584	13.03	60,976	23.65	59,852	23.22	81,625	31.66

¹Basic data from sources shown intable 31, footnote 3.
²After 1941 includes technicians, 3d grade.
³After 1941 includes technicians, 4th grade.
⁴After 1941 includes technicians, 5th grade.

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in oversea areas. After June 1942, the specialistratings were abolished, and although a minority of the men who had heldthem remained in the ranks of private and private, first class, the bulk of thespecialists were automatically placed in the newly created ranks of technician,5th grade, and technician, 4th grade. Their rank was thus brought up to thelevel of their pay rather than vice versa. Despite this immediate monetarylimitation, the level of pay of Medical Department troops neverthelessincreased considerably over a period of time through gains in the level ofgrades. Between 30 September 1942, by which time the conversion of the gradesof enlisted specialists had been completed, and 31 May 1944, the proportionin grades above that of private increased by nearly one-fourth; above that ofprivate, first class, by about one-half; and above that of corporal by asomewhat smaller ratio.

What proportion of this relative rise in rank of MedicalDepartment enlisted men took place overseas cannot be precisely determined. Asin the case of officers, attrition and special regulations favoring overseapersonnel undoubtedly had some effect on promotion rates in the late stages ofthe war, but not enough to put the Medical Department on a par with the Army asa whole in this respect. The medical soldier continued to have less chance ofpromotion to higher rank, with accompanying increase in pay, than had hisenlisted counterpart elsewhere in the Army.

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