CHAPTER IV
Requirements: 1941-45
In May 1941, the War Plans Division of the General Staff was given the taskof preparing a study on the ultimate munitions that the United States would haveto produce to defeat the Axis Powers. At the request of President Roosevelt inJuly and again in August, the study was expanded to include an estimate of troopstrength and total units necessary for the various theaters. This VictoryProgram submitted to the President on 25 September 1941 placed total strength at8,795,658.1 Theproduction goals for munitions were immediately established on the basis of theVictory Program, but no action was taken on a troop basis until after theJapanese attack on Pearl Harbor. The Victory Program became the War MunitionsProgram at that time, and the preparation of intermediate troop bases becamenecessary. The 1943 troop basis was set at 8,208,000 (7,533,000 enlisted men,675,000 officers); the 1944 troop basis reduced overall strength to 7,700,000.2In the spring of 1942, The Surgeon General estimated his requirements for thevarious corps of the Medical Department based on the strength estimates of theVictory Program and the 1943 troop basis, as yet unapproved.
MEDICAL CORPS
In April 1942, in compliance with a request from theAssistant Chief of Staff, G-1, War Department, General Magee estimated that theUnited States had a total of 176,000 physicians, and remarked that "whilemany are overage or have retired from practice * * * it will be assumed that the entire number isavailable for the period of national emergency." He doubted that theFederal services, including the Military Establishment, could obtain more than athird of these and declared that, if no more than 50,000 were available for theArmy, the existing allotments and tables of organization would have to bereduced by one-third. He estimated that under these existing allotments andtables 75,000 physicians would be needed for a 7,500,000-man Army, or one forevery 100 men. Initially, however, the ratio would be
1Watson, Mark Skinner: Chief ofStaff: Prewar Plans and Preparations. United States Army in World War II. TheWar Department: Washington: U.S. Government Printing Office, 1950, pp. 338-349.
2Kreidberg, Marvin A., and Henry, Merton G.: History of MilitaryMobilization in the U.S. Army, 1775-1945. Washington: U.S. Government PrintingOffice, 1955, pp. 628-629. (DA Pamphlet 20-212.)
68
greater, decreasing as the troop basis rose.3 In suggestingthat he might be allowed 50,000, TheSurgeon General at this early date had arrived at a figure very close to the 45,000ultimately granted him.
In the course of the next few months, the question of theratios of physicians to troops in foreign armies was injected into thediscussion of the desirable strength of the Medical Corps. This point may havebeen raised at this time by the fact that in July plans for the first Alliedassault landing (Operation TORCH) were being formulated. It was the Presidenthimself who raised the question by telling the Chief of Staff and the Chairmanof the War Manpower Commission that he could not reconcile the British ratio of 3physicians per 1,000 troops with the United States ratioof 8 per 1,000. At about the same time, a subcommittee of the Senate Committeeon Labor and Education dealing with war manpower issued a preliminary report inwhich it stated, after noting that the ratio of doctors to military strength inthe American Army appeared to be more than twice that maintained by the Alliesof the United States, that British experience should be studied in order to workout a balanced plan for use of this scarce national resource.
Shortly after this recommendation was published, The SurgeonGeneral took note of the President`s comment in a communication to the GeneralStaff. After stating a belief that the British ratio was 4.5 per 1,000 instead of3, hesaid that the ratio of physicians to population in Great Britain wasconsiderably lower than in the United States and that because of proximity toactive operations "a large percentage" of British casualties werecared for in civilian hospitals. Moreover, not only were standards of medicalcare much higher in the United States than in Great Britain but the Britishthemselves had recognized the inadequacy of their medical service by requesting"large numbers" of medical officers from the United States before weentered the war. Then, The Surgeon General, after reviewing the history ofcongressional action on ratios, pointed out that the act of 3 April 1939 in authorizing1,424 MedicalCorps officers had established a ratio of 6.33 per1,000 of enlisted strength. He contended, however, that this figure providedMedical Corps officers only for administrative overhead and hospital care, notfor combat units or for the organization and training of tactical medical units.He asserted that it had been demonstrated "through all the lean years priorto the present emergency" that this ratio would provide only for thenecessary care of the sick "in accordance with the accepted standards ofAmerican medicine."4 Butduring a war, he continued, it was necessary to man tactical units and toprovide a relatively higher proportion of Medical Corps officers for theincreased hospitalization incident to the care of battle casualties and troopsliving under adverse cli-
3Memorandum, The SurgeonGeneral (Col. John A. Rogers, MC, Executive Officer), for Personnel Division,Services of Supply, 27 Apr. 1942.
4Memorandum, The Surgeon General (General Magee), for Chief ofStaff, 23 Oct. 1942.
69
matic and general health conditions in various parts of theworld. Small garrisons and task forces scattered throughout the world increasedmedical personnel requirements, although The Surgeon General said it wasdifficult to evaluate that factor accurately. He pointed out that he had reducedtables of organization and service command allotments sufficiently to save morethan 8,600 doctors.
General Magee declared that he would be remiss in his duty if he"failed to emphatically protest any reduction of medical officers whichwould lower the standards of medical service * * * below that confidentlyexpected by the American public. Should these standards be dangerously loweredfuture criticism would be mainly directed against the Army." "Anyfurther material reduction," he said, "will lower medical efficiencyto a dangerous level." He believed that 50,000 physicians for an army of 7.5 million menwould enable his Department to perform its mission.
In concluding this strong statement of his position, The Surgeon Generalexpressed his conviction that from the national point of view the problem wasnot so much one of reducing the number of physicians in the Army as it was oneof redistributing available physicians to meet civil requirements.
The question of foreign ratios and also the proper ratio of doctors for theU.S. Army came before the Committee to Study the Medical Department of the Army.Those who testified on personnel matters included not only officers from the Surgeon General`s Office and the Services of Supply,but also individuals from the Directing Board of the Procurement and AssignmentService, the Director of the War Manpower Commission, which in April 1942 hadincorporated the Procurement and Assignment Service into its organization,officials of the American National Red Cross, and other civilians.
Shortly after General Magee`s reply to President Roosevelt concerning theratios of foreign and American doctors in army medical services throughout theworld, the committee made its report. Among other comments, the committeestated, on what authority is unknown, that the ratios of Medical Corps officersto military personnel adopted by the Army was 6.5 per 1,000 troops in the United States and10.5 per 1,000 in theaters of operations, but this ratio in foreign armies wasnot obtainable. Furthermore, the committee stated that it did not feelcompetent to express an opinion as to the adequacy of the American ratios."5
Meanwhile, the Deputy Chief of Staff in October 1942 asked The SurgeonGeneral to submit a plan for the medical service of a fully expanded army(fig. 18). The plan, concurred in by the Air and Ground Surgeons and presentedin December 1942, proposed 49,100 doctors for an army of 7,500,000-aratio of about 6.5 per 1,000-and recommended a reduction ofallotments to Zone of
5Report, Committee to Study the Medical Department, 1942.
70
71
72
Interior installations based on new personnel guides to be promulgated.6 Theproposed allotment to the three major forces were as follows:
|
Allotment | |
|
Army Ground Forces: | |
|
113,222 |
| Army Air Forces: | |
|
4,553 |
|
27,358 |
| Services of Supply: | |
|
314,254 |
|
48,809 |
|
Total |
549,100 |
1After a reduction of 827.
2After a reduction of 262.
3After a reductionof 361.
4Aftera reduction of 2,805.
5Includes 904 allotted to War Department filler and loss replacementpool.
After discussion about the number of doctors, the DeputyChief of Staff in March 1943 set thepermissible number at 48,000 for anArmy strength of 8,248,000 (the 1943 troop basis plus 40,000 Armynurses). Six months later, however, G-1 stated that in view of a reduction ofthe troop basis to 7,686,000 the WarDepartment could not support the previous figure and ordered a restudy to reduceit, indicating that 45,000 would beabout the right number. Shortly afterward, Army Service Forces headquartersdirected The Surgeon General to modify his plan for the utilization of MedicalCorps officers, using a basis of approximately 45,000 officersfor an army of 7,686,000 as of 31December 1943.7
At the end of September 1943, MedicalCorps strength stood at 39,951 andtotal Army strength at 7,273,784, ora ratio of 5.49 doctors per 1,000strength. Forty-five thousand doctors for an Army of 7,686,000 would have provided a ratio of slightly less than6 per 1,000. In protesting against this reduction, TheSurgeon General declared that 48,000 wasan irreducible minimum. Although no action seems to have been taken on thisrejoinder, The Surgeon General later noted that the reduction to 45,000 had been made while a draft of doctors was underdiscussion, and claimed that it was without prejudice to additional requirementsafter 1 January 1944.8 At this time,there was no question of
6Memorandum, Acting Surgeon General, for Deputy Chiefof Staff (through Military Personnel Division, Services of Supply), 14 Dec.1942, subject: Availability of Physicians.
7(1) Memorandum, Deputy Chief of Staff, forCommanding General, Army Service Forces, 10 Mar. 1943, subject: Availability ofPhysicians. (2) Memorandum, G-1, for Commanding General, Army Service Forces,attention: Military Personnel Division, 18 Sept. 1943, subject: OfficerRequirements. (3) Memorandum, Military Personnel Division, Army Service Forces,for The Surgeon General, 22 Sept. 1943, subject: Officer Requirements, MedicalCorps.
8(1) Memorandum, Military PersonnelDivision, Army Service Forces, for The Surgeon General, 22 Sept. 1943, subject:Officer Requirements, Medical Corps, with 1st endorsement thereto, 2 Oct. 1943.(2) Memorandum, The Surgeon General, for Assistant Chief of Staff, G-1, 11 Sept.1944, subject: Conference With Chairman, Procurement and Assignment Service.
73
exceeding an actual strength of 48,000 or even 45,000, sincethe total number of Medical Corps officers on duty was only about 40,000 as lateas the end of December 1943 (table 1).
By the end of September 1944, however, the number on duty wasapproximately 45,000, and on 7 October, the War Department again establishedthat figure as a ceiling; any excess was to be disposed of either bytransferring officers to the Veterans` Administration or by separating them fromthe service. Two days later, The Surgeon General stated that 47,000 as of 31December 1944 was a "firm requirement" and that further reduction oftables of organization was "out of the question."9 On 7November 1944, his appeal was rejected, but the War Department acknowledged thatit was "impracticable to maintain an exact ceiling of 45,000" and that"some tolerance or leeway appears desirable on the long side."10In any event, the strength of the Medical Corps waspermitted to exceed the ceiling; at the end of November 1944, it stood at 46,747and reached its maximum-about 48,000-in July 1945 (table 1).
Procurement and Assignment Service
The Procurement and Assignment Service, which had been established shortlybefore Pearl Harbor as a coordinating agency for all Federal services formedical, dental, and veterinary personnel, in April 1942 created a Committee onAllocation of Medical Personnel, which was charged with determining a safeminimum standard of medical care for civilians. The minutes of the first meetingof this committee (26 April 1942) show that it entered on its task with theidea not only of allocating personnel to civilian and military service, but oftrying to constrain the Army into what it considered an efficient use ofphysicians. Dr. Harold S. Diehl, Dean of Medical Sciences, University ofMinnesota, the chairman, said that the committee had to plan to prevent medicalpersonnel from being put into positions where their special qualifications werenot utilized. Dr. Roscoe G. Leland, Director of the Bureau of Medical Economicsof the American Medical Association, a member, expressed the opinion that itwould be the committee`s job to get the Army to change its position onrequirements by reducing the ratio of physicians to Army strength and byreplacing certain physicians with medical administrative personnel. Dr. Diehlthen said that "if we have a case and can get the figures to prove it, wecan get the Army to revise their demands."
This is one of the first indications that the members of the Procurement andAssignment Service actually meant to put a limit on the number of physicians theArmy could have so as to keep civilian communities from being stripped ofdoctors. The sequel was that for the duration of World War II
9Memorandum, The Surgeon General, for theAssistant Chief of Staff, G-1, 9 Oct. 1944, subject: Medical Officer Requirementsand Availabilities.
10Letter, The Adjutant General, to The SurgeonGeneral, 7 Nov. 1944, subject: Medical Corps Officers-Procurement, Assignment,and Ceiling.
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the Medical Department was governed in many aspects of its personnelprocurement program by the wishes of a civilian agency.
On 7 November 1942, at a meetingattended among others by Surgeon General James C. Magee; Vice Adm. Ross T.McIntire, his Navy counterpart; and Paul V. McNutt, Chairman of the War ManpowerCommission, the Procurement and Assignment Service recommended a ratio of 1physician to 1,500 of population as a minimum for civilian medical service ineach State. This of course would indirectly set a limit on the procurement ofdoctors for the armed services. Admiral McIntire agreed that every possibleeffort should be made to maintain the proposed ratio and stated that the Navycould operate with "anywhere from 6 to 6.5 inthis war." General Magee accepted the 1:1,500 ratiofor civilian medical service, but objected to committing himself as to theprecise number of doctors the Army would need. The Medical Department, he said,was reducing its figures "as far as our conscience and intelligence willlet us," but "if it comes to a point of making immediate decisions, Iam not in a position to do so at the present time." Mr. McNutt wasobviously dissatisfied with The Surgeon General`s position. He said that theProcurement and Assignment Service would give the Armed Forces all it possiblycould, but that he knew "full well" that tables of organization hadbeen too high. "If you want my candid appraisal of the situation," hesaid, "we cannot be dealing with any 8.2 or 8.3 per 1,000. We had better betalking about 6.4 or 6.5." Thelatter ratios would have given the Army about 48,000 doctorsfigured on a strength of 7.5 million, or in fact very nearly the 50,000 which The Surgeon General had earlier suggested. Thatsuggestion had probably been made, however, with a view to giving the Army notas many doctors as would be considered ideal but simply enough to enable theMedical Department to fulfill its function.
The Procurement and Assignment Service adhered to the 1:1,500 ratio for civilian medical service throughout thewar as a basis for authorizing the military services to procure doctors in theseveral States. Many States did not possess so high a ratio; some had higher.The Procurement and Assignment Service had small power to improve theirpositions by reallocating civilian doctors, and in fact, it achieved little inthat respect.
In discussing the Procurement and Assignment Service`s lack of powerto relocate doctors, the vice chairman of that organization had stated:
Our position would have been much easier, and some of ourobvious failures might have been avoided, if we had possessed the same"power" over the relocation of civilian doctors to needy communitiesthat we had to limit the commissioning of medical officers to those menconsidered "available." The fact that New York and Chicago, throughoutthe war, had an excess of doctors and dentists that we could not relocate,weakened our position and prevented the accomplishment of our obligations to thecivilians. If another great war should break out, I personally think that a bodywith power over all professional people should be set up.11
11Letter, Harvey B. Stone, M.D., to Col. C. H.Goddard, MC, Office of The Surgeon General, 3 June 1952.
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DENTAL CORPS
By the start of World War II, experience had shownthat any ratio of less than 1 dental officer for each 750 men would begrossly inadequate. Although formal requests for procurement objectives weregenerally brief, containing no discussion of the method of calculation, it isclear that the ultimate goal of the Surgeon General`s Office was an overallratio of 1 dentist for each 500 men. This ratio was agreed upon informallybetween the director of the Dental Division (fig. 19) and the chief of thePersonnel Service, both in the Office of The Surgeon General.12Even thoughit was not "officially recognized," the July request for a procurementobjective stated that it was based on a ratio of 2 dentists per 1,000, andpermission was asked to appoint up to 9,000 Dental Corps officers for an Armyof 4.5 million.13 In November 1942, The Surgeon General estimated that in view ofthe planned increase in the size of the Army
12Medical Department, United StatesArmy. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955.
13Letter, Office of The Surgeon General, to Commanding General,Services of Supply, 3 July 1942, subject: Procurement Objective, Dental Corps,Army of the United States.
76
he would need 17,248 dentists.This estimate was accepted by the War Department General Staff.14
The overall ratio of dental officers (1 to 500) which the Dental Service considered necessary was neverreached during the entire war period except in September and October 1942. Theproblem of meeting the needs of new recruits for dental rehabilitation, whichwas particularly serious during the early part of the war, seems to have beenpartially met by deferring all but work of an emergency nature.
Early in 1943, the Procurement and Assignment Service determined that 1dentist was required for each 2,500 civiliansand that a total of 22,620 could bespared for the Army and Navy, thereby leaving 50,250 incivilian practice.15 This standard and its application could be criticized onseveral grounds. In the first place, the standard was arbitrary, being basedmore on opinion than knowledge. Moreover, not all communities had as many as 1dentist per 2,500 civilians-many hadnot above half that ratio-and there was no machinery to give them more or evento restrict recruiting to other areas. Finally, if the number of dentists thatcould be spared for the Armed Forces had been arrived at simply by counting asavailable all dentists in excess of the 1:2,500 ratioin communities possessing a higher ratio, the number would have beenconsiderably larger than 22,620. Themilitary authorities, however, did not raise these or other objections to thecalculations of the Procurement and Assignment Service; they could hardly haveeffectively challenged a formula which gave them the right to solicit one-thirdof the Nation`s dentists for 12 millionmen while two-thirds were reserved for 120 millioncivilians.
In late 1943, Army Service Forces set a ceiling of 15,200 for the Dental Corps. According to Col. George F.Jeffcott, DC:
The manner in which the ceiling for the Dental Corps was established, and theexact date, are not entirely clear. In a memorandum to the Deputy SurgeonGeneral, of 7 Sep 43, Lt Col D. G. Hall of the Personnel Service, SGO, statedthat his office had "that day" been notified of a revised requirementbased on changed plans in ASF * * *. Other incidental references [however]indicate that representatives of the Dental Division [SGO], the MilitaryPersonnel Division, SGO, and of G-1 attended conferences on the matter before adecision was reached. It is also probable that PAS [Procurement and AssignmentService] had a hand in the matter, but the extent to which its influenceaffected ASF is not known.16
VETERINARY CORPS
Unlike the Medical, Dental, and Army Nurse Corps, the size of the VeterinaryCorps could not be calculated by a simple ratio of veterinarians to the overallstrength of the Army. One factor that complicated the process of calculationwas present to some degree before the United States entered
14 Letter, The Adjutant General, to The SurgeonGeneral, 27 Nov. 1942, subject: Increase in Procurement Objective for TheSurgeon General (Dental Corps).
15Minutes, Committee on Dentistry, Procurement andAssignment Service, 20 Feb. 1943.
16See footnote 12, p. 75.
77
the war-the inspection of food by the Army Veterinary Servicefor other branches of the Military Establishment and even for certainnonmilitary agencies of Government. During the war, one of the most importanttasks of Veterinary Corps officers was the procurement-inspection of food forthe Navy and the Marine Corps; by the end of the war, Army veterinarians wereinspecting about 90 percent of the Navy`s food at the time of procurement.17
New and increased requests for veterinary officers throughout the war periodtherefore perplexed the General Staff, for no fixed basis, such as troopstrength, could be used as a guide in making their decisions.18 ArmyRegulations No. 40-2035, 18 December 1942, governingveterinarians, listed the number of assistants a station veterinarian could have(depending on animal strength) and stated further:
A station having a human strength of approximately 1,000 will be allowed oneor more veterinary officers, as circumstances warrant, for duty in connectionwith meat and dairy hygiene, the maintenance of instruction courses, or otherduties pertaining to the veterinary service. At depots, ports of embarkation anddebarkation, purchasing points, and other places where foods of animal originare purchased, stored, or handled by the Army, the assignment of veterinaryofficers will be based on actual need as determined by The Surgeon General.
In practice, The Surgeon General from time to time requested new procurementobjectives which would authorize the Medical Department to obtain additionalveterinary officers as the occasion seemed to demand. Although the objectivesgranted were not as large as those he requested, they enabled the corps to bemoderately enlarged. No ceiling appears to have been set for the VeterinaryCorps until January 1945 andeven this was more in the nature of a procurement objective, since the WarDepartment General Staff not only set a figure (2,150) somewhat above the actualstrength but authorized procurement of the necessary officers from certainspecified, though restricted, sources.19
SANITARY CORPS
Throughout the war, no personnel ceiling was established forthe Sanitary Corps, and no ratio was adopted as a means of computing the numbersrequired. The Surgeon General merely requested and justified successive procurement objectives which, if approved by theWar Department General Staff,permitted him to add certain numbers to the corps. In February 1945, further commissioning in the corps was ordered stopped,the membership being considered large enough for the Army`s needs.
17Annual Reports, Veterinary Division, Office of TheSurgeon General, U.S. Army, 1942-46.
18Information from Maj. E. B. Miller, VC,U.S. Army Medical Service historian, 1950.
19Semiannual Report, ProcurementBranch, Military Personnel Division, Office ofThe Surgeon General, U.S. Army, 1 Jan.-31 May 1945.
78
FIGURE 20.-Brig. Gen. Edward Reynolds, MAC, Chief, Medical Administrative Corps.
PHARMACY CORPS
The number of personnel required by the Pharmacy Corps wasdetermined by The Surgeon General. Since most of the pharmaceutical work in theArmy could be done by pharmacy technicians working under supervision, the 72Pharmacy Corps officers permitted by the act of 1943 which created the corpsproved to be more than sufficient throughout the war from The Surgeon General`spoint of view.
MEDICAL ADMINISTRATIVE CORPS
On 30 June 1940, the ratio of Medical Administrative Corps(fig. 20) officers on active duty to Medical Corps officers was a little morethan 1:25; 5 years later, the ratio had risen to l:2.4. This was due not tothe establishment of a formal requirement for Medical Administrative Corpsofficers but rather to the transfer of administrative duties from Medical Corpsofficers to qualified nonprofessional personnel, thereby freeing the physiciansfor strictly professional work.
79
In April 1942 when, in reply to questions from G-1, The Surgeon General wasdiscussing the substitution of Medical Administrative Corps for Medical Corpsofficers, he said that whereas 75,000 physicians would be needed according toexisting tables of organization and allotments, probably 10 percent of thatnumber, or 7,500, could be supplanted by Medical Administrative Corps officers."It is doubtful that all of these or additional substitutions would prove ofeconomic value," he explained.20
Apparently not until the Medical Department found itself limited by theceiling on doctors did it envisage the great number and variety of assignmentsthat members of the Medical Administrative Corps were qualified to fill.Nevertheless, in a report on the procurement and supply of Medical Corpsofficers, the Control Division, Services of Supply, stated in June 1942 that asa result of the serious shortage of Medical Corps officers the MedicalDepartment had an obligation to release them from "all administrativeprocurement, and similar duties which can be assigned to nonmedicalpersonnel." This report did not limit those to be substituted to members ofthe Medical Administrative Corps, but suggested the use of Sanitary Corps,branch immaterial, and Army Specialist Corps officers as well.21 In July 1942, The Adjutant General issued a letterrequiring the relief of Medical Corps officers from duties that did not demandprofessional training.
The Committee to Study the Medical Department reviewed the problem ofreplacement of Medical Corps officers and made the following recommendations:
l. The practice of assigning Medical Corps officers, even temporarily, to anytype of work that could be performed by nonprofessional personnel should bediscontinued.
2. Medical and dental officers should be utilized to the fullest extent intheir professional fields.
3. All professional personnel engaged in administrative tasks except thosewho had lost the skills necessary for professional work should be replaced byMedical Administrative Corps personnel.
4. More nonmedical men who had proved competent in managing establishmentsproviding medical care should be used in positions of greater responsibility inArmy hospitals and even in the higher echelons of the Medical Department.
5. The Medical Department should take steps, "evenat this late date," [1942] to increase greatly the number of MedicalAdministrative Corps trainees per month.
The committee believed that statements made by The Surgeon General`srepresentatives that the supply of such officers would equal demand by 1 Jan-
20Memorandum, The Surgeon General (Col. John A. Rogers,MC, Executive Officer), for Personnel Division, Services of Supply, 27 Apr. 1942.
21The Army SpecialistCorps was composed of administrative, professional, scientific, and technicalspecialists who were "civilians in uniform" functioning under civilservice. The corps existed less than a year, being abolished in late1942.
80
uary 1943 were far too optimistic.22 As by thatdate only about 5,900 were on duty in contrast to the later peak strength ofnearly 20,000, the committee`s belief seems justified (table 1). Actually, theDepartment did not have enough Medical Administrative Corps officers untilnearly a year after the committee met; even then, the sufficiency lasted but afew months.
Not all high ranking Medical Department officers agreed on the extent towhich Medical Administrative Corps officers should replace those of the MedicalCorps. The commanding officer of the Medical Replacement Training Center at CampPickett, Va., was reported in 1942 as insisting that he "could notpossibly" run his center "on a sound basis" with fewer than twoand one-half or three Medical Corps officers per training company; this wouldhave required either 10 or 12 for each battalion. At the same time, it wasreported that the training center at Camp Barkeley, Tex., was operating withonly three Medical Corps officers per battalion.23
In 1943, the training center at Camp Grant, Ill., noted that young MedicalAdministrative Corps officers were rapidly replacing doctors and dentists, andthat in most cases the replacement had proved very satisfactory. Whereas, on 30June 1942, 37 percent of the 383 officers at the center had been Medical Corps,25 percent Dental Corps, and 19 percent Medical Administrative Corps officers, ayear later the percentage of medical and dental officers had fallen to 10 and 2,respectively, while that of Medical Administrative Corps officers had risen to73 in a total officer group of 423.
In the fall of 1943-at a time when difficulties were foreseen in furnishingdoctors to all the units and installations which The Surgeon General believed tobe in need of them-General Kirk determined to effect a more widespreadreplacement. He decided to replace one of the two battalion surgeons with aspecially trained Medical Administrative Corps officer to be known as battalionsurgeon`s assistant and to make other substitutions of a similar nature.24Although fear was expressed that such substitution in the battalion was a realsource of danger since it was "unquestionable that many such untrainedofficers will assume unwarranted diagnostic powers and seriously endanger thehealth of the soldier under treatment," The Surgeon General disagreed withthis belief, declaring flatly that the battalion surgeon`s assistant was notgiven that assignment to make diagnoses or to treat the seriously injured."He is put in there to do the administration of the detachment, command thelitter bearers and assist the battalion surgeon * * *." General Kirkreasoned that since there had been no trouble in the hospitals with MedicalAdministrative Corps officers attempting to assume professional duties there wasno reason to anticipate
22Report, Committee to Study the Medical Department,pp. 11, 38-39.
23Letter, 1st Lt. T. C. M. Robinson,Training Division, Office of The Surgeon General, to Col. Frank Wakeman, c/oCol. George M. Edwards, William Beaumont General Hospital, El Paso, Tex., 13Dec. 1942.
24Annual Report, Operations Branch, Military PersonnelDivision, Office of The Surgeon General, U.S. Army, 1943-44.
81
trouble in the units.25 Actually, although there may havebeen complaints against individual officers, the Office of the Surgeon, ArmyGround Forces, was reported as stating that the work of the assistants had beenvery satisfactory.26
Fortunately, there were about 1,500 Medical Administrative Corps officers in replacement poolsin the United States at the time The Surgeon General decided to use them in thisway,27 andbeginning in January 1944, theywere ordered to school in successive groups at Camp Barkeley to be trained asbattalion surgeon`s assistants. Ultimately (by May 1945), about 2,100 were graduated;28 in the later stages of the training program, recentlycommissioned Medical Administrative Corps officers were sent to the school.
In addition to serving as battalion surgeon`s assistants, MedicalAdministrative Corps officers came to be assigned to other positions formerlyreserved for doctors. In November 1943, The Surgeon General proposed using them as registrars inhospitals. Some months later, the General Staff announced that they were to bepreferred for assignment not only as registrars but as executive officers instation and general hospitals both at home and overseas.29The Surgeon General objected to making them executive officers of generalhospitals on the ground that these officers must act for and in the absence ofthe commanding officer and must have a professional appreciation of theproposals presented in order that the personnel of the hospital might beproperly utilized. As a consequence, the General Staff omitted reference to theuse of Medical Administrative Corps (also Pharmacy and Sanitary Corps) officersas executive officers of general hospitals in the restatement of its policy inAugust 1944.30
There were other places in hospitals, however, where MedicalAdministrative Corps officers could relieve doctors. For example, in the laterwar years when the bed census in Army hospitals in the United States was runninghigh, they were made ward property officers. In some hospitals, too, they cameto serve as administrative assistants to the chiefs of the medical and surgicalservices.31
The extent to which Medical Administrative Corps officerswere used in conjunction with Medical Corps officers in general hospitals of theZone of Interior during the later war years is indicated by the table ofsuggested allotments published by the War Department in May 1944 (table 3). A similar situation came to prevail in otherMedical Department installations as well; for example, in the replacementtraining centers, which late in the war were using large percentages of MedicalAdministrative Corps officers.
25Letter, Surgeon General Kirk, toMaj. Gen. Morrison C. Stayer, Surgeon, North African Theater of Operations, U.S.Army, 11 Sept. 1944, in reply to General Stayer`s letter of 3 Sept. 1944, inwhich General Stayer had reported the comments of one of his subordinateofficers.
26Semiannual History of Medical Administrative Corpsand Sanitary Corps, 1 Jan.-31 May 1945.
27Seefootnote 24, p. 80.
28See footnote 26.
29War Department Circular No. 99, 9 Mar. 1944.
30War Department Circular No. 327, 8 Aug. 1944.
31Annual Reports, William Beaumont General Hospital,1944; Ashburn General Hospital, 1944; and Fifth Service Command, 1945.
82
FIGURE 21.-Col. David E.Liston, MC, Deputy ChiefSurgeon, European Theater of Operations, U.S. Army.
As late as 10 years after the, war, there were differences ofopinion among Medical Corps officers as to how completely Medical AdministrativeCorps officers had been able to perform certain duties previouslyperformed by Medical Corps officers and noncommissioned officers. General Kirkstated that regardless of the number of Medical Administrative Corps officersemployed "there were never enough doctors to do the job properly"until V-E Day. Several other medical officers also expressed opinions based ontheir wartime
TABLE 3.-Numbers of Medical and Medical AdministrativeCorps officers suggested (1944) forZone of Interior general hospitals of various sizes
|
Number of beds |
Medical Corps officers (number) |
Medical Administrative Corps officers (number) |
Number of beds |
Medical Corps officers (number) |
Medical Administrative Corps officers (number) |
|
1,000 |
35 |
24 |
2,500 |
60 |
39 |
|
1,500 |
46 |
30 |
3,000 |
64 |
44 |
|
1,750 |
50 |
33 |
3,500 |
70 |
47 |
|
2,000 |
55 |
36 |
4,000 |
80 |
56 |
Source: War Department Circular No. 209, 26 May 1944.
83
FIGURE 22.-Col. Fred J. Fielding, MC,Office of The Surgeon General, U.S. Army.
experiences. Col. David E. Liston, MC (fig. 21), Deputy ChiefSurgeon, European Theater of Operations, U.S. Army, stated his belief that"the increased number of Medical Administrative Corps officers did notmaterially affect the requirement for doctors and did affect [that is, reduce]the requirement for senior noncommissioned officers. Often the Medical Corpsofficer had to exercise an equal degree of supervision over the MedicalAdministrative officer to that exercised over his NCO previously." On theother hand, Col. Fred J. Fielding, MC (fig. 22), stated that in the later waryears tables of organization and equipment "were culled to eliminate MCpositions of administrative nature except for CO [commanding officer]." Hewent on to state that when in 1944 Medical Administrative Corps officers weretrained as battalion surgeon`s assistants "* * * this produced a direct replacement ofmany MC officers formerly required in a position not of administrative naturebut related to the professional duty field. "Lt. Col. Paul A. Paden, MC,also favored using Medical Administrative Corps Officers where possible torelieve Medical Corps officers. He went so far as to state: "Except fortraining, there was no reason why other than a few Medical Department officersshould have been assigned to any type of unit until just before its actualemployment in a theater of operations." He feltthat even in combat the treatment should
84
have been minimal and that therefore a Medical Administrative Corps officercould easily have been a battalion surgeon`s assistant.32
ARMY NURSE CORPS
During the first months of the war, the Surgeon General`sOffice made its estimates for nurse requirements and submitted them to theGeneral Staff, which customarily accepted them. The ratio was approximately 6nurses for 1,000 overall strength. In September 1942, when the troop basis wasraised to 8,200,000, the Surgeon General`s Office transmitted to the GeneralStaff a figure of 51,177 asits estimate of the nurses required to serve a force of that size.33On this occasion, the General Staff did not approve the estimate. Some timeduring the first 2 months of 1943, G-3 notified the Surgeon General`s Officethat 51,177 was toohigh a figure and that the number was being held at 40,000 (including physicaltherapists and dietitians), which had been previously authorized for the fiscalyear ending on 30 June 1944. The nurse requirement was verbally agreed to by theAssistant Chief, Operations Service, Office of The Surgeon General, but neitherthe Nursing Division nor the Personnel Division, Office of The Surgeon General,nor the nursing authorities of the War Manpower Commission, were informed thatthe authorized figure was to be retained.34
As a result, the Superintendent of the Army Nurse Corps (fig.23) and various nursing organizations engaged in recruiting continued to assumefor months that the War Department had authorized a quota of 51,000 nurses. Therefore, when the Superintendent heard that thebudget contained provision for only 40,000 she refused to believe that thebudget directive constituted a limitation and insisted that it would beimpossible to operate with such a number. The nursing organizations alsocontinued to use the goal of 51,000 toimpress the nursing profession with the critical need for recruits.35
In a memorandum to the Commanding General, Army Service Forces, on 18December 1943, General Kirk argued that the ceiling figure of 40,000, whichactually included not only nurses but physical therapists and dietitians, wasfar too small to meet the requirements of the 1944 troop basis. In reaching
32(1) Letter, Maj. Gen. Norman T. Kirk (Ret.), to Col. JohnB. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 12Dec. 1955. (2) Col. David E. Liston, MC, to Col. John B. Coates, Jr., MC,Director, Historical Unit, U.S. Army Medical Service, 5 Jan. 1956. (3) Letter,Col. Fred J. Fielding, MC, to Col. John B. Coates, Jr., MC, Director, HistoricalUnit, U.S. Army Medical Service, 12 Dec. 1955. (4) Lt. Col. Paul A. Paden, MC,to Col. C. H. Goddard, MC, Office of The Surgeon General, 9 June 1952.
33At 6 per 1,000 of troop strength, the estimate would have been 49,200. Thehigher figure may have been set in order to provide for losses.
34Blanchfield, Florence A., and Standlee, Mary W.: TheArmy Nurse Corps in World War II. [Official record.]
35(1) Haupt, A. C.: National War Nursing Program. Hospitals 17: 26-30,April 1943. (2) "Have You Thought It Through, Private Duty Nurse?" Am.J. Nursing 43: 522-523, June 1943. (Moreover, the Subcommittee on Nursing of theNational Defense Council`s Health and Medical Committee, unaware of the truesituation, used the prospective depletion of civilian resources as a lever tosecure an authoritative place for the Nursing Supply and Distribution Service inthe Procurement and Assignment Service.)
85
FIGURE 23.-Col. Florence A. Blanchfield, ANC, Superintendent of the Army Nurse Corps.
this conclusion, he relied largely on the use of a ratio of 1nurse to 10 fixed beds, the approximate ratio established for Zone ofInterior hospitals and theater of operations fixed hospitals.36
G-1 of the War Department General Staff answered The Surgeon General`sprotest, but before doing so, it assembled further data on the subject. Fromthe Inspector General, G-1 obtained a report by Maj. Gen. Howard McC. Snyder,MC, the medical representative on the Inspector General`s staff. General Snydercited a recent survey of 95 Zone of Interior hospitals which showed that theyaveraged 19 beds and 12.4 patients per nurse without consistently overworkingthe nurses; this was bolstered by a consideration of the facts which the WarDepartment Manpower Board used to justify its estimate of Army nurserequirements for hospitals in the Zone of Interior; namely, 1 nurse per 12 bedsin general hospitals and 1 nurse per 12 to 17? beds in station hospitals. General Snyder pointed out thatonly 30.6 percent of the patients in the 95 hospitals surveyed were bedpatients, which reduced the amount of nursing care required. Taking this intoconsideration, and allowing for the dispersion of beds necessitated in part bythe care of patients having communi-
36War Department Circular No. 306, 22 Nov. 1943.
86
cable diseases, he estimated that a 750-bed "cantonmenthospital" would require 40 nurses, or 1 nurse per 18? beds. His general conclusion was that The SurgeonGeneral`s estimate of 1 nurse per 10 beds was excessive and that the allotmentof nurses for Zone of Interior hospitals should be reduced to 1 nurse per 17?beds and for fixed-bed theater of operations hospitals to 1 nurse per 15 beds.
G-1 added some observations of its own, chiefly on the subject of how manyfixed beds actually were required, and announced on 8 January 1944 that the ratio for Zone of Interior hospitalswould be 1 nurse to 15 beds and for theater of operations fixed hospitals 1nurse to 12 beds. The Surgeon General was to recommend reductions in allowancesfor Zone of Interior hospitals and in tables of organization to meet theseratios for the purpose of keeping within the 40,000 ceiling. G-1 concluded that"the present ceiling of 40,000 nurses will amply meet the overallrequirements provided the ratio of nurses to beds is decreased, convalescenthospitals established, and maximum use made of semi-skilled aides, civilians,and corpsmen to replace nurses." The only concession The Surgeon General`sPersonnel Service was able to secure was that physical therapists anddietitians, of which the combined total at that time was approximately 1,700,would not be lumped with the nurses but would be in addition to the 40,000limit.37
In response to this directive, The Surgeon General again entered a plea forthe 1 to 10 ratio. He proposed, however, to retain the 40,000 ceiling "forthe present" by filling all units in the troop basis with Army nurses atthe existing table-of-organization figures-which would require 38,818 of the40,000-and supplementing those who remained in theZone of Interior by civilian nurses so as to provide a ratio of 1 nurse to 10beds. G-1 rejected this proposal of 25 February 1944, "in view of thecritical shortage of military and civilian nurses," and a few days later,the Deputy Chief of Staff enjoined compliance with the original directive of 8 January.38
In a little more than a month, on 5 April 1944, GeneralSomervell was able to report that this directive was being carried out-in part.The Surgeon General had modified the tables of organization and also theallotments for Zone of Interior installations to provide the required ratios ofnurses to fixed beds-1 to 12 and 1 to 15, respectively. As to maintaining the40,000 ceiling, General Somervell referred to a study by The Surgeon Generalwhich showed that a total strength of 47,677 nurses was necessary to meetrequirements for 1944, taking into account the new ratios but not allowing forpotential requirements of 3,646 nurses "that can be foreseen at thistime." The figure of 47,677 nurses required was arrived at as follows:
37(1) Memorandum, G-1, for Chief ofStaff, 4 Jan. 1944, subject: Nurse Personnel Requirements. (2) Letter, G-1, toMilitary Personnel Division, Army Service Forces, to The Surgeon General, and toThe Adjutant General, 8 Jan. 1944, subject: Nurse Personnel Requirements.
38(1) Disposition Form, G-1, to The Surgeon General, 25 Feb.1944, subject: Nurse Personnel Requirements. (2) Memorandum, Deputy Chief ofStaff, for Commanding General, Army Service Forces, 1 Mar. 1944, subject: NursePersonnel Requirements.
87
|
Number | |
|
For general and station hospitals in Zone of Interior |
113,867 |
|
For fixed-bed theater of operations hospitals |
226,031 |
|
For other units, provided for in the 1944 troop basis: | |
|
Hospital ships |
1,309 |
|
Hospital trains |
228 |
|
Auxiliary surgical groups |
420 |
|
Composite units |
390 |
|
Air evacuation squadrons |
498 |
|
Evacuation hospitals |
988 |
|
Evacuation hospitals, semimobile |
2,200 |
|
Field hospitals |
1,746 |
|
47,677 |
1This number was calculated by applying the 1:15 ratio to108,000 beds in station hospitals and 100,000 beds in general hospitals; total,208,000 beds. Bed strength of station hospitals was arrived at by counting it as4 percent of a 2,700,000 troop strength.
2This number was calculated by applying the 1:12 ratio to 312,375 beds,which were provided for in the War Department Operations Division troop unitbasis.
General Somervell added that at his instance The SurgeonGeneral was continuing his studies to produce the greatest possible economies inthe use of nurses, but it seemed clear to General Somervell that the existingceiling of 40,000 should be increased by at least 5,000. Hetherefore asked for a further authorization of 5,000 "to avoid interruptionof the Nurse recruitment program."39
On 28 April 1944, G-1 more than met General Somervell`s request by raisingthe authorization for nurses to 50,000 whereit remained until almost the end of January 1945. Meanwhile,The Surgeon General`s estimates of requirements ran considerably above thatfigure. In October 1944, hisStrategic and Logistics Planning Unit forecast that by 31 December 1944 the need would rise to45,869 andwould remain at approximately that point until September 1945.40 Early in January1945, TheSurgeon General raised the forecast to 59,401 forJune 1945 (table 4).
The Surgeon General`s estimate was considerably higher than aforecast made about 2 weeks later by the Military Personnel Division, ArmyService Forces, which placed the requirement at 55,722 nursesby 30 June 1945. On 28 January 1945, the War Department General Staff virtually met thisrequirement by raising the ceiling to 55,000. Aweek afterward, it added 5,000 to make the total 60,000. These increases came in the midst of public agitationconcerning the adequacy of the nursing force and the necessity of a draft ofnurses. As many as 60,000 nursesmight have been needed if Germany had continued in the war beyond May 1945. With her defeat in that month, however, the requirementfor nurses rapidly diminished, and the problem became one of reduction ratherthan increase of the nursing force.
39Memorandum, Commanding General, Army ServiceForces, for Deputy Chief of Staff, 5 Apr. 1944, subject: Nurse PersonnelRequirements.
40Memorandum, Director, Strategic and LogisticsPlanning Unit, for The Surgeon General, 24 Oct. 1944, subject: Army Nurse CorpsRequirements, Medical Department, U.S. Army.
88
TABLE 4.-Proposed distribution of nurses,June 1945
|
Units and installations |
Authorized beds |
Bases for computation of requirements |
Nurse |
|
Table-of-organization units in troop basis: | |||
|
Overseas1 |
437,500 |
table of organization |
34,657 |
|
Zone of Interior |
6,325 |
...do... |
570 |
|
Non-table-of-organization in Zone of Interior: | |||
|
General hospitals |
165,000 |
1 nurse per 15 beds |
11,000 |
|
Convalescent hospitals |
50,000 |
1 nurse per 30 beds |
1,667 |
|
Regional and station hospitals |
2130,000 |
1 nurse per 15 beds |
8,667 |
|
Miscellaneous |
575 | ||
|
Miscellaneous: | |||
|
Theater of operations overhead |
265 | ||
|
Pipeline; pools; sick |
2,000 | ||
|
Total |
59,401 |
1Includes fixed and mobile beds actuallyoverseas.
2Estimated strength V-E Day+90.
Source: Memorandum, The Surgeon General, for G-1, 4 Jan. 1945.
DIETITIANS AND PHYSICAL THERAPISTS
Early in 1943, after the dietitians and physical therapists had attainedmilitary status, Maj. Emma E. Vogel, WMSC, Superintendent of Physical Therapists(fig. 24), recommended a ratio of 1 physical therapist to 100 beds in Zone ofInterior hospitals. She later was forced to lower the ratio when procurementfailed to meet it.41 Thenumber of physical therapists specified in the manning guide for 10 April 194342 reflected this lowered ratio. Seven months later, on 22 November, a furtherreduction, for the same reason, was put into effect.43 The November reductionwas drastic: for a 500-bed hospital, the number of physical therapists was cutfrom 4 to 2; for a 700-bed hospital, from 6 to 3; and for a 1,000-bed hospital, from 10 to 5.Dietitians, on the other hand, did not undergo comparable reductions. The guideissued in April 1943 allotted them to Zone of Interior hospitals at aconsiderably lower rate than physical therapists; for example, the 500-bedhospital was to have 3 dietitians, the 700-bed hospital 4, and the 1,000-bedhospital 5. The November guide, however reduced the allotment in only the largersized hospitals-those of 2,000- to 3,000-bed capacity-which were to have 1 to 3fewer dietitians than formerly. The result was that from November 1943 onwardthe guide for general, station, and eventually regional hospitals provided forthe same, or nearly the same, number of physical therapists and dietitians inproportion to a hospital`s bed capacity. This proportion was not changed,except for minor reductions in the largest hospitals,44 during the remainder ofthe war. The
41Vogel, Emma E.: Physical Therapists of the Medical Department, United States Army. [Official record.]
42War Department Circular No. 99, 10 Apr. 1943.
43See footnotes 36, p. 85, and 41.
44War Department Circular No. 209, 26 May 1944.
89
FIGURE 24.-Maj. Emma E. Vogel,WMSC, Superintendent of Physical Therapists.
new Zone of Interior convalescent hospitals, however, were tohave from two to six times as many physical therapists as dietitians, accordingto the guide issued in June 1945,45 but the proportion of both wasmuch smaller in relation to bed capacity than that allotted to other Zone ofInterior hospitals.
The general and station hospitals for service overseas were provided by theirtables of organization with fewer physical therapists and dietitians than wereallotted to similar hospitals of like capacity in the Zone of Interior, and in1943, even these few were reduced. Thus, in November 1943, the number ofphysical therapists in a 1,000-bed general hospital was cut from 5 to 3; in750- to 900-bed station hospitals, from 4 to 2; and in 500- to 700-bed stationhospitals, from 3 to 1. The numbers and reductions of dietitians were the sameas for physical therapists. In July 1944, dietitians in the 1,000-bed generalhospitals were reduced from 3 to 2, and 5 months later, physical therapists in750- to 900-bed station hospitals were reduced from 2 to 1. Evacuation hospitals(750-bed) retained one physical therapist from April 1943 to the end of the war.46
45War Department Circular No. 170, 8 June 1945.
46(1) See footnotes 36, p. 85, and 42, p. 88. (2) T/O8-550, General Hospital, 3 July 1944, and T/O 8-560, Station Hospital, 28 Oct.1944.
90
Requests for authorizations of both physical therapists anddietitians were based mainly on the manning guides and tables of organization,but the authorizations granted by the War Department usually fell below thoserequested by the Surgeon General`s Office. In September 1944, the latter asked for an increase in the ceiling forphysical therapists from 1,000 to 1,464 andfor dietitians from 1,500 to 2,000. In October, the War Department went no farther than1,250 for physical therapists and 1,750 fordietitians. Next month, the Surgeon General`s Office responded by asking for an increase from 1,250 to 1,700 inthe authorization for physical therapists. This was disapproved in December, butat the end of January 1945, the WarDepartment raised the ceiling for physical therapists to 1,500 and fordietitians to 2,000.47
A further increase was sought in April 1945. Based chiefly on manning guides and tables oforganization, the total requirement for physical therapists was 1,779 and for dietitians,2,303, madeup as follows:48
|
Dietitians |
Physical | |
|
Zone of Interior general hospitals |
597 |
668 |
|
Zone of Interior regional hospitals: | ||
|
Army Service Forces |
153 |
124 |
|
Army Air Forces |
133 |
90 |
|
Zone of Interior station hospitals: | ||
|
Army Service Forces |
233 |
121 |
|
Army Air Forces |
185 |
19 |
|
Zone of Interior convalescent hospitals: | ||
|
Army Service Forces |
40 |
101 |
|
Army Air Forces |
20 |
20 |
|
Instructors |
34 |
24 |
|
Surgeon General`s Office |
4 |
4 |
|
Table-of-organization units |
862 |
557 |
|
U.S. Army Military Academy |
2 |
1 |
|
Nonavailables: | ||
|
In transit and in personnel centers |
25 |
18 |
|
Patients and personnel on terminal leave |
15 |
12 |
|
Total |
2,303 |
1,779 |
The Surgeon General requested ceilings a trifle lower than this computationcalled for; namely, 1,750 forphysical therapists and 2,250 fordietitians. Six weeks later (30 May 1945), the War Department raised its total authorization forphysical therapists to 1,700 and fordietitians to 2,150.49 By that time, Germany was out of the war. Moreover,during the following months, recruit-
47(1) Letter, Chief, PersonnelService, Office of The Surgeon General, to Assistant Chief of Staff, G-1, WarDepartment, 14 Sept. 1944, subject: Request for an Increase in the ProcurementObjective for Dietitians and Physical Therapists, AUS. (2) Letter, The AdjutantGeneral, to Commanding General, Army Service Forces, 30 Oct. 1944, subject:Procurement Objective for Appointment of Nurses, Physical Therapists, andDietitians in the AUS. (3) Quarterly Report, Physical Therapy Branch, Office ofThe Surgeon General, U.S. Army, 1 Jan.-31 Mar. 1945. (4) Diary of PersonnelService, Office of The Surgeon General, for week ending 3 Feb.1945.
48Memorandum, The Surgeon General, for Assistant Chiefof Staff, G-1, 16 Apr. 1945, subject: Requirements for Dietitians and PhysicalTherapists.
49Letter, The Adjutant General, to Commanding General, Army ServiceForces, 30 May 1945, subject: Requirements for Dietitians and PhysicalTherapists.
91
ment did not succeed in increasing actual strength above 1,580 for the dietitians and1,300 for the physical therapists (table 1).
ENLISTED MEN
In 1940, the quota for the enlisted strength of the Medical Department wasraised from the 5 percent of total Army strength, established by the National Defense Act of 1920, to 7 percent or more, at the discretion of theWar Department, in case of emergency. This quota remained throughout the war.The lowest percentage in the period 1942-43 was 6.8; the highest, 7.5. After August 1944, it never rose above 7 percent; andbetween October 1944 and August 1945, it fell steadily from 6.9 to 6.1 (table1).
At the end of December 1944, the Enlisted Branch of the Surgeon General`sOffice observed that for some time it "had acknowledged that there wassufficient enlisted personnel, such as it was."At this time, total Medical Department enlisted strength was541,650 (table 1). By the end of March 1945, strength had decreased to533,044, but the decline was not considered dangerous since it was caused"mainly by the deactivation of a number of T/O units." Two monthsafterward (31 May 1945), although Medical Department enlisted strength hadfallen still further-to 524,332, of which 377,231 was overseas (table 5)-theenlisted personnel situation was described as "the best it has been for some time."50
Manning guides and tables oforganization provided a basis for estimating the enlisted requirements, as theydid in the case of other personnel. Guides for station hospitals in the Zone ofInterior were issued in April 1941, December 1942, and May 1944. A comparisonbetween the first and last of these will show the extent to which enlistedpersonnel were reduced in all except the 1,500- and 2,000-bed units:51
| ||
|
Table-of-organization bed capacity: |
April 1941 |
May 1944 |
|
250 |
150 |
131 |
|
300 |
175 |
157 |
|
350 |
200 |
180 |
|
400 |
225 |
198 |
|
450 |
250 |
222 |
|
500 |
275 |
239 |
|
600 |
325 |
292 |
|
700 |
370 |
341 |
|
750 |
390 |
368 |
|
800 |
410 |
383 |
|
900 |
455 |
422 |
|
1,000 |
500 |
458 |
|
1,500 |
700 |
706 |
|
2,000 |
900 |
912 |
50Quarterly Reports, Enlisted Personnel Branch, Personnel Service, Office ofThe Surgeon General, U.S. Army, for periods ending 31 Dec. 1944, and 31 Mar.1945, and for 2 months ending 31 May 1945.
51(1) Mobilization Regulations No. 4-2, Change No. 1, 9 Apr.1941. (2) See footnote 44, p. 88. (3) Smith, Clarence McKittrick: TheMedical Department: Hospitalization and Evacuation, Zone of Interior. UnitedStates Army in World War II. The Technical Services. Washington: U.S. GovernmentPrinting Office, 1956.
92-93
TABLE 5.-Medical Department enlistedstrength, worldwide and overseas, 31 July 1941-30 September 1945
|
Date and area |
Army enlisted strength |
Medical Department enlisted strength | |||||
|
Number1 |
Percentage of total Army strength2 |
Number3 |
Percentage of worldwide Medical Department enlisted strength |
Rate per 1,000 troops4 |
Percentage of Army enlisted strength |
Percentage of total Medical Department strength5 | |
|
31 July 1941: | |||||||
|
Worldwide |
1,422,158 |
92.9 |
106,662 |
100.0 |
--- |
7.5 |
83.8 |
|
Overseas |
128,476 |
94.7 |
4,301 |
4.0 |
31.7 |
3.3 |
81.5 |
|
30 Nov. 1941: | |||||||
|
Worldwide |
1,523,116 |
92.6 |
108,674 |
100.0 |
--- |
7.1 |
81.6 |
|
Overseas |
154,938 |
93.8 |
6,580 |
6.1 |
39.8 |
4.2 |
82.3 |
|
31 Mar. 1942: | |||||||
|
Worldwide |
2,235,113 |
93.7 |
169,627 |
100.0 |
--- |
7.6 |
84.3 |
|
Overseas |
306,638 |
93.5 |
15,512 |
9.1 |
47.3 |
5.1 |
77.9 |
|
30 June 1942: | |||||||
|
Worldwide |
2,867,762 |
93.3 |
209,952 |
100.0 |
--- |
7.3 |
82.8 |
|
Overseas |
565,384 |
94.0 |
35,252 |
16.8 |
58.6 |
6.2 |
82.4 |
|
30 Sept. 1942: | |||||||
|
Worldwide |
3,670,954 |
92.4 |
283,331 |
100.0 |
--- |
7.7 |
81.1 |
|
Overseas |
768,165 |
93.3 |
48,547 |
17.1 |
59.0 |
6.3 |
82.5 |
|
31 Jan. 1943: | |||||||
|
Worldwide |
5,370,755 |
92.2 |
417,307 |
100.0 |
--- |
7.8 |
83.9 |
|
Overseas |
1,036,329 |
92.5 |
72,263 |
17.3 |
69.7 |
7.0 |
82.1 |
|
30 Apr. 1943: | |||||||
|
Worldwide |
6,147,248 |
91.5 |
499,657 |
100.0 |
--- |
8.1 |
84.9 |
|
Overseas |
1,288,913 |
92.1 |
92,446 |
18.5 |
66.1 |
7.2 |
81.7 |
|
31 July 1943: | |||||||
|
Worldwide |
6,467,436 |
90.7 |
529,360 |
100.0 |
--- |
8.2 |
84.3 |
|
Overseas |
1,634,890 |
91.9 |
114,162 |
21.6 |
64.2 |
7.0 |
81.8 |
|
31 Oct. 1943: | |||||||
|
Worldwide |
6,625,157 |
90.3 |
507,611 |
100.0 |
--- |
7.7 |
82.5 |
|
Overseas |
2,054,499 |
91.7 |
146,959 |
29.0 |
65.6 |
7.2 |
81.7 |
|
31 Jan. 1944: | |||||||
|
Worldwide |
6,792,871 |
89.9 |
515,124 |
100.0 |
--- |
7.6 |
81.9 |
|
Overseas |
2,580,104 |
91.7 |
196,696 |
38.2 |
69.9 |
7.6 |
82.3 |
|
30 Apr. 1944: | |||||||
|
Worldwide |
7,042,116 |
89.7 |
532,771 |
100.0 |
--- |
6.8 |
81.8 |
|
Overseas |
3,251,857 |
91.5 |
248,003 |
46.5 |
69.8 |
7.6 |
82.5 |
|
31 July 1944: | |||||||
|
Worldwide |
7,191,703 |
89.3 |
558,828 |
100.0 |
--- |
7.8 |
82.2 |
|
Overseas |
3,716,742 |
90.8 |
284,791 |
51.0 |
69.9 |
7.7 |
82.8 |
|
31 Oct. 1944: | |||||||
|
Worldwide |
7,204,580 |
88.9 |
562,796 |
100.0 |
--- |
7.8 |
81.9 |
|
Overseas |
4,225,564 |
91.2 |
324,711 |
57.7 |
70.0 |
7.7 |
83.0 |
|
31 Jan. 1945: | |||||||
|
Worldwide |
7,139,700 |
88.5 |
537,303 |
100.0 |
--- |
7.5 |
80.5 |
|
Overseas |
4,678,043 |
91.3 |
357,567 |
66.5 |
69.8 |
7.6 |
83.2 |
|
30 Apr. 1945: | |||||||
|
Worldwide |
7,274,779 |
88.2 |
532,029 |
100.0 |
--- |
7.3 |
79.1 |
|
Overseas |
4,974,051 |
91.2 |
385,296 |
72.4 |
71.9 |
7.8 |
83.1 |
|
31 May 1945: | |||||||
|
Worldwide |
7,305,854 |
88.1 |
524,332 |
100.0 |
--- |
7.2 |
78.6 |
|
Overseas |
4,925,323 |
91.1 |
377,231 |
71.9 |
69.8 |
7.7 |
82.9 |
|
30 June 1945: | |||||||
|
Worldwide |
7,283,930 |
88.1 |
521,282 |
100.0 |
--- |
7.2 |
78.4 |
|
Overseas |
4,783,503 |
91.3 |
367,844 |
70.6 |
70.2 |
7.7 |
82.9 |
|
31 July 1945: | |||||||
|
Worldwide |
7,200,220 |
87.9 |
514,511 |
100.0 |
--- |
7.1 |
78.0 |
|
Overseas |
4,491,271 |
91.2 |
350,056 |
68.0 |
71.1 |
7.8 |
83.0 |
|
31 Aug. 1945: | |||||||
|
Worldwide |
7,040,446 |
87.7 |
493,209 |
100.0 |
--- |
7.0 |
77.3 |
|
Overseas |
4,214,725 |
91.2 |
311,047 |
63.0 |
67.3 |
7.4 |
82.5 |
|
30 Sept. 1945: | |||||||
|
Worldwide |
6,598,986 |
87.2 |
454,989 |
100.0 |
--- |
7.9 |
76.0 |
|
Overseas |
3,788,062 |
91.1 |
273,049 |
60.0 |
65.7 |
7.2 |
82.4 |
1Male personnel only. All data arefrom "Monthly Strength of the Army, Continental United States," and"Monthly Strength of the Army, Foreign and En Route," in "Strength of the Army," 1 Oct. 1945, pp. 58-59, with the followingexceptions: Oversea data for 31 March 1942 are from sources of correspondingdata listed in table 31, footnote 2 (see the cited footnote for the reasons forthe substitution); worldwide data for 31 March 1942 are oversea strength asshown here plus male enlisted strength for the same date reported in"Monthly Strength of the Army, Continental United States," citedabove; data for 31 July 1944 are from "Strength of the Army" for thesame date and exclude personnel unaccounted for by commands (such personnel areincluded in the male enlisted strength for oversea areas (3,734,062) reported in"Monthly Strength of the Army, Foreign and En Route," cited above, butare excluded from this table since the number of medical personnel among them isunknown).
2For total Army strength, see table 31.
3Worldwide strength for July andNovember 1941 from "Strength of the Army" for corresponding dates; forother dates, from table 1 (SGO data). Oversea strength from sources shown intable 31, footnote 3, for period prior to September 1942 and for April 1944 inpart, from "Strength of the Army" in all other instances.
4For troop strength, see table 31; for worldwide rates, see table 1 (SGO data).
5For total Medical Department strength, see table 31.
94
TABLE 6.-Guide for utilization ofpersonnel in named general hospitals, Zone of Interior
|
Number of authorized beds |
Officers |
Enlisted men |
Total personnel |
Total personnel per 100 beds | |||||||||||||||
|
Medical Corps |
Dental Corps |
Medical Administrative Corps |
Sanitary Corps |
Veterinary Corps |
Army Nurse Corps |
Hospital dietitians |
Physical therapists |
Quartermaster Corps |
Corps of Engineers |
Signal Corps |
Finance Department |
Chaplain Corps |
Corps of Military Police |
Warrant officers |
Total | ||||
|
1,000 |
35 |
7 |
24 |
4 |
1 |
67 |
6 |
5 |
1 |
1 |
1 |
1 |
2 |
2 |
3 |
160 |
558 |
718 |
71.80 |
|
1,500 |
46 |
8 |
30 |
4 |
1 |
100 |
7 |
6 |
2 |
1 |
1 |
1 |
3 |
2 |
5 |
217 |
838 |
1,055 |
70.33 |
|
1,750 |
50 |
9 |
33 |
5 |
1 |
117 |
7 |
6 |
2 |
2 |
1 |
2 |
4 |
3 |
5 |
247 |
965 |
1,212 |
69.25 |
|
2,000 |
55 |
12 |
36 |
5 |
1 |
133 |
8 |
7 |
2 |
2 |
1 |
2 |
4 |
3 |
6 |
277 |
1,096 |
1,373 |
68.65 |
|
2,500 |
60 |
14 |
39 |
5 |
2 |
167 |
9 |
8 |
2 |
2 |
1 |
2 |
4 |
3 |
6 |
324 |
1,383 |
1,707 |
68.28 |
|
3,000 |
64 |
16 |
44 |
6 |
2 |
200 |
10 |
9 |
3 |
2 |
2 |
3 |
5 |
4 |
7 |
377 |
1,653 |
2,030 |
67.66 |
|
3,500 |
70 |
19 |
47 |
7 |
2 |
233 |
12 |
10 |
3 |
3 |
2 |
3 |
5 |
4 |
7 |
427 |
1,952 |
2,379 |
67.97 |
|
4,000 |
80 |
21 |
53 |
9 |
2 |
267 |
14 |
12 |
5 |
4 |
2 |
3 |
7 |
5 |
9 |
493 |
2,291 |
2,784 |
69.60 |
Source: War Department Circular No. 209, 26 May 1944.Substitution of civilians for enlisted men on a three-for-two basis waspermitted. This obtained until War Department Circular No. 87, 19 Mar. 1945,required that substitution be made only on a one-for-one basis.
95
As for the Zone of Interior general hospitals, The Surgeon General in 1942 instructed them to use the table of organization foroversea general hospitals as their guide. This table provided for 500 enlistedmen in a 1,000-bed hospital. A guide specifically for Zone of Interior generalhospitals was issued at the end of 1942 anda new one in May 1944. The latterallotted from 558 enlisted men for a 1,000-bed hospital to 2,291 for a 4,000-bed hospital (table 6). The new guides forboth general and station hospitals permitted the replacement of enlisted men"by similarly qualified civilians generally on a three-civilian fortwo-enlisted-men basis" because of the disparity in working hours. Theguide for Zone of Interior convalescent hospitals, issued in June 1945, also permitted the replacement of enlisted men bycivilians, but made no reference to ratios. It allotted from 200 enlisted menfor the 500-bed hospital to 1,400 forthe 6,000-bed hospital (table 7). It will be noted that in these guides theratio of enlisted men to bed capacity was much lower in convalescent hospitalsthan in station hospitals, and lower in the latter than in general hospitals.
Successive tables of organization for oversea units, like the manning guidesfor Zone of Interior installations, showed reductions in the number of enlistedmen during the war period, as is illustrated in the tables for various types ofhospitals and for the medical detachment of the infantry regiment (tables 8 and9).
The total requirement for personnel in table-of-organization units of alltypes appeared in the troop basis issued from time to time by the WarDepartment. An analysis of the troop basis for 1 October 1944, prepared by the Surgeon General`s Office, showed thedistribution of Medical Department personnel among table-of-organization unitsof the ground, air, and service forces at the actual strength on 30 September 1944and at the strength planned on 1 October 1944 for 31 December 1944 and30 June 1945. The distribution
TABLE 7.-Guide for utilization ofpersonnel in convalescent hospitals, Zone of Interior
|
Number of authorized beds |
Officers |
Enlisted men |
Total personnel |
Total personnel per 100 beds | ||||||||
|
Medical Corps |
Dental Corps |
Medical Administrative Corps |
Sanitary Corps |
Hospital dietitians |
Physical therapists |
Chaplain Corps |
Warrant officers |
Total | ||||
|
500 |
13 |
3 |
30 |
1 |
1 |
2 |
1 |
1 |
52 |
200 |
252 |
50.4 |
|
1,000 |
20 |
5 |
50 |
1 |
1 |
4 |
1 |
1 |
83 |
323 |
406 |
40.6 |
|
1,500 |
24 |
6 |
60 |
1 |
1 |
5 |
2 |
1 |
100 |
428 |
528 |
35.2 |
|
2,000 |
28 |
8 |
68 |
1 |
1 |
6 |
2 |
1 |
115 |
529 |
644 |
32.2 |
|
2,500 |
34 |
10 |
80 |
1 |
2 |
7 |
3 |
1 |
138 |
649 |
787 |
31.5 |
|
3,000 |
40 |
12 |
91 |
1 |
2 |
7 |
3 |
2 |
158 |
768 |
926 |
30.9 |
|
4,000 |
50 |
16 |
109 |
1 |
2 |
8 |
3 |
2 |
191 |
958 |
1,149 |
28.7 |
|
5,000 |
63 |
20 |
130 |
1 |
3 |
10 |
4 |
3 |
234 |
1,203 |
1,437 |
28.7 |
|
6,000 |
74 |
24 |
146 |
1 |
3 |
12 |
4 |
3 |
267 |
1,400 |
1,667 |
27.8 |
96-97
TABLE 8.-Table-of-organization changes incertain types of hospitals, 1940-44
|
Type of hospital and authority |
Officers |
Total enlisted men |
Aggregate | ||||||||||
|
Medical Corps |
Medical Administrative Corps |
Dental Corps |
Sanitary Corps |
Chaplain Corps |
Quartermaster Corps |
Warrant officers |
Army Nurse Corps |
Hospital dietitians |
Physical therapists |
Total | |||
|
General (1,000-bed): | |||||||||||||
|
T/O 683, 6 July 1932 |
30 |
6 |
4 |
--- |
1 |
1 |
--- |
120 |
--- |
--- |
162 |
400 |
562 |
|
T/O 8-507, 25 July 1940 |
55 |
6 |
7 |
1 |
2 |
2 |
--- |
120 |
--- |
--- |
193 |
500 |
693 |
|
T/O 8-550, 1 Apr. 1942 |
38 |
7 |
5 |
2 |
2 |
2 |
1 |
105 |
--- |
--- |
162 |
500 |
662 |
|
T/O 8-550 (Ch 2), 5 Oct. 1942 |
37 |
8 |
5 |
2 |
2 |
2 |
1 |
105 |
--- |
--- |
162 |
500 |
662 |
|
WD Cir. 306, 22 Nov. 1943 |
37 |
8 |
5 |
2 |
2 |
2 |
1 |
100 |
3 |
3 |
163 |
500 |
663 |
|
T/O 8-550 (Ch 3), 4 Mar. 1944 |
37 |
8 |
5 |
2 |
2 |
2 |
1 |
83 |
3 |
3 |
146 |
500 |
646 |
|
T/O 8-550, 3 July 1944 |
32 |
110 |
6 |
2 |
3 |
--- |
1 |
83 |
3 |
2 |
142 |
450 |
2594 |
|
Station (250-bed): | |||||||||||||
|
T/O 684-W, 1 July 1929 |
11 |
2 |
2 |
--- |
--- |
--- |
--- |
35 |
--- |
--- |
50 |
150 |
200 |
|
T/O 8-508, 25 July 1940 |
15 |
3 |
2 |
--- |
--- |
--- |
--- |
30 |
--- |
--- |
50 |
150 |
200 |
|
T/O 8-560, 22 July 1942 |
13 |
5 |
2 |
--- |
1 |
--- |
--- |
30 |
--- |
--- |
51 |
150 |
201 |
|
WD Cir. 306, 22 Nov. 1943 |
13 |
5 |
2 |
--- |
1 |
--- |
--- |
25 |
--- |
--- |
46 |
150 |
196 |
|
T/O 8-560 (Ch 3), 4 Mar. 1944 |
13 |
5 |
2 |
--- |
1 |
--- |
--- |
21 |
--- |
--- |
42 |
150 |
192 |
|
T/O 8-560, 28 Oct. 1944 |
10 |
5 |
2 |
--- |
1 |
--- |
--- |
21 |
--- |
--- |
39 |
138 |
2179 |
|
Station (500-bed): | |||||||||||||
|
T/O 8-508, 25 July 1940 |
23 |
8 |
4 |
--- |
--- |
--- |
--- |
60 |
--- |
--- |
95 |
275 |
370 |
|
T/O 8-560, 22 July 1942 |
19 |
8 |
3 |
1 |
2 |
--- |
1 |
55 |
--- |
--- |
89 |
275 |
364 |
|
WD Cir. 306, 22 Nov. 1943 |
19 |
8 |
3 |
1 |
2 |
--- |
1 |
50 |
1 |
1 |
86 |
275 |
361 |
|
T/O 8-560 (Ch 3), 4 Mar. 1944 |
19 |
8 |
3 |
1 |
2 |
--- |
1 |
42 |
1 |
1 |
78 |
275 |
353 |
|
WD Cir. 99,3 9 Mar. 1944 |
16 |
11 |
3 |
1 |
2 |
--- |
1 |
42 |
1 |
1 |
78 |
275 |
353 |
|
T/O 8-560, 28 Oct. 1944 |
16 |
411 |
3 |
1 |
1 |
--- |
1 |
42 |
1 |
1 |
77 |
253 |
330 |
|
Station (750-bed): | |||||||||||||
|
T/O 8-508, 25 July 1940 |
37 |
8 |
4 |
--- |
--- |
--- |
--- |
90 |
--- |
--- |
139 |
390 |
529 |
|
T/O 8-560, 22 July 1942 |
24 |
9 |
4 |
1 |
2 |
--- |
1 |
75 |
--- |
--- |
116 |
392 |
508 |
|
WD Cir. 306, 22 Nov. 1943 |
24 |
9 |
4 |
1 |
2 |
--- |
1 |
75 |
2 |
2 |
120 |
392 |
512 |
|
T/O 8-560 (Ch 3), 4 Mar. 1944 |
24 |
9 |
4 |
1 |
2 |
--- |
1 |
63 |
2 |
2 |
108 |
392 |
500 |
|
WD Cir. 99,3 9 Mar. 1944 |
21 |
12 |
4 |
1 |
2 |
--- |
1 |
63 |
2 |
2 |
108 |
392 |
500 |
|
T/O 8-560, 28 Oct. 1944 |
20 |
412 |
4 |
1 |
2 |
--- |
1 |
63 |
2 |
1 |
106 |
351 |
457 |
|
Evacuation (750-bed): | |||||||||||||
|
T/O 283-W, 1 July 1929 |
32 |
4 |
2 |
--- |
1 |
1 |
--- |
60 |
--- |
--- |
100 |
300 |
400 |
|
T/O 8-232, 1 Oct. 1940 |
37 |
5 |
3 |
--- |
1 |
1 |
--- |
52 |
--- |
--- |
99 |
318 |
417 |
|
T/O 8-580, 2 July 1942 |
34 |
8 |
3 |
--- |
1 |
1 |
--- |
52 |
--- |
--- |
99 |
318 |
417 |
|
T/O 8-580, 23 Apr. 1943 |
37 |
5 |
3 |
--- |
2 |
--- |
1 |
52 |
1 |
--- |
101 |
308 |
409 |
|
WD Cir. 306, 22 Nov. 1943 |
37 |
5 |
3 |
--- |
2 |
--- |
1 |
53 |
1 |
--- |
102 |
308 |
410 |
|
T/O 8-580, 31 Jan. 1945 |
37 |
5 |
3 |
--- |
2 |
--- |
1 |
53 |
1 |
--- |
102 |
303 |
405 |
|
Evacuation (400-bed): | |||||||||||||
|
T/O 8-581, 2 July 1942 |
29 |
7 |
2 |
--- |
1 |
--- |
1 |
48 |
--- |
--- |
88 |
248 |
336 |
|
T/O 8-581, 26 July 1943 |
29 |
6 |
2 |
--- |
1 |
--- |
1 |
40 |
--- |
--- |
79 |
217 |
296 |
|
T/O 8-581, 25 Mar. 1944 |
28 |
7 |
2 |
--- |
1 |
--- |
1 |
40 |
--- |
--- |
79 |
217 |
296 |
1Five of these might be members of thePharmacy Corps. Since none of the tables of organization or circulars cited inthe table stipulated that a Pharmacy Corps officer had necessarily to be placedin any of these hospitals, no column has been shown for them. See also footnote4.
2Includes one engineer officer and one officer, branch immaterial.
3In order to conserve Medical Corps officers, this circular statedthat "executive officers and registrars of numbered or fixed general orstation hospitals should preferably be Medical Administrative Corps officerscommissioned because of prior training or experience as civilian hospitaladministrators or Medical Department noncommissioned officers." WarDepartment Circular No. 152, 17 April 1944, allowed officers of other corps thanthe Medical Administrative Corps to be substituted in these jobs, stating thatexecutive officers "of all numbered or fixed station hospitals andregistrars of all numbered or fixed general or station hospitals" shouldpreferably be either Medical Administrative Corps, Pharmacy Permission to useother than Medical Corps officers as executive officers of general hospitals waslater withdrawn (War Department Circular No. 327, 8 Aug. 1944).
4These officers might be in the Pharmacy Corps.
98
of Medical Department enlisted personnel presented in this analysis was as follows:52
|
Actual strength, |
Planned strength, | |
|
Army Ground Forces: | ||
|
Combat and communications zones |
166,935 |
164,664 |
|
Zone of Interior |
807 |
943 |
|
Total |
167,742 |
165,607 |
|
Army Air Forces: | ||
|
Combat and communications zones |
24,709 |
25,011 |
|
Zone of Interior |
117 |
193 |
|
Total |
24,826 |
25,204 |
|
Army Service Forces: | ||
|
Combat and communications zones |
180,250 |
217,904 |
|
Zone of Interior |
1,656 |
816 |
|
Total |
181,906 |
218,720 |
|
Grand total |
374,474 |
409,531 |
TABLE 9.-Table-of-organization changes inthe medical detachment of the infantry regiment (T/O 7-11), 1938-45
|
Date |
War strength of regiment |
Medical Corps |
Dental Corps |
Medical Administrative Corps |
Enlisted men in medical detachment |
|
6 Dec. 1938 |
2,542 |
8 |
2 |
--- |
96 |
|
1 Mar. 1940 |
2,776 |
8 |
2 |
--- |
96 |
|
1 Oct. 1940 |
3,449 |
8 |
2 |
--- |
96 |
|
1 Apr. 1942 |
3,472 |
8 |
2 |
--- |
126 |
|
1 Mar. 1943 |
3,088 |
7 |
2 |
--- |
103 |
|
26 Feb. 1944 |
3,257 |
7 |
2 |
--- |
126 |
|
30 June 1944 |
3,207 |
5 |
2 |
3 |
126 |
|
1 June 1945 |
3,697 |
5 |
2 |
3 |
126 |
|
5 Sept. 1945 |
3,697 |
5 |
2 |
3 |
136 |
52Letter, Military Personnel Planning and Placement Branch,Military Personnel Division, Office of The Surgeon General (Lt. Col. Fred J.Fielding), to Director, Military Personnel Division, Office of The SurgeonGeneral, 1 Dec. 1944, subject: War Department Troop Basis as of 1 October 1944.
99
ENLISTED WOMEN
The establishment of a requirement for enlisted women-membersof the Women`s Army Corps (usually called Wacs)53-evolvedduring the course of 1942. The Surgeon General rejected the idea of adding themto the hospital complements when it was first broached in the spring of 1942.His objection to taking them was that it would interfere with the employment ofcivilians and the training of enlisted men and would cause difficulties in theway of housing and recreation. His opinion changed as a result of pressure fromvarious sources before the end of 1942-the insistence of the General Staff andServices of Supply headquarters that all services should make use of Wacs inorder to release more men for combat duty, the recommendations of the Committeeto Study the Medical Department that Wacs could supplement the supply of nurses,the difficulty of enlarging or even maintaining the civilian staffs, and thetrend of thought in his own Office and among hospital commanders. Accordingly, after proposing a test at two hospitals, which could not becarried out because WAC personnel were not available, he appointed a board inJanuary 1943 to consider the matter and asked for reports from the servicecommands, the Air Forces, the Transportation Corps, the Military District ofWashington, and the Army Medical Center on the possibilities involved. While not all hospital commanders were favorable to the use of Wacs, Services ofSupply hospitals of 600 beds or more estimated that Wacs could replace from 30 to50 percent of their enlisted men; the Air Forces planned to make use ofWacs in hospitals having a capacity of as few as 200 beds. On this basis, TheSurgeon General`s board calculated that more than 10,000 Wacs would be needed inthe hospitals. The Surgeon General sent the service commands tabulations of WAC personnel for hospitals to be used in makingup anticipated requisitions.Before the matter could be carried further, a falling off in WAC recruitmentcaused WAC headquarters to notify The Surgeon General in June 1943 that he could expect only 150 to 175women a month for training, beginning inSeptember. The use of large numbers of Wacs in hospitals therefore had to bepostponed.
Late in 1943, whenmedical installations were requisitioning these women, the Deputy SurgeonGeneral wrote that the Medical Department could employ all of them who couldbe made available, "in fact," he declared, "the entire WACorganization could be utilized in order to release male military operatingpersonnel.``54 Severalcampaigns to recruit members of the Women`s Army Corps for employment as MedicalDepartment technicians (fig. 25) ensuedduring 1944 and 1945, onesetting its quota as high as 7,000. This quota was met.
53For convenience, the later title of thisorganization will be used here. Its earlier title (until 1 July 1943) was"Women`s Auxiliary Army Corps."
54Memorandum, General Lull, for Commanding General, Army ServiceForces, 27 Dec. 1943, subject: Reduction of Military Operating Personnel, ArmyService Forces.
100
CIVILIANS
No formula was established for computing the total number ofcivilians required for Army medical service in the Zone of Interior until theestablishment of bulk authorizations in June 1943.55 Before then, the number of civilians who could beemployed was unrestricted except through the allotment of funds. Under the newsystem, the permitted number varied inversely with the number of militarypersonnel authorized.
Large numbers of civilians were used throughout the war assubstitutes for military personnel in many kinds of work. The process ofsubstitution was intensified during the later war years when the MedicalDepartment had to move large numbers of officers and enlisted men out of itsinstallations in the United States for service overseas. As the number ofenlisted men remaining was more than ever inadequate to meet all demands,Medical Department authorities could hardly repeat their earlier protestsagainst the free substitution of civilians in their installations with anyprospect of being heeded. At one time (May 1944), the General Staff permitted the substitution of civiliansin hospitals for enlisted personnel on a three-for-two basis (taking account ofthe civilians` work day of only 8 hours as against that of 12 for enlistedpersonnel); in 1945, however,the General Staff ordered that substitutions be
55This section deals only with developments in the Zone ofInterior. Of necessity, there was no requirement for civilians in overseatheaters. They were used if they were available but could not be counted on inadvance. Oversea use of civilians is therefore treated under"Procurement" in chapter VIII.
101
made on a one-for-one basis.56This one-for-one rule handicapped commanders of hospitals and otherinstallations which operated for more than 8 hours a day.
Civilians employed inMedical Department installations represented all grades of skill, from thejanitor who kept the floors of a hospital tidy to the highly specialized medicalor surgical consultant. Technical positions, including those of dentalhygienists and laboratory technicians, were more difficult to fill than thosedemanding less skill. As male help became scarcer, large numbers of women wereemployed. For example, in 1943, when many enlisted men were withdrawn frominstallations for shipment overseas, the commander of Percy Jones GeneralHospital, Mich., reported that he had elicited the help of the families ofmilitary personnel.57
In the nursing field, Army nurses were supplemented bycivilian nurses` aides (fig. 26), both paid and volunteer; by cadet nurses, whowere students receiving part of their training in Government hospitals, in thecourse of which they rendered nursing service and on graduation acceptedemployment as full-fledged nurses in one branch or another of the Federalhospital system; and finally, graduate nurses who for one reason or anothercould not meet the qualifications of the Army Nurse Corps but who could meet thequalifications of the Civil Service Commission.58
56(1) See footnote 55, p. 100. (2) War Department Circular No. 87, 19 Mar. 1945.
57Annual Report, Percy Jones General Hospital, 1942.
58See footnote 34, p. 84.
102
Occupational therapists also were employed as civilians throughout the war bythe Medical Department.
The Army Specialist Corps, as already mentioned, during 1942 furnished a limited number, possibly about a hundred, ofadministrative, professional, scientific, and technical specialists. In late 1942,the Secretary of War decided that it was not feasible tohave two uniformed services and abolished the corps, permitting its members tothe extent practicable to apply for commissions in the Army of the UnitedStates.59
Although some difficulties and complaints arose concerningthe use and performance of civilian employees in the Medical Department,certainly thousands of intelligent, hard-working, and responsible civilianemployees were to be found in its establishments. It is even more obvious thatwhatever drawbacks the use of civilians involved, the Medical Department wouldhave been quite unable to carry its load without their assistance.
While Red Cross workers in Army hospitals were not regardedas making up deficiencies in the supply of military personnel, at least not inthe same sense as were civilians hired for that purpose, they performed avariety of services in connection with the care of patients, for which theyreceived no pay from the Government. The Medical Department had reason to begrateful for the contributions these workers made to the well-being of itspatients.
ADDITIONAL UNIT REQUIREMENTS OVERSEAS
Additional requirements overseas60were based on four factors: (1) Losses, both physical oradministrative; (2) additions to non-table-of-organization personnel; (3)reorganizations of table-of-organization units; and (4) shortages.
Losses
An individual was officially recognized as a physical"loss" to his unit when the unit was notified of his death, capture,internment in a neutral country, absence without leave for an appreciableperiod, or hospitalization. The unit could then request a replacement. Thequestion as to whether a hospitalized soldier should remain on the rolls of hisunit was resolved in the light of the amount of time it was believed that theunit could operate efficiently without the services appropriate to his position.A difference necessarily existed between units functioning in forward areas andthose operating in the rear. Under combat conditions, a unit could not afford towait any appreciable period for the return of an individual, and its right toreplace him arose simultane-
59Memorandum, Secretary of War, for Director, ArmySpecialist Corps, 31 Oct. 1942, subject: Disposition of the Army SpecialistCorps.
60Unless otherwise indicated, this section is based on (1)Annual Reports, Surgeon, European Theater of Operations, U.S. Army, 1943 and1944, and (2) Administrative and Logistical History of Medical Service,Communications Zone, European Theater of Operations, U.S. Army, chs. IV and X. [Official record.]
103
ously with his hospitalization.61In July 1944, this situation wasgiven official recognition when the War Department in effect directed thattroops in combat areas officially designated by the theater commander be droppedfrom the rolls of their units immediately upon hospitalization. For mostpersonnel whose hospitalization originated in locations not designated as combatareas, the assignment to the original unit was to be severed only aftercompletion of 60 days` total hospitalization.62
Administrative losses occurred when table-of-organizationpositions were vacated by the transfer of individuals to other assignmentswithin the unit or in other units or when they were separated from the militaryservice altogether for reasons wholly within the control of the Army. From themiddle of 1943 on, rotation wasstill another cause. Even if the vacancy were filled by reassignment orpromotion, another vacancy was thus created.
Non-Table-of-Organization Allotments
The War Department recognized the need for oversea personnel beyond thatshipped in units from the Zone of Interior and therefore established a "nonT/O allotment" for each theater. In the European theater, the amount ofpersonnel authorized for the medical service out of thenon-table-of-organization allotment during 1943 and 1944 was as follows:
|
1 April 1943: | |
|
Total |
1,143 |
|
Officers (including warrant officers) |
281 |
|
Enlisted |
862 |
|
1 September 1943: | |
|
Total |
1,275 |
|
Officers (including warrant officers) |
390 |
|
Enlisted |
885 |
|
1 April 1944: | |
|
Total |
1,710 |
|
Officers (including warrant officers) |
362 |
|
Enlisted |
1,348 |
|
6 September 1944:1 | |
|
Total |
1,403 |
|
Officers (including warrant officers) |
416 |
|
Enlisted |
987 |
1This date is only approximate, the authorization being fixedabout the time Headquarters, European Theater of Operations, U.S. Army, wasestablished in Paris.
In relation to theater medical strength, the authorizationfor 1 April 1943 amounted to 10.86 percent; that for 1 September 1943, to 6.05 percent; 1 April1944, to 1.54 percent; and 6 September 1944,0.83 percent. During 1944, the
61In the European theater, unitsengaged in combat were authorized in November 1944 to include in their dailyreplacement requisitions a statement of anticipated losses for a period of 48hours after the requisition was made as a basis for provision of replacements.
62War Department Circular No. 280, 6 July 1944.
104
number of Medical Department personnel actually assigned tonon-table-of-organization establishments, including, besides the offices of theTheater Chief Surgeon and base section surgeons, two central dentallaboratories, the supply depots, and other installations, declined from about 4percent of the total number of medical personnel in the theater to less than 1percent.
Additional and Reorganized Table-of-Organization Units
In some cases, the Zone of Interior failed to provide theoversea theaters with a sufficient number of table-of-organization units to meetthe requirements. It was therefore necessary to set up such units locally and toprovide them with personnel. In the early part of 1945, for example, the WarDepartment authorized the European theater to activate 11 medical teams, eachwith a strength of 10 men; 34 mess teams, each with 4 men; 23 dental prostheticteams, each with a similar strength; and 2 optical repair teams which requiredan aggregate of 9 men.63 Theestablishment of newly activated table-of-organization units in the SouthwestPacific Area in late 1944 was one of the factors which created a large number ofvacancies for dental officers in that region.64
An increase in the authorized size of a unit after it hadarrived in a theater of operations also made it necessary for authorities withinthe theater to provide it with additional personnel. In 1943, several smallstation and general hospitals arriving in the United Kingdom were rerated aslarger units. This required additional personnel. Additional personnel also wererequired in certain units in the North African theater through augmentation insize of all 1,000-bed general hospitals by 50 to 100 percents.65 For example, the6th General Hospital, by an increase of its authorized bed capacity from 1,000to 1,500 beds in mid-1944, witnessed an expansion of its authorized enlistedstrength from 500 to 562 men.66 When patients in excess of thetable-of-organization bed capacity of certain hospitals in the Seine Sectionwere hospitalized in these installations during January-March 1945, augmentationof the nursing personnel became necessary wherever this took place. Revisions oftables of organization that established additional authorizations for personnel,such as dental and medical administrative officers, likewise compelled theatermedical authorities to look for the personnel with which to fill these slots. Asone example, the revision of Table of Organization 8-560 on 28 October 1944created 326 new medical administrative officer posts in oversea stationhospitals.
63For the table-of-organization strength of the unitsmentioned see "Medical Department Service Organization," T/O&E8-500, 23 Apr. 1944.
64Essential Technical Medical Data, U.S. Army Forces,Far East, for December 1944, dated 15 Feb. 1945.
65Logistical History of North African-MediterraneanTheater of Operations, U.S. Army, pp. 291-294. [Official record.]
66Historical Report, 6th General Hospital,Mediterranean Theater of Operations, 22 Oct. 1944. [Official record.]
105-106
Shortages
Another factor which created a need for personnel to fill vacancies overseaswas the practice dating from the spring of 1944 of sending table-of-organizationunits abroad short of their full complements of medical personnel. In the latterpart of that year, many general hospitals were sent to the European theater withonly 16 Medical Corps officers in each; field units likewise were dispatchedwithout their full complement of such officers. One justification for thisprocedure was that by this time the theater already boasted an ample supply ofspecialist personnel who could be assigned to these understaffed units, butthere continued to be shortages outside the specialties. During June and July1944, the European theater received 12 general hospitals, each of 1,000-bedcapacity, without their nurse complements (table 10).
TABLE 10.-Medical Department overstrengthsand understrengths in various oversea theaters or areas,
30 November 1943
|
Theater or area |
Authorized strength1 |
Overstrength |
Understrength | ||
|
Number2 |
Percent |
Number2 |
Percent | ||
|
Medical Corps | |||||
|
Europe |
3,812 |
2 |
0.05 |
0 |
0 |
|
North Africa |
3,434 |
102 |
2.97 |
0 |
0 |
|
China-Burma-India |
671 |
0 |
0 |
0 |
0 |
|
Central Pacific |
740 |
70 |
9.46 |
0 |
0 |
|
South Pacific |
1,131 |
0 |
0 |
157 |
13.88 |
|
Dental Corps | |||||
|
Europe |
729 |
0 |
0 |
0 |
0 |
|
North Africa |
650 |
11 |
1.69 |
0 |
0 |
|
China-Burma-India |
106 |
0 |
0 |
0 |
0 |
|
Central Pacific |
195 |
0 |
0 |
26 |
13.33 |
|
South Pacific |
207 |
0 |
0 |
21 |
10.14 |
|
Veterinary Corps | |||||
|
Europe |
51 |
0 |
0 |
0 |
0 |
|
North Africa |
30 |
7 |
23.33 |
0 |
0 |
|
China-Burma-India |
85 |
0 |
0 |
0 |
0 |
|
Central Pacific |
22 |
2 |
9.09 |
0 |
0 |
|
South Pacific |
19 |
0 |
0 |
1 |
5.26 |
|
Sanitary Corps | |||||
|
Europe |
91 |
0 |
0 |
0 |
0 |
|
North Africa |
118 |
2 |
1.69 |
0 |
0 |
|
China-Burma-India |
20 |
0 |
0 |
0 |
0 |
|
Central Pacific |
17 |
0 |
0 |
0 |
0 |
|
South Pacific |
61 |
0 |
0 |
19 |
31.15 |
|
Medical Administrative Corps | |||||
|
Europe |
835 |
0 |
0 |
0 |
0 |
|
North Africa |
786 |
33 |
4.20 |
0 |
0 |
|
China-Burma-India |
125 |
0 |
0 |
0 |
0 |
|
Central Pacific |
201 |
0 |
0 |
29 |
14.43 |
|
South Pacific |
239 |
0 |
0 |
56 |
23.43 |
|
Army Nurse Corps | |||||
|
Europe |
4,142 |
0 |
0 |
0 |
0 |
|
North Africa |
4,120 |
5 |
.12 |
0 |
0 |
|
China-Burma-India |
633 |
0 |
0 |
0 |
0 |
|
Central Pacific |
1,054 |
0 |
0 |
157 |
14.90 |
|
South Pacific |
1,117 |
0 |
0 |
290 |
25.96 |
| Enlisted men | |||||
|
Europe |
41,972 |
439 |
1.05 |
0 |
0 |
|
North Africa |
39,349 |
924 |
2.35 |
0 |
0 |
|
China-Burma-India |
6,200 |
3 |
.05 |
0 |
0 |
|
Central Pacific |
14,056 |
0 |
0 |
1,521 |
10.82 |
|
South Pacific |
13,593 |
0 |
0 |
1,105 |
8.15 |
1The exact authorized strength used in determiningoverstrength or understrength is unknown. For the purposes of this table, it isassumed that the authorized strength is the actual strength on 30 November 1943as reported in "Strength of the Army" for that date minus theoverstrength or plus the understrength.
2Memorandum, Acting Adjutant General, for AssistantChief of Staff, G-3, subject: Monthly Reports of Replacements Available inOverseas Theaters, 27 Dec. 1943. (Overstrengths appear to be strength above T/Ostrength and non-T/O allotments plus permanent overstrength as authorized by theWar Department.)
107
In some instances, the overall strength was up to the table-of-organizationrequirement, but the personnel were not professionally suitable. For example,the 5th Auxiliary Surgical Group, after repeated depletions of its well-qualified professional personnel in order to fill other units, was finally shipped tothe European theater in the summer of 1944 withwhatever medical officers were available, regardless of their suitability to theorganization`s functions.67
During 1944, theEuropean theater was almost consistently below authorized strength in MedicalCorps officers. Even on D-day, there was a shortage of 35 MedicalCorps officers in the theater. A persistent shortage of Dental Corps officersexisted during the same year, which was aggravated by increases intable-of-organization authorizations; in November, the shortage amounted to 238.With regard to nurses, the situation was similar to thatpertaining to Medical Corps officers. Consistent shortages began to appear inApril and continued into June. From the end of July, the shortages reappearedand steadily increased so that by the end of the year the theater lacked 345 of its proper table-of-organization strength in nurses.Until October, there was a critical shortage of physical therapy aides. A severeshortage of dietitians also existed throughout the year. From November, therewas a steady increase in the deficit in enlisted men, particularly in groundforce units. Because of the losses occasioned by the Battle of the Bulge, ashortage of approximately 500 medicalenlisted men appeared in each of the four field armies engaged in the theater.
The shortages persisted to the end of the war. In mid-March 1945, the medical service of the communications zone of theEuropean theater was reported to be at 94.1 percentof its table-of-organization strength. In this respect, it was worse off thanevery other service except the Signal Corps. For all arms and services, thecorresponding figure was 96.2 percent.As regards Medical Department officers, the shortage in table-of-organizationstrength was 9.9 percent and in thiscategory of personnel, too, only the Signal Corps was at a greater disadvantage.The shortage of Army officers as a whole was 7.7 percent.
In other theaters, there were similar shortages in 1944. For example, as of 31 December1944, the Southwest Pacific Area needed approximately 124 officers to reach the dentalstrength required undertables of organization.68 With regard to nurses, the shortage was inexcess of 1,300.69
As of 31 May 1945, theEighth U.S. Army, operating in the Pacific, had shortages of medical officersand nurses which were, respectively, in excess of 10 and 25 percent ofauthorized strengths (table 11). In July 1945, theshortage of medical officers in the entire Pacific was at least 300.70
67Annual Report, 5th Auxiliary Surgical Group, 1944, pp. 98, 144-145.
68See footnote 64, p. 104.
69Annual Report, Surgeon, U.S. Army Services of Supply,Southwest Pacific Area, 1944, p. 47.
70Memorandum, Eli Ginzberg, Director,Resources Analysis Division, Office of The Surgeon General, for LieutenantColonel Lueth, 26 July 1945, subject: Notes on 10 July Conference With AFPAC.
108
TABLE 11.-Authorized and actual strengthsof medical personnel, Eighth U.S. Army, 31 May 1945
|
Group |
Strength |
Percent short | |
|
Authorized |
Actual | ||
|
Medical Corps |
786 |
703 |
10.6 |
|
Medical Administrative Corps |
354 |
330 |
6.8 |
|
Veterinary Corps |
3 |
4 |
0 |
|
Dental Corps |
172 |
160 |
7.0 |
|
Sanitary Corps |
41 |
42 |
0 |
|
Army Nurse Corps |
372 |
278 |
25.3 |
|
Enlisted men |
11,973 |
11,148 |
6.9 |
Source: Quarterly Report, Surgeon, Eighth U.S. Army, 1945 (2d quarter), p. 2.
In the Middle Pacific Area, although there was no shortage of Medical Corpsofficers in July 1945, there were inadequate numbers of medical and surgicalspecialists. After V-E Day, certain units designed for the European theater hadbeen diverted to the Pacific and arrived in that area short of such specialists.71
In the period 7 December 1941-31 August 1945, Medical Corpsofficers in the Central Pacific attained their authorized strength only duringthe month of January 1945.72 In late 1943, reports to the WarDepartment indicated that in terms of table-of-organization andtable-of-allotment strength plus authorized overhead there was a surplus in theNorth African theater among all, or virtually all, Medical Department elements.At that time, there were also some surpluses in the European theater and theCentral Pacific. The Central Pacific, however, had substantial shortages indental and medical administrative officers as well as in enlisted men, theshortages apparently being greater than 10 percent of the authorized strength ineach case. The situation was even worse in the South Pacific, every elementreported being understrength. In some elements, the understrength was over 25percent.
Both line officers and Medical Department authorities weresometimes extremely reluctant to use nurses in forward areas, particularlyduring the earlier phases of combat operations. Units sometimes were givenadditional enlisted personnel instead of nurses.73 In at least onecase, after a unit had been transferred from Alaska to Europe, it wasconsidered necessary or advisable to replace the extra enlisted technicians bynurses.74
71Col. Fred J. Fielding, formerly of the Military PersonnelDivision, Office of The Surgeon General, minimizes the extent to which unitsarrived in the Pacific short of specialists. Commenting on the statement in thetext, he remarks (Letter to Col. J. B. Coates, Jr., MC, Director, HistoricalUnit, U.S. Army Medical Service, 12 Dec. 1955): "This was not the policy,however, and only one or two units were diverted while on high seas or beforelanding in ETO. Units from ETO were reorganized with balanced staff and shippedto Pacific after V-E Day."
72Whitehill, Buell: Administrative History of Medical Activities in theMiddle Pacific, 1946, p. 12. [Official record.]
73This was authorized for certain evacuation hospitals by T/O&E 8-581 (25 Mar. 1944).
74Annual Report, 28th Field Hospital, European Theater ofOperations, U.S. Army, 1944, p. 11.
109
Shortages of enlisted specialists also existed although it is difficult toassess their prevalence. For example, the 3d General Hospital, through theoperation of the 38-year draft limitation, lost 140 enlisted men in the 2 monthsbefore its departure for the North African theater on 12 May 1943. This createda shortage which was manifested overseas primarily in the clerical field sincethe unit had not obtained adequately trained replacements before leaving theUnited States.75
75Annual Report, 3d General Hospital, 1944.
