History

CHAPTER V

Procurement During the Emergency Period

During the period 1939-41, the problems of procurement wereapparently of greater moment to The Surgeon General than those of requirements.Especially difficult was the procurement of Medical Corps officers although inno category of Medical Department personnel was the supply always equal to thedemand. Shortages varied, of course, and according to Lt. Col. Paul A. Paden,MC, a former chief of The Surgeon General`s Personnel Division: "Army-wideshortages were never so acute as local shortages."¹

PREEMERGENCY PROCEDURES

The National Defense Act of 1920 stated that the Army of theUnited States should consist of the Regular Army, the National Guard, and theOrganized Reserves. Thus, there were three means of entering the medical serviceof the Army

1. Regular Army.-Individuals interested in securing anappointment in the Regular Army could apply to The Adjutant General. Applicantshaving the necessary educational qualifications had to pass a competitiveexamination prepared by The Surgeon General and conducted by an examining boardwhich also considered the candidate`s physical condition, moral character, andgeneral fitness.² Theboard`s report went to the Central Medical Department Examining Board for reviewand the necessary grading of papers. If the candidate was found qualified bythis board and was recommended by The Surgeon General, and if the recommendationwas approved by the Secretary of War, he was appointed to the appropriateMedical Department corps as a Regular Army officer.³

2. Officers` Reserve Corps.-Persons interested in obtaining Reservecommissions applied to the corps area commander. The latter, acting on therecommendation of a board which examined the candidates` qualifications(educational and otherwise), transmitted the names of successful applicants

¹Letter, Lt. Col. Paul A. Paden, to Col. John B. Coates, Jr., MC, Director,Historical Unit, U.S. Army Medical Service, 10 Dec. 1955.
²Beginning at least as early as 1921,the competitive examination was dispensed with in the case of medical and dentalinterns who had completed a year`s internship in an Army hospital, and who werefound qualified by a board of officers, and were recommended by the commandingofficer of the hospital wherein their internship was served. Examinations forsuch interns were apparently in effect, however, from August 1939 to November1941. (AR 605-10, 24 Feb. 1921; AR 605-20, 16 Aug. 1939 and C 1, 14 Nov. 1941.)
³Army Regulations No. 605-20, 16 Aug. 1939.

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to The Adjutant General for issuance of letters of appointment to theappropriate Medical Department Reserve Corps.⁴

3. National Guard.-Any officer of aState National Guard Unit might be commissioned in the National Guard of theUnited States upon passing "such tests as to his physical, moral, andprofessional fitness as the President may prescribe."⁵Most State National Guard officers obtained suchcommissions.⁶ In peacetime, this made them eligible for active duty with theGuard at the order of the State Governor, and in time of national emergencydeclared by Congress, it enabled the President to call them into the activeservice of the United States. Enlisted men of the National Guard also might holdcommissions in the National Guard of the United States, which would give themofficer status whenever the latter was called into active service.

EARLY RESERVE MEASURES

The Situation at the Beginning of the Emergency

The most important function of the procurement system during the earlyemergency period-at least from the standpoint of the MedicalDepartment-was toprovide additional officers and nurses, by way of the Reserves, for the medicalservice of the active forces. These forces were constantly expanding, and theirneeds were immediate. On 30 June 1939, the NurseCorps and all officer corps except the Veterinary Corps were below theirauthorized active-duty strength, and authorizations of medical, dental, andveterinary officers, as well as nurses, increased considerably during thefollowing year. The National Guard and the Regular Army could not furnish theadditional strength that would be needed under conditions of rapid expansion.The National Guard was called in August 1940, but Congress did not authorize officer appointment to theRegular Army in sufficient numbers to correspond with the 1939-40 increases in enlisted strength. Even the small RegularArmy additions which Congress permitted were not realized in full. Thus, at theend of June 1940, therewere 46 vacancies inthe Regular Army Medical Corps, 11 in the Dental Corps, and 10 in the MedicalAdministrative Corps; only the Veterinary Corps had filled its quota.⁷ Thebacklog of reservists, however, looked more than adequate on paper. On 30 June 1939,theReserves of three of the five officer corps were above their procurementobjectives (table 12), while Reserve nurses registered with the Red Cross weremany times the number of the nurses on active duty with the Army.⁸ Changesin the Officers` Reserve Corps as of June 1940 and June 1941 areshown in table 13. Comparable figures for the National Guard are in table 14.

⁴ Army Regulations No. 140-33, 30 July 1936.
⁵48Stat. 53.
⁶Annual Report of the Chief, National Guard Bureau, 1940, p. 9.
⁷Annual Report of The Surgeon General, U.S. Army, Washington: U.S.Government Printing Office, 1940, p. 162.
⁸The active duty strength was 672; the Red Cross Reserve amounted to 15,761.

113-115

TABLE 12.-Active-duty strength ofMedical Department groups, by Army components, 30 June 1939-30 November 1941¹

Component	30 June 1939	30 June 1940	30 June 1941	30 November 1941²
Regular Army:³
Medical Corps	1,094	1,160	1,206	1,271
Dental Corps	220	252	266	270
Veterinary Corps	126	126	126	126
Medical Administrative Corps	64	62	61	68
Army Nurse Corps	672	942	1,280	1,402
Total officers and nurses	2,176	2,542	⁴2,939	⁵3,137
Enlisted men⁶	9,359	14,974	⁷31,343	⁸31,872
Grand total	11,535	^17,516	^34,282	35,009
Reserves:⁹
Medical Corps	706	414	8,025	8,984
Dental Corps	157	101	¹⁰2,090	2,531
Veterinary Corps	96	⁴⁵	¹⁰404	541
Sanitary Corps	---	⁸	186	226
Medical Administrative Corps	¹¹17	4	772	933
Army Nurse Corps	---	---	4,153	5,409
Total officers and nurses	976	¹²572	15,630	18,624
Enlisted men¹³	^---	---	1	10
Grand total	976	572	15,631	18,634
National Guard:
Medical Corps	---	---	1,080	1,072
Dental Corps	---	---	280	280
Veterinary Corps	---	---	33	28
Sanitary Corps	---	---	1	1
Medical Administrative Corps	---	---	275	266
Total officers	---	---	¹⁴1,669	¹⁵1,647
Enlisted men	---	^---	¹⁶14,715	12,075
Grand total	^---	^---	16,384	13,722
Army of the United States:
Medical Corps	---	---	---	---
Dental Corps	---	---	---	---
Veterinary Corps	---	---	---	---
Medical Administrative Corps	---	---	---	76
Total officers¹⁷	---	---	---	76
Enlisted men¹⁸	---	---	755	794
Grand total	---	---	755	870
Selectees, enlisted men¹⁹	---	---	²⁰51,255	63,351

¹Unless otherwise specified, data on officers andnurses from 30 June 1939 to 30 June 1941, inclusive, are from corresponding"Annual Reports of The Surgeon General, U.S. Army"; and data onenlisted men are from equivalent "Annual Reports of The Secretary ofWar."
²Data for male officers, with the exceptions mentionedin other footnotes, are from Memorandum, F. M. Fitts, to Colonel Lull, 29 Oct.1942, subject: Status of Medical Department Officers as of 7 Dec. 1941,addendum to "History of Military Personnel Division, Personnel Service,1939-April 1944." The figures represent strength on 5 December 1941.
³Authorized Regular Army strengths were: (1) For 30June 1939: MC, 1,133; DC, 233; VC, 126; MAC, 72; ANC, 675; and enlisted men,8,643. (2) For 30 June 1940: MC, 1,210; DC, 264; VC, 126; MAC, 72; ANC, 949; andenlisted men, 13,628. (3) For 30 June 1941: MC, 1,230; DC, 267; VC, 126; MAC,72; ANC, 1,875; (no figures for enlisted men). (Data are from "AnnualReports of The Surgeon General, U.S. Army" for dates corresponding to thoseshown except authorization for enlisted men in 1939 which is from the report for1940, p. 170.)
⁴Probably includes retired officers on active duty as follows: MC, 18;VC, 2; and MAC, 3. (Figures pertaining to the Medical and MedicalAdministrative Corps are for the week ending on 4 July 1941 and were providedby the Military Personnel Division, Office of The Surgeon General, on 30 August1949.)
⁵Includes the following retired officers on active duty: MC, 38; DC, 2;VC, 2; and MAC, 7. (Data from source of Regular Army strength figures on thesame date, see footnote 2, above.)
⁶Includes Philippine Scouts.⁷Includes an estimated 608 members of the Regular ArmyReserve. The number of Regular Army Enlisted Reserves who, regardless of branch,were called into active service was 12,190; all of these went on duty inFebruary 1941. Of the total, 672 or somewhat more than 5 percent were MedicalDepartment personnel. By 30 June 1941, the Regular Army Enlisted Reserves onactive duty had declined to 10,919. Assuming that 5 percent of the decline hadoccurred in the Medical Department, the loss to the medical service amounted to64, leaving a balance of 608.
⁸Figure supplied by Statistics and Accounting Branch,Statistics Section, Office of The Adjutant General, 24 October 1957. Includes anestimated 548 members of the Regular Army Reserves. This estimate is based onthe rate of decline of the Regular Army Reserves without distinction of branchbetween February and 30 June. As shown in footnote 7, above, this rate whenapplied to the Medical Department left a balance of 608 on 30 June. If the rateof decline, approximately 12 per month, is assumed to have continued, the lossbetween this date and 30 November 1941 amounts to 60, and the strength on thelatter date is reduced to the figure stated at the beginning of this note.
⁹Authorized active-duty strengths for the Reserves are known only for 30June 1940. At that time they were: MC, 1,271; DC, 219; VC, 76; and MAC, 4.The number authorized for the Medical Corps was 1,283 minus the number ofMedical Administrative and Sanitary Corps Reserve officers on active duty.
¹⁰Divisional reports in the source for these figures (Annual Report of TheSurgeon General, 1941) show 1,745 dental Reserve officers and 435 veterinaryReserve officers on extended active duty (pp. 183, 190). The explanation for thediscrepancy in the case of the dental officers may be similar to that mentionedin footnote 12 (that is, the figure stated in the table may include individualsfor whom active-duty orders had been requested), but it does not explain thedifference in the Veterinary Corps figures.
¹¹Includes Sanitary Corps.
¹²Data are described in the source as "on duty orduty orders requested as of June 30, 1940." Except in the case of theSanitary Corps, where the strength is reduced to 6, the same figures arereproduced in the report for 1941 (p. 142) under the simple heading of "onduty June 30, 1940." The report for 1940 also states (p. 209) that 25Veterinary Corps reservists were on active duty on 30 June; failure to includethose who had not yet come on active duty may account for the discrepancy.
¹³Does not include Regular Army Reserve (see footnotes 7 and8, above). The figure for 30 November 1941 was provided by the Statistics andAccounting Branch (see footnote 8, above) on 24 October 1957.
¹⁴Commissioned personnel of the Medical Department inthe National Guard of the United States, as reported by the Chief of theNational Guard Bureau in his annual report for fiscal year 1941.
The Annual Report of The Surgeon General, U.S. Army, for the same date (p.260), gives the following figures instead of those shown: For MC, 1,120; DC,243; VC, 60; MAC, 153; total, 1,576.
No strength is shown for the SanitaryCorps, but 16 warrant officers are credited to the Medical Department;presumably, these were men serving in medical units.
Elsewhere in the 1941 Annual Report of The Surgeon General,the number of Veterinary Corps officers of the National Guard is stated to be 34(p. 190), and the number of Dental Corps officers, 282 (p. 183). These figures,which approximate those shown in the body of this table, undoubtedly are moreaccurate than the corresponding personnel figures stated. It also is unlikelythat the strength of the Medical Corps personnel, like that of the VeterinaryCorps personnel, could have exceeded the strength shown for the National Guardof the United States, which consisted of all individuals who had been inductedsince the federalization of the National Guard minus those who had beencompletely separated from the Federal service and also had been dropped fromtheir National Guard status. On the other hand, the figure for the MedicalAdministrative Corps probably is very low in view of the much higher strengthshown for the group at later periods and the fact that few if any members of thecorps could have been inducted after 30 June 1941. (See footnote 15.) As late as30 June 1943, the active-duty strength of the Medical Administrative Corps inthe National Guard was shown to be 277. (Annual Report, Military PersonnelDivision, Office of The Surgeon General, U.S. Army, 1943.) Similarconsiderations govern the strength of the Dental Corps personnel, which at thesame date was reported to be 273.
The Annual Report of the Secretary of War for the fiscal year 1941 shows nobreakdown for the Medical Department corps in the National Guard but reports theaggregate strength of these groups on 30 June 1941 as 1,491.
¹⁵Adjustment of strengths shown for 1 November 1941, in memorandum cited infootnote 2, p. 114, for MC is 1,072; for DC, 300; for VC, 28; and for MAC,266.
In view of the considerations mentioned in footnote 14, it is unlikely thatthe Dental Corps personnel of the National Guard numbered 300, since at the endof June it had been only 280. At that time, the total number of MedicalDepartment officers of the National Guard remaining to be inducted had been six.(In Annual Report of Chief of National Guard Bureau for the fiscal year 1941,pp. 117-118.) For that reason, the number of Dental Corps officers of theNational Guard on active duty on 1 November 1941 has been reduced to 280. Inview of the fact that the Active National Guard as late as 30 June 1942 iscredited with one Sanitary Corps officer, one such officer is credited to theactive duty strength on 1 November 1941. A breakdown of the National Guardstrength of Medical Department officers on 30 November 1941 is not available,but it is assumed that it did not differ greatly from the same strength at thebeginning of the month. However, according to information supplied by theStatistics and Accounting Branch, Statistics Section, Office of The AdjutantGeneral, on 24 October 1957, the aggregate of the strength on 30 November 1941was 1,590, but for purposes of consistency, the total of 1,647 as of 1 November1941 is stated in the body of this table.
¹⁶Strength for 30 June 1941 is based on Annual Report of Secretary ofWar for 1941, which shows medical enlisted strength of National Guard on thatdate to be 15,470. Since 755 of these are estimated to be Army of the UnitedStates personnel (see footnote 18), the strength of the National Guard personnelproper is deemed to be 14,715. Strength of 30 November 1941 is based on datasupplied by Statistics and Accounting Branch, 24 October 1957, showing medicalenlisted strength of the National Guard on the former date to be 12,869. Sinceno separate strength figures for AUS enlisted personnel are shown inthese data, it is assumed that the estimated 794 medical enlisted men in thatcategory (see footnote 18) must be subtracted from 12,869 in order to arrive atapproximately the true National Guard strength, that is, 12,075.
¹⁷Personnel who entered the Army ofthe United States directly, without previous service as members of the RegularArmy, the Reserves, or the National Guard. Strength information from Statisticsand Accounting Branch (see footnote 8), 24 October 1957. This information is notbroken down by corps, but the number 76 corresponds closely to the strength (77)of the first class for MAC`s at Carlisle Barracks, Pa., which graduated inSeptember 1941. The entire 76 therefore have been attributed to the MedicalAdministrative Corps. According to "Officers Appointed in the MC, DC, VC,MAC, and PhC. From 1 January 1939 through 1946. Month of Occurrence OTN337," (prepared by the Adjutant General`s Office, Strength AccountingBranch, 8 July 1946), 161 Medical Department officers classified as AUS had comeon duty by 30 November 1941. They included the following: MC, 28; DC, 38; VC,10; MAC, 85. However, some of these are shown as having come on active dutyas early as January 1941, and it is possible that many of those comprehended inthe data entered upon active duty at the time stated but as members of theReserves or the National Guard, acquiring AUS status later.
¹⁸Comprises volunteers on 1-yearenlistments. According to the Annual Report of the Secretary of War, 1941, atotal of 767 enlisted volunteers had come on duty with the Medical Departmentfrom September 1940 to the end of June 1941. The corresponding number for theArmy as a whole was 22,390. Of these, 22,060 remained on duty on 30 June 1941,for a loss of 1.5 percent. Applying the same percentage to the enlistedvolunteers of the Medical Department, the balance remaining on 30 June 1941 was755. The number of such personnel on duty on 30 November 1941 is unknown, but on31 December 1941, it was 802. (Information from Statistics and AccountingBranch, 24 October 1957.) By prorating the difference between the numberspresent on 30 June and 31 December on a monthly basis, the estimated strength ofMedical Department enlisted personnel classified as "AUS" is found tobe 794.
¹⁹The figure for 30 November wasprorated by the Statistics and Accounting Branch (see footnote 8), 24 October1957.
²⁰Of these, 38,756 were serving in Regular Army units and 12,799 inNational Guard units. (Annual Report of Secretary of War, 1941.)
At this time, the total authorized strength of MedicalDepartment enlisted personnel, both selectees and others, was approximately82,150. Of these, about 20,437 were allotted to National Guard units, 1,387 tothe veterinary service, and 60,326 to the remainder of the MedicalDepartment establishment. (Annual Report of The Surgeon General, 1941, p. 148.)

116-118

TABLE 13.-Strength of Medical DepartmentReserves (Regular Army Reserve and Reserve Corps), 1939-41

Personnel	Strength, 30 June 1939	Changes, 1 July 1939-30 June 1940		Strength, 30 June 1940	Net change since 30 June 1939 (percent)	Changes, 1 July 1940-30 June 1941		Strength, 30 June 1941	Net change since 30 June 1940 (percent)	Changes, 1 July-30 Nov, 1941		Strength, 30 Nov. 1941	Net change since 30 June 1941 (percent)
Personnel	Strength, 30 June 1939	Procured	Lost	Strength, 30 June 1940	Net change since 30 June 1939 (percent)	Procured	Lost	Strength, 30 June 1941	Net change since 30 June 1940 (percent)	Procured	Lost	Strength, 30 Nov. 1941	Net change since 30 June 1941 (percent)
	Regular Army Reserve
Enlisted men:¹
All branches	19,301	---	---	28,020	+45	---	---	10,919	-61	---	---	---	---
Medical Department	1,028	---	---	1,475	+43	---	---	---	---	---	---	---	---
	Reserve Corps
Total officers:
All branches²	131,726	---	---	132,652	+0.6	---	---	---	---	---	---	---	---
Male only³	115,965	⁴11,008	⁵10,120	³116,853	+0.8	⁴17,541	⁵11,647	³122,747	+5	---	---	---	---
Medical Department	39,100	^---	^---	39,918	-0.5	---	---	---	---	---	---	---	---
Male only⁶	23,339	⁵⁰¹	701	23,139	-0.9	4,903	6,740	21,302	-8	---	---	20,609	-3
Medical Corps	^15,198	308	207	15,299	+0.7	3,919	5,244	13,974	-9	---	---	13,745	-1
Dental Corps	5,063	0	398	4,665	-8	722	959	4,428	-5	---	---	4,060	-8
Veterinary Corps	1,381	163	7	1,537	+11	74	218	1,393	-9	---	---	1,346	-3
Sanitary Corps	454	0	9	475	+5	47	63	459	-3	---	---	415	-10
Medical Administrative Corps	1,243	0	80	1,163	-6	141	256	1,048	-10	---	---	1,043	-0.5
Army Nurse Corps (Red Cross Reserve)⁷	15,761	---	---	15,779	+0.01	---	---	---	---	---	---	---	---
Enlisted men:⁸
All branches	3,054	---	---	3,233	+6	---	---	2,149	-34	---	---	157,000	+720
Medical Department	16	---	---	49	+206	---	---	---	---	---	---	13,020	---
Affiliated units, officers:
All branches	---	---	---	---	---	---	---	---	---	---	---	---	---
Male only	---	---	---	---	---	---	---	---	---	---	---	---	---
Medical Department, male only	---	---	---	---	---	---	---	⁹1,639	---	---	---	---	---
Medical Corps	---	---	---	---	---	---	^---	⁹1,414	---	---	---	---	---
Dental Corps	---	---	---	---	---	^---	^---	⁹176	---	---	---	---	---
Medical Administrative Corps	---	---	---	---	^---	^---	^---	⁹49	---	---	---	---	---
Affiliated Reserve Officers:¹⁰
All branches	---	---	^---	^---	^---	^---	---	---	---	---	---	---	---
Male only	---	^---	^---	^---	^---	---	^---	¹¹1,561	---	---	---	---	---
Medical Department, male only¹²	^---	^---	^---	^---	---	^---	^---	1,410	---	---	---	1,405	-0.4
Medical Corps	^---	^---	^---	---	^---	^---	---	1,257	---	---	---	1,264	+0.6
Dental Corps	^---	^---	---	^---	^---	---	---	122	---	---	---	120	-2
Medical Administrative Corps	^---	---	^---	^---	---	---	---	31	---	---	---	21	-32

¹Figures for 1939 and 1940 are, respectively, from"Annual Report of the Secretary of War" (1939) p. 85, and (1940) p.61. Figure for 1941 is number of members of the Regular Army Reserve on activeduty on 30 June 1941. (See table 12.) Since the entire membership of the RegularArmy Reserve was required to be called to active duty by 15 February 1941, it isassumed that those on active duty on 30 June 1941 constituted the entirestrength of this Reserve. The corresponding figure for the Medical Department isestimated to be 608 (table 12, footnote7) which is 59 percent less than thestrength for Medical Department members for the Regular Army Reserve on 30 June1940.
²Aggregate of strengths, as shown in this table, of male officers inall branches and nurses.
³Adjustments of strengths shown in "Annual Reports of theSecretary of War" for corresponding dates; that is, for 1939-116,719; for1940-116,636; for 1941-122,020, by subtracting from these strengths theamounts attributed in the same sources to the Medical Department; namely,

	1939	1940	1941
Medical Corps	15,956	15,187	14,497
Dental Corps	4,979	4,627	4,630
Veterinary Corps	1,509	1,525	1,319
Sanitary Corps	432	451	498
Medical Administrative Corps	1,217	1,132	1,631
Total	24,093	22,922	22,575

and adding the aggregate strength of the corps listed as shownin the body of this table.

⁴Computed by subtracting from total accessions for Officer Reserve Corps asshown in "Annual Reports of the Secretary of War" for 1940 and1941; that is, for 1939-40-12,300, for 1940-41-16,189, accessions of MedicalDepartment officers reported in the same sources as follows:

	1939-40	1940-41
Medical Corps	1,518	2,686
Dental Corps	35	649
Veterinary Corps	143	57
Sanitary Corps	47	35
Medical Administrative Corps	50	124
Total	1,793	3,551

and adding aggregate accessions of the same groups as stated in this table.
⁵Computed by adding number procured to strength at beginning of the period and subtracting the strength at the close of the period from the total.
⁶Basic data through June 1941 from "Annual Reports of The Surgeon General, 1939-41." Basic data for November 1941 from Memorandum, F. H. Fitts to Colonel Lull, 29 Oct. 1942, subject: Status of Medical Department Officers as of 7 Dec. 1941, addendum to History of Military Personnel Division, Personnel Service-1939-April 1944.
⁷Basic data from Memorandum, Superintendent, Army Nurse Corps, for The Surgeon General, 2 Dec. 1941, in Miss Byers` Book Data on Army Nurses, 1941.
⁸Basic data through June 1941 from "Annual Reports of the Secretary of War" for dates corresponding to those shown. Strength on 30 November 1941 is unknown, but is estimated to have been 157,000 for the Army in general. The vast increase in the strength of the Enlisted Reserve Corps which this figure signifies is the result of amendments to the basic Selective Service law in August 1941 authorizing release from active duty of men inducted under the act who were over 28 years of age upon their own request and release of men below this age upon showing that their retention in the Army would subject them or their wives and dependents to undue hardship. Under these provisions over 155,000 men were released between 1 September 1941 and Pearl Harbor, but all of them were retained in the Enlisted Reserve Corps ("Selective Service in Peacetime," First Report of Director of Selective Service, 1940-41, pp. 267-268). Since more than 2,000 were in the corps on 30 June 1941, this figure has been added to 155,000 to determine the estimated strength of the corps on 30 November. Medical Department enlisted strength during the period July-November 1941 was in the vicinity of 8.4 percent of the total draftee strength of the Army. (According to "Annual Report of the Secretary of War" for 1941), the total number of drafted enlisted men on active duty was 606, 915 on 30 June 1941. Of these, 8.5 percent (see table 12) were Medical Department personnel. On 30 November 1941, in accordance with data supplied by the Statistics and Accounting Branch, Statistics Section, Office of The Adjutant General, on 7 May 1958, the total number of selectees on active duty was 756,747. The proportion of those assigned to the Medical Department was 8.4 percent (table 12). Assuming that the same percentage of the 155,000 released men comprised Medical Department personnel, the number of such personnel placed in the Enlisted Reserve Corps was 13,020. The number of Medical Department enlisted men who were in the Enlisted Reserve Corps after 30 June 1940 and before 1 September 1941 is unknown, but in view of the earlier figures on the same topic, it must have been negligible. Consequently, 13,020 is taken as an approximation of the Medical Department membership in the Enlisted Reserve Corps on 30 November 1941.
⁹From "Annual Report of The Surgeon General" for 1941. Includes members of the Affiliated Reserve (footnote 10) and members of the Officers Reserve Corps who were not members of the Affiliated Reserve although members of the affiliated units.
¹⁰Members of the Officers Reserve Corps who possessed Reserve Status only through assignment to an affiliated unit.
¹¹Adjustment of strength of all branches as shown in "Annual Report of the Secretary of War" for 1941; that is, 1,659, by subtracting strengths reported therein for the Medical Department (Medical Corps, 1,326; Dental Corps, 137; and Medical Administrative Corps, 45) and adding the strength of the Affiliated Reserves in these corps as stated in the body of this table.
¹²Basic data for June 1941 from "Annual Report of the Surgeon General," 1941, pp. 145-146. Slightly different figures are also given in the same source (pp. 146-147); namely, Medical Corps, 1,264; Dental Corps, 120; and Medical Administrative Corps, 31. (The source states that these figures represent the strength of the affiliated units, but their size indicates that they really apply to the Affiliated Reserve.) Basic data for November are from Memorandum, F. H. Fitts, to Colonel Lull, cited in footnote 6. This source reports the total number of Medical Administrative Corps officers in the Affiliated Reserve to be 31, but the distribution of the same group by rank results in a total of 21. However, since 31 is the strength which the group possessed on 30 June 1941, it is possible that the figure 31 is correct for 30 November.

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TABLE 14.-Strengthof Medical Department Reserves (National Guard), 1939-41

Component	Strength, 30 June 1939	Changes, 1 July 1939-30 June 1940		Strength, 30 June 1940	Net change since 30 June 1939 (percent)	Changes, 1 July 1940-30 June 1941		Strength, 30 June 1941	Net change since 30 June 1940 (percent)	Changes, 30 June-30 Nov. 1941		Strength, 30 Nov. 1941	Net change since 30 June 1941 (percent)
Component	Strength, 30 June 1939	Procured	Lost	Strength, 30 June 1940	Net change since 30 June 1939 (percent)	Procured	Lost	Strength, 30 June 1941	Net change since 30 June 1940 (percent)	Procured	Lost	Strength, 30 Nov. 1941	Net change since 30 June 1941 (percent)
National Guard of United States:¹
Officers:²
All branches	16,341	---	---	16,415	+0.5	---	---	19,069	+16	---	---	15,926	-16
Medical Department	1,592	---	---	1,509	-5	---	---	1,669	+11	---	---	1,557	-7
Medical Corps	1,078	---	---	1,022	-5	---	---	1,080	+6	---	---	1,081	+0.9
Dental Corps	245	---	---	288	-7	---	---	280	+23	---	---	260	-7
Veterinary Corps	73	---	---	65	-11	---	---	33	-49	---	---	29	-12
Sanitary Corps	2	---	---	1	-50	---	---	1	0	---	---	1	0
Medical Administrative Corps	195	---	---	193	-1	---	---	275	+42	---	---	186	-32
Warrant officers³	212	31	28	215	+1	73	87	201	-7	---	---	196	-2
Enlisted men⁴	---	---	---	---	---	---	---	---	---	---	---	---	---
All branches	183,233	---	---	224,882	+23	---	---	243,057	+8	---	---	213,449	-12
Medical Department	12,144	---	---	14,745	+21	---	---	14,735	-.07	---	---	12,075	-18
Sources of National Guard of United States:⁵
Active National Guard officers:⁶
All branches	14,465	1,523	1,426	14,562	+0.7	5,125	3,471	16,216	+11	---	---	15,926	-2
Medical Department	1,537	309	274	1,572	+2	808	767	1,613	+3	---	---	1,557	-3
Medical Corps	1,089	242	216	1,115	+2	593	587	1,121	+0.5	---	---	1,081	-3
Dental Corps	235	48	40	243	+3	138	111	270	+11	---	---	260	-4
Veterinary Corps	67	1	8	60	-10	14	40	34	-43	---	---	29	-17
Sanitary Corps	1	0	0	1	0	0	0	1	0	---	---	1	0
Medical Administrative Corps	145	18	10	153	+6	63	29	187	-22	---	---	186	-0.5
Warrant officers⁷	212	31	28	215	+1	73	87	201	-7	---	---	196	-2
Enlisted men⁸	---	---	---	---	---	---	---	---	---	---	---	---	---
All branches	184,825	---	---	266,837	+23	---	---	243,057	+6	---	---	213,449	-12
Medical Department	12,197	---	---	14,799	+22	---	---	14,735	-0.4	---	---	12,075	-18
Inactive National Guard officers:
All branches	674	---	---	739	+10	---	---	533	-28	---	---	343	-36
Medical Department	42	---	---	47	+12	---	---	24	-49	---	---	15	-38
Medical Corps	30	---	---	33	+10	---	---	14	-58	---	---	9	-36
Dental Corps	4	---	---	4	0	---	---	6	+50	---	---	3	-50
Veterinary Corps	7	---	---	8	+14	---	---	3	-63	---	---	2	-33
Sanitary Corps	0	---	---	0	0	---	---	0	0	---	---	0	0
Medical Administrative Corps	1	---	---	2	+100	---	---	1	-50	---	---	1	0
Warrant officers⁹	---	---	---	---	---	---	---	---	---	---	---	---	---
Enlisted men⁹	---	---	---	---	---	---	---	---	---	---	---	---	---
Holding commissions in National Guard of United States:¹⁰
All branches	1,602	---	---	1,955	+22	---	---	3,081	+57	---	---	3,001	-3
Medical Department	53	---	---	54	+2	---	---	115	+113	---	---	120	+4
Medical Corps	0	---	---	1	---	---	---	7	+600	---	---	7	0
Dental Corps	4	---	---	0	-100	---	---	20	---	---	---	20	0
Veterinary Corps	0	---	---	0	0	---	---	0	0	---	---	0	0
Sanitary Corps	1	---	---	1	0	---	---	0	-100	---	---	0	0
Medical Administrative Corps	48	---	---	51	+6	---	---	88	+73	---	---	93	+6

¹Members of the National Guard who had taken an oath and had been appointedfor Federal service whenever it became necessary (Dictionary of United StatesArmy Terms TM 20-205, 18 Jan. 1944).
²Basic data through June 1941 from "Annual Reports of Chief of NationalGuard Bureau" for corresponding dates. Strength on 30 November 1941computed by prorating on a monthly basis the difference between the strength on30 June 1941 and the strength of the Active National Guard on 30 June 1942 (seefootnote 5). Membership in the Active National Guard of the United Statesand the difference prior to completion of the induction of the Guard into theFederal service between the commissioned strength of the Active National Guardand that of the National Guard of the United States (exclusive of enlisted menholding commissions) was the result almost entirely of the timelag betweenappointment in the Active National Guard and recognition of the appointee by theChief of the National Guard Bureau. (See "Annual Reports of Chief ofNational Guard Bureau" for 1939 and 1941.) With the induction of the Guardand termination of appointments therein, the difference disappeared. (In theAnnual Report of the Chief of the Bureau for 1942, only the strength of theActive National Guard was reported.)
³Comprises individuals with the status of warrant officers in the Active National Guard.
⁴Enlisted men in the Active National Guard did not have a separate status inthe National Guard of the United States. Figures shown are therefore the same asthose stated under Active National Guard except those for 1939 and 1940 whichare the difference between the number of enlisted men in the Active NationalGuard at those times and the number of enlisted men of the National Guard holding commissions in the NationalGuard of the United States. The numbers of enlisted men actually inducted withthe National Guard were substantially in excess of the strengths shown here; by30 June 1941, according to the National Guard Bureau, the number in all brancheshad reached 278,526 and those in the Medical Department had grown to 17,238.(Annual Report of Chief of National Guard Bureau, 1941.) The number furtherincreased slightly so that on 30 November 1941 the total inducted for all branches reached 279,358. The number inducted in the MedicalDepartment is unknown but could scarcely have been more than 100 greater than ithad been on 30 June. (Annual Report of Chief of National Guard Bureau, 1942.) Figuresprovided by the Secretary of War relative to 30 June 1941 are considerably lessthan those reported by the National Guard Bureau: 272,559 in all branches and 15,011 in the MedicalDepartment. (Annual Report of the Secretary of War, 1941.)
⁵All basic data pertaining to officers and warrant officers through 30 June1941 come from the "Annual Reports of the Chief of the National GuardBureau" corresponding to the dates shown. Figures for 30 November 1941 werecomputed by prorating on a monthly basis the differences between the strengthson 30 June 1941 and the corresponding strengths on 30 June 1942. According tothe "Annual Report of the Chief of the National Guard Bureau" for1942, the strengths on the latter date were as follows:

	Active National Guard	Inactive National Guard	Enlisted men holding commissions
All branches	15,524	75	3,001
Medical Department:
Medical Corps	1,043	4	7
Dental Corps	251	1	20
Veterinary Corps	27	0	0
Sanitary Corps	1	0	0
Medical Administrative Corps	184	0	99
Total	1,506	5	126
Warrant officers	189	1	---

⁶Basic data on losses are from the sources of the accompanying strengthdata. (See footnote 5.) Figures on procurement were computed by adding losses tothe strength at the end of the period and subtracting the strength at thebeginning of the period from the resulting sums.
⁷Strengths for 1939 and 1940 include 1 cornet.
⁸Basic data for 1939 and 1940 from the corresponding "Annual Reports ofthe Chief of the National Guard Bureau." Basic data for June and November1941 are active-duty strength of National Guard enlisted men at these times (seetable 12).
⁹Information not available.
¹⁰Basic data through June 1941 from corresponding "Annual Reports of the Chief of the National Guard Bureau." Figures for 30 November 1941 were computed by prorating on a monthly basis the difference between the strengths on 30 June 1941 and30 June 1942. In addition to enlisted men, the following held commissions in theNational Guard of the United States: 1939 and 1940, warrant officers, 2;cornets, 1; June 1941, warrant officers, 1. None of these held commissions in aMedical Department component. All data from "Annual Reports of the Chief ofthe National Guard Bureau," 1939 to 1941, inclusive.

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Since no means existed at this time by which persons could be compelled toaccept appointments in the Regular Army or the Reserves, or even (if reservists)to accept a call to active duty, Army authorities had to depend on appeals tothe patriotism or self-interest of those they wished to reach; in the case ofnurses, the Red Cross joined in the appeal. During the spring and summer of1940, publicity campaigns were undertaken to speed the entry of medicalreservists into active service. The Surgeon General requested medical journalsto print informational letters, and prominent civilian members of the ReserveCorps as well as Reserve Officers` Training Corps instructors in medical schoolswere utilized to encourage recruitment.

The procedure for bringing Reserve officers and nurses onactive duty began with a summons from the chief of the reservists assignmentgroup (the corps area commander or The Surgeon General). The reservist had theright to either accept or refuse the call as he wished. If he accepted, the nextstep was a physical examination. If that was satisfactory, the necessary paperswere forwarded to The Adjutant General, who issued duty orders.

Act of 3 April 1939

But the problem of applying the officer Reserves to actual needs proved to beacute. The first move of any importance to draw on the Medical DepartmentOfficers Reserve Corps for the benefit of the active forces was made in the actof 3 April 1939-the same act that fixed the authorized strength of the RegularArmy officer corps. Under this act, the President was empowered to call up 255male Reserve lieutenants and captains of the Medical Department for not morethan 1 year of voluntary active duty with an extension, at the discretion of theSecretary of War, to as long as 2 years. Only during an emergency declared byCongress could Reserve officers be ordered to duty without their consent;virtually no means existed by which, in time of peace, they could be compelledto serve even their 2-week tour of active duty when called upon. They couldresign, or if they persisted in ignoring the call, one of two courses was opento the Army: It might place them on the ineligible list for the remainder oftheir 5-year term of appointment, or if they had had 15 years of satisfactoryservice to their credit, it could transfer them to the Inactive Reserve. Ineither case, they lost certain privileges, such as right of promotion.⁹Like all previous legislation pertaining to reservists, the new act imposed nopenalties whatever on those who declined to serve for the 1 or 2 yearsspecified; in fact, it was only on their application that the duty orders couldbe issued. This concession was necessary as a matter of good faith, sincereservists had accepted their commissions under no obligations of lengthypeacetime service.

The act of 3 April 1939 was the last occasion, until the later emergencyperiod, that Congress itself laid down the conditions under which new incre-

⁹Army Regulations No. 140-5, 16 June 1963.

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ments of Reserve officers were to be called to active duty.¹⁰Thereafter, the War Department assumed that function.

Modification of the act

In making allotments to the Medical Department for the purpose of bringingReserve officers on duty, the General Staff did not always prescribe the sameconditions of service as were laid down in the act of 3 April 1939. Withonly 139 of the 255 medical officers allotted under this act procured andplaced under orders by the end of November, the General Staff modified therules. A proposed further enlargement of the Army would give the MedicalDepartment an additional 508 officers, whenever the necessary legislation shouldbe passed. In anticipation of such legislation, corps area commanders wereinstructed to recruit only captains and lieutenants who were less than 35 years old. These men could be placed on active duty for 1year only.¹¹ The Surgeon General, foreseeing administrative difficultiesarising from these differences, recommended to The Adjutant General (1) thatprocurement of officers over 35 years of age for active duty be permitted, and(2) that the allowable tour of duty be extended beyond 1 year. The latter stepwould reduce the annual turnover to a number "considered more withinreason."¹² A fewmonths later, the War Department granted authority to extend the tour of allMedical Department officers to 2 years,but there is no indication that, for the time being, the age limit was raisedabove 35.¹³ Therestriction was lifted only after the enactment of compulsory service for theReserves in August 1940.

Since the bulk of the new officer and nurse strength addedduring this period was to come from the Reserves, anything that limited thenumber of reservists subject to call, that interfered with summoning them toactive duty, or that prevented the Medical Department from using them as long asnecessary might mean that requirements could not be fully met. Late in December 1939,therefore, the War Department authorized new appointmentsin the Reserve if the existing members would not accept active duty voluntarilyand if the new appointees would agree to serve immediately. This authority seemsto have had a rather limited application and to have resulted in the appoint-

¹⁰Letter, Secretary of War, to Hon. Daniel W. Bell,Acting Director, Bureau of the Budget, 27 May 1939.
¹¹(1) Letter, The Adjutant General, to each Corps AreaCommander, 23 Oct. 1939, subject: Additional Reserve Officers To Be Placed onDuty With the Regular Army. (2) Letter, The Adjutant General, to each Corps AreaCommander, 8 Dec. 1939, subject: Age Limit, Reserve Officers, MedicalDepartment. (The policy was laid down in October 1939, in anticipation of theappropriation act of February 1940 which made the procurement possible.)
¹²Letter, The Surgeon General, to The Adjutant General, 18 Jan. 1940,subject: Removal of Certain Restrictions Governing Selection of AdditionalMedical Department Reserve Officers.
¹³Memorandum, Brig. Gen. William E.Shedd, Assistant Chief of Staff, G-1, for Chief of Staff, War Department GeneralStaff, 27 May 1940, subject: Medical Department Reserve Officer Personnel, with1st endorsement thereto, 4 June 1940.

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ment of no more than 125 Medical Department officers between June and August1940.¹⁴

Emergency Measures

An indication of the scarcity of officers is the fact that, in January 1940,The Surgeon General was forced to recommend the summoning of Reserve officers toactive duty for periods of 28 days as a provision for the year`s maneuvers. TheGeneral Staff approved the use of 138 Medical Department Reserve officers onthis basis for service in tactical units.¹⁵

At almost the same time, the General Staff announced twomeasures of more permanent relief. One was a program recalling retired RegularArmy officers to active duty for utilization with Reserve Officers` TrainingCorps units and the recruiting service. This was of small importancenumerically, and it was not until 6 months later that The Surgeon Generalsubstituted retired officers for some of the 23 Regular Army Medical Corpsofficers on Reserve Officers` Training Corps duty.¹⁶Much more significant from the standpoint of policy was the grant of authorityto substitute reservists of the Medical Administrative and Sanitary Corps formembers of the Medical Corps Reserve in meeting the quotas for active-dutyassignments.

THE BEGINNING OF MOBILIZATION

The Change From Voluntary to Involuntary Service

Full mobilization began with the calling of the NationalGuard into Federal service (27 August 1940) and the enactment of the SelectiveTraining and Service Act less than a month later (16 September). More or lessconcurrently with these measures, a number of steps were taken to increase thesupply of Medical Department officers and nurses. The law ordering the inductionof the National Guard was itself perhaps the most important in this respect.This law also made active duty compulsory for all reservists, including those ofthe Medical Department. It authorized the President during the

¹⁴(1) Letter, The Adjutant General, toeach Corps Area Commander, 22 Dec. 1939, subject: Procurement of MedicalDepartment Reserve Officers. (2) Letter, The Surgeon General, to The AdjutantGeneral, 15 Aug. 1940, subject: Reserve Officer Personnel. (3) Letter, TheSurgeon General, to The Adjutant General, 24 Aug. 1940, subject: Appointmentsin Medical Department Reserve. (4) Memorandum, Assistant Chief of Staff, G-1,for Chief of Staff, 30 Dec. 1940, subject: Cancellation of Authority to Appointin the Medical Department Reserve.¹⁵(1) Letter, The Surgeon General(Executive Officer), to The Adjutant General, 18 Jan. 1940, subject: AdditionalMedical Department Reserve Officers Required for Temporary Duty With RegularArmy. (2) Memorandum, War Department General Staff (Personnel Division, G-1),for Chief of Staff, 3 Feb. 1940, subject: Additional Medical Department ReserveOfficers Required for Temporary Duty With Regular Army, with 2d endorsementthereto, 6 Mar. 1940.
¹⁶(1) Letter, The Adjutant General, toCorps Area and Department Commanders, 22 Jan. 1940, subject: Assignment ofRetired Officers to Active Duty. (2) Letter, The Surgeon General, to TheAdjutant General, 3 July 1940, subject: Utilization of Retired Officers (citedin Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Director,Historical Division, Office of The Surgeon General, 20 Apr. 1944, subject:History of Procurement Branch, Military Personnel Division, Personnel Service,Office of The Surgeon General.)

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period ending on 30 June 1942 to call to active duty for aperiod of 12 months, with or without their consent, members and units of theReserve components of the Army of the United States (Officers` Reserve Corps,National Guard, and Enlisted Reserve Corps) and retired members of the RegularArmy. There were important restrictions, however. Reserve components could notbe employed beyond the limits of the Western Hemisphere, except in territoriesand possessions of the United States. The law also stipulated that any reservistcalled to duty, if below the rank of captain and having no income beyond what hehimself earned to support dependents, could resign and be discharged upon hisown request if made within 20 days of his entry upon duty.¹⁷

Signalizing as it did the passing from voluntary toinvoluntary military service, this law constituted an important step towardplacing the United States on a preparedness basis as far as personnel wasconcerned. Physically qualified Reserve and National Guard officers holding the rank ofcaptain or above were for the first time compelled to serve. Previously, too,Congress had in one way or another limited the numbers of Reserve officers to beplaced on active duty; this law, carrying no such limitations, opened the wayfor mobilization on a much wider scale. The effect of granting individualofficers below the grade of captain the right to resign, however, reduced thebenefit of the law, for hundreds of Medical Department Reserve officersexercised this right before it was canceled on 13 December 1941, shortly afterentry of the United States into the war. Desirable as it was from the standpointof the Army to prohibit resignations entirely, Congress may have felt thatpublic opinion demanded some concessions to officers in the lower ranks; it isworth noting that these concessions were similar to the exemptions granteddraftees when selective service legislation was enacted shortly afterward.

Further Emergency Reserve Measures

Immediately following the enactment of the Selective Service Act, two measures were introduced to increase the supply of officers for the Army as a whole and therefore for the Medical Department. On 27 September 1940, the War Department called Reserve officers employed with the Civilian Conservation Corps to active duty for assignment within Army installations.¹⁸ The second measure came in October when the system of corps area debits and credits was initiated. If the number of Reserve officers available to a corps area commander was insufficient for his needs, he was ordered to report the shortage to the War Department, which would then start action to supply additional officers from other corps areas. Such a system was necessary because the distribution of men in training by corps areas did not correspond to the distribution

¹⁷54 Stat. 858.
¹⁸Letter, The Adjutant General, toeach Corps Area Commander and Commanders of Arms or Services, 13 Sept. 1940,subject: Placing on Active Duty of Reserve Officers Who are Employees of theCivilian Conservation Corps.

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ofReserve officers.¹⁹ A similar system had already been applied to nurseprocurement.²⁰

Medical Administrative Corps

Members of the Medical Administrative Corps Reserve responded to the call toactive duty in larger proportion than did Medical Corps reservists (tables 12 and 13). A possible reason is that some of those holdingReserve commissions in the Medical Administrative Corps were enlisted men of theRegular Army who for reasons of pay and prestige would accept active duty asofficers more readily than would civilian doctors in the Medical Corps Reserve.Yet the number responding fell far short of the demand for qualified personnelwho could act as instructors in medical training centers or serve in hospitaladministration. Men therefore had to be trained for commissioning in the corps.It was not until July 1941, however,that the first officer candidate school, at Carlisle Barracks, Pa., opened forMedical Administrative Corps training. In April, The Surgeon General had askedfor the establishment of such a school, to accommodate 100 candidates witheventual expansion to a capacity of 200. Aspart of a general enlargement of the officer candidate school program (plannedbut not yet put into effect), the Chief of Staff authorized a school for 100Medical Administrative Corps candidates, to be opened on 1 July instead of on 1August 1941, although The SurgeonGeneral had recommended the latter date. One class of 77 second lieutenantsgraduated before Pearl Harbor.²¹

Sanitary Corps

The procurement of Sanitary Corps officers presented no greatproblem, from the standpoint of actual numbers, during this period. Members onactive duty increased from 6 on 30June 1940 to 186 a year later; the shortage on 30 June 1941 was only 22. The Sanitary Corps in the prewar periodconsisted of professional men, such as entomologists, bacteriologists, andsanitary engineers. As such, its members required long periods of civiliantraining. No officer candidate school, therefore, was established for the corpsat this time-or even later when the practice of commissioning nonprofessionalmen in the corps began.

¹⁹(1) Letter, TheAdjutant General, to Commanding General, each Corps Area, 2 Oct. 1940, subject:Additional Reserve Officers for Extended Active Duty with Corps Areas. (2)Memorandum, Lt. Col. D. G. Hall, Office of The Surgeon General, for Director,Historical Division, Office of The Surgeon General, 20 Apr. 1944, subject:History of Procurement Branch Military Personnel Division, Personnel Service,Office of The Surgeon General.
²⁰Letter, The Adjutant General, to each Corps AreaCommander and The Surgeon General, 24 Sept. 1940, subject: Procurement ofReserve Nurses.
²¹(1) Letter, The Surgeon General, toThe Adjutant General, 3 Apr. 1941, subject: Officer Candidate School. (2)Memorandum, Operations and Training Division, War Department General Staff, forChief of Staff, 9 Apr. 1941, subject: Officer Candidate School. (3) Memorandum,Reserve Division, Office of The Adjutant General (Col. H. N. Sumner), for MajorWest, G-3, 15 Oct. 1941, with enclosure thereto.

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DEFERMENT OF SERVICE FOR RESERVE OFFICERS

While The Surgeon General was anxious to place many reservists on active duty as possible, he recognized that in some cases they might, at least temporarily, be employed to greater advantage in a civilian capacity. Reserve officers on inactive status were exempt from the draft, and the process of granting them deferment of service differed from that employed with respect to potential draftees. On his own authority, The Surgeon General could defer the service of Medical Department Reserve officers in the Arm and Service Assignment Group only. Appeals for deferment by officers in the Corps Area Assignment Group (which contained much the larger portion of the Reserve) could be acted upon only by the corps area commanders. At times, in order to protect civilian interests, The Surgeon General recommended the transfer of officers from the latter to the former group.²²In September 1940, he recommended to the Office of the Secretary of War thatReserve officers who held key positions as public health officers or as teachersat medical institutions be transferred to the War Department Reserve Pool forassignment and retention in their civilian jobs. That office disapproved theproposal, stating that they must be available for active duty if their serviceswere needed, but agreed that the military service of State public healthofficers and teachers at medical institutions would be deferred as long aspossible.²³ Throughout the emergency and war periods, deferment continued to begranted to certain members of faculties (either reservists or civilians) whowere declared by the respective deans to be essential.

U.S. Public Health Service and Veterans` AdministrationReserves

The U.S. Public Health Service and the Veterans`Administration cooperated with The Surgeon General in keeping to a minimum thedeferments of members of their staffs who were also Reserve officers in theMedical Department. The Surgeon General of the U.S. Public Health Servicestated in a circular addressed to members of his organization that except incases of emergency or in unusual situations, where the services of the men whohappened to be Reserve officers were most essential to the conduct of PublicHealth Service work, no effort would be made to delay or prevent such officersfrom being ordered to active duty. When called, they were to be releasedimmediately from employment by the Public Health Service.²⁴

²²Letter, The SurgeonGeneral, to Dean, School of Medicine, Creighton University, Omaha, 7 Feb. 1941.
²³Memorandum, The Surgeon General, for Maj. F. H. Kohloss,Office of Assistant Secretary of War, 2 Dec. 1940, subject: Deferment ofExtended Active Duty of Certain Categories of Officers of the Medical DepartmentReserve.
²⁴Circular (unnumbered), Surgeon General, U.S. Public HealthService, to Commissioned Officers in Charge, U.S. Public Health Service, andOthers Concerned, 9 Oct. 1940, subject: Commissions in Reserve Corps of Army,Navy, or Marine Corps.

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The Veterans` Administration and the War Department,beginning in August 1940, worked out a plan by which the Medical Department whennecessary could obtain the services of the Medical and Dental Corps Reserveofficers employed as civilians by the Veterans` Administration withoutdisrupting the medical service of the latter. The Veterans` Administrationemployed about 400 such Reserve officers, and to call to duty any appreciablenumber at one time would obviously have disorganized the work of that agency.The plan agreed upon provided that the War Department would defer the militaryservice of key employees as long as possible; it would submit names of officersdesired but would not order anyone to active duty until the Veterans`Administration had an opportunity to secure a replacement.²⁵ The WarDepartment would ascertain from the Veterans` Administration the earliest dateon which an officer could be made available. If that date was more than 60 daysahead, the officer would be transferred to the War Department Reserve Pool andnot called to active duty. A similar plan was adopted for Reserve nurses whowere in the employ of the Veterans` Administration.²⁶ Later, thisplan was modified, at the request of The Surgeon General, by a provision thatthe headquarters having assignment jurisdiction was to make every reasonableeffort to determine the officer`s physical fitness before requesting his releasefrom the Veterans` Administration.²⁷ Obviously, an officer found physically unfit for duty wasnot requested, and the Veterans` Administration therefore was spared the troubleand expense of obtaining a replacement for a man who later was returned to itafter being rejected for Army service.

Establishment of Rosters for Reserve Officers

In November 1940, the Secretary of War directed each assignment authority(corps area, departmental, and arm or service headquarters) to prepare andmaintain rosters for the purpose of establishing priority in which Reserveofficers would be ordered to active duty. These headquarters were to maintainseparate rosters for Medical Department Reserve officers, general provisions andrestrictions on selection of Reserve officers being clearly defined. Theposition of an officer on a roster was to depend on the following factors: Extentof deferment proposed by the officer and reasons therefor, personal obligationas to dependents, professional attainments and value to the service (in thisconnection age and physical aptitude were to be considered), and the need forthe officer`s services to the community in his civilian status. In the

²⁵(1) Letter, The Secretary of War, to theAdministrator of Veterans Affairs, 18 Oct. 1940. (2) Letter, The SurgeonGeneral, to Senator Chan Gurney (South Dakota), 22 Oct. 1940.
²⁶(1) See footnote 25(1), above. (2) Letter, Col.Florence A. Blanchfield, USA (Ret.), to Col. John B. Coates, Jr., MC, Director,Historical Unit, U.S. Army Medical Service, 21 Feb. 1956, with enclosurethereto.
²⁷(1) Letter, The Surgeon General, to The Adjutant General,25 Aug. 1941, subject: Release of Medical Department Reserve Officers byVeterans` Administration for Extended Active Duty. (2) Letter, The AdjutantGeneral, to Commanding General, First Corps Area [and other corps areas], 11Sept. 1941, subject: Release of Medical Department Reserve Officers by Veterans`Administration for Extended Active Duty.

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preparation of these rosters, assignment authorities weredirected to use the supplementary classification questionnaires for MedicalDepartment Reserve officers (W.D., A.G.O. Form No. 178-2).²⁸ Such asystem of rosters became necessary after the Chief of Staff stated that asindividuals had accepted commissions in the Officers` Reserve Corps with theunderstanding that a national emergency meant war, they would be consulted as totheir availability before being arbitrarily called to duty for training duringpeacetime.²⁹

EXTENSION OF RESERVISTS` TOUR OF DUTY

As early as January 1939, even before the augmentation of the Army began, TheSurgeon General stated that the tours of duty of Medical Department Reserveofficers might have to be extended beyond 1 year. As voluntary procurementmeasures failed to secure the desired number of officers, it became more evidentthat an extension of the 1-year tour was necessary.³⁰ In 1939 and 1940, MedicalDepartment Reserve officers were brought on duty for 1 year, with a possibleextension of service to 2 years.

Extension by Interpretation

After Congress made active duty compulsory (or partially so)for both Reserve and National Guard officers (August 1940), the Judge Advocate General ruled that officers who hadentered on active duty before passage of this legislation could be compelled toserve an extra year without their consent. He ruled further that officers calledto duty under the new law without their consent were exempt from the extra dutyunless they agreed to it.³¹ In other words, those who had volunteered priorto August 1940 for1 year`s service were now forced to stay in for 2; those who had been broughton duty involuntarily after August 1940 did not have to stay in for the second year unless they sorequested.

At first, The Surgeon General favored retaining MedicalReserve Corps officers on duty for the second year.³² Twomonths later, however, he conceded that since few officers were concerned, thenumber thus made available for military service would be negligible, and thepsychological reaction of the individual and the profession at large would beunfavorable. The Secretary of War adopted The Surgeon General`s point of viewand announced that, with

²⁸Letter, The Adjutant General, to Commanding Generals, allCorps Areas, and Commanders of War Department Arms and Services, 20 Nov. 1940,subject: Reserve Officers for Extended Active Duty Under Public Resolution 96,76th Congress.
²⁹Letter, Lt. Col. F. M. Fitts, to Col. Calvin H. Goddard, Director,Historical Unit, Office of The Surgeon General, 21 Jan. 1952.
³⁰Letter, General Magee, to Colonel McCornack, 24 Jan. 1939.
³¹(1) Letter, The Adjutant General, to each Corps Area and DepartmentCommander, 19 Sept. 1940, subject: Reserve Officers Ordered to ActiveDuty Without Their Consent. (2) Letter, The Adjutant General, to Chiefs of allWar Department Arms and Services, 10 Oct. 1940, subject: Continuation of ActiveDuty, Without Their Consent, of Reserve Officers Now on Extended Active Duty.
³²Letter, The Surgeon General, to The Adjutant General, 15 Jan. 1941, subject:Extensions of Tours of Active Duty for Medical Corps Reserve Officers.

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the exception of officers whose current tours of active dutywere based on agreement for extension of tour, the policy of the War Departmentwas that Reserve officers of the Medical Department be not continued on activeduty for a period longer than 1 year without their consent. With minorexceptions, Reserve officers of the Medical Department whose tours had beenextended without their consent under the law of August 1940 would uponapplication be relieved from active duty.³³

Service Extension Act, 1941

The Service Extension Act of August 1941 permitted the President to extend for18 months theservice of members of the Reserves and National Guard. The act also provided forthe release of officers whose retention would cause them undue hardship. The WarDepartment announced that so far as practicable it would release all Reserveofficers (other than officers of the Air Forces) having 12 months` service ifthey did not wish to extend their tours beyond that period. The Surgeon General,under pressure to obtain more officers, recommended and the War Department inresponse directed that the tours of all Medical Reserve Corps officers beextended where it had been determined that replacements were not available.³⁴

Establishment of the Army of the United States

On 22 September 1941, a joint resolution of Congress permitted the President tocommission newly appointed officers in the Army of the United States as analternative to one of its several components (including the Reserves). Personsso appointed might be ordered to active duty for any period the Presidentprescribed, and the appointment might continue "during the period of theemergency and six months thereafter."³⁵ On this basis, the Secretary of War declared that, withexceptions that would not include many officers, all persons commissionedthereafter during the emergency were to be appointed in the Army of the UnitedStates. Applications for appointment in the Officers` Reserve Corps then beingprocessed would, with the exceptions mentioned above, be considered asapplications for appointment in the Army of the United States.³⁶ Shortlyafter Pearl Harbor, the problem of extending the term of active duty forNational Guard and Reserve officers was solved by an act of 13 December 1941 which obliged all members of the Army to serve for theduration of the war and 6 months thereafter.

³³Letter, The Adjutant General, to Commanding Generals of all Armies, ArmyCorps, and others, 1 May 1941, subject: Extension of Tours of Active Duty,Reserve Officers.
³⁴Letter, Office of The Surgeon General, to Office of The Adjutant General,3 Sept. 1941, subject: Extension of Tours of Active Duty, Reserve Officers, with1st endorsement thereto, 20 Sept. 1941. (It must be assumed that National Guardofficers, although they were not specifically mentioned in this correspondence,were covered by the same policy.)
³⁵55 Stat. 728.
³⁶Letter, The Adjutant General, to Commanding Generals ofall Armies, Corps Areas, Departments, and others, 7 Nov. 1941, subject: PoliciesRelating to Appointments in the Army of the United States Under the Provisionsof Public Law 252, 77th Congress.

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FIGURE 27.-Col. Richard H. Eanes, MC, Chief Medical Officer, Selective Service System.

EFFECT OF SELECTIVE SERVICE LEGISLATION

When the Selective Training and Service Act was passed on 16September 1940, no occupational group, as such, was excluded except ordainedministers of religion and students preparing for the ministry. Thereforedoctors, dentists, veterinarians, and other professional people of value to theMedical Department would be drafted as needed and duly commissioned in any ofthe corps except the Nurse Corps (women were exempt from the draft). Inaddition, age limits were originally broad enough (21 to 35, inclusive) tocover a large number of the physicians and a much larger proportion of thedentists in the country.

The prospect of drafting professional men in both the numbersand types needed was dimmed by the action of the Selective Service boards. Theseboards, in whom sole authority for the selection lay, may not have been technically qualified to pass upon the essentiality of professional personnel eitherto the Army or to the local community; their decision as to whether a doctor ordentist was or was not to be deferred might depend somewhat on his localpopularity. On the other hand, Col. Richard H. Eanes, MC (fig. 27), who was onduty with Selective Service headquarters during the war, stated later

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that while it was "technically correct" that localboards were not technically qualified to make decisions concerning the absoluteessentiality of the individual for the medical needs of the community,"sound judgment on the part of many local boards generally resulted indecisions that were proper."³⁷ Itwas quite reasonable to expect, however, that since the boards had to considerthe health needs of their local communities they would consider these needsfirst before taking into account those of the Army.

On the other hand, however lenient the draft boards might betoward doctors and dentists, individual members of those professions could notbe certain of escaping the draft. That fact undoubtedly caused some to apply forcommissions before the blow fell. In that way, they avoided the indignities-assome considered them-of being compelled to enter the Army and serve as enlistedmen until accepted for a commission, as all draftees must do. Such a prospectwas rather remote, especially for physicians, but it remained a possibility.

The Medical Department, partly at the request of theprofessional organizations, desired to remove that possibility completely. TheArmy felt that it would be the target for widespread criticism if the servicesof professional men were wasted in relatively minor, nonprofessional activities.On the day the Selective Training and Service Act was passed (16 September1940), therefore, The Surgeon General recommended to the War Department thatappointments in the Reserves be opened to persons who might be drafted. Since noaction was taken, substantially the same request was repeated on 26 October,again with no immediate result.³⁸ About the same time, The Surgeon Generalreminded the corps area surgeons that they could make appointments in theReserve Corps if vacancies existed and when an applicant was desired for activeduty.³⁹ Meanwhile, the heads of selective service and the local draftboards, foreseeing no shortage of civilian dentists, did not hesitate to inductas an enlisted man any dentist who was not needed at the moment in his owncommunity. The American dental profession, supported by The Surgeon General,voiced its concern, claiming that serious difficulties might ensue if dentistswere not used in their professional capacity.⁴⁰ In January 1941, the chief ofthe Dental Division, Office of The Surgeon General, suggested to the AssistantChief of Staff, G-1, that qualified physicians, dentists, and veterinarians whostood high on the list for induction should be granted commissions in theReserve Corps "without reference to procurement objectives." He alsoadvised that such persons be "assigned to active duty as soon ascommissioned." This suggestion was no doubt vitiated from the WarDepartment General Staff`s point of view by a further and apparently

³⁷Letter, Col. Richard H. Eanes (Ret.), Chief MedicalOfficer, Selective Service System, to Col. C. H. Goddard, Office of The SurgeonGeneral, 5 Sept. 1953.
³⁸Letters, The Surgeon General, to The AdjutantGeneral, 16 Sept. 1940, and 26 Oct. 1940, subject: Appointment in Medical,Dental, and Veterinary Corps Reserve.
³⁹Letter, Office of The Surgeon General (ExecutiveOfficer), to each Corps Area Surgeon, 29 Oct. 1940, subject: Extended ActiveDuty Vacancy Required for Approval of Applicant for Commission.
⁴⁰Memorandum, Office of The Surgeon General (Brig. Gen. AlbertG. Love), for G-1, 25 Mar. 1941.

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conflicting proposal that a person so commissioned should becalled to active duty "as soon as his services can be properlyutilized."⁴¹ No action wastaken on these proposals.

Congressional Action

In the meantime, several bills were introduced in Congress tocommission licensed physicians and dentists in lieu of induction, and also todefer students and teachers in medical and dental schools. The Army disapprovedall these bills on the grounds that no one group should get preferentialtreatment. In addition, The Surgeon General did not want to be placed in theposition of commissioning all doctors and dentists.⁴²

War Department Action

At this same time, The Surgeon General desired to add to thenumbers in the Dental, Veterinary, and Sanitary Corps Reserve, but he wished toretain the power to determine just which officers were to be commissioned. Thepublicity surrounding the induction of dentists for service as enlisted mencontinued to embarrass him; communities and professional societies persisted indemanding that dentists be commissioned rather than be allowed to serve asenlisted men. On 5 May 1941, the War Department finally stated that inductedindividuals who qualified for appointment in the Dental or Veterinary CorpsReserve should be encouraged to apply for appointment in the Reserve so thatthey could serve in a professional capacity. Those qualified would be dischargedas enlisted men and ordered to active duty as commissioned officers for a periodof 12 months,⁴³ after which they would, presumably, return to inactivestatus in the Reserve. Although this order undoubtedly accommodated manyinducted men, it did not prevent the induction of dentists or veterinarians.Agitation continued both to commission inducted men and to open the ReserveCorps to permit further commissioning,⁴⁴thereby preventing the induction of additional dentists. The Office of TheSurgeon General, however, held that the Army could not justify commissioningunlimited numbers in the Reserve without reference to its needs, as this wouldbe tantamount to granting a deferment denied to persons outside the medicalprofession.⁴⁵

⁴¹Letter, Brig. Gen. Leigh C. Fairbank, to Brig. Gen. WilliamE. Shedd,G-1, 22 Jan. 1941, subject: Reserve Commissions for Physicians, Dentists, andVeterinarians Subject to Induction.
⁴²(1) S. 783 and 197, 77th Cong. (2) Senate Committee on Military Affairs,77th Cong., 1st sess., hearings on S. 783, "Doctors and Medical StudentsUnder the Selective Service," pp. 155, 159, 163-164. ⁴³Letter,The Adjutant General, to each Commander of Army or Service, 5 May 1941, subject:Appointment in the Dental and Veterinary Corps Reserve of Inducted Individuals.
⁴⁴Letter, C. Willard Camalier, Chairman, Dental Preparedness Committee,American Dental Association, to James Rowe, Jr., Administrative Assistant to thePresident, 17 Sept. 1941.
⁴⁵Memorandum, Office of The Surgeon General (Col. Robert C. Craven), for TheAdjutant General, 8 Oct. 1941.

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By the spring of 1941, the selective service authorities werebeginning to show some alarm over the professional personnel situation, and on22 April they cautioned local boards that a shortage of dentists might impend.This warning was strengthened on 12 May.⁴⁶At that time, local boards were reminded that (1) they still had fullresponsibility for determining whether a dentist was indispensable to hiscommunity; (2) the Army did not need dentists for the time being; and (3) if aboard felt that a dentist should nevertheless be inducted, he should be advisedthat he might apply for a commission as soon as he went on active duty. Thisdirective must have discouraged the draft of dentists, but it did not positivelyprohibit it. Although the Selective Service System maintained that groupdeferments should not be granted, it can be seen from these memorandums that theauthorities of that agency moved closer to sanctioning the deferment of at leastone group. There were no major changes of policy on the subject during theremainder of 1941, and with the creation of the Procurement and AssignmentService in the fall of that year, a new agency was to determine whether doctors,dentists, and veterinarians were available for military service or should bekept in their communities.

ARMY NURSE CORPS

Applicants for appointment to the Army Nurse Corps underwenta somewhat different routine from the other Medical Department corps. To enterthe Regular Army component of the corps, they applied directly to The SurgeonGeneral, and did not ordinarily have to take a professional examination,although The Surgeon General might prescribe one if he chose. An applicant must,however, present a certificate from the superintendent of the nursing schoolattended, and if she was qualified professionally, morally, and physically,according to Army standards, and was registered in the State in which she hadgraduated or in which she was practicing nursing, she became eligible forappointment. Entrance to the Reserve could be gained primarily but notexclusively by enrollment with the Red Cross Nursing Service which furnished TheSurgeon General a list of available nurses who could be called upon in time ofemergency. While Reserve nurses must be obtained from the Red Cross "so faras practicable," they could also be recruited "from any otheracceptable source."⁴⁷

The law calling up the Reserves did not affect Reserve nurses, since thelatter were not part of the Army Reserves. Two weeks after the law was enacted,however, the General Staff authorized the assignment of 4,019 Reserve nurses toactive duty on a voluntary basis. Previously, all nurses procured for active duty had to be appointed to the Regular Army. They couldnow also

⁴⁶Memorandums I-62 and I-99, Selective Service Headquarters, 22 Apr. 1941and 12 May 1941, respectively, for State Directors.
⁴⁷Army Regulations No. 40-20, 31 Dec. 1934.

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be brought in with the status of reservists serving for 1 year, but undersuitable conditions, the period could be extended.⁴⁸

The recruitment of nurses proved to be much less simple thanThe Surgeon General had expected. With over 15,000 enrolledin the First Reserve of the Red Cross, he anticipated little difficulty inmeeting the first requirements for Reserve nurses, amounting to 5,019, by January1941. Atfirst, however, relatively few accepted active duty, and only 607 had been assigned by 1 February1941. The Red Cross sometimes found it necessary to canvass asmany as 10 Reserve nurses before discovering one willing to accept active duty.⁴⁹

The meagerness of the response impelled The Surgeon General to recommendinvoking the more liberal terms of Army regulations, and corps area commanderswere accordingly authorized to procure Reserve nurses not only from the RedCross but from "any acceptable source."⁵⁰TheRed Cross was thus prodded to more vigorous action. A publicity campaign wasundertaken, using the radio, newspapers, and magazines, to promote recruitment.These measures apparently had their effect-between the first of February and themiddle of March 1941, 1,000 nurseswere placed on active duty. By 30 June 1941, 1,280 Regular Army and 4,153 Reserve nurses were in service,500 ofthe Regulars having been brought in within the past 12 months, and all theReserves since September 1940. Thisrepresented 595 and 866 fewer thanthe respective authorizations as they existed on 30 June 1941.⁵¹

Procurement for the Army Nurse Corps, unlike that for otherMedical Department Corps, was hampered by the fact that its Reserve, built up bythe Red Cross, was never under legal compulsion to accept active duty. On theother hand, no limit was ever placed on the number who could be recruited forthe Red Cross Reserve. The War Department could restrict only the number ofnurses who were placed on active duty as Reserve appointees; it could not-as inthe case of other components-impose procurement objectives which limited theinactive as well as the active membership to a certain figure. Adherence tothese procurement objectives for other corps sometimes reduced the number oftransfers from inactive to active status by preventing the recruitment of newreservists who might be more amenable to accepting active duty or more availablefor performing it than the existing members. The Red Cross, however, could go onenlarging its backlog of Reserve nurses indefinitely, with the prospect thatamong the larger number more would be found to volunteer for active service.

⁴⁸(1) Letter, Office of The Surgeon General (ExecutiveOfficer), to The Adjutant General, 10 Sept. 1940, subject: Procurement ofReserve Nurses. (2) Letter, The Adjutant General, to each Corps Area Commanderand The Surgeon General, 24 Sept. 1940, subject: Procurement of Reserve Nurses.
⁴⁹(1) Annual Report of The Surgeon General, U.S. Army, Washington: U.S.Government Printing Office, 1941. (2) Statement of Medical Department Activitiesby Maj. Gen. James C. Magee, The Surgeon General, for the Sub-Committee of theCommittee on Appropriations, House of Representatives, 77th Cong., 1941, p. 10.(3) Blanchfield, Florence A., and Standlee, Mary W.: The Army Nurse Corps inWorld War II. [Official record.]
⁵⁰(1) Letter, The Surgeon General, to The Adjutant General,16 Dec. 1941, subject: Reserve Nurses. (2) Letter, The Adjutant General, to eachCorps Area Commander and The Surgeon General, 4 Jan. 1941, subject: Procurementof Reserve Nurses.
⁵¹See footnote 49 (1).

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STUDENTS IN PROFESSIONAL SCHOOLS

Only one phase of the problem of obtaining professionalpersonnel has so far been discussed-that which concerned fully trained doctors,dentists, veterinarians, and sanitarians. This aspect overlaps the second phaseof the problem, which concerned students in professional schools. Recentgraduates were a highly regarded source of officer personnel. For them and forthe community at large, the transition to military service was easier than formen already established in civilian practice. As a group, these young men werealso physically best able to perform arduous military duties. The MedicalDepartment was therefore anxious to obtain their services as soon as they hadfinished their education. But to do this, it was desirable to place a claim onthem some time in advance-while they were still students. They alsohad to bepermitted to complete their studies, which meant protecting them against thedraft and against a premature call to duty as officers. Thus, the phase ofprocurement having to do with fully trained doctors (and other professionalpersonnel) merged with that of maintaining the source of future supply-studentsin professional schools. The civilian community was also interested inmaintaining such a supply for its own needs, and the Medical Department couldtherefore cooperate with leaders of the civilian profession in protecting thestudent group.

Although at the beginning of mobilization the Officers` Reserve Corps seemedto contain ample numbers of dentists and veterinarians for immediate needs, itwas early recognized that a continuing supply of men in those fields as well asin medicine could come only from the group of graduating students, interns, andresidents if civilians as well as military needs were to be met.

Medical Students

In 1939, medical educators raised the question of how theArmy would utilize its young Reserve officers who, upon the declaration of anational emergency, might be engaged in the study of medicine. Among those inprocess of receiving their medical education, the Army had some claim on thoseholding commissions in either medical or nonmedical sections of the Officers`Reserve Corps, or enrolled in either of the corresponding sections of theReserve Officers` Training Corps.

In February 1940, the War Department announced that MedicalCorps Reserve officers would not be called up until they had completed one yearof hospital internship.⁵² Aconsiderable number of medical students, however, held commissions in nonmedicalsections of the Officers` Reserve Corps, commissions which they had received oncompleting a course in the Reserve Officers` Training Corps undertaken duringtheir premedical years. Retention of these commissions would have eliminatedthem as future officers in the Medical

⁵²Letter, The Adjutant General, to all Corps Area and DepartmentCommanders and The Surgeon General, 19 Feb. 1940, subject: Extended Active Dutyfor Medical Reserve Officers.

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Corps. The growing possibility of war caused their status toreceive careful study within the War Department. As a result, the Department inApril 1940 authorized the transfer of these nonmedical Reserve officers to theMedical Administrative Corps section of the Officers` Reserve Corps if theywere full-time students in approved medical, dental, or veterinary schools. Thetransfer was to be effective only at the direction of the War Department during mobilization, and the call to active duty was made a function of The SurgeonGeneral. The War Department ordered the transfer in August 1940. By June 1941, 529 medical, 48 dental, and 32 veterinary students had been transferred to theMedical Administrative Corps Reserve.⁵³

Students in the medical units of the Reserve Officers`Training Corps were few; only 23 medical schools and colleges had such units andonly a small percentage of their students were enrolled. No similar unitsexisted in dental or veterinary schools. There were many more nonmedical ReserveOfficers` Training Corp units in the educational institutions of the country,but how many premedical students belonged to them is unknown. In September1940, the Selective Service Act granted deferment of service to third- and fourth-year students in all sections of the Reserve Officers` TrainingCorps.⁵⁴

But the vast majority of medical students, interns, andresidents had assumed no military obligations whatever. At first, The Surgeon General attempted to obtain for immediate service in the Medical Departmentsome of those who had just completed their studies as interns or residents.Later on, as selective service became imminent, he tried to protect others ofthe unobligated group-veterinary and dental as well as medical students-fromcalls to service until they had finished their schooling. In the early monthsof 1940, The Surgeon General appealed to residents and interns (the latter afterthey had finished a year`s internship) to take commissions in the Officers`Reserve Corps with the obligation of accepting active duty for 1 year beginningabout 1 July 1940. He appealed to them because he thought they might be morewilling than others to accept such duty since they had not committed themselvesto practice. As their acceptance had to be voluntary, The Surgeon General waslimited to publicity and persuasion in his efforts to commission these youngphysicians.

When it seemed probable in the summer of 1940 that selective service would be introduced, the situation of students, interns, and residents changedconsiderably. The vast majority of them, not being members of the Officers` Reserve Corps or Reserve Officers` Training Corps, could lay no claim to exemption or deferment. The War Department made no plans to exempt them, andit was assumed that they would be faced with the choice of accepting commissions in the Medical Department Reserve or being inducted into theArmy, in which case they would serve as privates. At the same time, the leadersof medi-

⁵³(1) Letters, The Adjutant General, toCorps Area and Department Commanders and each Chief of Arm or Service, 17 Apr.1940, and 25 Aug. 1940, subject: Special Mobilization Procedures for Procurementof Medical Department Reserve Officers Who are Students in Approved Schools. (2)See footnote 49 (1), p. 135. ⁵⁴54 Stat. 858.

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cine, dentistry, and veterinary medicine expressed theirconcern over the harm these professions might suffer if the supply were cut offby an interruption of training. In this matter, Army authorities, including TheSurgeon General and his assistants, had a dual responsibility. They must firstof all provide the necessary medical service for an expanding Army. At the sametime, they had to take into account the problems of civilian medicine duringperiods of mobilization and war.

Commissioning of Interns

The Surgeon General had followed the policy of approvinginterns` applications for commissions with the understanding that they would notbe called to active duty before the completion of training.⁵⁵ In May 1941, theWar Department authorized the commissioning of interns in the Medical CorpsReserve "with the understanding that they will be ordered to one year`sactive duty immediately upon completion of their internship."⁵⁶ On 19 December1940, the WarDepartment had issued an order authorizing appointment of a sufficient number ofapplicants to fill any vacancies in the procurement objectives of the MedicalDepartment Officers` Reserve Corps. Men accepting commissions under the termslaid down in this order had to agree that they did not come within the categoryof those entitled to resign (granted by the law of August 1940 making active duty for reservists compulsory) and thatthey would not exercise the right if ordered to active duty.⁵⁷

Deferment Under Selective Service

The Selective Training andService Act deferred the service of all college and university students untilJuly 1941. Otherwise,local draft boards were to grant deferments for persons whose employment oractivity was necessary to the maintenance of the national health, safety, orinterest. Spokesmen for the medical profession objected to leaving the decisionon interns and residents to the "wisdom or lack of wisdom" of thelocal draft boards, demanding that medical men should have a voice in deciding"what is important to protect in medical training and in the maintenance ofAmerican medical institutions."⁵⁸ A full-scale controversy was soon in progress, as the WarDepartment attempted to persuade a large number of students who would graduatein June 1941 toapply for commissions in the Medical Corps Reserve. The procedure for grantingsuch commissions was simplified in February 1941, and, as the end of the school year approached,considerable publicity was given to the plan among military authorities anddeans of medical schools. The

⁵⁵Statement of Brig. Gen. A. G. Love,Office of The Surgeon General, at Conference, Committee on Medical Preparedness,Chicago, 23 Nov. 1940, reported in the Journalof the American Medical Association, 7 Dec. 1940, p.2008.
⁵⁶Letter, The Adjutant General, to all Corps Area andDepartment Commanders and The Surgeon General, 26 May 1941, subject: Defermentof Medical Students.
⁵⁷Letter, The Adjutant General, to each Corps Area andDepartment Commander and The Surgeon General, 19 Dec. 1940, subject: Appointmentin the Medical Department Reserve.
⁵⁸Wilbur, R. L.: Some War Aspects of Medicine. J.A.M.A. 116: 661-663, 22 Feb. 1941.

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response was not satisfactory. Of the 5,000 male studentswho graduated in medicine in 1941, only 1,500 made application for commissionsin the Medical Corps Reserve.⁵⁹ Many interns and residents preferredto take their chance with the draft, knowing the reluctance of local boards toinduct physicians as enlisted men. If actually drafted, that would be timeenough to apply for a commission.

The policy of the Selective Service authorities towardstudents was an important factor in the situation. Although at first this agencystood firmly against group deferments, it stated in February 1941 that it was of great importance that the supply ofphysicians "be not only maintained but encouraged to grow" and that nomedical student or intern who gave promise of becoming an acceptable physicianshould be called for military duty prior to his becoming one. A short time later(May 1941), theSelective Service office made the same statement apropos of dental students.⁶⁰There is no doubt that local boards placed vast numbers of students-medical,dental, and veterinary, as well as other-in class II and deferred them foroccupational reasons. A compilation prepared by the Selective ServiceAdministration covering the period from the passage of the Selective Service Actto Pearl Harbor shows the percentage of deferred students in several fields ofstudy:⁶¹

Field of study	Percentage in class II
Dentistry	81
Medicine	80
Veterinary medicine	72
Engineering	71
Chemistry	69
Pharmacy	66
Physics	59
Geology	56
Biology	46

Medical Administrative Corps Reserve Commissions

In February 1941, The Surgeon General, linking a desire tobuild up the strength of the Reserve Corps with his wish to permit thecontinuance of training in civilian schools, submitted to the War Department adetailed analysis of the problem with a recommendation that provision be madefor the granting of commissions in the Medical Administrative Corps Reserve tojunior and senior students not only in approved medical schools but in approveddental

⁵⁹⁽¹⁾Letter, TheAdjutant General, to all Corps Area Commanders, 18 Feb. 1941, subject:Appointment in Medical Corps Reserve of Graduates of Approved Medical Schools.(2) See footnote 49(1), p. 135.
⁶⁰(1) Memorandum I-91, National Headquarters, SelectiveService System, for all State Directors, 22 Apr. 1941, subject: Supplement to Memorandum I-62: Occupational Deferment of Doctors, Internees and MedicalStudents (III). (2) Memorandum I-99, National Headquarters, Selective Service System, for all State Directors, 12 May 1941, subject: Supplement to Memorandum I-62: Occupational Deferment of Dentists and Dental Students (III).⁶¹Selective Service in Peacetime, First Report of theDirector of Selective Service, 1940-41, p. 172.

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and veterinary schools. This would have extended the practicealready adopted to the case of interns but not yet formally approved by the WarDepartment. In rejecting this new proposal, the General Staff expressed the viewthat "such action would constitute special treatment for aparticular class of students which would result in exempting them from SelectiveService"; exemptions from selective service could not be granted for anyparticular group unless it could be clearly demonstrated that personnel in thatgroup would be required in key positions in industries essential to the nationaldefense.⁶²

Under pressure from various medical and dental societies andbacked by the knowledge that the Under Secretary of War, Robert P. Patterson,was keenly interested in the problem, on 10 May 1941 The Surgeon General againrecommended to the War Department that either of the following actions be taken:To commission a medical student in the Medical Administrative Corps Reserve assoon as he was enrolled in a grade A medical school or to enroll him at thattime in the Enlisted Reserve Corps for a period of 3 years and then commissionhim in the Medical Administrative Corps Reserve until graduation, when he wouldbe commissioned in the Medical Corps Reserve and called to duty on completinghis internship.⁶³

On 26 May 1941, the War Department went part of the way by granting authorityto commission as second lieutenants in the Medical Administrative Corps Reserve,after 1 July 1941, male junior and senior students in approved medical schoolsin the United States who were fit for military service. Under regulationspublished several weeks later, students so commissioned were transferred to andretained in the War Department Reserve Pool⁶⁴ until eligible for appointment in the Medical CorpsReserve (at the end of their 4-year course). No examination except thephysical was necessary. Appointments were to be made without reference to theprocurement objective for the Medical Administrative Corps Reserve. Officerswere to be discharged from the Reserve if they discontinued their medicaleducation, dropped out of school entirely, matriculated in an unapproved schoolof medicine, or failed to secure appointment in the Medical Corps Reserve withina year of the completion of the 4-year course in medical school.⁶⁵Discharge from the Medical Administrative Corps Reserve placed the individualagain within the purview of selective service. It will be noted that this grantof authority took no account of dental and veterinary students or of first- andsecond-year medical students. No further concessions, however, were made untilafter the outbreak of war.

⁶²Memorandum, TheSurgeon General, for The Adjutant General, 18 Feb. 1941, subject: Commissioningof Junior and Senior Students in the Medical Department Reserve Corps, with 1stendorsement thereto, 18 Mar. 1941.
⁶³(1) Memorandum, Under Secretary of War, for General Marshall, 1 May 1941. (2) Memorandum, TheSurgeon General, for Assistant Chief of Staff, G-1, 10 May 1941.
⁶⁴Officers in this pool could beordered to active duty only with the approval of the War Department.
⁶⁵Letter, The Adjutant General, to TheSurgeon General (and others), 26 May 1941, subject: Deferment of MedicalStudents.

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RESERVE UNITS

Revival of Affiliated Units

The affiliated Reserve units constituted a special type of Reserve, and, fromthe personnel viewpoint, they possessed a character in many respects differentfrom that of other medical units. They had their own quotas and their own systemof procurement, and their development affected the general personnel situationin a number of special ways.

The Protective Mobilization Plan

As the threat of war increased, the value of an affiliatedReserve such as that so successfully used in World War I again became evident.The Protective Mobilization Plan of 1939 called for a number of tacticalhospitals to be brought into service during the first months of an emergency. Areserve of personnel for these hospitals composed of men and women highlyskilled and already trained to work together as a unit would make them quicklyavailable if the need arose. It was for this purpose that The Surgeon General,Maj. Gen. Charles R. Reynolds, in March 1939 proposed the revival of affiliatedunits.

He had made the suggestion several times before withouteffect. This time, he submitted a formal and detailed request, beginning with astatement of the case for affiliated units. Hospitals called for by theProtective Mobilization Plan, he argued, must be completely integrated unitswith harmonious staffs of competent and qualified physicians and surgeons, whichwould be sufficiently coordinated and organized to be able to function in atheater of operations with a minimum of delay. General Reynolds stated it to behis firm conviction that such units would be forthcoming only if they wereaffiliated in peacetime with large and well-staffed civilian hospitals. Anobstacle to the provision of a superior medical service for mobilization, in anycase, was the fact that the necessary specialists could not be recruited underexisting Reserve regulations. These regulations provided that appointees to theOfficers Reserve Corps must be less than 35 years of age and must enter thecorps as first lieutenants. Few of the outstanding specialists who would beneeded in case of mobilization or war were under 35, for very few physiciansacquired the desired proficiency before reaching that age. Those who werequalified could not be expected to accept commissions as first lieutenants andthus find themselves in the same grade with recent graduates of medical schools.

On the basis of the facts just outlined, General Reynoldsmade a series of recommendations, the most important of which was that selectedhospitals and medical schools rated as satisfactory by the American College ofSurgeons and the American Medical Association be invited to organize hospitalunits. He also recommended that selected individuals in participatinginstitutions, above the age of 35 years, be commissioned in the Reserve withgrades (and oppor-

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tunities for promotion) which were commensurate with their professionalqualifications.

During succeeding months, the War Department General Staffstudied this proposal; it opposed the recommendation that officers becommissioned above the rank of first lieutenant as contravening current policy,but, on 3 August 1939, the proposal was approved, subject to the determinationof certain details.⁶⁶ Thesedetails concerned the proposed waiving of restrictions on the appointment,promotion, and training of Medical Department Reserve officers for these units.The Surgeon General was requested to submit recommendations on these points, andalso on the allocation of units and other administrative details.

In reply, General Magee, who had succeeded General Reynolds in June 1939,advised that, as a beginning, all theater of operations hospitals provided forin the Protective Mobilization Plan-32 general, 17 evacuation, 13 surgical, and4 station hospitals-be affiliated units. He proposed to allocate these, as faras possible, to institutions that had sponsored similar units in World War I.The commanding officer of each unit was to be a member of the Regular Army, aswas the executive officer in general and evacuation hospitals; these twoofficers would join the unit when it was activated. It was recommended that allother officers be members of the Reserve. The unit director was to be the seniorstaff member, and he would be the responsible peacetime head of theorganization. General Magee outlined a detailed procedure for the appointmentand promotion of Reserve officers which included authority to appoint officersbetween the ages of 23 and 55 to any grade for which there existed anappropriate vacancy. Promotion in the unit was to be by virtue of appointment toa position which carried a higher grade. Withdrawal from the staff of thesponsoring institution would automatically operate to terminate the Reserveappointment. Active- and inactive-duty training requirements were also listed.⁶⁷

On 19 October 1939, General Magee submitted a revised list ofsponsoring institutions, including all of the proposed units except the fourstation hospitals.⁶⁸ War Department approval followed a month later. At thesame time, The Surgeon General was given assignment jurisdiction over officerpersonnel prior to mobilization and was authorized to proceed with theorganization of these affiliated units upon issuance of the necessary WarDepartment directive. Details of the plan were approved early in 1940.⁶⁹

⁶⁶Letter, The Adjutant General, to TheSurgeon General, 3 Aug. 1939, subject: System of Affiliating Medical DepartmentUnits With Civilian Institutions, and Appointment and Promotion in the MedicalReserve Corps.
⁶⁷Letter, The Surgeon General, to The AdjutantGeneral, 22 Sept. 1939, subject: Affiliation of Medical Department Units WithCivilian Institutions.
⁶⁸Letter, The Surgeon General, to The AdjutantGeneral, 19 Oct. 1939, subject: Affiliation of Medical Department Units With CivilianInstitutions.
⁶⁹(1) Letter, The Adjutant General, toThe Surgeon General, 22 Nov. 1939, subject: Affiliated Medical Units-Allocation,Organization, and Mobilization. (2) Letter, The Adjutant General, to The SurgeonGeneral, 26 Jan. 1940, subject: Officers of Affiliated Medical Units-Appointment, Reappointment, Promotion, and Separation. (3) Letter, TheAdjutant General, to The Surgeon General, 11 May 1940, subject: Officers ofAffiliated Medical Units-Appointment, Promotion, and Separation.

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Organization of the units

Meanwhile, the Office of The Surgeon General had beenactively engaged in implementing this project. Once the sponsoring institutionshad been chosen and approved, The Surgeon General notified these institutions,outlined the plan, asked their acceptance of it, and requested them to beginthe necessary work of establishing and training the proposed units. Upon receiptof concurrence, the Office of The Surgeon General advised The Adjutant General,and thus affiliation was formally established.⁷⁰

The response during the spring and summer of 1940 wasenthusiastic. Since the project had been first proposed, Germany had overrunNorway, France, and the Low Countries,and involvement of the UnitedStates seemed imminent to many. The resulting patriotic appeal was reinforcedby the fact that most of the proposed sponsors had organized similar units inthe First World War, and the old numerical designations were revived for the new units. Not only did the listed institutions respond to the appeal, butmany others applied to General Magee during 1940 and 1941 for inclusion in the project. He rejected these offers, stating that theprogram might later be broadened to include additional smaller hospitals.

The actual organization of the units through the commissioning and assignmentof officers was a long and tedious process, requiring many months to complete.Detailed instructions were distributed .⁷¹ With rare exceptions, officerappointments made by the institution were not questioned by The Surgeon General.The Office of The Surgeon General maintained contact with the sponsoringinstitutions through its Reserve Subdivision and during the organization periodestablished rosters of unit personnel. At the time, there was no definiteprovision for furnishing these hospitals with enlisted men. It turned out,however, that when the hospitals were activated-in1942-43-a large part of thispersonnel was drawn from existing theater of operations hospital units. Anotherpart came from the reception or training centers. Special arrangements were alsomade whereby men from the sponsoring institution could be voluntarily inductedinto the service and earmarked for assignment to the affiliated unit when it wasactivated.⁷²

The original list of hospitals proposed by The SurgeonGeneral and approved by the General Staff provided for the necessary theater ofoperations hospitalization envisaged by the Protective Mobilization Plan for thefirst 120 days of mobilization. There still remained the problem of insuring theadditional hospitalization required for the four successive augmentations of thebasic plan. It had been The Surgeon General`s intention to create additionalaffiliated units for this purpose, once the organization of the first group of

⁷⁰Memorandum, Lt. Col. Paul A. Paden, Director, Medical Personnel Division,Office of The Surgeon General, for Colonel Love, Historical Division, Office ofThe Surgeon General, 15 Apr. 1944.
⁷¹Letter (mimeographed), The Surgeon General, to each affiliatinginstitution, 16 May 1940, subject: Affiliated Units, Medical Department, U.S.Army.
⁷²(1) Smith, Clarence McKittrick: The Medical Department:Hospitalization and Evacuation, Zone of Interior. United States Army in World War II. The Technical Services. Washington: U.S. GovernmentPrinting Office, 1956. (2) See footnote 70.

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hospitals had been accomplished. By June 1940, the preparation of theapproved hospitals had proceeded sufficiently to make the organization ofadditional affiliated units feasible. The widespread publicity given to theprogram had resulted, as already mentioned, in a large number of requests foraffiliation from institutions not on the first list, including some that hadsponsored units in 1917. It seemed the proper time therefore to expand theprogram. On 26 June 1940, General Magee requested permission to organizeadditional hospitals. He proposed that neither the exact number of units northeir distribution be determined at that time. On 22 July 1940, the WarDepartment approved the organization, as affiliated units, of an additional 36general hospitals, 13 evacuation hospitals, and 10 surgical hospitals as partof the first augmentation of the Protective Mobilization Plan.⁷³ This authorization almost doubled the number of affiliatedhospitals to be made available.

The original plan had been to provide, at the time of activation, RegularArmy officers as commanding officers of these affiliated units who would replacethe directors when the units were called into service. As the organizationproceeded, however, it became apparent that in certain instances it would bedesirable to continue unit directors as commanding officers during mobilization.Four unit directors, each of whom had had experience and training during WorldWar I and who had maintained an unusually active interest in the OrganizedReserve since that time, were considered qualified to command their units.General Magee recommended that these men receive mobilization assignments ascommanding officers, and that officers of the Regular Army Medical Corps beassigned as executive officers. He further proposed that if similarly qualifieddirectors were appointed in other units he should be authorized to make similarassignments. The request for the assignment of the four officers (fig. 28) wasapproved: Col. Thomas R. Goethals, MC, to the 6th General Hospital, Lt. Col.(later Col.) Henry R. Carstens, MC, to the 17th General Hospital, Col. E. T.Wentworth, MC, to the 19th General Hospital, and Col. J. G. Strohm, MC, to the46th General Hospital; but The Surgeon General was required to make separaterequests for future assignments, as these would involve changes in the approvedallotments of officers.⁷⁴

By October 1941, the organization of affiliated units hadreached an advanced stage, and 41 general hospitals, 11 evacuation hospitals,and 4 surgical hospitals actually had been organized. A certain number ofinstitutions had not shown interest in the project, and no personnel wereassigned to those units; a number of additional units also were contemplated,but the Secretary of War had not yet authorized them.⁷⁵

⁷³Letter, The Surgeon General, to The AdjutantGeneral, 26 June 1940, subject: Affiliated Units, Medical Department, with 1stendorsements thereto, 22 July 1940.
⁷⁴Letter, The Surgeon General, to The Adjutant General, 18 June 1940,subject: Affiliated Units, Medical Department, with 1st endorsement thereto, 8July 1940.
75⁽¹⁾ Memorandum, Lt. Col. Francis M.Fitts, Office of The Surgeon General, 7 Oct. 1941, subject: Status Report,Affiliated Units. (2) The publication cited in footnote 72(1), p. 143, containslists (tables 6 and 7) of the affiliated general and evacuation hospitals,showing Army number, institution with which affiliated, dates of activationand embarkation, and initial destination.

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FIGURE 28.-Early appointments as commanders of affiliated units. Upperleft: Col. Thomas R. Goethals, MC, to the 6th General Hospital. Upper right:Col. Henry R. Carstens, MC, to the 17th General Hospital. Lower left: Col. E.T. Wentworth, MC, to the 19th General Hospital. Lower right: Col. J. G. Strohm,MC, to the 46th General Hospital.

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Deferment of Active Duty for Members of Affiliated Units

While affiliated units awaited activation, the Reserve officers in themenjoyed what amounted to a deferment of service. The possibility of calling theofficers of these units to active duty received consideration in September andOctober 1940. Duringthe spring and summer of that year when large numbers of Reserve officers inother categories were being called to duty, the directors of affiliated unitswere recruiting for their organizations on the understanding that appointeeswould remain on inactive status until the units themselves were called up.Following mobilization of the National Guard and the advent of selective servicein the autumn of 1940, however,a number of persons suggested calling the officers of affiliated unitsindividually to active duty. The Surgeon General not only rejected theseproposals but attempted to get assurances from the War Department that neitherindividual reservists nor the affiliated units in which they served would becalled to active duty before war came. While the General Staff would make noclear-cut declaration of policy to that effect, it followed (for the time being)The Surgeon General`s recommendation in practice.⁷⁶ No affiliatedunit was activated until after Pearl Harbor, and no steps were taken to call upindividual members until still later (table 15).

The urgent demand for additional Medical Corps officersthroughout 1941 drewattention once more to the affiliated units as a source of supply, andparticularly to the more than two hundred Medical Corps Reserve officers inthese units who were of draft age. In May 1941, The Surgeon General submitted a recommendation to TheAdjutant General that these officers be discharged from their specialcommissions and that upon application they then be appointed in the Reserve inthe grade of first lieutenant and ordered to active duty as soon as theirservices were required; they were also to be instructed that if their units werecalled they would be assigned for duty with them. Apparently, the heavy demandfor additional officers prompted The Surgeon General to recommend a measurewhich would in effect have abrogated

TABLE 15.-Medical Department officers ofaffiliated Reserve in affiliated medical units, February 1941

Status	Medical Corps	Dental Corps	Medical Administrative Corps	Total officers
Original appointments in the affiliated Reserve	547	53	13	613
Transfers from nonaffiliated to affiliated Reserve	239	19	6	264
Total	786	72	19	877

Source: Report, Operations Service, Office ofThe Surgeon General, subject: Officers in Affiliated Units, as of February 26th,1941.

⁷⁶(1) Memorandum,The Surgeon General, for Assistant Chief of Staff, G-1, 28 Sept. 1940. (2)Memorandum, The Adjutant General, for The Surgeon General, 29 Oct. 1940,subject: Mobilization of Affiliated Units.

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the original understanding with some of the officers in the sponsoringinstitutions. To this recommendation, the War Department replied that a programto discharge affiliated Medical Corps Reserve officers from their commissionsand permit them then to volunteer for appointment in the nonaffiliated Reserveas first lieutenants would probably result in the loss of many officers. It waspointed out that many of these officers would not accept reappointment in thatgrade. However, the War Department authorized the discharge of affiliatedofficers above the rank of first lieutenant who, prior to discharge, volunteeredto accept an immediate appointment in the nonaffiliated Reserve in the lowerrank. The number of affiliated Reserve officers who accepted active duty onthese terms is unknown, but past experience indicates that it was probablyapproximately 2 percent.⁷⁷

While The Surgeon General was suggesting means of placing onactive duty some of the officers in affiliated units already formed, he was alsosanctioning the formation of additional units for use in case of war. In June1941, the general regulations for affiliated units were modified, providing forsome amelioration of the condition mentioned above.⁷⁸The Surgeon General announced that no additional appointments would be made toaffiliated units in the age group eligible for induction under selectiveservice. Officers of the nonaffiliated Reserve who had been assigned withoutchange of grade to affiliated units were to be considered as available foractive duty. But officers of the affiliated Medical Corps Reserve could bebrought on active duty only when they requested appointment in the nonaffiliatedReserve in the grade of first lieutenant.

The number of personnel assigned to affiliated units on 30 June 1941 is givenin table 16. Of those shown, 1,257 Medical Corps, 122 Dental Corps, and 31Medical Administrative Corps officers were said to belong to the affiliatedReserve and the remainder to the nonaffiliated Reserve. In October

TABLE 16.-Medical Departmentofficers in affiliated units, 30 June 1941

Type of hospital	Medical Corps	Dental Corps	Medical Administrative Corps
General	1,144	157	44
Evacuation	233	15	3
Surgical	37	4	2
Total	1,414	176	49

Source: Annual Report of The Surgeon General, U.S. Army. Washington: U.S.Government Printing Office, 1941, pp. 145-146.

⁷⁷(1) Letter, Office of The SurgeonGeneral (Executive Officer), to The Adjutant General, 5 May 1941, subject:Physicians of Draft Age Holding Commissions in Affiliated Units, with 1stendorsement thereto, 26 May 1941. (2) Letter, The Surgeon General, to TheAdjutant General, 5 Aug. 1941, subject: Active Duty Orders for Medical Officers(Affiliated).
⁷⁸Letter, Office of The Surgeon General, to each affiliating institution, 2 June 1941.

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1941, 158 Medical Corps, 3 Dental Corps, and 1 Medical Administrative Corps officersfrom affiliated units were on active duty.⁷⁹ Thus, thebasicproblem of obtaining the services of medical personnel in affiliated units forthe rapidly expanding Army remained unsolved right up to the outbreak of war-and even afterward.

OTHER SOURCES OF OFFICER PERSONNEL

Additional sources of professional personnel for the Medical Department inthe prewar years existed, but for a variety of reasons were still looked upon as"off limits." These included graduates of foreign and of substandardAmerican medical schools, Japanese-Americans, female doctors and dentists, andcertain other professional minorities.

Graduates of Foreign and Substandard American Medical Schools

Foreign graduates

As early as 1933, the National Board of Medical Examiners, while not raisinga general bar against graduates of foreign schools, stipulated that a studentmatriculating in a European medical school after the school year 1933 would have to submit evidence of the following in order tobe admitted to the board`s examination: (1) A premedical education equivalent tothe requirements of the Association of American Medical Colleges and the Councilon Medical Education of the American Medical Association; (2) graduation from aEuropean medical school after a course of at least 4 academic years; and (3) a license to practice medicine inthe country in which that school was located. In 1939, the same board barred from its examinations the graduatesof "extramural" (that is, not university connected) British medicalschools.⁸⁰

Army Regulations No. 140-33, issued on 30July 1936, required a candidate for the Medical CorpsReserve to possess a license to practice in a State, Territory, or the Districtof Columbia, or a diploma from the National Board of Medical Examiners; he mustalso hold the degree of Doctor of Medicine from a class A medical school-thatis, one approved by the American Medical Association. Although in the fall of 1940The Surgeon General received many protests, both fromindividuals and from organizations such as the American Jewish Congress,⁸¹protesting the exclusion of foreign graduates from the Medical Corps, a revisionof AR 140-33 on15 December 1940 didnot change essentially the previous conditions for admission to the MedicalCorps.

⁷⁹See footnotes 49(1), p. 135, and 75(1), p. 144.
⁸⁰Letter, Office of The Surgeon General (Colonel Lull), to George L.Cassidy, Associate Editor, New York Post, 14Nov. 1940, with enclosure thereto.
⁸¹Letter, Carl Sherman, Chairman, Administrative Committee, AmericanJewish Congress, to Assistant Secretary of War, 28 Nov. 1940.

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At that time, The Surgeon General stated that he himself had no means ofclassifying foreign medical schools definitively. While some were undoubtedlysatisfactory, there was considerable evidence that many did not have acceptablestandards, and he did not desire to have the American soldier treated byphysicians not fully qualified in accordance with the standards of approvedAmerican schools.⁸² Several officers who were inthe Surgeon General`s Office at the time have restated and enlarged upon thesepoints. Brig. Gen. Albert G. Love (Ret.) has pointed out that "in the yearsprior to World War II, the American Medical Association had done * * * atremendous job in classifying medical schools, raising the standard of medicaleducation, and forcing substandard schools to raise their standards or closetheir doors." A former staff member of The Surgeon General`s PersonnelDivision, who dealt with hundreds of graduates of foreign medical schools, wrotethat "some were unquestionably well qualified professionally, mentally,physically and socially. Others were, however, very undesirable as MedicalCorps officers * * * many had failed in American medical schools beforeentering foreign schools. Others had Arts school academic averages so low thattheir admission to an approved [medical] school was not justified. It was alsoknown that many European medical schools, particularly German, had deterioratedrapidly in the late twenties and in the thirties.⁸³

Also in December, 1940, Dr. J. John Kristal, Chairman of the ExecutiveCommittee of the American Alumni of British Medical Schools, wrote to Dr. IrvinAbell, Chairman of the Committee on Medical Preparedness of the AmericanMedical Association, listing six "quite stringent" requirements thatmight be established for graduates of the British medical schools in order toobtain commissions in the U.S. Army Medical Corps Reserve. His proposal wasapproved by The Surgeon General who on 30 December 1940 forwarded it to the War Department General Staff, substituting, however, the word "foreign"where Dr. Kristal had used "British," and including a stipulation ofcitizenship. The six requirements were as follows:

1. They shall be citizens of the United States. They shall presentsatisfactory evidence of premedical education equivalent to the requirements ofthe Association of American Medical Colleges and the Council on MedicalEducation of the American Medical Association.

2. They shall have completed a medical course of at least four academic years.

3. They shall have obtained a license to practice in the country in which themedical school from which they graduated is located.

4. They shall have evidence of a year`s internship or more in a hospitalacceptable to the Council on Medical Education and the Committee on Hospitals ofthe American Medical Association.

5. They shall be eligible to take the examination given by the National Boardof Examiners.

6. They shall have a license to practice medicine in some state orterritory of the United States.

⁸²Letter, Office of The Surgeon General (ColonelLull), to The Adjutant General, 23 Nov. 1940.
⁸³(1) Letter, Brig. Gen. Albert G.Love (Ret.) to Col. John B. Coates, Jr., Director, Historical Unit, U.S. ArmyMedical Service, 29 Nov. 1955. (2) Letter, Col. Paul A. Paden, to Col. C. H.Goddard, Office of The Surgeon General, 21 Jan. 1952.

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Two months later (5 February 1941), the War Department General Staff approvedthese recommendations.⁸⁴

Graduates of unapproved American schools

As to graduates of unapproved schools in the United States,The Surgeon General continued to hold that they should be rejected, urging thatas soldiers had to take what the Army offered in the way of doctors they shouldbe afforded at least the protection which most States accorded them ascivilians. Therefore, only doctors who could be licensed to practice in amajority of the States should be granted commissions in the MedicalCorps.⁸⁵ (The graduates of these unapproved schools could receive licensesin only one or two States.)

Again, as in the case of graduates of foreign schools,objections were raised to the existing policy. This time, however, it was feltthat considering the shortage both in the Armed Forces and in civilian life thepolicy not only subjected doctors to the chance of being drafted, after whichthey would serve not as doctors but as enlisted men,⁸⁶ but also that it worked to the economic disadvantage ofdoctors already in the service. "When these men get out of the Army,"the president of a State medical society wrote to The Surgeon General,"they will find that [graduates of unapproved schools] have adopted [thatis, taken over] their practices." He considered this an unfair advantage totake of any doctor and asked if it was possible to commission graduates ofunapproved schools as second lieutenants "or some lower commission"and allow them to serve as mess or sanitary officers. The Surgeon Generalreplied that the advantage given to graduates of unapproved schools was moreapparent than real. However, he held out a promise: "If the general thoughtof the medical profession should be that these men should be accepted on thesame footing as graduates of Grade A schools, thought can be given to amodification of our present practice."⁸⁷

Soon, thereafter, the Directing Board of the Procurement and AssignmentService suggested terms on which graduates of unapproved medical schools mightbe accepted for commissions. In April 1942, accordingly, The Surgeon Generalannounced that such graduates would be commissioned in the Medical

⁸⁴(1) Letter, Office of The SurgeonGeneral (Col. G. F. Lull), to The Adjutant General, 30 Dec. 1940, subject:Appointment of Graduates of Foreign Medical Schools. (2) Letter, The AdjutantGeneral, to The Surgeon General, 5 Feb. 1941, subject: Appointments ofGraduates of Foreign Medical Schools in Medical Department Reserve. (3) Letter,The Adjutant General, to Corps Area and Department Commanders and The SurgeonGeneral, 5 Feb. 1941, subject: Appointments of Graduates of Foreign MedicalSchools in Medical Department Reserve.⁸⁵Letter, The Adjutant General, to President,Association of Medical Students, Middlesex Hospital, Cambridge, Mass., 22 Dec.1941. (The Surgeon General had sent this reply to The Adjutant General forforwarding to the president of the Association of Medical Students, 16 Dec.1941.)
⁸⁶(1) Letter, Dr. John F. McGuinness,Woburn, Mass., to President Roosevelt, 7 Jan. 1942. (2) Letter, Senator C.Wayland Brooks (III), to The Surgeon General, 13 Feb. 1942. (3) Letter, JosephH. Dorfman, Detachment Commander, Headquarters Detachment, Detachment ofIllinois, Sons of American Legion, to The Surgeon General, 10 Feb. 1942.
⁸⁷(1) Letter, President, MassachusettsMedical Society, to Surgeon General Magee, 31 Jan. 1942. (2) Letter, SurgeonGeneral Magee, to Dr. Frank R. Ober, President, Massachusetts Medical Society, 7Feb. 1942.

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Corps of the Army of the United States if they met thefollowing conditions: The applicant must, in addition to possessing the doctor ofmedicine degree, have had a 1 year`s rotating internship, and have a license topractice medicine in one of the States or in the District of Columbia; he mustalso have been engaged in the ethical practice of medicine and must present fiveletters to this effect from doctors who knew him and who were graduates ofrecognized schools of medicine. The Surgeon General would determine whether thegraduate was eligible. The final stipulation-that the applicant must be a memberof his local county medical society and be indorsed by his State medical society-had to be changed later because some medical societies refused to admitgraduates of unapproved schools until they had been practicing for 5 years. TheSurgeon General agreed, therefore, that he would accept those who met the otherconditions if they presented a statement from the secretary of the county ordistrict medical society that they were engaged in the ethical practice ofmedicine and would be eligible for society membership except for the fact thatthey had been in practice less than 5 years.⁸⁸ Schools whose graduates theMedical Department agreed to accept on these terms were Middlesex UniversityCollege of Medicine, the Chicago College of Medicine, and the Cincinnati Collegeof Eclectic Medicine. The Surgeon General judged the graduates of two otherschools more on their individual merits. Doctors graduated from any of theseunapproved schools were commissioned only in the grade of first lieutenant.

When in the fall of 1943 theState authorities of Massachusetts declared that graduates of the MiddlesexUniversity College of Medicine would not be eligible for the licensingexaminations held after June 1944, theMedical Department refused to recommend for appointment additional graduates ofthat school (not waiting until Massachusetts examined the last ones it hadstipulated it would admit to examinations); in July 1944, the Medical Department announced, however, that it wouldaccept recent graduates of that school under terms previously in effect. Nofigures are available on the total number of graduates of unapproved schools whojoined the Army Medical Corps under the terms laid down by The Surgeon General,although in early 1944 itwas stated that between 200 and 300 graduates of Middlesex University College ofMedicine alone had been appointed.⁸⁹

The problem of unapproved schools did not arise in the caseof dentists, there being no such dental schools. As for veterinary schools, TheSurgeon General refused to commission graduates of the sole unapprovedinstitution of

⁸⁸(1) Letter, The Adjutant General, to The Surgeon General, 28 Apr. 1942,subject: Admission of Graduates of Certain Nonrecognized Schools of Medicine tothe Army of the United States. (2) Letter, The Surgeon General, to Dr. Frank H.Lahey, Boston, Mass., 15 July 1942.
⁸⁹(1) Letter, The Surgeon General, to Dr. Frank H.Lahey, War Manpower Commission, 24 Aug. 1942. (2) Memorandum, The SurgeonGeneral, for Officer Procurement Service, Army Service Forces, Attn: Col. E. G.Welsh, Acting Director, 3 Dec. 1943, subject: Discontinuance of Appointments * ** of Graduates of Middlesex University College of Medicine. (3) Memorandum, TheSurgeon General, for Director, Officer Procurement Service, Army Service Forces,20 July 1944, subject: Middlesex University School of Medicine. (4) Letter, TheSurgeon General, to The Adjutant General (for forwarding to the Hon. David I.Walsh, U.S. Senator (Mass.) ), 7 Jan. 1944.

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that kind, the veterinary school of Middlesex University.⁹⁰Graduates of that school who were drafted served in enlisted status-unless theyreceived commissions in an officer component, such as the Medical AdministrativeCorps, which required completion of the regular course at an officer candidateschool.

Alien and Naturalized Physicians

Alien and naturalized physicians in the Army in an enlisted status could becommissioned in the Army of the United States provided they met the followingrequirements: (1) Citizens of cobelligerent Allied countries had to meetrequirements for professional training and the necessary War Departmentinvestigations, such as those of the Military Intelligence Service and theProvost Marshal. Such applicants had to have a release from the military attach?of their country`s legation in the United States, and as The Surgeon Generalpointed out, that process involved many difficulties. Since the applicant`sgovernment had to be acceptable to the U.S. Department of State, it was oftennecessary for The Adjutant General to determine from day to day thatDepartment`s evaluation of the foreign government concerned. (2) Enemy aliens hadto meet the investigation of all agencies, including that of the Assistant Chief of Staff, G-2 (intelligence), and in addition had to be naturalized.(Naturalization had been rendered easier in March 1942 by an enactment ofCongress that persons who had served 3 months in enlisted status could obtaincitizenship immediately.)⁹¹ They must, moreover, have arrived inthis country before 1 January 1938, and also "as a general, but less rigidrule," they had to prove that they did not have relatives remaining inenemy countries. (This meant that, even though naturalized, they had some of thelegal disabilities of aliens.) As a further barrier, most foreign physiciansapplying for commissions had been educated in foreign schools and hence had tomeet the special requirements The Surgeon General had laid down for suchgraduates.⁹²

The question of what to do about alien physicians not servingin the Army was a matter of concern to the Procurement and Assignment Service.Since many States required applicants to establish American citizenship as oneprerequisite to admission to State licensing examinations, and other Statesissued temporary licenses which were subject to cancellation unless the holderobtained American citizenship within a specified time, the Department of Justicetook steps in January 1943 to have the Immigration and Naturalization Serviceassist in relieving the shortage of civilian physicians by expediting the legalprocess of naturalizing alien physicians.

⁹⁰Letter, Office of The Surgeon General (Col. J. F. Crosby, VC), to Dr.Louis Karasoff, Middletown, N.Y., 17 Apr. 1942, with 2d wrapper endorsementthereto, 10 Jan. 1945.
⁹¹56 Stat. 182.
⁹²Memorandum, The Surgeon General (Chief, Personnel Service), to Col.Richard H. Eanes, Medical Division, National Headquarters, Selective Service, 8Feb. 1943.

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Japanese-American Medical Personnel

Physicians and dentists

Japanese-American citizens were treated differently fromother groups. The Surgeon General recommended in May 1942 against commissioning them, whether they were serving in enlisted status or were civilians. He statedthat although they might meet all the requirements for commissions "theywould be placed at a personal disadvantage and in many embarrassing positions.They would inspire a lack of confidence and distrust throughout the Army * * * rendering no military value and being under suspicion at all times.``⁹³

Regulations prohibited the assignment of Japanese-American officers to unitsmade up of others than their own group. At Camp Shelby, Miss., however, when the 442d Regimental Combat Team (a Japanese-American unit) had an oversupply of doctors and dentists, the commander loanedone of the doctors to another unit and the excess dentists to the camp dentalclinic, where their services proved very satisfactory. They could not, however,be permanently assigned to these organizations for the reason stated above. On avisit to Camp Shelby in October 1943, the Assistant Secretary of War learned ofthis incident and called it to the attention of The Surgeon General as anindication of what might be done if War Department policy were changed,remarking that Japanese-American medical talent was "not being usefullyemployed." The Surgeon General followed this suggestion by attempting todetach some of the Japanese-American doctors from the Army Ground Forces, butwithout success.⁹⁴

Nurses

The question of whether to commission nurses who were Nisei(that is, American citizens of Japanese ancestry) caused considerablediscussion, particularly after it had been announced (January 1945) that adraft of nurses was necessary to meet the Army`s needs. The SurgeonGeneral had previously stated that there were no position vacancies for Niseinurses. This assumed that because of their racial background they could beplaced only in special jobs. Possibly the belief existed in some quarters thatuse of such nurses would antagonize soldier patients. In August 1944, however,the Secretary of War ruled out the factor of race by announcing that qualifiedNisei nurses could be appointed in the Army if their loyalty was vouched for bythe

⁹³Letter, Office of The Surgeon General (Col. J. A.Rogers, Executive Officer), to The Adjutant General, 11 May 1942, subject:Physicians, Dentists, and Veterinarians of Japanese Ancestry.⁹⁴(1) Letter, Assistant Secretary of War, to The SurgeonGeneral, 23 Oct. 1943. (2) Letter, Surgeon General Kirk, to Assistant Secretaryof War (McCloy), 10 Nov. 1943.

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Provost Marshal General`s Department, and that The Surgeon General woulddirect their assignment to duty.⁹⁵

Early in 1945, the Surgeon General`s Office estimated that about 300 of the800 Nisei nurses in the United States would be available for military duty.Under pressure from the New York newspaper, PM, which had also previouslycriticised him for rejecting these nurses because there were no vacancies forthem, The Surgeon General announced that he would take them on the terms laiddown by the Secretary of War. This meant that while they were subject to thesame conditions of availability, professional training, and physical conditionas other nurses they would not be rejected because of ancestry alone. Theywould, however, be used only in the United States. These transactions did notlead to the admission of any large number of Nisei nurses into the Army. ByFebruary 1945, only four had been appointed, all that were accepted during thewar.⁹⁶

Female Doctors and Dentists

With a few possible exceptions, before World War II, the Army had notaccepted women of any group in full commissioned status,⁹⁷although nurses had held relative rank. In late 1942, dietitians and physicaltherapists received the same status. During World War I, 55 female doctors hadserved on a contract basis.⁹⁸Even before World War II, certain civilian groups had agitated to have womencommissioned in the Medical Corps in the event of war. In England, after warbroke out, female doctors were commissioned in the "women`s forces,"but not in the Royal Army Medical Corps.⁹⁹

In June 1942, the Services of Supply took steps to procure female doctors,not for service with the Medical Corps, but with the Women`s Auxiliary ArmyCorps. They served as contract surgeons when first placed on duty and if foundacceptable were made members of the corps, in the status of "secondofficer," which was not a commissioned status. In January 1943, 25 femaledoctors were assigned to the Women`s Auxiliary Army Corps or were beingconsidered for assignment.¹⁰⁰

In 1942, The Surgeon General testified before the Committee to Study theMedical Department that he had requested that a few women doctors be com-

⁹⁵Letter, G-1, to The Adjutant General, 11 Aug.1944, subject: Enlistment of Japanese-American Nurses.
⁹⁶(1) Memorandum, Acting Chief, Personnel Service,Office of The Surgeon General, for The Surgeon General (and others), 17 Mar.1945. (2) Weekly Diary, Acting Chief, Personnel Service, Office of The SurgeonGeneral, week ending 17 Mar. 1945. (3) Manuscript, Col. [Florence A.] Blanchfield, and Mary [W.] Standlee, The Appointment of Racial Minorities in the ArmyNurse Corps, p. 32. ⁹⁷During the Civil War, at least one woman, aDr. Mary Walker, was commissioned as an Assistant Surgeon. (Letter, Office ofThe Surgeon General (Col. Albert G. Love), to Dr. Morris Fishbein, AmericanMedical Association, 5 Apr. 1943.)⁹⁸Letter, Office of The Surgeon General (Lt. Col. Francis M. Fitts),to Unit Director, 2d General Hospital, Presbyterian Hospital, N.Y., 16 Aug.1941.
⁹⁹Crew, F. A. E.: Army Medical Services, Administration. London: HerMajesty`s Stationery Office, 1953, vol. 1, p. 206.
¹⁰⁰Memorandum, Office of The SurgeonGeneral (Brig. Gen. Larry B. McAfee, Acting Surgeon General), for CommandingGeneral, Services of Supply, 4 Jan. 1943, subject: Utilization of WomenDoctors, with 1st endorsement thereto, 19 Jan. 1943.

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missioned to serve the Women`s Auxiliary Army Corps, butthe Comptroller of the United States had informed him that women could not holdcommissioned rank in the Army of the United States. A few months later, hereiterated the Comptroller General`s ruling to General Somervell and added thatif enabling legislation were introduced, women belonging to other professionaland technical groups might feel that they had been discriminated against. Hestated that there was no other objection to commissioning qualified femaledoctors in the Army of the United States, but suggested that their use belimited to service with the Women`s Auxiliary Army Corps either in the UnitedStates or abroad. The Secretary of War, undeterred by the thought thatintroduction of a bill to grant commissions to female doctors might antagonizewomen of other professional and technical groups, pressed for such legislation;he suggested that, once commissioned, female doctors should be confined for thetime being to duties with the Women`s Auxiliary Army Corps and to hospitalswhere there was a large number of women patients.

The necessary legislation was passed in April 1943. Applying to both Army and Navy, it provided that licensedfemale physicians could be granted commissions in the Army of the United Statesor the Naval Reserve, "during the present war and six monthsthereafter." Such officers were to enjoy the same rights, privileges, andbenefits as other members of those organizations having the same grade andlength of service.¹⁰¹ This law did not limit their service to the United States, and a number servedabroad. It made female doctors the first women to hold full commissioned rank inthe Army of the United States, antedating not only the nurses,¹⁰²dietitians, and physical therapists (by more than a year), but the officers inthe Women`s Army Corps, whoattained that status a few months later (1 July 1943).

Desirable though it was in itself, the new law did little to meet the MedicalDepartment`s demand for personnel. Although the Army placed no limit on thenumber of professionally and physically qualified female doctors it wouldaccept, only 76, or 1 percent of the approximately 7,600 women doctors in theUnited States, were ultimately commissioned.¹⁰³On 28 February 1945, when 74 women were serving in the Army Medical Corps, 4 were majors,36 captains, and 34 first lieutenants; on the same date, 17 were overseas. Atleast one received a promotion to the grade of lieutenant colonel upon beingseparated from the Army.¹⁰⁴

Between June 1943 andMarch 1945, several attempts were made in Congress to authorize thecommissioning of women dentists, but all attempts failed,

¹⁰¹57 Stat. 65.
¹⁰²Two exceptionswere the Army Nurse Corps Superintendent, and her Assistant Superintendent,promoted to the grade of colonel and lieutenant colonel, respectively, in March1942. (Letter, Col. Florence A. Blanchfield, USA (Ret.), to Col. J. B. Coates,Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 21Feb. 1956.)
¹⁰³(1) Memorandum,Lt. Col. D. G. Hall, Office of The Surgeon General, for Brig. Gen. G. F. Lull and Col. J. R. Hudnall, Office of theThe Surgeon General, 21Apr. 1943. (2) Sixteenth Census of United States: 1940,Population: The Labor Force, vol. III, p. 75 (table 58).
¹⁰⁴Army Medical Bulletin No. 88, 1945. p. 50.

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probably because the War Department felt that there was no shortage ofdentists in the Army.¹⁰⁵

Other Minority Groups

Efforts to secure commissioned status for certain other groups serving in theenlisted ranks occurred spasmodically throughout the emergency and war periods.Groups who sought such status included chiropractors, optometrists, osteopaths,and podiatrists. Of these groups, the optometrists alone were commissioned andthese only after the cessation of hostilities.

CONTRIBUTIONS OF ORGANIZED MEDICINE AND NURSING

Before the end of 1940, civilian professional organizations in the medical fieldwere becoming involved in the process of recruiting medical officers and nursesfor the Army. The most influential of these organizations was the AmericanMedical Association, whose interest in procurement extended beyond the Reserves-at first the main source of officers-and included the entire civilianprofession. It was for this reason that The Surgeon General requested thecooperation of the association. To obtain much larger numbers of officers thanit already had, the Medical Department would have to go outside the ranks ofthose previously enrolled in the Reserves and recruit officers directly fromcivilian life. Moreover, if a major war occurred, even though the United Stateshad more physicians per capita of population than any other country,¹⁰⁶ the supply would have to be rationed between the militaryand civilian medical services. The civilian professional organizations would bevitally interested in both processes and might render valuable aid in solvingthe problems they involved. A precedent for collaboration had been set duringWorld War I, when the American Medical Association and its constituent groups,the State medical societies, had participated in the recruitment of medicalofficers.

Committee on Medical Preparedness

The American Medical Association, having offered its servicesto the Federal Government in May 1940, responded to The Surgeon General`s request at its annualsession in June 1940 bycreating a Committee on Medical Preparedness. This committee, consisting of 10members, was to establish and maintain contact with appropriate governmentalagencies "so as to make available at the earliest possible moment everyfacility that the American Medical Association can

¹⁰⁵Medical Department, United States Army. Dental Service in World War II.Washington: U.S. Government Printing Office, 1955.
¹⁰⁶According to figures compiled probably in 1942, by theProcurement and Assignment Service for Physicians, Dentists, and Veterinarians,the United States had 1 physician for each 750 people. The latest figures availablefor other countries, published in 1932, showed that England and Wales, on theother hand, had only 1 for each 1,490; Germany, 1 for each 1,560; France, 1for each 1,690; and Sweden, 1 for each 2,890. "Final Report of theCommission on Medical Education" (New York, 1932), p. 99.

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offer for the health and safety of the American people andthe maintenance of American democracy."¹⁰⁷The committee was to cooperate with the AdvisoryCommission to the Council of National Defense, the U.S. Public Health Service,and other Federal agencies, as well as with the Medical Department of the Armyand the Bureau of Medicine and Surgery of the Navy. The committee was also toconsider problems in other fields besides those concerned with providing medicalpersonnel for military needs.

At the same session, the American Medical Associationconsidered a plan presented by The Surgeon General of the Army; at his request,it agreed to conduct a survey of the medical profession, and accepted inprinciple his suggested procedure for designating physicians who could bespared from civilian practice and brought into the Army. The plan had toreceive the sanction of the General Staff before it could become in all respectsoperative, and was evidently intended to take full effect only "in theevent of a national emergency of great magnitude"¹⁰⁸-or, morespecifically, a war.

The survey of the medical profession, however, was undertaken immediately bythe Committee on Medical Preparedness. To get information for the preparationof a roster, the committee sent questionnaires to all physicians in the UnitedStates. The committee realized that the returns would be based on the individualdoctor`s own estimate of his availability and utility as a medical officer, butit planned to control this by using data from the various specialty boards andother information in the possession of the American Medical Association. Thequestionnaire was a single-sheet schedule, coded for transfer to machine recordcards. In addition to the usual personal data, the committee asked forinformation concerning details of medical education, licensure, membership inmedical societies, full-time appointments, type of practice, certification ofexamining boards, details of specialty practice, previous military experience,present commission, willingness to volunteer in the event of war, "serviceyou consider yourself best qualified to perform," and physicaldisabilities.¹⁰⁹

The questionnaires were mailed in July 1940. Eventually, more than 185,000physicians received them, and by 2 January 1942, 85.8 percent had been returned.About 26,000 had to be completed for those who failed to do so for themselves.These were prepared from available information on file in the offices of theState and county medical societies. Eventually, 96 percent of the questionnaireswere completed.¹¹⁰ Meanwhile, the process of transferring the information on thereturned questionnaires to punchcards began, and the cards were sorted intospecialist groups and others. Various directories and lists were constantly usedin editing the returns.

The object of the survey was to determine (1) the number of physicianslicensed to practice medicine, (2) the number suitable for active service andthe

¹⁰⁷Medical Preparedness. J.A.M.A. 114:2466, 22 June 1940.
¹⁰⁸Memorandum, Colonel Dunham, for The Surgeon General, 14 June 1940.
¹⁰⁹Medical Preparedness. J.A.M.A. 115: 137, 13 July 1940.
¹¹⁰Information from Lt. Col. Harold C. Lueth, MC, former liaison officer,Office of The Surgeon General, with Chicago office of the American MedicalAssociation, 26 May 1945.

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FIGURE 29.-Lt. Col. Harold C.Lueth, MC, liaisonofficer from the Office of The Surgeon General, to American Medical Association,1942-45.

number incapacitated, (3) thenumber and location of physicians who were qualified and available for the ArmedForces and for other essential services in case of national emergency, (4) thenumber available for service to the civilian population under emergencyconditions, (5) the availability and qualifications of those who could serve inspecial fields of medicine, (6) the number and identity of physicians qualifiedfor teaching and research who were essential to the maintenance of educationalinstitutions, and (7) the number, age, qualification, availability, and othercharacteristics of all members of the medical profession.

In planning and carrying out this project, there was close liaison betweenthe Committee on Medical Preparedness and the Office of The Surgeon General. Thelatter assigned a representative, Lt. Col. (later Col.) Charles G. Hutter, MC,to the headquarters of the American Medical Association in Chicago; he reportedfor duty in October 1940. His successor, from 15 March 1942 to 26March 1945, was Lt. Col.Harold C. Lueth, MC (fig. 29). An important part of the liaison work consistedof an exchange of information. From data supplied by corps area commanders, the Journal of the American Medical Associa-

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tion published weekly lists of Medical Corps Reserve officersordered to active duty, and the same information was recorded in the files ofthe committee. In turn, the corps area surgeons were assisted in theclassification and procurement of Reserve officers by members of the committee.¹¹¹

When the federalization of the National Guard and theinauguration of selective service created a heavy demand for more medicalofficers in the fall of 1940, theCommittee on Medical Preparedness offered to aid in procuring and classifyingphysicians qualified to act as chiefs of services, if a sufficient number couldnot be obtained from the Reserve. The Surgeon General accepted this offer.

Acceptance of The Surgeon General`s Plan

Meanwhile, in August 1940, The Surgeon General presented to the General Staff forapproval a revised version of the plan placed before the American MedicalAssociation in June. The original plan had involved a rather elaborate systemof cooperation between Army authorities and the national, State, and countyorganizations of the American Medical Association for the purpose of designatingphysicians available for the Army. This one developed the first more fully insome respects and curtailed it in others. The General Staff criticized twopoints of the proposal-the decentralization of responsibility for the Army`spart in the program to the corps area commanders and the commissioning of newlyappointed civilians in a rank appropriate to the position they were to fill.Nonmedical officers of the War Department had difficulty in appreciating thefact that the average Medical Department Reserve officer who held advanced rankby virtue of length of service and the fulfillment of certain nonprofessionaltraining requirements was not necessarily qualified to act as chief of themedical or the surgical service in a large hospital. To bring in qualifiedcivilians for such positions and commission them in grades appropriate to theirresponsibilities meant changing the rules pertaining to rank and promotion inthe Reserves, which the General Staff wished to uphold. After some discussion,however, G-1 was inclined to go part of the way, conceding that the grade should"in all cases be appropriate to the age of the applicant."¹¹²

The approved version of the plan appeared on 3 February 1941.¹¹³ It made no mention of advanced rank (although this wasalready being granted in some cases) and allowed for only a small part of thedecentralization which

¹¹¹(1) Letter, Officeof The Surgeon General, to each Corps Area Surgeon, 30 Oct. 1940, subject:Weekly Report for Liaison Officer, U.S. Army, in Care of the American MedicalAssociation. (2) Letter, Office of The Surgeon General, to Corps Area Surgeons,27 Nov. 1940, subject: Assistance of the American Medical Association inClassification and Procurement of Physicians.
¹¹²Memorandum, Officeof The Surgeon General (Col. L. B. McAfee), for Assistant Chief of Staff, G-1,for Chief of Staff, 7 Oct. 1940, subject: Assistance of American MedicalAssociation in Classification and Procurement of Physicians.
¹¹³Letter, The AdjutantGeneral, to The Surgeon General and Corps Area and Department Commanders, 3 Feb.1941, subject: Assistance of American Medical Association in the Classificationand Procurement of Physicians.

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The Surgeon General had recommended as a means of speeding the appointment ofnew medical officers. The plan stated that the American Medical Associationwould prepare and maintain a roster of civilian physicians, with theirspecialties and qualifications, who had agreed to accept commissions in the Armyof the United States when needed for active duty in a "national emergency." The Surgeon General was to designate one or more officers torepresent him at the headquarters of the American Medical Association in Chicagofor all matters concerning the association and the Medical Corps Reserve.Vacancies existing in any corps area were to be reported to the War Department,which would attempt to fill them by transfers of Reserve officers from the Armand Service Assignment Group or from the surplus of other corps areas before theservices of the American Medical Association were called upon. If no qualifiedReserve officers could be found, The Surgeon General was to notify the AmericanMedical Association concerning the professional vacancies required to be filledand their respective locations. His representative would then forward therecommendations of the association to the corps area commander who would havethe designated person or persons examined physically and send their applicationsfor commissions to The Adjutant General for final action. The corps areacommander could not grant waivers for physical defects, but could reject anapplicant on these grounds. Applicants appointed in this way must not be morethan 55 years of age and their appearance before the examining board would bedispensed with.

The War Department General Staff announced that the planwould be put in operation "at such time as the War Department maydirect." It took no further action before Pearl Harbor. Nevertheless, TheSurgeon General, the American Medical Association, and the corps areas hadalready carried out some features of the plan before it was approved. TheAmerican Medical Association had compiled its roster (which was intended toinclude all physicians in the country, not merely those willing to acceptcommissions), The Surgeon General had appointed his liaison officer with theassociation in Chicago, and information had been exchanged concerning theavailability of civilian physicians for certain appointments in the Army.

The plan, while it might have met the requirements of a warsituation from a military standpoint, would not have insured adequate civilianmedical service under war conditions. In his original proposal to the AmericanMedical Association, The Surgeon General had made the point that in time of warsuch a plan would "distribute the professional load, and if properlyadministered, should prevent the stripping of rural and isolated communities oftheir necessary medical personnel."¹¹⁴ This was a point that greatly concerned the professionbefore and during the war. But, in the first place, neither The SurgeonGeneral`s original plan nor the one finally approved by the War Departmentspecifically exempted members of the Reserves from a call to active duty even iftheir departure should "strip" the local com-

¹¹⁴See footnote 108, p. 157.

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munities. As early as November 1940, the secretary of the American Medical Association warnedthe Surgeon General`s Office that certain localities in Kentucky and Tennesseewere being deprived of doctors by that means.¹¹⁵ Moreover,nothing prevented a civilian doctor from volunteering his services to the Army,and only the self-restraints of the latter and the limits of the procurementobjectives would keep it from accepting him. There were few volunteers, however,in relation to the total need.

The plan had certain advantages in that it initiated joint action betweenvarious agencies of the Federal Government and the American Medical Association,and after it was approved by the association, several conferences took placebetween representatives of the Army, Navy, and Public Health Service. It failed,however, to provide for the creation of an "independent" governmentagency to control the apportionment of doctors between the civilian community onthe one hand and Federal agencies on the other.

Origin of the Procurement and Assignment Service

While The Surgeon General was seeking the approval of the War Department for his procurement plan, the American Medical Association was projecting a broader plan of collaboration which led ultimately to the establishment of the Procurement and Assignment Service in October 1941. The association`s Committee on Medical Preparedness,seeing "evidence of duplication of effort and of much confusion," feltthat "the early appointment of a coordinator for medical and healthservices is greatly desired to speed mobilization of medical resources for anyemergency." It voted that a message to that effect be sent to PresidentRoosevelt and the Advisory Commission to the Council of National Defense.Whether or not as a result of this action, the Council of National Defenseestablished a Health and Medical Committee in September 1940to coordinate these aspects of defense and to advise theCouncil concerning them.¹¹⁶Its membership consisted of thechairman of the American Medical Association`s Committee on MedicalPreparedness, who served as chairman, the Surgeons General of the Army, Navy,and Public Health Service, and the chairman of the National Research Council`sDivision of Medical Sciences. Six months later (31 March 1941), its Subcommittee on Medical Education¹¹⁷ recommendedthe establishment of an official procurement and assignment agency. The Healthand Medical Committee transmitted this proposal to the American MedicalAssociation, which resolved on 3 June 1941 that the Government be urged "to plan * * *immediately for the establishment of a central authority with representatives ofthe medical profession to be known as the Procurement and Assignment

¹¹⁵Letter, O. G. West, American Medical Association, to Gen. A. G. Love,18Nov. 1940.
¹¹⁶(1) Medical Preparedness. J.A.M.A. 115: 465, 10 Aug. 1940. (2) Minutesof the Advisory Commission to the Council of National Defense, pp. 90, 92.
¹¹⁷Membership: The Chairman of the Health and MedicalCommittee (chairman), the Commissioner of Hospitals of New York City, andmembers of the Harvard, Minnesota, and Tulane Medical Schools and the StanfordUniversity Hospital.

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agency for physicians for the Army, Navy, and Public HealthService and for the Civilian and Industrial needs of the nation." TheSurgeon General`s Office expressed its full support of this resolution.¹¹⁸

The Health and Medical Committee in turn voted to adopt the association`sresolution in principle and held a meeting on 22 October 1941 to "initiatethe development of a Procurement and Assignment Service." At this meeting,which included the Surgeons General of the Army, Navy, and Public HealthService, a number of consultants from the American Medical and DentalAssociations and one from the Veterans` Administration, a committee wasappointed to draft a program for the proposed agency.

The committee submitted a detailed report analyzing the medical and alliedpersonnel needs of the various public and private agencies and outlining theorganization and duties of the proposed Procurement and Assignment Agency. Twodays later (30 October 1941), Paul V. McNutt, the Director of Defense Health andWelfare Services (under whom the Health and Medical Committee now functioned),sent a letter containing the substance of these proposals to President Rooseveltfor his approval which was given the same day. After outlining the purpose andorganization of the new agency, Mr. McNutt stated:

The functions of the Agency would be: (1) to receive from variousGovernmental and other agencies requests for medical, dental and veterinarypersonnel; (2) to secure and maintain lists of professional personnel available,showing detailed qualifications of such personnel; and (3) to utilize allsuitable means to stimulate voluntary enrollment, having due regard for theoverall public needs of the Nation, including those of governmental agencies andcivilian institutions.

The letter concluded with a statement proposing to instructthe Agency to draft legislation providing for the "involuntaryrecruitment" of medical, dental, and veterinary personnel if the nationalemergency appeared to require it.¹¹⁹

On 17 November 1941, The Surgeon General appointed Capt. (later Lt. Col.)Paul. A. Paden, MC, as his liaison officer with the Procurement and AssignmentAgency.¹²⁰(The "Agency" had been designated a "Service" shortly afterits creation.) Another medical officer of the Army, Maj. (later Col.) Sam F.Seeley, MC (fig. 30), became Executive Officer of the Service`s Directing Board.¹²¹

War came a few weeks after the new Service was established and before it hadbegun to function. It should be emphasized here, however, that the Procurementand Assignment Service neither procured nor assigned personnel. Its purpose wassimply to assist in these operations. In that respect, it differed

¹¹⁸(1) Proceedings ofthe Cleveland Session [American Medical Association], 2-6 June 1941. J.A.M.A.116: 2783, 21 June 1941. (2) Letter, American Medical Association, to Henry L.Stimson, Secretary of War, 12 June 1941, with 2d endorsement thereto, 23 July1941.
¹¹⁹Letter, Paul V. McNutt,Administrator, Federal Security Agency, to the President, 30 Oct. 1941.
¹²⁰(1) Letter, Paul V. McNutt,Administrator, Federal Security Agency, to The Surgeon General, 14 Nov. 1941.(2) Letter, The Surgeon General, to PaulV. McNutt, 17 Nov. 1941.
¹²¹For composition ofthe directing board, see Mordecai, Alfred: A History of the Procurement andAssignment Service for Physicians, Dentists, Veterinarians, Sanitary Engineers,and Nurses-War Manpower Commission.

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FIGURE 30.-Col. Sam F. Seeley, MC, Executive Officer, Directing Board, Procurement
and Assignment Service.

little from the machinery contemplated in The SurgeonGeneral`s plan approved by the War Department 9 months before-which, in fact, itsuperseded. The Procurement and Assignment Service had no powers of compulsion-other than moralforce-over the men it declared available for Federalservice; and if they entered the service, it could only exhibit theirqualifications, not insure their assignment to jobs for which they werespecially equipped; in fact, "assignment" in the title of the newagency referred to the declaration of availability for one or other of theservices rather than for a particular job. Some of the objections that mighthave been made to the earlier War Department plan therefore applied to the newagency. It met the request of the American Medical Association, however, inbeing a coordinating body for all Federal services; it also had the prestige ofa Federal agency.

Subcommittee on Nursing

Meanwhile, the nursing profession was being organized fordefense purposes not only by the Red Cross but by other organizations as well,both governmental and private. A Federal agency, the Subcommittee on Nursing,

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established late in 1940 underthe Medical and Health Committee of the Office of Defense Health and WelfareServices, had the following broad functions:¹²²

To coordinate on a national level all nursing for defensein the Government agencies and the American Red Cross.

To act as a two-way channel between the Government agencies and the NursingCouncil on National Defense.

To assist the Health and Medical Committee and its various subcommittees inall questions dealing with nursing.

To act as the Nursing Advisory Committee to the Office of Civilian Defense.

To suggest Federal legislation regarding nursing and to assist in thedevelopment of policy under which nursing programs are carried out.

The National Nursing Council

Private nursing groups had also created organizationsdesigned to assist in supplying the Armed Forces and to distribute nursesequitably in civilian life. The National Nursing Council for War Service,originally formed on 29 July 1940 asthe Nursing Council for National Defense, represented five national nursingorganizations-the American Nurses Association, the National League of NursingEducation, the National Organization for Public Health Nursing, the Associationof Collegiate Schools of Nursing, and the National Association of ColoredGraduate Nurses-together with the Red Cross. The National Council encouraged thecreation of State councils. In 1940, ithad also initiated a National Survey of Registered Nurses, "to determinethe number of professional nurses, their availability for military andparticularly, for civil duty, and their special attainments." Lacking themoney to complete such an ambitious project, however, it turned it over to theSubcommittee on Nursing, where it was placed under the guidance of a SpecialInventory Committee, which completed it in 1941.¹²³ The Public Health Service assisted in coding and compilingthe information gathered. This survey was comparable in purpose to the survey ofdoctors conducted by the American Medical Association.

PROCUREMENT OF ENLISTED MEN

The enlisted strength of the Medical Department on 30 June 1939 was 9,359 and by30 November 1941 had risen to 108,674, representing 8 percentof that of the Army as a whole (table 1). Most of the increment came by way ofvoluntary enlistment, or after November 1940 byselective service, although the induction of the National Guard into Federalservice also added sizable

¹²²Haupt, Alma C.,Executive Secretary of Subcommittee: Report of the Subcommittee on Nursing,Health and Medical Committee, Office of Defense Health and Welfare Services.Read before Joint Boards of the National Nursing Associations, New York City,N.Y., 24 Jan. 1942.
¹²³(1) See footnote 49(3). p. 135. (2) "News About Nursing." Am. J. Nursing 41: 223, 1941.(3) Speech presented by Pearl McIver, 12 July 1941, to joint meeting of theSubcommittee on Nursing, Nursing Council on National Defense, and the AmericanRed Cross Advisory Committee.

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numbers. The Medical Department Enlisted Reserve was only a negligible sourceof personnel; in contrast with the Medical Corps Reserve, which had many timesthe strength of the Regular Army Medical Corps, the medical sections of theEnlisted Reserve Corps and the Regular Army Reserve in June 1940 togethernumbered 1,524, only a little over one-tenth of the Regular Army enlistedstrength of the Medical Department. None of its members was on active duty.¹²⁴

The supply of enlisted personnel could be increased-in effectand over short periods-by speeding the production of trained men, for theMedical Department could not make full use of a man`s services until he hadreceived a modicum of instruction in medical techniques. The establishment of trainingcenters was one means of attaining this goal. In the prewar period, medicalreplacement training centers were established at Camp Lee, Va., and Camp Grant,Ill., in January 1941, and at Camp Barkeley, Tex., in November 1941. In thelatter month, The Surgeon General asked for additional training-centerfacilities and requested that those in being should be kept at full capacity bythe prompt shipment of selectees to them. Reduction of the training period from13 to 11 weeks at those centers and elsewhere, which The Surgeon Generalrecommended at the same time, would also increase the rapidity of supply. It wasthe maximum reduction he then considered possible.¹²⁵

It was important that after enlistment or induction enlistedmen with medical skills should find their way into the Medical Department andremain there; it was also important that if possible they should be put in jobswhere their civilian experience or natural intelligence could best be utilized.One interesting experiment to this end was undertaken by the Medical Departmentin collaboration with the Red Cross. Under an agreement signed in January 1940,the Red Cross established a Registry of Medical Technologists, listingindividuals who met age and technical qualifications set by the MedicalDepartment. Male registrants who qualified physically were to serve as eitherstaff or technical sergeants in the Medical Department when called to duty in case of mobilization. Female registrants and men who did not qualify physicallywould be employed as civilian workers by the Medical Department in case of war,and civil service grades were established for them. The Army set age limits of21 to 45 years. Members of the Regular Army, National Guard, or Reserve were noteligible for enrollment. Types of technologists enrolled included the following: Dietitians; physiotherapy and occupational therapy aides; dental hygienists;dental and orthopedic mechanics; laboratory, chemical laboratory, pharmacy, andX-ray technicians; meat and dairy hygiene inspectors; and statistical clerks. BySeptember 1940, after almost 80,000 announcements had been mailed to thesegroups, 639 men and 403 women technologists were enrolled.

¹²⁴Annual Report of the Secretary ofWar. Washington: U.S. Government Printing Office, 1940, pp. 45, 61.
¹²⁵Letter, The Surgeon General, to Assistant Chief of Staff, G-1,3 Nov. 1941, subject: Replacements From Medical Replacement Training Centers.

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Vastly more important than any other means of channeling newly inducted menwith appropriate backgrounds into the Medical Department was the system ofclassification used from September 1940 onward at the Army`s reception centers,a system which performed a similar service for all branches of the Army. Theclassification at reception centers, although it did not, or could not, alwaysproduce the desired results, was not only extremely useful in channeling newrecruits into the proper branch of the Army but aided in directing them to theproper type of job within that branch.

The Medical Department experienced difficulty in the emergency and warperiods in retaining trained noncommissioned officers. During the emergency,many Regular Army enlisted men and some National Guardsmen in the first threegrades (master or first sergeants, technical sergeants, and staff sergeants)quickly became commissioned officers. Some were commissioned directly, othersafter a course in officer candidate school; still others accepted active dutyunder commissions which they already held in the Officers` Reserve Corps. Mostof these were only "paper" losses, for the great majority of the menconcerned accepted commissions within the Medical Department as Sanitary andMedical Administrative Corps officers; thus, a loss in the enlisted group becamea gain in officer personnel.

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