CHAPTER IX
Classification
OFFICERS AND NURSES, 1939-41
Proper classification, in the Army as elsewhere, is a majorfactor in proper utilization of available resources. This is particularly truewhere the resources concerned are highly trained individuals whose total numberis strictly limited. It was clearly recognized by The Surgeon General that,while the Medical Department must be prepared at all times to carry out itsmilitary mission, the members of the various corps must also keep abreast ofcivilian professional developments. The emphasis shifted between militarypreparedness and professional accomplishment in terms of the current mission ofthe Army as a whole.
Background of the Classification System
During World War I, while the Medical Department utilized professionalconsultants, little if any official classification of its officers took place.Between the two World Wars, specialization developed greatly in many civilianoccupations and professions. The years in the 1930`s were especially importantto the medical profession in the various fields of specialization. In 1935, thefirst American specialty board, the American Board of Ophthalmology, wasorganized, followed by many others in the next few years. The Surgeon Generalkept in close contact with civilian medicine, and a count of Regular Armymedical officers qualified as specialists shows that their number in 1938, on anoverall percentage basis, was not seriously at variance with that of thecivilian specialists. The distribution did, however, reflect the difference inneeds in the various categories between civilian and military medical practice.Of all the members of the Medical Corps, 6.71 percent were diplomates ofspecialty boards, as against 8 percent of all physicians in the country.1Nevertheless, specialization in the peacetime Medical Department was restrictedby the limited number of personnel available to perform all the necessary tasks,and by the constant awareness that in a national emergency involving a generalmobilization the officers of the Regular Army would be the nucleus on which theenlarged forces would be built. The role of leadership that would underemergency or war conditions fall to the officers of the Regular Army Medical
1(1) Kubie, L. S.: The Role of the Specialist in Military Medicine. Surg. Gynec. & Obst. 80: 109-110, January 1945. (2) Kubie, L. S.: Problem of Specialization in Medical Services of Regular Army and Navy Prior to the Present Emergency. Bull. New York Acad. Med. 20: 495-511, September 1944. (3) Correspondence: Letter, Maj. Gen. George F. Lull, USA, Deputy Surgeon General, to Editor. Surg. Gynec. & Obst. 80: 448, April 1945.
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Department also required that these officers be thoroughlyversed in military subjects, such as command, tactics, logistics, and medicaladministration.
Although the pressure to do so was not great, the Medical Department betweenWorld War I and 1939 made constant but ineffective efforts to classify itsReserve officers professionally. On the Army-wide level, the MobilizationRegulations of September 1939 required that assignments which individuals wouldoccupy during mobilization should be designated beforehand, and could be basednot only on the qualifications of the individual but also on the requirements ofthe situation. By that date, neither the Medical Department nor the WarDepartment General Staff had worked out a comprehensive and detailed system ofclassifying officers.
Classification of Reserve Officers, 1940
In 1940, however, the War Department ordered a classificationof Reserve officers. Under this plan, all Reserve officers of the Army wererequired to fill out information forms (W.D., A.G.O. Form No. 178),supplementary information being required from Reserve officers of the MedicalDepartment. These forms were reviewed in corps area headquarters and in theOffice of The Surgeon General.2
Establishment of position categories
The Surgeon General established a set of position categories for MedicalCorps officers, necessarily the first element in a system of classification forany group. It distinguished various types of positions and also four degrees ofproficiency within each. A symbol was provided for each type of position andcapacity, and the appropriate symbol could be entered in the individual`srecords as a guide to assigning him. Thus "S-3" stood for a generalsurgeon in the third degree of capacity, fourth being the lowest; "S(Ortho)-1" stood for an orthopedic surgeon in the highest grade, and soforth, the degree originally based on civilian credentials, education, andlength of experience in his field. After he had been tested by performance inthe Army, his classification could be changed, if necessary,3 although this kindof change was made more commonly in the later war period than earlier.
Work of civilian agencies
Various agencies throughout the country assisted the Medical Department inclassifying the Medical Reserve officers. Soon after this work was undertaken in1940, the American Medical Association, through its Committee on MedicalPreparedness, began its survey and classification of all physicians
2Annual Report of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1940.
3An officer`s classification was different from his efficiency rating. The latter was a grade-"superior," "excellent," "satisfactory," "unsatisfactory"-assigned at intervals to an individual by his commanding officer and denoting his general value to the service
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throughout the United States. This project supplied muchinformation on specialty training and type of practice to The Surgeon General.4But final classification could not be made from this information alone.Committees of the National Research Council began cooperating on this projectwith the American Medical Association as early as July 1940. The general planwas for these committees to send lists of specialists to the American MedicalAssociation, where its committee would record additional information obtainedfrom its survey or from other sources. Some of the lists submitted by theNational Research Council were graded to show a man`s proficiency within hisspecialty. The National Research Council sent duplicates of some lists to TheSurgeon General, thus aiding him directly to evaluate members of the Reserve andNational Guard, then coming on active duty.5
The system developed by committees of the National ResearchCouncil, for designating the proficiency of men in a specialty-assigningthem a number from 1 to 4-was the first one adopted bythe Medical Department.6
The National Roster of Scientific and Specialized Personnel,established in June 1940, also rendered assistance. The primary function of thisagency was "to provide for the most effective utilization of * * *scientifically and professionally trained citizens * * *."7Because the American Medical Association was developing its own lists ofphysicians, the National Roster during the early part of its existence undertookto list only the smaller groups of specialists, such as bacteriologists,immunologists, pathologists, anatomists, physiological chemists, psychologists,physiologists, zoologists, and entomologists.8Colleges of medicine and specialty boards also cooperated in this effort,contributing whatever information they possessed. Of course, those charged withclassifying officers used, in addition to other information, directories ofphysicians, such as those of the American Medical Association, the AmericanCollege of Physicians, the American College of Surgeons, and the directory ofmedical specialists certified by American specialty boards.9In the early pleases of the work of classifying officers, The Adjutant General`sOffice gave little assistance, and the systems it devised seem to have been nonetoo effective.10
4Letter, The Surgeon General, to Dr. R. G. Leland, Committee on Medical Preparedness, American Medical Association, Chicago, Ill., 22 Jan. 1941.
5(1) Minutes, Meeting of Subcommittee on Cardiovascular Diseases, 23 July 1940, Division of Medical Sciences, National Research Council. (2) Minutes, Eighth Meeting of Subcommittee on Venereal Diseases, 20 Sept. 1945, Division of Medical Sciences, National Research Council.
6(1) Farrell, Malcolm J., and Berlien, Ivan C.: Neuropsychiatry, Personnel. [Official record.] (2) Special Meeting of Personnel Group, 16 Dec. 1940, Division of Medical Sciences, National Research Council. (3) Minutes, Meeting of Subcommittee on Tuberculosis, 23 Dec. 1940, Division of Medical Sciences, National Research Council.
7Carmichael, L. : The National Roster of Scientific and Specialized Personnel. Scient. Month. 58: 141, February 1944.
8(1) Mordecai, Alfred: A History of the Procurement and Assignment Service for Physicians, Dentists, Veterinarians, Sanitary Engineers, and Nurses-War Manpower Commission. (2) See footnote 6(2).
9Letter, Office of The Surgeon General (Col. C. C. Hillman), to Surgeon, each Corps Area, 10 Apr. 1941.
10Davenport, Roy K., and Kampshroer, Felix: Personnel Utilization: Selection, Classification, and Assignment of Military Personnel in the Army of the United States During World War II. [Manuscript.]
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The work of classifying Reserve Medical Corps officers hadonly been initiated when mobilization began, but was completed by Pearl Harbor.This classification constituted a long step forward in providing the MedicalDepartment with knowledge of its qualitative resources in the Reserve sections.11Being the first real attempt to classify Medical Department officers, it servedas the basis of the more intensive procedures developed during the war. Had thisclassification been completed before mobilization began, the Medical Departmentwould have been in a much more advantageous position to make studies andsatisfactory assignments. It is true that formal classification as a guide tofilling jobs was less necessary when the number of persons and the number ofplaces for them were small, as had been true before the great expansion of theMedical Department began. Officers responsible for making job assignments couldbe personally familiar with the attainments of each member of the group andassign him accordingly. Many assignments even in the early war years continuedto be made on the basis of this kind of personal knowledge. Formalclassification could not, of course, eliminate all or perhaps even most of thework in making assignments, for no system of classification-atleast none that was devised-could take account of allvariations in jobs (even of the same category) or in the personal qualificationsof individuals. Nevertheless, formal classification became practicallyindispensable at least as a preliminary sifting when large numbers of personnelhad to be dealt with.
OFFICERS AND NURSES, 1941-43
Although The Surgeon General had established a system of position categoriesfor Medical Corps officers during the emergency period, no system of categoriescovering all types of positions to which officers of the Army at large wereassigned appeared until 1943. In that year, The Adjutant General published sucha comprehensive series, which included medical categories developed and testedby the Military Personnel Division of the Surgeon General`s Office. Those mainlyresponsible for it were Lt. Col. Gerald H. Teasley, MC, and 1st Lt. (later Lt.Col.) Robert W. W. Evans, MC. This classification system, which servedthroughout the war, was first presented in January 1943 as Army Regulations No.605-95 (Tentative). Volume I of the regulations was entitled "OfficerCivilian Classification," and volume II, "Officer MilitaryClassification and Job Specifications." Volume II is the more important tothis discussion. Some months after its publication, the Surgeon General`s Officewas called upon to furnish additional information. This was incorporated in WarDepartment Technical Manual 12-406, "Officer Classification, Commissionedand Warrant," which appeared in October 1943 and superseded the tentativeregulation. The latter listed a code number, an MOS (military occupationalspecialty), and a job specification for nearly 700 Army
11Letter, Lt. Col. Francis M. Fitts, MC, Military Personnel Division, Office of The Surgeon General, to Maj. Gen. C. R. Reynolds, formerly The Surgeon General, 25 June 1941.
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jobs. The job specifications consisted of a summary statementof duties, a list of typical tasks, special skill and knowledge requirements,military and civilian occupational experience prerequisites, educationalprerequisites, and the civilian jobs whose occupants would be most likely tomeet the requirements of the military.
Establishment of the Code Number System
The tentative regulations (and also its successor, the technical manual), inits listing of job categories for Medical Corps officers, followed that alreadyin use in the Medical Department, except that it substituted numerical symbolsfor the symbols previously used and fitted them into a series of job categoriesfor all officers of the Army. Each numerical symbol or code number consisted offour digits, the first digit (0 to 9), indicating a major grouping. The majorgrouping for most types of medical jobs was that relating to health,distinguished by the figure "3." The second digit represented asubgroup while the third and fourth digits stood for a specialty within thatsubgroup. Thus, an orthopedic surgeon, instead of having the symbol "S(Ortho)," now had the code number 3153. Moreover, in designating degrees ofcapacity or proficiency within each job category, the letter A, B, C, or D wasused instead of 1, 2, 3, or 4, and "S (Ortho)-1" became A-3153.Dietitians and physical therapy aides were listed in the technical manual butnot in the earlier regulations, which was issued only a month after theyachieved military status.
In April 1943, it was proposed that after the following 5 MayArmy officers should be requested by code number, but as Medical Departmentpersonnel had not yet been coded, they were not included in the proposal.12Apparently, The Surgeon General found the changeover to the numbered codingsystem quite time consuming, for not until 1944 did that system supplant thelettered code.
Since the categories listed in the regulations and thetechnical manual did not include every type of position separately, the moredifficult aspect in the whole process of classifying officers was choosing menfor an unlisted category. The classifier would then have to consult the wholerecord of each of a number of officers and decide which of them fitted the need.There could be no automatic or pushbutton system of classifying officers;individual judgment played an indispensable part in the process.
Role of the Surgeon General`s Office
In the Medical Department, the Surgeon General`s Office continued to do muchof the work of classification, and as early as March 1942, there was aClassification Branch in that office. For a time, however, it appears to havelost its identity and to have been reestablished under that name in
12Report of conference called by Military Personnel, Army Service Forces, signed by Lt. Col. Gerald H. Teasley, MC, Military Personnel Division, Office of The Surgeon General, 23 Apr. 1943.
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March 1943. At the latter date, this branch not onlyclassified officers of the Medical Corps but recommended their originalassignments, searched for misassignments, and recommended changes. It kept abody of records containing an enormous amount of information on which to baseits classifications and its recommendations for assignments-surveysof the ability and assignments as well as records of the special schoolsofficers had attended and of their attainments in foreign languages.13Classification of officers other than members of the Medical Corps-andlittle of this took place during the early war years-wasdone not in the Classification Branch but in other segments of The SurgeonGeneral`s Military Personnel Division.
Role of the Field Commands
Classification was performed not only in the SurgeonGeneral`s Office but, at least during 1942, in corps area (service command) andArmy headquarters as well. Since many Medical Department officers reporteddirectly to these headquarters from civilian life, which meant that they hadreceived no classification of any kind, it was necessary to classify them on thebasis of data given on questionnaires and whatever additional information couldbe obtained about them.14 Althoughsuch methods were necessary in order that the officers be given assignments,unfortunately they did not always tend to promote the kind of uniformity TheSurgeon General desired.
After the consultant system was established in 1942, some ofthe tasks of these specialists concerned the proper classification and gradingof personnel. As used by the Medical Department, the word "consultant"applied not merely to specialists who acted as advisers only, but to those who,as in this case, had administrative functions. In early 1942, The SurgeonGeneral brought to his Office from civilian life a consultant in surgery and onein medicine and, later in that year, one in neuropsychiatry. As the Officeorganization grew in size and complexity, other specialists were assigned tohandle subspecialties. In the summer of 1942, a beginning was made in supplyinga consultant in each of the three aforementioned specialties to each servicecommand. All these men assisted, through their knowledge of specialists in theirfields and through their training and accomplishments, in the properclassification of medical specialists. Those in the Surgeon General`s Office notonly aided in initial grading but in reviewing and revising the classificationof officers after they had had an opportunity to demonstrate proficiency in aspecified field while on duty with the Army. Those in the service commandstraveled to hospitals, induction stations, and other installations where, byinterview and inspection of the specialist`s work,
13Annual Report, Classification Branch, Military Personnel Division, Office of The Surgeon General, U.S. Army, 1944.
14(1) Annual Report, Surgeon, Third U.S. Army, 1942. (2) Committee to Study the Medical Department, 1942.
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they were able to make more accurate judgments of ability than those who hadonly the records.
Classification Within the Air Forces
The Army Air Forces used similar measures to assure that a physician wasproperly classified according to his qualifications. The Chief of the MedicalBranch and the Chief of the Section on Professional Care of Air Forces hospitalstestified before the Committee to Study the Medical Department of the Army thatthey not only classified officers initially but also made investigations at AirForces hospitals and in a man`s civilian locality. The former stated that he had"somebody traveling all the time checking this thing."
The sources of information made use of by Medical Department classifiers atthis period were much the same as those that had been available to them since1940-the forms filled out by individual officers anddata furnished by the American Medical Association, the Division of MedicalSciences of the National Research Council, the Procurement and AssignmentService, and the American specialty boards. The source that yielded more datathan any other was W.D., A.G.O. Form No. 178-2, "ClassificationQuestionnaire of Medical Department Officers," published on 1 August 1943.This was a revision of W.D., A.G.O. Form No. 178, published in 1940 when the WarDepartment had begun to classify Reserve officers.
In helping the Medical Department to classify medicalspecialists, particularly as to the proper proficiency groups, the Americanspecialty boards performed very useful work. They sent to The Surgeon General(or to his liaison officer, located at the headquarters of the American MedicalAssociation) the names of men who had recently passed their examinations and hadbeen certified by the boards as competent specialists. Sometimes, they indicatedthe proficiency grade they believed fitting for these men, together withinformation on whether they were in service, whether they were Reserve officersnot yet called to active duty, or, if not committed to Army service, whetherthey were willing or unwilling to accept military duty.15Thus, they helped incidentally to procure officers as well as to classify them.
In early 1942, at the suggestion of The Surgeon General, the "Directoryof Medical Specialists" established a "control file," whichlisted about 10,000 names of uncertified applicants to the American specialtyboards, men who had done varying amounts of work toward board certification.(These names were in addition to the 18,000 physicians already certified byAmerican specialty boards
15(1) Letter, Secretary-Treasurer, American Board of Otolaryngology, Omaha, Nebr., to The Surgeon General, 13 June 1942. (2) Letter, Secretary-Treasurer, American Board of Radiology, Rochester, Minn., to Col. G. F. Lull, MC, Office of The Surgeon General, 23 June 1942. (3) Memorandum, Surgeon General`s Liaison Officer, American Medical Association, for The Surgeon General, 28 July 1942, subject: List of Recommendations of the American Gastro-Enterological Association. (4) Letter, American Proctologic Society, to The Surgeon General, 17 Dec. 1942.
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who were listed in the "Directory of MedicalSpecialists.") The names in the central file were listed as"cleared" and "not cleared." The "cleared" groupconsisted of men whose training and other qualifications met board standards andrequirements for admission to their examinations, but who had not yet gainedcertification. The "not cleared" group consisted of men who had donework in a specialty but who had not yet been accepted for examination, those whohad had failures requiring complete reapplication for the examination, and thosewhose certification had been revoked. A set of name cards from this file wasmade available to The Surgeon General. He could also ask the appropriatespecialty board for additional information on any man listed.16 As changes weremade in the list of those physicians "cleared" or "notcleared" the directing editor of the "Directory of MedicalSpecialists" made the changes known to The Surgeon General.
The cited sources of information for classifiers appliedmostly to data on physicians. Apparently, during the early part of the war, theorganizations of dentists and veterinarians furnished information as tospecialists in these professions,17 butmethodical and painstaking efforts by the Medical Department to classify anyofficers other than members of the Medical Corps came only later in the war.
MALE AND FEMALE OFFICERS, 1943-45
Classification Measures
Throughout the war years, even though considerable emphasishad been placed by the Army Service Forces upon decentralization generally, anattempt was made to centralize more of the process of classification of medicalofficers in the Office of The Surgeon General. The effort to bring officerclassifications up to date and, for that purpose, to assemble currentinformation on their qualifications appeared in communications from the SurgeonGeneral`s Office and other agencies in the latter part of 1943 and afterward. Alarge part of this effort was directed toward revising the"proficiency" ratings of Medical Corps officers, which were more aptto be incorrect than placement of these officers in the larger categories ofspecialization. It was probably with the "proficiency" record in mindthat The Surgeon General, in a letter to service command surgeons referring tochanges in initial classification ratings of Medical Corps officers made by hisoffice, advocated revising these ratings whenever competent professionalobservers found that the performance of officers, or their ability to perform,was not reflected in their ratings.18
16Letter, Directing Editor (Dr. Paul A. Titus), Board of Directory of Medical Specialists, 1942 issue, to Lt. Col. F. M. Fitts, MC, Office of The Surgeon General, 24 Apr. 1942, subject: Applicants for Certification by American Boards.
17Military Preparedness. J.A.M.A. 118: 634, 21 Feb. 1942.
18Letter, The Surgeon General, to Commanding General, First Service Command, attention Service Command Surgeon, 21 July 1944, subject: Classification of Medical Corps Officers.
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At the end of 1944, The Surgeon General was able to inducehigher War Department authority to order an annual review of all Medical Corpsofficer classifications.19 Commanders overseasas well as in the Zone of Interior were directed to finish the first review by31 March 1945 and forward the results to The Surgeon General. A fairly completeclassification of all Medical Corps officers based on the latest availableinformation was completed by the end of June 1945.20The war ended, however, before any more such reviews could fall due.
Questionnaires
Officers themselves furnished data for classifications in theform of answers to the classification questionnaire (W.D., A.G.O. Form No.178-2), whose form was revised twice during the war-inAugust 1943 and January 1944. In November 1943, The Surgeon General advised theservice command surgeons to have all medical, dental, and veterinary officerscomplete classification forms. The next month, a War Department circularrequired officers of these corps returning from duty overseas to do the same.21Some months later, Army Service Forces headquarters supplemented this directiveby ordering all its officers who had not filled out questionnaires in the pastto do so now; the order was intended to apply to officers returning from dutyoverseas, graduates of officer candidate schools, officers newly assigned toArmy Service Forces from other commands, and officers newly commissioned fromcivilian life or from the enlisted ranks.22
Instructions of The Surgeon General
Aside from answers to questionnaires and reports fromprofessional observers, there were other sources of information which TheSurgeon General reminded the service commands to employ as a basis forclassification. In his letter of 22 November 1943, he requested the servicecommand surgeons to "establish a procedure by which information can beobtained from the professional consultants, the commanding officers ofhospitals, and other available sources concerning the ability of MedicalDepartment officers." This and "other pertinent information"should be "maintained on personnel records in the Office of the ServiceCommand Surgeon." The medical officer responsible for classifying andassigning Medical Department personnel should be encouraged to obtain firsthandinformation by visiting the installations where such persons were assigned.
19War Department Circular No. 460, 5 Dec. 1944.
20Letter, Brig. Gen. Harold C. Lueth, USAR, to Col. John B. Coates, Jr., MC, Director, Historical Unit, U.S. Army Medical Service, 10 Mar. 1956, with enclosure thereto.
21(1) Letter, Office of The Surgeon General (Maj. Gen. G. F. Lull, Deputy Surgeon General), to Commanding General, Second Service Command, attention: Service Command Surgeon, 22 Nov. 1943, subject: Classification and Assignment of Medical Corps Officers. (2) War Department Circular No. 33, 24 Dec. 1943.
22Army Service Forces Circular No. 212, 8 July 1944.
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How information from these sources should be produced andevaluated so as to permit a reestimate of a Medical Corps officer`s rating wasdescribed in a letter from The Surgeon General to service command surgeons on 21July 1944. The original recommendations for changes in officers` ratings couldcome either from their commanders, who should be encouraged to submit suchproposals, or from the appropriate professional consultants, who should beinstructed to make recommendations in the course of their inspections. Theconsultants should screen and evaluate the recommendations made by officers`commanders. Their judgment should be based not only on the record of anofficer`s formal training and experience but on an appraisal of his capability.The Surgeon General`s Office would furnish each service command a list of theMedical Corps officers assigned to it and their current ratings. The servicecommand consultants were to return the list, marked with the changes in ratingsthey recommended. The Surgeon General would then take final action.23
Role of the Classification Branch
In November 1943, The Surgeon General informed the servicecommands that his Classification Branch would classify all the medical, dental,and veterinary officers who were ordered to fill out questionnaires at thattime. The War Department circular of December 1943, which required answers tothe classification questionnaire from all officers of these corps returning fromoverseas, directed that the classification forms be sent to The Surgeon General,who was to distribute them and issue instructions concerning their use. InAugust 1944, the War Department directed that each officer of the same threecorps in the Army Air Forces should prepare answers to the classificationquestionnaire and send one copy to the Surgeon General`s Office. Whether or notthe latter was to use it in the exercise of any power of classification,however, the circular did not state.24
More effort to centralize the classification of officers wasdirected at members of the Medical Corps than at those of any other MedicalDepartment officer group. A proposal of The Surgeon General that his Office makethe initial classification of all Medical Corps officers was agreed to by theArmy Ground Forces in April 1944. In December of the same year, the WarDepartment granted him that authority with respect to any officer thereafterappointed to the Medical Corps.25 As the WarDepartment had stopped the procurement of doctors from civilian sources somemonths previously, this authorization applied mainly, if not exclusively, tofuture graduates in medicine who were enrolled in the Army Specialized TrainingProgram or who held student commissions in the Medical Administrative Corps.
The classification of members of certain Medical Department officercomponents was not centralized in the Surgeon General`s Office-atleast not to the
23See footnote 18, p. 274.
24War Department Circular No. 349, 26 Aug. 1944.
25(1) Memorandum, Adjutant General, Army Ground Forces, for Chief of Staff, 26 Apr. 1944. subject: Assignment of Medical Corps Officers and Nurses. (2) See footnote 19, p. 275.
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same extent as was that of Medical Corps officers. This wastrue of Dental Corps,26 Medical AdministrativeCorps, and Army Nurse Corps officers. The Surgeon General carried on aclassification of Medical Administrative Corps officers assigned toinstallations under his own jurisdiction; in the later war years, members of thecorps graduating from officer candidate schools were classified at the schoolswhere they received their commissions.
Efforts Toward Greater Uniformity in Classification
Manuals
The continuous efforts to promote uniformity inclassification of officers for the whole Army came to fruition with thepublication of War Department Technical Manual 12-406, on 30 October 1943. Thismanual was supplemented, so far as it related to the Medical Department, byspecial instructions embodied in War Department Circular No. 232, 10 June 1944.The groups of standard qualifications established by these instructions for eachof the four degrees of proficiency within the Medical Corps specialties werestated in broad terms-so broad, in fact, that they couldhardly, of themselves, produce a completely uniform classification of theofficers to whom they applied. The four groups of proficiency qualificationswere set forth as follows:
Group A (To be substituted for SGO Group 1). Officers withcivilian or military background of recognized and outstanding ability in aspecialty, for example, officers who were professors and/or heads of departmentsand associate professors in large teaching centers; officers who can functionwithin their specialty without professional supervision.
Group B (To be substituted for SGO Group 2). Officers withsuperior training and demonstrated ability. Classification in this groupindicates a probable training period of one year as an intern and a three yearresidency or fellowship devoted to the specialty in a recognized teachingcenter. Officers with mature experience and demonstrated ability may beclassified in this group even though they have not had the formal trainingindicated above. Diplomates of American Specialty Boards are classified in thisgroup or higher but absence of certification does not prohibit inclusion in thisgroup. These officers can function within their specialty without professionalsupervision.
Group C (To be substituted for SGO Group 3). Officers who haverecently completed periods of training including one year as an intern and oneyear of residency; officers who have demonstrated some ability in a specialty;officers with shorter periods of training but with minor proportion of practicedevoted to a specialty such as general practitioners giving particular attentionto the specialty for a period of at least three years.
The Air Forces issued its own classification manual in April 1944.27Every job category listed in the Air Forces manual for the Medical, Dental,Veterinary, and Army Nurse Corps and for the Hospital Dietitians and PhysicalTherapists had appeared in the War Department manual.28The only difference
26Report, Military Personnel Division, Office of The Surgeon General, to Historical Division, Office of The Surgeon General, summer 1945, subject: Medical Department Personnel.
27Army Air Forces Manual 35-1, 3 Apr. 1944, subject: Military Personnel Classification and Duty Assignment.
28No attempt has been made to compare the job listings in these manuals for members of the Medical Administrative, Sanitary, and Pharmacy Corps, since the job designations given do not always clearly indicate whether the post could be filled only by a member of one of these corps.
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was that the Air Forces manual listed fewer job categoriesfor some of the components than did the War Department manual, presumablybecause certain types of jobs would not be needed in the Air Forces. Bothmanuals also appear to have contained the same set of qualifications for eachkind of job.
Role of consultants
The Surgeon General, in addition to making full use of the consultants in hisOffice, designated the service command consultant in each specialty as the finalauthority within the service command for recommending all changes in the ratingof specialists in his field. If the consultant was consistent in maintaining hisown standards, this would result in considerable uniformity of classificationwithin the service command so far as the proficiency ratings were concerned.Uniformity throughout a broader area, however, was desirable; the task ofclassification, it was held, must be performed not from the point of view of asingle service command,29 but from that of the entire Army. No doubt,a certain uniformity of view among consultants in a given specialty resultedfrom their similar training and experience. Moreover, if The Surgeon General`sscheme just mentioned was adhered to, their recommendations as to changes inratings were passed upon finally in his own Office, where differences instandards could be reconciled.
Individual records
Uniformity of classification was also a matter of keeping the records up todate. If changes in men`s capabilities were not promptly recorded, the effectwas the same as if uniform standards were not being applied. It was necessarytoo that all records of a man`s classification should agree with one another.The Surgeon General had urged uniformity in that sense when, in calling on theservice commands for questionnaires from all medical, dental, and veterinaryofficers in November 1943, he had stated that the classification symbols giventhese officers by his Classification Branch should be entered on all theirrecords in the service command surgeon`s office. Almost a year later, heemphasized that revised questionnaires of all Medical Corps officers should beavailable in his Office and that copies of them should be filed in the servicecommand headquarters. About the same time, a representative of The SurgeonGeneral urged that the same classification should appear on all records used inthe assignment and evaluation of an officer; when the rating was changed, itshould be changed on all records simultaneously. It appears that in at least oneservice command, for a time at any rate, two groups of classification data weremaintained-one determined by The Surgeon General, theother by the service command.30
29Speech, Maj. Robert W. W. Evans, MC, Office of The Surgeon General, "The Classification and Assignment of Personnel," 10 Oct. 1944. In Annual Report, Surgical Consultants Division, Office of The Surgeon General, U.S. Army, 1945.
30See footnote 29.
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Evaluation of the Classification System
Doctors
The classification process for Medical Corps officersimproved gradually, beginning possibly about the middle of 1943. This was at atime when the number of doctors accepting active duty had for several monthsbeen relatively quite small. Specialists who were diplomates of specialty boardsprobably fared better than others in their initial classification, simplybecause the evidence of their training was more readily ascertained and theycould be easily placed in their specialty with a proficiency rating of at leastB, as the classification manual prescribed. There were of course doctors welltrained in some branch of medicine for which no specialty board yet existed, whotherefore might be classified as nonspecialists. There was also the case ofdoctors who had simply not acquired membership in a specialty board, even thoughthey were as competent in the specialty as those who had. On this point, TheSurgeon General repeatedly declared that mere lack of board membership would notplace a specialist in a lower proficiency bracket if he had demonstrated topprofessional capacity in his specialty.
Initial classification was not enough.31Reevaluations had to be made on the basis of actual performance. These weresometimes considerably delayed through lack of opportunity to make them. It wasreported that even during 1943, units were arriving in the European theater inwhich the commanding officer and the chief of the medical service had had noopportunity to judge the capacity of officers in the field of internal medicineexcept by paper evaluation. Presumably, the same held true of officers in thesurgical specialties. A period of confusion therefore ensued until areevaluation, based on the officer`s work, could be made.32
Knowledge of the workings of classification was not universalamong Army doctors. In 1944, it was reported that few of them had any idea as totheir own professional classification and that a considerable number, especiallyamong those who had been overseas, were not even aware of the classificationsystem itself. Their assignments, nevertheless, reflected their militaryoccupational specialties as determined by the Personnel Service, Office of TheSurgeon General, and a very high percentage of them were better than adequate.33
Dentists
While the major part of this classification discussion is given to theMedical Corps, it points up the problems and means of solving them as theyrelate to
31Initial classification in the sense of formally placing a man in one of the categories prescribed by the Army, so that this record would govern all future assignments, might be delayed until after his commander had examined his credentials and placed him in a job. The formal initial classification was therefore sometimes made on the basis of actual performance.
32Annual Report, Office of the Chief Surgeon, Headquarters, European Theater of Operations, U.S. Army, 1944, Exhibit A thereto.
33(1) Memorandum, Maj. Henry McC. Greenleaf, MC, for Colonel Schwichtenberg, MC, Office of The Surgeon General, 13 June 1944, subject: Informal Report of Trip to Several Zone of Interior Army Hospitals. (2) See also Chapter X, pp. 289-338, this volume.
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the full officer strength of the Medical Department, even though considerablyless control of classification for the other components was ever centralized inthe Surgeon General`s Office. The classification of Dental Corps officers seemsto have been less satisfactory than that of doctors. The Military PersonnelDivision of the Surgeon General`s Office stated in April 1945 that"incomplete, insufficient, and improper classification of Dental Corpsofficers was a major problem throughout the war." It gave three reasons forpoor classification of these officers during the early part of the war: (1)Dental Corps officers originally did not have to fill out a classificationquestionnaire; (2) in spite of the fact that instructions to fill out thequestionnaire were changed to cover all Medical Department officers, doubtwhether this included Dental Corps officers was so persistent that as late asApril 1945 the Surgeon General`s Office considered it necessary to call thematter to the attention of those concerned; and (3) the early classificationquestionnaire did not call for sufficient information to make it a reliablebasis for accurate classification. Even when complete information becameavailable, accurate classification was hampered by several conditions. In theservice commands and oversea theaters, there was considerable variation in theevaluation of dental skills. The early form of the classification questionnaireauthorized the commanding officer of a unit to recommend the classification heconsidered appropriate for his subordinate officers. In the Army Ground Forces,this was usually a line officer who understood little or nothing of professionalstandards and qualifications. Later, the senior medical officer maderecommendations, but this did not solve the problem of evaluating dentalspecialties in any installations other than the large ones in which thecommanding officer, a Medical Corps officer, took the time to confer with thechief of the dental service.
Many Dental Corps classification records dated only from1943, and classification records on 20 percent of the members of the corps werenever received at all. Classification would certainly have been better forDental Corps officers, if procedures had been centralized in the SurgeonGeneral`s Office, if classification questionnaires had been submitted annuallyso that records could be kept current, and if professional evaluations had beenreviewed by qualified classification officers. Personal visits to dentalinstallations for the evaluation of the utilization of Dental Corps officerswould also have proved useful.34 "Too muchreliance had to be placed on the dentist`s own estimate of his qualifications,so that men with little more than a desire to do a certain type of work weredesignated as specialists, while other trained officers were placed in routinejobs."35
Sanitary Corps officers
Some fault was also found with the classification of Sanitary Corps officers.In February 1945, The Surgeon General`s Classification Branch heard
34See footnote 26, p. 277.
35Medical Department, United States Army. Dental Service in World War II. Washington: U.S. Government Printing Office, 1955, p. 107.
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of "a pernicious method" of changing theirclassification-apparently one service command wouldsometimes alter an officer`s classification simply to justify his promotion.36As regards sanitary engineers, in particular, who formed a substantial part ofthe corps, some acquired that classification who were unfitted for it, despitethe efforts of The Surgeon General`s Sanitary Engineering Division and thevigilance of the service commands. This was probably because part of the work ofclassifying was done by surgeons of posts and commands, who were ordinarilyunqualified to judge whether a man had the proper training in sanitaryengineering. Some officers were also improperly classified as entomologists,entomology being another specialty of the Sanitary Corps.37
Development of Local Classification Systems Overseas
As early as 1942, it became apparent to oversea commandersthat the classification system as it applied to medical officers was notadequate. In the first place, many of these officers had never been classifiedprior to being shipped overseas while others who had been classified failed tobring their classification records with them.38Probably more inadequacies existed in the proficiency rating than elsewhere.39Proper classification overseas was no less necessary than it was at home, butthe experience attained by officers abroad and the opportunity to observe themunder field conditions would have called for reclassifications regardless of anyclassifying that might have been done in the Zone of Interior. The result wasthe development within the theaters of local systems of categorization whichwere independent of those in the continental United States.
The North African and European theaters
The North African and European theaters had similar systems based primarilyon (1) questionnaires issued to each medical officer arriving in the theater(the North African theater went one step farther and distributed thesequestionnaires to all medical officers already in the theater);40and (2) evalua-
36Weekly Diary, Classification Branch, Military Personnel Division, Office of The Surgeon General, 24 Feb. 1945.
37Hardenbergh, W. A.: Organization and Administration of Sanitary Engineering Division. [Official record.]
38Letters, to Col. C. H. Goddard, MC, Office of The Surgeon General, from (1) Theodore L. Badger, M.D., 25 Sept. 1952; (2) Alan Chalman, M.D., 11 Sept. 1952; (3) John M. Flumerfelt, M.D., 8 Sept. 1952; (4) George P. Denny, M.D., 25 Sept. 1952; (5) Garfield G. Duncan, M.D., 8 Sept. 1952; (6) Robert Evans, M.D., 8 Dec. 1952; and (7) Joseph S. Skobba, M.D., 10 Oct. 1952.
39Letters, to Col. C. H. Goddard, MC, Office of The Surgeon General, from (1) Garfield G. Duncan, M.D., 19 Aug. 1952; and (2) Walter D. Wise, M.D., 23 Sept. 1952.
40(1) Annual Report, Personnel Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1942. (2) Munden, Kenneth W.: Administration of the Medical Department in the Mediterranean Theater of Operations, U.S. Army. Vol. I. [Official record.] (3) Annual Report, Surgeon, North African Theater of Operations, U.S. Army, 1943. (4) Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944. (5) Report, Lt. Col. Stewart F. Alexander, MC, Personnel Officer, Surgeon`s Office, Seventh U.S. Army, on Medical Department Activities in Mediterranean Theater of Operations, 14 July 1945.
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tion by consultants. The latter method had already proved helpful in the Zoneof Interior.
In the European theater, Col. William S. Middleton, MC, ChiefConsultant in Medicine, personally interviewed all officers on the medicalservice in each hospital unit arriving in the theater, evaluated them, andreported on their qualifications to the Chief Surgeon.41Col. Elliott C. Cutler, MC, Chief Consultant in Surgery, requested the basesection consultants to do virtually the same thing and send their reports tohim.42 In addition, as early as 1943, each officer entering the theater as acasual was evaluated, if he had a specialty, by a senior consultant from theChief Surgeon`s Office.43 The consultants didnot confine their attention to newcomers. As early as 1942, they assessed thequality of the personnel assigned to the medical and surgical specialties inhospitals.44 The following year, all unitswithin the theater were evaluated by the consultants from the ProfessionalServices Division of the Chief Surgeon`s Office as to the professionalcapacities of their medical officers. In 1944, Colonel Middleton visited andinterviewed the medical officers of 112 general and 13 station hospitals.45
Col. Perrin H. Long, MC, medical consultant in the North African theater,also used this method, reviewing the qualifications of Medical Corps officers assoon as possible after the hospitals had reached the theater.46By the latter part of 1944, the consultants appear to have classified allof the medical officers in the theater.
Even in those theaters where classification activities weremost advanced, however, they were marked by failure at least to useclassification forms and job categories established by the Zone of Interior.Furthermore, in the case of individuals having more than one specialty, localconditions dictated which of these specialties was to be regarded as primary andwhich secondary. The Zone of Interior, for example, considered it important toclassify a cardiologist primarily as such and secondarily as an internistwhereas in the European theater the opposite was true. Similarly, anobstetrician and gynecologist was classified primarily as a general surgeon inthe theater, but at home, his subspecialties were given first place. In eachcase, the practice was based on the principle of giving a man a classificationin skills that the Army most needed, but the necessities of the Zone ofInterior, with its comparatively large numbers of older troops, femalepersonnel, and dependents entitled to Army medical
41Annual Report, Professional Services Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1943.
42Annual Report, Professional Services Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1944.
43Annual Report, Personnel Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1943.
44(1) Annual Report, Professional Services Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1942. (2) See footnote 43.
45Middleton, W. S.: Medicine in the European Theater of Operations. Ann. Int. Med. 26: 191-200, February 1947.
46Long, Perrin H.: History of the Medical Consultant in the North African and Mediterranean Theaters of Operation. [Official record.]
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care, were different from those of the oversea theaters with theirpreponderance of young combat men.47
Efforts Toward Uniformity in Theaters of Operations
The European and Mediterranean theaters
On 13 May 1944, the final plans for demobilization andredeployment were approved by the Deputy Chief of Staff, based on the 1 Octoberdate for the defeat of Germany. While the plans for redeployment of MedicalDepartment strength were being developed, the necessity for establishinguniformity among the classification systems of the Zone of Interior and theatersbecame apparent. To accomplish this Lt. Col. Gerald H. Teasley, MC, of thePersonnel Service, Office of The Surgeon General, and others from the SurgeonGeneral`s Office were sent to the European and Mediterranean theaters to observethe systems in operation.
As a result of this visit, War Department Circular No. 460 was issued on 5December 1944, requiring classification of Medical Corps officers in accordancewith established procedures. This circular was designed primarily to promoteuniformity in classification procedures for all Medical Department officers.
The circular further directed that the commanding generals ofoversea theaters and oversea commands were to be given final responsibility foraccurate up-to-date classification of all medical officers over whom they hadassignment jurisdiction and were not to delegate this responsibility to fieldagencies or lower headquarters. In reviewing classifications, each commandinggeneral, furthermore, was directed to utilize the advice of his surgeon and theprofessional consultants. Finally, by 31 March 1945, each pertinent headquarterswas required to furnish each Medical Corps officer over whom it had assignmentjurisdiction a copy of W.D., A.G.O. Form 178-2 with a publication date of 1August 1943 or later. By this same date, the first annual review of theclassification of each Medical Corps officer was scheduled for completion.
As a result of War Department Circular No. 460, many officers received forthe first time a War Department, or standard classification, number as opposedto theater classification.48 And for the firsttime in the European Theater of Operations, Medical Corps personnel came underthe central classification activities of the theater.49
47(1) Memorandum, Lt. Col. J. C. Rucker, MC, for Lt. Col. G. H. Teasley, MC, 1 Nov. 1944, subject: Personnel Records in the European Theater of Operations. (2) Memorandum, Lt. Col. G. H. Teasley, MC, for The Surgeon General, 29 Nov. 1944, subject: Report of Trip to Mediterranean Theater of Operations. (3) Letters, Robert Evans, M.D., to Col. C. H. Goddard, MC, Office of The Surgeon General, 8 Dec. 1952 and 14 Apr. 1953.
48Letter, Col. Perrin H. Long, MC, to Col. C. H. Goddard, MC, Office of The Surgeon General, 29 July 1952.
49Annual Report, Personnel Division, Office of the Chief Surgeon, European Theater of Operations, U.S. Army, 1944.
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Difficulties were eventually encountered in carrying out theprovisions of the circular. The supply of forms was short; in the spring of1945, units were moving so rapidly and so freely from one command to anotherthat it was difficult to ascertain which ones had reported; and finally, the"human factor" entered the picture-to manyindividuals and unit commanders, this was "just another form." As aresult, a fairly complete classification was not accomplished until June 1945.50
The Pacific and China-India-Burma theaters
The Pacific theaters and the China-Burma-India theater do notappear to have placed any early emphasis on the classification problem. Noindividual systems were initiated, as in the European and North African-Mediterranean theaters. In 1944, in the Central and South Pacific, medicalofficers were classified in accordance with the system established by theSurgeon General`s Office.51
In the Southwest Pacific Area, however, nothing wasaccomplished until Maj. Robert W. W. Evans, MC, Chief of the ClassificationBranch of the Military Personnel Division in the Surgeon General`s Office wastransferred to the Southwest Pacific at the request of Brig. Gen. Guy B. Denit,Chief Surgeon. Following the consolidation of commands in the Pacific, MajorEvans became, in the latter part of July 1945, head of the Personnel Division ofthe Chief Surgeon`s Office in the Pacific theater.52
The increased availability of consultants also facilitatedthe work of classification and reevaluation both in the Pacific and inIndia-Burma. In the latter theater, the source of classification data had beeninformation obtained in the Zone of Interior in the early part of the war, andsuch classification as had been performed in the theater had been accomplishedby a nonmedical officer.53
ENLISTED PERSONNEL, 1939-45
The same reservation must be made when discussing theplacement of enlisted personnel as when discussing that of officers-aman assigned to a job that did not call for his best talents cannot be said tohave been misassigned if the overriding needs of the Army required him to beused where he was. With that exception, proper placement will be considered hereas one that fitted the job to the man.
50Administrative and Logistical History of the Medical Service, Communications Zone-European Theater of Operations, 1945. Ch. X. [Official record.]
51(1) Whitehill, Buell: Administrative History of Medical Activities in the Middle Pacific (1946). [Official record.] (2) Annual Report, Surgeon, Central Pacific Base Command, 1944. (3) Letter, Verne R. Mason, M.D., to Col. C. H. Goddard, MC, Office of The Surgeon General, 18 Dec. 1952.
52Annual Report, General Headquarters, U.S. Army Forces, Pacific, 1945.
53(1) Letter, Col. Herrman L. Blumgart, MC, to Col. C. H. Goddard, MC, Office of The Surgeon General, 7 Aug. 1952. (2) Letter, Hugh J. Morgan, M.D., to Col. C. H. Goddard, MC, Office of The Surgeon General, 7 Aug. 1952. (3) Graham, Stephens: History of Professional Surgical Experience in the India-Burma Theater in World War II (1945). [Official record.]
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It was not nearly so important, for the most part, to fit the job to the manin the case of enlisted personnel as it was in the case of officers. With fewexceptions, jobs for enlisted men in the Medical Department called for a muchshorter period of technical training than did most jobs for officers. Ifnecessary, therefore, the Medical Department could train its own enlistedtechnicians after they entered the service. A great deal of such training wasdone, although there were complaints that the quality of the material was notalways adequate-that too many men of limited physical endurance or mentalability were assigned to the Medical Department. Nevertheless, in order toeconomize on the training effort, it was desirable to place men in jobs forwhich they were already qualified and to keep them there until they could beused more effectively elsewhere.
The first essential was to see that enlisted men who were qualified fordistinctly medical work got into the Medical Department-and stayedthere-insteadof being placed in some other branch of the Army, but only a comparativelysmall number were earmarked for medical work upon induction into the Army. Inthe vast majority of cases, enlisted men went, after induction, to the receptioncenters of the Army as draftees without any previous arrangement as to wherethey would be used and were only then assigned to some particular branch of theservice. The Medical Department received its enlisted personnel mainly in thisfashion or by transfer from some other branch of the Army.
Classification Guides
As early as September 1940, the reception centers and other assigningauthorities had a better guide for classifying and therefore assigning enlistedmen than for officers. An Army regulation issued at that time contained a list of occupational specialties required in the Army and alist of the specifications for those occupations. This regulation included aserial number to identify each specialty. A three-digit number designated eachjob. Thus, for example, under the heading "medical technician"appeared the specification serial number "123" under which were listedduties in military service, qualifications, and civilian occupations in whichmedical technicians would be found. Male nurses and medical students were placedin the same category.54 Later on, the job descriptions were refined, and someof the specification serial numbers were changed. In July 1944, the WarDepartment replaced its existing guide with War Department Technical Manuals12-426, "Civilian Occupational Classification of Enlisted Personnel,"and 12-427, "Military Occupational Classification of EnlistedPersonnel."
Such a guide, though useful, did not insure that all enlistedmen would be either properly classified or assigned. In January 1942, TheAdjutant General, after making a general statement on the need to utilize theabilities of
54Army Regulations No. 615-26, 3 Sept. 1940, subject:Enlisted Men: Index and Specifications for Occupational Specialists and Indexto Military Occupational Specialists. (This list was superseded in December1941, and still another appeared in September 1942.)
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enlisted men to full capacity, listed several skills thatmust be carefully conserved. This list, antedating the list of scarce-categoryspecialists published later in the war, included the following MedicalDepartment enlisted specialties: Dental hygienist, dental laboratory technician,medical technician, surgical technician, optician, orthopedic mechanic,pharmacist, sanitary technician, veterinary surgical technician, and X-raytechnician. The Adjutant General designated the specialties on this list inwhich the shortage could be overcome in part by Army training.55
Proper classification was necessary, as set forth in Army Regulations No.615-25, 3 September 1940, in order that-
a. All units and installations obtain a proportionate share ofthe abilities possessed by personnel coming directly from civil life.
b. Combat units obtain priority in the assignment of personnel possessingmilitary training and qualities of leadership.
c. Men with occupational skills are assigned to units or installationsrequiring those skills in the proportion and to the extent available, avoidingwastage.
The System in Operation
The system was designed to work as follows: Recruits were to be classified atthe reception centers. Classification was always to be in terms of what theindividual could do best for the Army. On the basis of his score on the ArmyGeneral Classification Test and an interview with a classifier, each recruit wasto be assigned to the training center of the arm or service which could bestutilize his education and experience.
Difficulties encountered
The immediate needs of the Army took precedence, of course,over this planned method of classifying and assigning. Moreover, the system didnot always operate according to plan. Improper classification and assignmentoften occurred in the emergency and early war periods, owing in part to a lackof trained classifiers and to the fact that numbers of individuals were assignedto branches merely so that quotas could be met.
Another difficulty was that recruits spent an average of only72 hours at reception centers, a limit imposed by the lack of housing and therapidity of mobilization. This was not always enough time to determine where aman could be most properly assigned. It also meant that centers could not retaina man until a requisition for his specialty arrived. Particular centers mightnot have requisitions for a given specialty for several weeks, although thecenters were meanwhile receiving men with the required qualifications. As thewar progressed, procedures were improved, more experienced classificationpersonnel were available, and more efficient placement ensued.
55Letter, The Adjutant General, to Commanding General, each Army Corps;Chiefs of Arms and Services, 29 Jan. 1942, subject: Reclassification andReassignment of Enlisted Personnel.
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Continual reevaluations
Whether or not the reception centers did their work efficiently, men would inmany cases have to be reclassified and in most cases reassigned after they leftthe centers. The reason, of course, was that some acquired specialized skillsthrough Army training which entitled them to a new classification, and that mosthad to be moved about from post to post if not from job to job as the exigenciesof the service demanded. In fact, The Adjutant General declared thatclassification procedure must be carried out during an enlisted man`s entireArmy career, and in January 1942, all commanders were directed to survey theclassification cards of their enlisted men at least every 6 months for thepurpose of improving their placement; commanders were to report any surplus ofmen whose skills they could not use "to the utmost."56
56See footnote 55, p. 286.
