AMEDD Corps History > U.S. Army Dental Corps > United States Army Dental Service in World War II
COMPOSITION OF THE DENTAL CORPS
Important items in a discussion of officers of the wartime Dental Corpsare background, age, and previous military preparation. Information isnot available concerning all of the 18,000 dental officers who served inthe Army between 1 October 1940 and 31 December 1945,1 but across-sectional view of the 15,302 officers who were either on duty 31May 1945 or had been released shortly before that date2 revealsthe following:3
Distribution by Age | |||
| Age | Number | Percent | Approximate years of practice before entering the Army* |
| Under 30 | 3,902 | 25.5 | 0-2 |
| 30-34 | 4,086 | 26.7 | 3-7 |
| 35-39 | 4,958 | 32.4 | 8-12 |
| 40-44 | 1,423 | 9.3 | 13-17 |
| 45-49 | 581 | 3.8 | 18-22 |
| 50-over | 352 | 2.3 | 23-over |
*Years of practice based on average age at graduationof 25-264 and assumption that men on duty in 1945 averaged 2years of military service.
Distribution by Race | ||
| Race | Number | Percent |
| White | 15,131 | 98.89 |
| Negro | 132 | 0.86 |
| Chinese | 25 | 0.16 |
| Japanese | 8 | 0.05 |
| Others | 6 | 0.04 |
Distribution by Component | ||
| Component | Number | Percent |
| Regular Army | 266 | 1.7 |
| National Guard | 117 | 0.8 |
| Organized Reserve Corp. | 3,106 | 20.3 |
| AUS (obtained through ASTP) | 1,802 | 11.8 |
| AUS (obtained from civilian life) | 10,011 | 65.4 |
1Memo, Mr. Isaac Cogan for Dir, Dent Cons Div,SGO, 29 Aug 46, sub: Dental Corps officers--historical data. SG: 322.053-1.
2The number of dental officers actually on duty on V-E Day wasabout 14,700. When the data given here were calculated in June 1945 reportsof separations during the preceding month were incomplete.
3See footnote 1 above.
4Strusser, H.: Dental problems in postwar planning. J. Am. Dent.A. 32:991-1003, 1 Aug 45.
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Distribution by Specialty | ||
| Specialty | Number | Percent |
| Oral Surgeon (MOS 3171) | 65 | 0.4 |
| Exodontist (MOS 3172) | 325 | 2.1 |
| Periodontist (MOS 3174) | 20 | 0.1 |
| Prosthodontist (MOS 3175) | 255 | 1.7 |
| Staff Dentist (MOS 3178) | 170 | 1.1 |
| No specialty (MOS 3170) | 14,467 | 94.6 |
The "average" dentist was about 33 when he entered the Army(assuming 2 years of service in 1945) and had been in private practicenearly 8 years. Though well-qualified as an operative dentist, he was notlikely to have had extensive training as a specialist. Only 4 per 1,000were oral surgeons and only 1 per 1,000 was a periodontist. Nearly two-thirdshad entered the Army with no previous experience in the Armed Forces, andthough professionally competent, almost all of this group needed more orless additional military training before they were fitted to fill responsiblepositions. This was the "raw material" from which the Army DentalService was assembled.
ASSIGNMENT OF DENTAL OFFICERS
The proportion of dentists in service command installations in the UnitedStates, in the Air Forces, and in tactical organizations in the UnitedStates and overseas fluctuated with the progress of mobilization and withchanges in the course of the war. The greatest number of dentists on dutyat any time was 15,292 in November 1944.5 Subsequent strengthreductions were not significant until after V-E Day. The maximum figurein the United States was reached a year earlier, in November 1943, witha total of 11,544 men (Air Forces, service commands, and tactical units).6The largest number on duty with the Air Forces (United States and overseas)was about 3,739 in May 1945. The number of Army dentists overseas increasedfrom about 1,000 (10 percent) in December 1942 to 3,221 (22.5 percent)in December 1943 and 6,017 (39.8 percent) in December 1944. The maximumnumber abroad was reached in March 1945 when 7,111 dental officers, or48.1 percent of all Army dentists, were on foreign service, but the highestratio was not reached until May 1945 when the 7,103 dentists overseas were48.3 percent of the total on duty. At the end of 1915 only 2,886 (30.0percent) of all dentists were overseas. The maximum number of Air Forcesdentists overseas was 1,103 (29.5 percent) in May 1945.7
5Memo, Mr. Isaac Cogan for Chief, Dent ConsDiv, SGO, 8 Oct 46, sub: Basic data for Dental Corps. SG: 322.0531.
6Unpublished data from the Resources Analysis Division, SGO,given to author in Oct 1946.
7Unpublished data from the Personnel Division, Office of theAir Surgeon, given to author on 1 Oct 46.
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The approximate authorized percentages of dentists in different typesof assignments on 31 March 1944 were as follows:8
| Percent |
Tables of organization units (U.S. and overseas) | 36.9 |
Army Service Forces, U.S. (Exclusive of T/O Units) | 32.3 |
Army Air Forces, U.S. (Exclusive of T/O Units) | 21.1 |
Theater overhead (Exclusive of T/O Units) | .7 |
Replacement pools | 6.8 |
Other | 2.2 |
This ratio was of course subject to constant change as emphasis wastransferred from training activities in the United States to combat operationsoverseas. During the early part of the war a majority of dentists wererequired for work on new men in Army Service Forces and Air Forces installationsin the United States. Later they were needed in the units actually engagedin operations (T/O units overseas and in the United States).
PROFESSIONAL CLASSIFICATION OF DENTAL OFFICERS
At the start of mobilization there was no effective plan for the classificationof dental officers according to special qualifications. Some attempt wasmade locally to assign dentists to appropriate work but these efforts werehampered by the absence of any standardized system by which the specializedabilities of an officer could be determined at a glance. Too much reliancehad to be placed on the dentist's own estimate of his qualifications, sothat men with not much more than a desire to do a certain type of workwere designated as specialists, while other trained officers were placedin routine jobs.9
On 21 October 1943 The Adjutant General directed that dental officerswould be evaluated in respect to professional qualifications on the basisof questionnaires to be sent to The Surgeon General.10 At aboutthe same time a War Department Technical Manual (TM 12-406) described sixclassifications for dentists, as follows:11
MOS 3170 | (Dental officer) general practitioner. |
MOS 3171 | (Oral surgeon, dental) fully qualified oral surgeon. Should have extensive experience in oral surgery and have been a member of a hospital staff. Internship, residency, or fellowship desirable. |
MOS 3172 | (Exodontist) qualified as extraction specialist. Extensive training in exodontia, and internship or residency desirable. |
MOS 3174 | (Periodontist) qualified to treat investing tissues of teeth. Extensive training or experience very desirable. |
8Memo, Chief, Oprs Br, SGO, for CG, ASF, 5Jun 44, sub: Requirements for Dental Corps officers. SG: 322.0531-1.
9Final Rpt for ASF, Logistics in World War II. HD: 319.1-2 (DentalDivision).
10Ltr SPX 220.01 (6 Oct 1943) OC-E-SPGAP-MB-A, 21 Oct 43, sub:Correct classification and assignment of Army Service Forces officers andenlisted men. AG: 220.01 (19 Sep 43) (1).
11TM 12-406, Officer classification, commissioned and warrant,30 Oct 43.
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MOS 3175 | (Prosthodontist) qualified to construct bridges and dentures. Extensive training or experience essential. |
MOS 3178 | (Dental officer, staff) qualified to advise surgeons of major units on the operation of the dental service. Must have previous military experience. |
(All dentists were required to be graduates of accepted schools, licensed to practice dentistry, and actually engaged in ethical practice at the time of entry into the Army.) | |
Early in 1944, TM 12-406 was amended to authorize the use of modifyingletter symbols in connection with the MOS numbers, of medical officersonly, to indicate relative ability within a specific field. Thus a surgeonof moderate skill might be designed "MOS D 3150," while a surgeonwith outstanding back ground and experience would be listed as "MOSA 3150."12 This refinement, however, was not applied toother Medical Department officers, possibly because there were then inexistence no recognized civilian standards for dental and veterinary specialists.
Original classifications of medical, dental, and veterinary officerswere made from information contained in the "Classification Questionnaireof Med ical Department Officers."13 Later adjustments inclassification were made from reports of "Reevaluation Data for MedicalDepartment Officers."14 In the case of dental officers,the assignment of an MOS number was carried out in the Dental Division,SGO.
The Director of the Dental Division, SGO, found that these measuresaided in the appropriate assignment of dentists, but that they were nota complete solution of the problem. He Stated after the war that:15
. . . the system is very weak because there is no "measuringrod" and no "official" check or follow-up to determine anofficer's true classification . . . There are too many officers classifiedas oral surgeons and as prosthodontists who in reality have had no formaltraining in those specialties and whose experience in these fields hasbeen very limited. . . . The fact that a man's MOS states that he is anoral surgeon does not really mean that he is a qualified oral surgeon.. . . Although the present mechanics set up for the classification of dentalofficers is a definite advancement over that used at the beginning of thewar, it definitely is not an effective instrument in the assignment andutilization of manpower.
The solution recommended was a "clearer definition of the meaningand intent of the several classifications as well as the setting up ofadditional criteria for selection; a dental classification section in PersonnelService, SGO, with sufficient personnel, which can currently follow upon all changes of classification, and which can check effectively on qualificationsas well as on assignments of Dental Corps personnel."16
12TM 12-406, C 1, 10 May 44.
13WD AGO Form 178-2, 1 Jan 45.
14WD AGO Form 178-3, 1 Aug 45.
15See footnote 9, p. 107.
16Ibid.
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PROMOTION
In time of peace, promotion in the Dental Corps of the Regular Armywas based on the same regulations which governed promotion in the MedicalCorps, providing for original appointment in the grade of first lieutenant,with periodic advancement thereafter on the basis of total service.17Total service required for promotion to the various grades above that oflieutenant was as follows:
Captain | 3 years |
Major | 12 years |
Lieutenant colonel | 20 years |
Colonel | 26 years |
For reasons which are not clear, Reserve officers could be promotedeven more rapidly, after the following periods of total service:18
Captain | 4 years |
Major | 9 years |
Lieutenant colonel | 15 years |
Colonel | 22 years |
Regular Army dental officers were required to pass examinations on bothprofessional and military subjects, except that candidates for advancementto the two highest grades were examined only on military problems.19Reserve officers had to pass examinations in military subjects or completespecified correspondence courses appropriate to the higher grade.20In addition, they had to attend at least one summer camp of 2 weeks durationprior to each promotion.
Original commissions in the grade of first lieutenant helped to equalizethe status of the professional officer, who generally entered the serviceat an older age, with that of the line officer who started his career severalyears earlier and who generally obtained his education at Government expense.Promotion solely on the basis of time-in-grade was criticized because itdid not reward the outstanding officer nor provide an incentive to specialefforts. It did, however, eliminate political influence as a factor inadvancement and left the officer more opportunity to exercise his own judgmentwithout fear of reprisal as long as his performance and behavior met acceptedstandards.
With mobilization, key positions in a rapidly expanding Army had tobe filled quickly by procedures which could be applied to Regular, Reserve,and temporary officers. On 1 January 1942 most of the peacetime promotionregulations were suspended, and advancement was thereafter based on thefollowing factors:21
17AR 605-50, 30 Jul 36.
18AR 140-5, 16 Jun 36.
19AR 605-55, 11 Oct 35.
20See footnote 18, above.
21WD Cir 1, 1 Jan 42.
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1. Completion of a minimum specified time-in-grade.
2. Recommendations from superiors, attesting to the officers' qualifications.
3. Existence of a vacancy in the desired grade. Under these provisionsdental officers enjoyed the same promotion status as members of other branches,at least in theory. In practice, unfortunately, stagnation of promotionin the Dental Corps soon became so serious that it was the cause for frequentcriticism during the latter part of the war.22
A minor reason for the lack of opportunity for advancement in the DentalService was of course the relatively low rate of attrition among dentalofficers.23
Another factor was the difficulty encountered, under emergency conditions,in determining which officers were best qualified for promotion. Littleeffort was made to transfer eligible officers from posts where no vacanciesexisted to installations where opportunities were better. At the worst,an officer's efficiency might actually reduce his chances for advancementsince he was more likely to be held at the old, established installation,while the less desirable officer might be transferred to a new facilitywhere more vacancies could be expected. A considerable element of chancewas thus introduced into the promotion program, and men who were luckyenough to be in the right place at the right time advanced rapidly whileequally competent men held the same grade for the duration of the war.
By far the most important reason for slow promotion in the Dental Corps,however, was the lack of positions in the Dental Service calling for gradesabove that of captain.
In the Zone of Interior, where the size and mission of installationsvaried widely, local commanders were given considerable freedom to determinewhat grades would be allotted to individual activities, as long as prescribedtotals were not exceeded. The commanding general of a service command,for instance, received a total authorization of grades for his entire area,and he could distribute them among the respective corps pretty much ashe pleased, according to their relative strength, his own estimate of responsibilitiesinvolved, or any other factors which seemed important. Similarly, the commanderof a post or hospital might or might not allocate to the Dental Serviceenough of the field grades at his disposal to make reasonable promotionpossible. Only in the case of very gross and obvious discrimination wasthe local commander likely to be called upon to justify his actions inthis respect. The advantage of this policy was that promotion was placedin the hands of officials who were familiar with duties and responsibilitiesin the installation concerned; the disadvantage was that personal factorsmight play a considerable part in determining who should be advanced. Also,under regulations then in effect the dental officer could not personallysupport his recommendations concerning the grades needed by his activity,and he had to rely on the good will and aggressiveness of the surgeon,who alone served on the commander's staff.
22See chapter I.
23See chapter III, p. 56.
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Under such circumstances it was perhaps inevitable that opportunitiesfor promotion in the Dental Service varied greatly in different commandsand installations in the Zone of Interior, and that serious inequitieswere possible. The normal allotment of dentists for a 25-chair clinic,for example, was considered to be 1 lieutenant colonel, 5 majors, and 19captains or lieutenants,24 but this ratio was seldom attained.One general hospital was reported to have no dental officer in field gradein spite of the fact that it had 15 majors in other branches.25Since the senior dentist was always a subordinate of the senior medicalofficer the former's grade tended to be set below that of the surgeon,and this lower grade of the dental surgeon was in turn reflected in lowergrades for his subordinates throughout the Dental Service. At the end of1943 only 1.6 percent of all service command dentists were colonels, 3.3percent were lieutenant colonels, and 11.6 percent were majors; the proportionof medical officers in these top grades was approximately twice as great.26
The composition of tactical commands was not left to the discretionof commanders, but was prescribed by rigid "tables of organization."An infantry regiment could have two dentists in the grade of captain orlieutenant, and no deviation in number or grade was permitted. A captainin such a regiment could be promoted only if he could be transferred toanother organization where a vacancy existed. Some limitation on promotionwas obviously required to prevent a top-heavy accumulation of officersin grades not justified by their duties and responsibilities. As constitutedduring World War II, however, tables of organization provided few fieldgrade vacancies in tactical commands.
In an infantry division, only 1 of the 12 dental officers was a major.Even a field army, with from 300 to more than 600 dentists, provided relativelyfew positions for field grade officers. In a "type" army of threecorps and supporting troops, there were only 9 majors and 1 full colonel(the army dental surgeon) among about 244 dental officers in troop units.Among the 70 dentists with army hospitals the situation was better sincethis group included 16 majors and 3 lieutenant colonels, but of the totalof about 314 dentists in this "type" army only 1 (0.3 percent)was a colonel, 3 (1.0 percent) were lieutenant colonels, and 25 (8.0 percent)were majors.
Hospitals in the overseas areas generally fared better than combat com-mands.Field hospitals, evacuation hospitals, and the smaller station hospitals(under 250 beds) provided no field grades for dentists in the first partof the war, but a 250-bed station hospital had a major, and all stationhospitals with over 500 beds included both a lieutenant colonel and a majoramong their 4 or 5 dental officers.27 A 1,000-bed general hospitalhad a lieutenant colonel, and a 1,500-bed or 2,000-bed general hospitalhad a full colonel, a lieutenant colonel,
24ASF Cir 389, 16 Oct 45.
25The Surgeon General's Conference with Service Command Surgeons,10 December 1943. HD: 337.
26Info from Strength Accounting Br, AGO, given to author on6 May 46.
27Data extracted from the T/O's for combat and medical units.
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and a major on its staff of dentists. The larger number of these medicalinstallations in the communications zone raised the proportion of fieldgrade dental officers in that area, but not to a sufficient degree to assurereasonable promotion in overseas areas as a whole.
Because the Air Force had very few hospitals the limitations imposedby tables of organization worked an especial hardship on its overseas dentalpersonnel, and the ratio of Air Force dentists in the two top field grades(United States and overseas, combined) was only about half the meager ratioallotted to the Dental Service as a whole.28
The f act that dental officers had less opportunity to reach the gradesabove that of captain is shown in the following tabulation which liststhe percentage of all officers of the Dental Corps, Medical Corps, andtotal Army in each grade as of 30 April 1945:29
| Grade | Dental Corps | Medical Corps | Total Army* | |
| General | ------- | ------- | 0.18 | (-------) |
| Colonel | 0.83 | 2.35 | 1.24 | (1.69) |
| Lieutenant colonel | 2.71 | 7.34 | 3.36 | (4.56) |
| Major | 10.38 | 21.61 | 8.24 | (11.20) |
| Captain | 67.25 | 56.50 | 23.33 | (31.70) |
| First lieutenant | 18.83 | 12.20 | 37.42 | (50.85) |
| Second lieutenant | ------- | ------- | 26.23 | (-------) |
*Figures in parentheses provide a distribution of thetotal Army officers excluding generals and second lieutenants. The percentagesfor the total Army (not in parentheses) are based on total commissionedofficers including generals as well as second lieutenants.
In August 1945 the Medical Corps had 9 major generals and 46 brigadiergenerals, while the Dental Corps had 1 major general and 1 brigadier general.
Comparisons between the proportions of medical and dental officers inthe grades of lieutenant and captain slightly favor the latter, but cannotbe considered significant since any lieutenant could be promoted captainas soon as he had spent the required time in grade. It is more difficultto explain the wide discrepancy in the general grades, but this situationprobably had little effect on morale as very few dentists could hope tobecome general officers under any circumstances. It is in the range ofthe field grades that the dental officer was at the greatest disadvantage,and inability to reach those, grades was the greatest cause for dissatisfactionwith promotion policies. The ratio of colonels and lieutenant colonelsin the Dental Service was about one-third that in the Medical Corps, andabout one-half that in the Army as a whole if generals and second lieutenantsare not considered. The ratio of majors in the Dental Corps was about halfthat in the Medical Corps, and less than the ratio for the Army as a wholeif generals and second lieutenants are not considered, in spite of thefact that most dental officers started one grade higher than most officersof branches outside the Medical Department.
28See footnote 7, p. 106.
29Strength of the Army, 1 May 45.
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The unfortunate results of slow promotion in the Dental Corps were describedas follows by the dental surgeon of the Middle East theater:30
A condition which had a very adverse effect on the moraleof dental officers ... was relative discrimination in the grades to whichdentists could hope to attain. This is a familiar complaint, but it waswell founded. When twenty-five percent of medical officers were in fieldgrade, for instance, only seven and one-half percent of dental officerscould reach field grade. The inevitable result . . . was that dental officersfound themselves passed at regular intervals by men of other branches withless experience and ability. I do not wish to imply that the discriminationexisted only between the Medical and Dental Corps, nor can the blame beplaced on medical officers commanding in this theater. . . . I merely drawattention to the condition as it undoubtedly existed. Dental officers,like the rest of the Army, recognized that in time of national emergencyindividuals must be prepared to sacrifice their own personal welfare forthe successful prosecution of the war. They had given up their practicesand their homes because they felt they could make an important contributiontoward winning that war, and as long as they had this conviction they wereglad to give their best efforts, with or without promotion. But when adental officer was passed again and again by men of other branches whowere less experienced, no more intelligent, and certainly no harder working,he inevitably arrived at the conclusion that his own work was not consideredimportant. I need not elaborate on the danger of such an attitude.
The Director of the Dental Division, SGO, stated in 1945 that:31
There is no doubt that proportionately there are moreposition vacancies for briga-dier generals, colonels, and lieutenant colonelsin the Medical Corps by virtue of the fact that the medical officer commandsthe hospitals. . . (but) it is believed generally in the Dental Corps thatthe ratio of Medical Corps officers to Dental Corps officers, in accordancewith strength figures, is not equitable. It was extremely difficult forofficers of the Dental Corps to understand such a vast difference in allfield grades, and there was only one general result-lowered morale.
During the war a number of efforts were made to improve the status ofdental officers in respect to promotion. In 1943 the American Dental Associationclaimed that failure to insure equal promotion for dentists violated theact of 6 October 1917 (40 Stat. 397) which provided that officers of theDental Corps would have the same grades, proportionately distributed, asofficers of the Medical Corps.32 These charges were based onthe contention that Section 10 of the National Defense Act, as amendedby Section 10, act of 4 June 1920 (41 Stat. 766), which prescribed promotionby length of service, had merely amplified the principle established inthe act of 1917, but The Judge Advocate. General ruled that the law providingfor promotion by length of service had rescinded the earlier legislation,and that there was no legal requirement that
30Address by Col George F. Jeffcott beforethe Association of Military Surgeons in New York on 2 Nov 44. This paragraphwas omitted from the version of that talk which was published in The MilitarySurgeon, Jan 1945.
31See footnote 9, p. 107.
32Ltr, Dr. J. Ben Robinson, Pres ADA, to Maj Gen James C. Magee,5 Feb 43, no sub. SG: 080 (American Dental Association).
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the Medical and Dental Corps should have the same proportion of officersin each grade.33
In January 1943 the Director of the Dental Division, SGO, initiatedimportant steps to speed the promotion of lieutenants. Prior to this timetables of organization or tables of allotment had prescribed specific numbersof lieutenants for the Dental Service of units or installations, and inmany cases the result was complete stagnation of promotion, regardlessof length of service. The situation was particularly serious in the smallertactical commands, where the lieutenant of an infantry regiment was practically"frozen" in grade since changes in personnel were infrequentafter the unit was once organized. The Director of the Dental Divisionrequested that tables of organization which included dental lieutenantsbe amended to read "lieutenants or captains," thus making itpossible to advance dentists out of the lowest grade when they met otherrequirements for promotion, regardless of the existence of a position vacancy.This recommendation was adopted for both medical and dental officers oftable-of-organization units in May 1943.34 It was extended toinclude Zone of Interior installations in July of the same year.35The effect in tactical units was immediate, but some difficulty was encounteredin Zone of Interior installations since service commands were operatingunder maximum ceilings in each grade, and they hesitated to advance MedicalDepartment officers when such action would use up position vacancies previouslyearmarked for other activities.36 By January 1944, however,the proportion of captains in the Dental Corps had risen from about 25percent to over 48 percent, and by V-E Day 68 percent of all dental officerswere captains and only 19 percent were lieutenants.37
Partially successful efforts were also made to increase the grades heldby dentists in hospitals, which provided almost the only opportunity forpromotion to field grade. In 1942, for instance, a 300-bed station hospitalwas authorized only a captain and a lieutenant, but by 1944 the allotmentwas a major and a captain. Similarly, the major, captain, and lieutenantof a 750-bed evacuation hospital were each authorized the next higher grade.A major was added to the tables of organization of the 1,000-bed generalhospital. In general, an effort was made to have the senior dental officerof any hospital given the same grade held by the chiefs of the medicalor surgical services.38
The Deputy Surgeon General39 stated in October 1943 thatbrigadier generals would be appointed in the Dental Corps to act as dentalsurgeons of the three principal theaters, but no such action was takenuntil February 1945,
331st ind, Chief Mil Affairs Div, JAGD, 2 Nov43, on ltr, Chief of Legal Div, SGO, to JAG, 28 Oct 43, sub: Rank of dentalofficers. SG: 322.0531-1.
34WD Cir 122, 18 May 43.
35WD Cir 169, 24 Jul 43.
36See footnote 25, p. 111.
37See footnote 29, p. 112.
38See footnote 9, p. 107.
39Memo, Brig Gen George F. Lull, for Pers Div, G-1, 26 Oct 43.SG:322.053-1.
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when Col. Rex McDowell, of the Dental Division, SGO, was promoted. In1945 the Director of the Dental Division, SGO, asked for legislation toauthorize 1 major general and 4 brigadier generals for the Dental Service,with 1 each of the latter to be assigned to the Air Forces, the GroundForces, and the Service Forces, but no action was taken on this request.40
Efforts to increase the authorization of field grades for dentists intactical commands, outside of hospitals, were generally unsuccessful. Asingle dental officer in a battalion was unlikely to be granted a gradehigher than that held by a company commander who was responsible for over200 men. It is probable that some improvement would have been possible,if the Dental Service of the larger elements, such as the division, couldhave been organized into larger detachments, in which higher grades forthose officers having increased professional or administrative responsibilitywould have been justified. Such an organization had more important advantagesthan the possibility of increasing the allotment of field grades (see chapterVIII), but it was attempted only on an experimental basis during WorldWar II.
In general, the opportunities for promotion in the Dental Corps wereincreased during the war, especially in respect to the company grades,but the Director of the Dental Division, SGO, stated at the end of hostilitiesthat the measures taken had not been adequate, and that "there wasno real solution reached with reference to field grades."41
MORALE
Official wartime reports seldom mentioned morale problems among dentalofficers, suggesting that deficiencies were not considered serious. Fromthe practical point of view, dentists certainly rendered loyal and effective,service during the period of hostilities. Unfortunately, here is good evidencethat many dental officers left the Armed Forces, including the Army, withthe feeling that they had not received fair treatment, and relations betweenthe Dental Corps and the civilian profession left much to be desired asthe Medical Department faced the postwar era.42 The ADA, inparticular, was called upon to defend itself from the bitter criticismsof members who felt that their interests had not been adequately guarded,43and these criticisms were passed on to the Dental Services of the ArmedForces with interest.
Many complaints could of course be ascribed to the age-old militaryprivilege of "griping." Also, it would be too much to expectthat wartime
40Memo, Maj Gen R. H. Mills for Col B. C. T.Fenton, 21 Sep 45. This memorandum has been seen by the writer, but itwas not placed in permanent files of SGO.
41See footnote 9, p. 107.
42Series of editorials in Oral Hygiene from July to October1943. See also (1) The Army Dental Corps. J. Am. Dent. A. 32: 487-488,1 Apr 45. (2) Sauce for the goose. J. Am. Dent. A. 32 : 888-889, 1 Jul45. (3) New regulations for the Army Dental Corps. J. Am. Dent. A. 32:1290, 1 Oct 45. (4) Theory and fact in dental legislation. J. Am. Dent.A. 32: 1301-1308, 1 Oct 45. (5) The right to gripe: The fifth freedom.J. Am. Dent. A. 33:118, 1 Jan 45.
43Ibid. (4).
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service should be pleasant and in the haste of mobilizing the nation'sdefense resources it was probably inevitable that some men should get morefavorable assignments than others, that promotion should not always beequitable, and that misassignments should be made. Such injustices willprobably continue to exist under emergency conditions in spite of all effortsto end them. On the other hand, some criticisms were undoubtedly justified,and even those which appear to have been exaggerated deserve considerationsince imagined deficiencies were often as detrimental to morale as thosewhich were, real.
Among the more important causes of dissatisfaction were the following:
1. Unfavorable promotion status. (See discussion, this chapter.)
2. A fairly widespread opinion that the Dental Service was unnecessarilydominated by medical officers. (See discussion under "MedicodentalRelations" in chapter I, pp. 7-15.)
3. Unfavorable assignments and lack of opportunity for promotion formembers of the Reserve called to active duty early in the war. Reserveofficers were among the first to be brought into the service, before otherdentists were, being taken from civilian life in large numbers. Becausethey had had some military training they were often placed in tacticalunits where dental practice was limited to routine, minor operations, andwhere promotion was notoriously slow. The inexperienced man, on the otherhand, was more likely to be placed under supervision in a large clinicor hospital where military knowledge was less important. Here his opportunitiesfor improving his professional skill were better, probability of advancementwas increased, and the chance of being shipped overseas to a combat theaterreduced. The Reserve officer tended to feel that he had been "solddown the river" because he had taken sufficient interest to preparehimself for military service before war broke out. This matter is discussedin greater detail in chapter III.
4. The establishment, especially during the early part of the war, of"amalgam mills" where long hours were spent at the chair doingroutine operative work which offered little stimulation to professionalinterest. The situation was sometimes complicated further by the prescriptionof daily "quotas" which each officer had to meet. Insofar as"production line" procedures contributed to efficiency and assuredthat the best qualified men would render specialized treatment, they wereprobably unavoidable. At best, approximately 90 percent of all dental carerequired by recruits consisted of routine restorative work, and the understandabledesire of dentists to widen the scope of their experience could be gratifiedonly to a limited extent in wartime. (See the discussion of quota dentistryin chapter VI, pp. 223-225.)
5. The handling of the dental ASTP, and related demobilization policies.First protests in this field came in June 1944 when ASTP graduates whohad received part of their training at Government expense were dischargedto enter private practice. (See discussions in chapters 111, pp. 56-59and IX, pp. 340-342.)
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The serious drop in the morale of dental officers during the war, asexpressed in postwar personnel difficulties and criticism in the professionalpress, was of course regrettable. At the same time it served a constructivepurpose in that it emphasized defects which urgently needed attention.44
COMBAT ACTIVITIES, AWARDS
Dental officers shared the risks and hardships of the units to whichthey were assigned. They participated in Pacific landings, in assaultson Europe's fortified lines, and in airborne attacks in the Mediterranean.One dentist served as commanding officer of an infantry regiment,45and another was dropped by parachute into Greece late in 1943, aiding theGreek guerillas and organizing a medical service for them until that countrywas liberated in 1945. After liberation of Greece this officer was instrumentalin obtaining the release of British officers held as hostages by leftistGreek forces. For his efforts he received the Order of the British Empireas well as Greek and American awards.46 Recognized and unrecognizedinstances of heroism and exceptional devotion to duty were too numerousto be discussed in detail. In addition to those receiving the Purple Heartfor wounds received in action, 384 dental officers received other awardsas follows: Legion of Merit, 24; Silver Star for gallantry in action, 10;Soldier's Medal, 2; Bronze Star, 347.47 In October 1945 Maj.Gen. Robert H. Mills, who had been Director of the Dental Division, SGO,during more than 3 years of war, was awarded the Distinguished ServiceMedal, the highest award for outstanding administrative duties.
From 7 December 1941 through 31 December 1946,48 116 dentalofficers died from all causes. In this period, 20 dental officers werekilled in action; 60 dentists were wounded, 5 of whom died; 38 were madeprisoners of war, of which number 12 died (including 2 shown among the20 killed in action), and 1 reported missing in action who subsequentlyreturned to duty. (There were a total of 91 nonbattle deaths, 10 of whichoccurred while in a prisoner of war status.) Capt. Howard A. McCurdy, DentalReserve, who lost his life in
44By the end of 1948 the Dental Corps had beengiven new administrative status, temporary promotion policies were beingrevised, and the military were showing an increased willingness to takethe representatives of the civilian professions into their confidence whenproblems concerning members of those professions were encountered. "Quota"dentistry was dead, probably for good, and the more knotty question ofgiving individual dentists greater freedom in military practice withoutreducing efficiency was being considered. These changes would probablynot eliminate all complaints in any future mobilization, but they promisedmuch for long-term improvement in the efficiency and morale of the DentalService.-Ed.
45Colonel Roy A. Green to return to private practice. J. Am.Dent. A. 33: 379, 1 Mar 46.
46Iowa dental officer receives honor from Britain. J. Am. Dent.A. 32: 1350, 15 Nov 45.
47HTM-14, 1 Aug 46, Decorations and awards awarded by the WarDepartment and overseas theater commanders, for period 7 December 1941thru 31 May 1946. In Decorations and Awards Br, AGO.
48Army Battle Casualties and Nonbattle Deaths in World War II,Final Report, 7 Dec 41-31 Dec 46. Strength and Acctg Br, AGO.
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the Philippines in January 1942, was the first dental officer killedby enemy action in World War II.49
TRAINING OF DENTAL OFFICERS
World War I
During the First World War, over 4,000 inexperienced dental officerswere called to duty in a relatively short period of time. Initially, noprovision had been made for training these men, but fortunately, many hadbeen members of the Preparedness League of American Dentists and had receivedsome instruction in both military dentistry and military administration.The Preparedness League was formed in March 1916 to provide free dentalservice for men wishing to enlist in the Army and, later, to prepare potentialdraftees to meet induction requirements.50 51 It had also extendedits activities to sponsor study clubs for dentists who expected to enterthe Reserve, a program which was started even before the United Statesentered the war. A standard course of study was drawn up by the Leagueand approved by The Surgeon General. This included instruction in anatomy,dental and oral surgery, pathology, X-ray, fractures, anesthesia, prostheticrestoration, bone grafting, first aid, military law, and military administration.52The Association of Deans of Dental Schools approved the plan and afterJune 1917 most schools made their facilities available without cost tothe Government or individuals. Colonel Logan, head of the Dental Service,stated that the majority of schools cooperated in the program and thatfrom 4,000 to 5,000 dentists completed the training.53
The first effort by the Army to train dentists came with the establishmentof the section on Surgery of the Head in the SGO. This office sponsoredclasses in maxillofacial surgery for selected officers at Washington University,St. Louis; Northwestern University, Chicago; and the University of Pennsylvania,Philadelphia, (Thomas W. Evan Institute). From October 1917 to March 1918these courses provided instruction along the same lines as that given inthe Preparedness League program.54
In March 1918 a field service school was established at Camp Greenleaf,Fort Oglethorpe, Georgia, for the instruction of dental officers and theirenlisted assistants.55 The course at Camp Greenleaf includeda month of in-
49Dental officer killed in action. Army Dent.Bull. 13:149, Apr 1942.
50Beach, J. W.: Preparedness League of American Dentists. J.Nat. Dent. A. 4: 176, Feb 1917.
51Beach, J. W.: Preparedness League of American Dentists-Ourfirst birthday. J. Nat. Dent. A. 4: 363-370, Apr 1917.
52Synopsis of study club course in war dental surgery for thesectional units of the Preparedness League of American Dentists. J. Nat.Dent. A. 4: 795-797, Jul 1917.
53Logan, W. H. G. : Development of the dental service duringthe present war. J. Nat. Dent. A. 5: 993-1004, Oct 1918.
54Ibid.
55Ibid.
119
struction in basic military subjects, followed by a month of study inanatomy, oral surgery, the effects of focal infection, and the fixationof fractures. Every effort was made to have new officers sent to this school,and 1,200 had been enrolled when the war ended in November 1918.
Training for Regular Army Dental Corps
Officers Prior to World War II
Candidates for the Regular Army Dental Corps in the period between WorldWars I and II were required to be graduates of accepted civilian dentalschools and to have at least 2 years of experience in the practice of dentistry.Many were without previous military experience, however, and required bothbasic military training and additional professional instructions beforethey were qualified to assume complete responsibility for the Dental Serviceof a camp or post. As they reached the higher grades, dental officers alsorequired additional training to fit them for positions of greater responsibility.The Army was therefore called upon to provide graduate instruction of alltypes from the most elementary to the most advanced, both military andprofessional.
Basic Graduate Course, Army Dental School. The first step inthe preparation of a new dental officer was to supplement his, previouseducation in oral surgery, operative dentistry, and prosthetics; subjectsin which he would need to be especially proficient if called upon to takeover the operation of the Dental Service at an isolated post. In a 4-monthbasic course at the Army Dental School in Washington (postgraduate only)the new officer received training in these specialties as well as refresherinstruction in those subjects which he might have forgotten since graduationfrom dental school. Unfortunately, a chronic shortage of officers madeit impossible to schedule these courses regularly and the last class wasgiven in 1935. An average of seven officers took this course annually between1930 and 1935.56
Officers' Basic Course, Medical Field Service School. After theprofessional education of the new dental officer had been brought up todate at the Army Dental School, he was sent to the Medical Field ServiceSchool (MFSS) at Carlisle Barracks for an additional 5 months of basicmilitary instruction. With other officers of the Medical, Veterinary, andMedical Administrative Corps he studied the organization of military units,the organization and function of medical field units, preventive medicine,first aid, the evacuation of wounded, records and returns, supply procedures,and military law. He learned about Army regulations and customs of theservice and he practiced close-order drill in the ranks. During 2 weeksof field maneuvers he put into practice the fundamentals he had studiedin the classroom and served as part of the staff of a battalion aid station,a collecting station, and a medical regi-
56Annual Reports of Technical Activities, ArmyMedical Center, for the years 1930-35. HD: 319.1-2.
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ment. In separate classes for dentists the new officer became familiarwith dental field equipment and the administration of a dental clinic.One hundred and forty-one dental officers graduated from this course fromthe founding of the school in 1921 through 1939.57
Advanced Graduate Course, Army Dental School. As the Army dentalofficer approached field grade he might be sent to the advanced graduatecourse of the Army Dental School where he received 4 months of instructionin oral surgery, x-ray technique, prosthetics, operative dentistry, preventive,dentistry, and periodontal diseases. This course was not expected to qualifythe dentist as a specialist but it gave him the general background he neededto act as chief of the Dental Service at a larger post or hospital. Outstandingcivilians were brought in to lecture oil special subjects and all the facilitiesof the Army Medical School, Walter Reed General Hospital, the Dental ResearchLaboratory, the Army Institute of Pathology, and the Central Dental Laboratorywere utilized to make this training the most effective possible. The potentialvalue of the course was limited, however, by the small number of officersable to attend, and only 27 men graduated in the 11 years from 1930 through1940.58
In 1936 the Army Dental School provided a course for professional specialistswhich was attended by four officers,59 but with this singleexception it did not attempt to furnish extensive instruction leading toqualification in a dental specialty.
Advanced Officers' Course, Medical Field Service School. Afterattaining field grade, usually before examination for promotion to lieutenantcolonel, dental officers might be sent to the 3-month advanced course ofthe MFSS. This course was designed to fit the officer for staff dutiesand the administration of the Dental Services of large units. A relativelysmall proportion of eligible officers were able to take the course, however,and from 1923 to 1939 there were but 21 graduates.60 A largerproportion of senior officers took the special extension course of theMFSS which covered essentially the same material and exempted the candidatefrom solution of a field problem in his examination for promotion to thegrade of lieutenant colonel.
Instruction in Civilian Institutions. A limited number of dentalofficers were authorized to receive instruction in civilian institutionsfor periods of from a few weeks to a year. In the 11 years from 1930 to1940 (inclusive) 32 received such training, though from 1937 to 1940 only3 courses were authorized.61
Nonmedical Service Schools. Dental officers were theoreticallyeligible for courses of instruction at such advanced Army schools as theCommand and
57Special Rpt, undated, from Col Neal Harper,DC, received in 1945. HD: 314.1-2.
58Annual Reports of Technical Activities, Army Medical Center,for the years 1930-40. HD: 319.1-2.
59Annual Reports of Technical Activities, Army Medical Center,for the year 1936. HD: 319.1-2.
60Annual Reports, Medical Field Service School, 1923-39. HD:319.1-2.
61Annual Reports of The Surgeon General, U. S. Army, 1930-1940,Washington, Government Printing Office, 1930-1940 (cited hereafter as AnnualReport . . . Surgeon General).
121
General Staff School and the War College. In practice they were notordered to these schools until after the start of hostilities in WorldWar II, and then in almost negligible numbers.
Extension Courses.At any time in his career the dental officerwas eligible to take correspondence courses published by the MFSS. Thesewere primarily designed for Reserve officers, however, and the number ofregulars enrolled was small. Command and General Staff extension courseswere also open to dental officers with appropriate background, but enrollmentwas limited and few dentists in the peacetime establishment were able toget advanced training in general staff procedures.
Dental Internships. Dental internships were first authorizedin February 1939.62 Eight graduates of the class of June 1939were selected and trained for 1 year in 1 of 6 major hospitals. (WalterReed General Hospital, Letterman General Hospital, Fitzsimons General Hospital,Army-Navy General Hospital, William Beaumont General Hospital, and theStation Hospital, Fort Sam Houston.) Interns were regarded as potential,candidates for the Regular Army Dental Corps and were selected on the basisof scholarship, physical fitness, and adaptability for military service.They were eligible for appointment in the Dental Corps without the 2 yearsof private practice required of other applicants and without competitiveprofessional examination.63 They received $60 monthly plus quartersand subsistence. Only about one-fifth of all applicants were accepted andthe qualifications of successful candidates were high. A total of 27 internswere taken into the Dental Corps out of 28 receiving this training between1940 and 1942. The last class of nine interns graduated in June 1943, butnone of this group were taken into the permanent establishment due to thesuspension of all Regular Army procurement during the war. An earnest effortwas made by the Dental Division, SGO, to have these men commissioned atthe end of hostilities, but the request was rejected by higher authority.Tentative plans for resumption of the dental intern program after the warcalled for the granting of reserve commissions to accepted candidates,who would then be called to active duty for the required period of training,with the pay and allowances of their grade.
Summary. The prewar training of the Regular Army dental officerwas generally effective, but the fact that the permanent Dental Corps numberedonly about 260 officers at the start of World War II meant that this sourcecould supply only key personnel, a negligible proportion of the 15,000officers needed to staff the Dental Service.
Training for Reserve Officers Prior to World War II
On 30 June 1941 the Dental Reserve Corps numbered 4,428 officers inthe following grades: 7 colonels, 96 lieutenant colonels, 354 majors, 909captains,
62SG Ltr 6, 14 Feb 39.
63AR 605-20, 19 Aug 42.
122
and 3,062 lieutenants.64 From 1 January 1939 through 28 February1946,3,606 Reserve dentists were called to active duty,65 includinga few who were given commissions after 30 June and before 7 November 1941,when procurement for the Reserve was terminated.
Immediately following World War I the Reserve was made up largely ofofficers who had had some active military experience. In the period betweenthe two World Wars, however, the Dental Reserve was maintained and augmentedwith men who either had had no military training whatever, or who had receivedlimited training in connection with their professional education. Thesenew officers required additional instruction and practical experience tofit them for the duties they would perform on mobilization.
Reserve Officers' Training Corps. For 10 years, until 1932, eightdental schools cooperated with the Army to offer courses which would qualifystudents for commissions in the Dental Reserve on graduation. Regular Armypersonnel were loaned as instructors, and students attended 30 hours ofclass yearly. (Credit, for 60 additional hours was given for courses suchas maxillofacial surgery, taken by the undergraduate as part of his regularprofessional training.) The course was divided into basic and advancedsections of 2 years each. Enrollment in the basic class was usually obligatoryand entitled the student to no pay. A smaller number of selected studentstook the senior course on a voluntary basis and received a "rationallowance" of about $9 a month. Advanced students were required toattend one 6-week summer camp during which they received the pay of anenlisted man of the lowest grade ($21 monthly). Instruction was given onthe organization of the Army and the Medical Department, dental reportsand records, the care of maxillofacial injuries, and the operation of dentalfield facilities. In the summer camp the candidate drilled, set up fieldinstallations, and observed military organizations in actual operation.Of 6,854 officers commissioned in the Dental Reserve from 1922 to 1935,2,274 or 33.2 percent were graduates of the ROTC senior course.66Unfortunately, the dental ROTC program was drastically curtailed as aneconomy measure in 1932 and the last class graduated in 1935.
Extension Courses for Reserve Officers. Before the war, the,Army sponsored a series of graduated correspondence courses designed tomeet the needs of Reserve officers of all degrees of experience and inall grades. Extension courses began with such basic military subjects asmap reading, military law, customs of the service, and organization ofthe Army. They advanced to specialized instruction in sanitation, evacuationof wounded, medical reports, and the tactics of medical organizations inthe field. Completion of the appropriate courses was practically a prerequisitefor promotion, and the Reserve officer
64Annual Report ... Surgeon General, 1941 (1941)p. 143-147.
65Officers appointed in the Dental Corps from 1 January 1939through February 1946. Strength Acctg Br, AGO, 8 Jul 46. HD: 320.2.
66Annual Reports of the Secretary of War, 1922-1940, Washington,Government Printing Office, 1922-1940 (cited hereafter as Annual Report. . . Secretary of War).
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was able to develop his knowledge as his responsibilities increasedwith each higher grade. From 1935 to 1938 all average of 8,000 MedicalDepartment Reserve officers, or a little over one-third of the total strength,were continually enrolled in extension courses.
Summer Camps for Reserve Officers. The Medical Field ServiceSchool routinely devoted the summer period to training programs for Reserveofficers. A 2-week camp was scheduled for the instruction of junior Reserveofficers, another was held for those assigned to units. A 6-week camp,designed to train key personnel for larger medical units, was held forsenior captains and field grade officers. Reserve dentists all over theUnited States were also given occasional 2-week tours of active duty atnearby posts where they received "on-the-job" training. In the12 years before 30 June 1940, 6,034 dental officers received some typeof summer camp training, though there is considerable duplication in thisfigure since it includes those who attended more than one camp during theperiod.67 In addition, between 200 and 300 National Guard Dentalofficers annually attended camps conducted by that component.
Following the war, senior dental officers stated that, in general, prewarReserve training bad been adequate for the company grades, but that ithad not always been extensive enough to prepare men in the higher gradesto hold key positions in the Dental Service. In particular, Reserve trainingwas found to have placed greater stress on didactic instruction ratherthan on practical experience. The completion of correspondence courses,plus 2 weeks of active duty every few years, was often insufficient preparationfor a former small town dentist who might be called upon to operate a campdental service for 25,000 men. These comments on the deficiencies of prewarReserve training should not be construed as blanket criticism of the Reserveprogram; thousands of dentists were able to step into routine militaryduties without delay because they had received some preliminary trainingas civilians, and some Reserve officers administered major dental serviceswith distinction. But the utilization of field grade dentists who, throughno fault of their own, were inadequately trained for the duties appropriateto their grades, was a problem for the Dental Service and for the officersconcerned.68
Training for Dental Officers During World War II
At the start of World War II the Regular Army Dental Corps and auxiliarycomponents could together provide less than one-third of the 15,000 dentalofficers needed for the expanding military establishment. The remainderhad to be obtained directly from civil life. Most of these new officersneeded intensive professional and administrative training before they werequalified to assume unfamiliar duties in a military organization. Thisnecessi-
67See footnote 66, p. 122.
68Pers interv by the author with Maj Gen Robert H. Mills, 6Oct 47. Also pers ltr to the author from Brig Gen Leigh C. Fairbank, 9Oct 47.
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tated a large-scale expansion of all prewar programs and the initiationof extensive new facilities.
Basic Training, Medical Field Service School. The Medical FieldService School at Carlisle, Pa., assumed an important role in the trainingof dental officers mobilized for the emergency. Though the courses variedsomewhat to meet changing conditions, the school continued throughout thewar to instruct new officers in military organization and administration,the functions of field units, and the operation of the Dental Service.Before 1942 special dental lectures had been given as an incidental dutyby the senior officer of the post, but in June of that year the dentalrepresentative received full faculty status.69 At the heightof the training program in 1944 the dental representative had five assistants.In the 6-week course which was in effect during most of the wax, dentalofficers received 22 hours of special dental instruction in addition to250 hours on general military subjects with officers of the Medical, Veterinary,and Medical Administrative Corps. The dental course covered the organization,functions, and administration of the Dental Corps, the duties of dentalofficers in fixed and mobile installations, dental property, the trainingof assistants, dental surveys, first aid to and evacuation of jaw casualties,approved splinting methods, and the relations of dental officers to otherarms and services.70
The first change to a wartime schedule at the MFSS came late in 1939when the normal 5-month basic course was reduced to 3 months so that anextra class could be started in the spring of 1940. In December 1940 thecourse was cut to 4 weeks and called the "Refresher Course."Up to this time the basic course had been intended for new Regular Armyofficers, but by the end of 1940 Reserve officers with some military experiencewere being called to active duty and it was felt that 1 month of trainingwould be sufficient to supplement their previous preparation. Summer classesfor Reserve and National Guard officers were dropped in 1940 since allofficers were then being prepared for extended active duty. Extension courseswere carried on until the summer of 1941. By September 1941 the pool ofReserve officers was becoming exhausted and dentists without any previoustraining we're being called to active duty, leading to the decision tolengthen the course to 8 weeks. A critical shortage of officers in July1942 caused the basic course to be temporarily reduced to 4 weeks but assoon as possible (December 1942) it was restored to 6 weeks and remainedat that figure for most of the remainder of the war. In February 1945 thecourse was further extended to 8 weeks.71 In February 1946 activitiesof the MFSS were transferred to Brooke Army Medical Center, Fort Sam Houston,Texas.
69History of the Army Dental Corps, 1941-43,p. 82 of Personnel Section. HD: 314.7-2 (Dental).
70The training of dental officers. Bulletin of the U. S. ArmyMedical Department, 80: 14, Sep 1944 (cited hereafter as Army Medical Bulletin).
71History of training, World War II, vol X, Chart 3. HD:314.7-2.
125
From 1 January 1941 to 30 June 1945, 4,473 dental officers completedthe basic training courses at the Medical Field Service School, as follows:7273
1941 | 421 |
1942 | 440 |
1943 | 1,508 |
1944 | 1,574 |
1945 (January to June, incl.) | 530 |
A little over 25 percent of all dental officers on duty during the warreceived Medical Field Service School training.74 It was notuntil May 1945 that the War Department was able to direct that all dentalofficers would thereafter complete field training before being assignedto a Unit.75
Basic Training, Medical Department Replacement Pools. About themiddle of 1942, training programs were instituted for officers in replacementpools at the MFSS, 4 officer replacement centers, 14 named general hospitals,several medical supply depots, and at the Gulf Coast Air Corps TrainingCenter.76 These pools had an authorized capacity of 200 dentalofficers. While officers were available for varying lengths of time, thecourses were planned on a 1-month basis and were mainly "on-the-job"training in medical facilities of the installation. Since these courseswere informal in nature, and since the flow of officers through the pooldetermined the instruction each man received, it is impossible to statehow many dental officers completed this training.
Professional Training, Army Dental School. In the year ending30 June 1940 the Army Dental School gave no professional courses for officers.In the year ending 30 June 1941 the basic graduate class, which until 1935had been given as a 4-month course, was revived as a 3-month "SpecialGraduate Course" and given to two classes totaling 40 Regular Armyofficers. In addition, refresher courses of from 1 to 4 weeks were commencedin February 1941.77 These were designed to train dentists inoral surgery, prosthetics, or operative dentistry in preparation for assignmentas chiefs of such services in dental clinics. Refresher courses were continueduntil June 1942, when they were dropped after a total of 166 officers hadcompleted the training. Four other general hospitals and the station hospital,Fort Sam Houston, also gave refresher courses during this period but thetotal number of officers attending these classes cannot be determined.
After 31 August 1941 the Army Dental School cooperated with the ArmyMedical School and Walter Reed General Hospital in giving maxillofacial
72Summary of Dental Corps officers graduatedfrom the MFSS, 9 September 1940 to 3 August 1946. HD: 353 (1946).
73In addition to the figures given here, a few dental officersmay have graduated in a special class of 802 Medical Department officerswhich passed through Camp Barkley in 1944. Reports do not break down thecomposition of this class by corps, but since it was scheduled to meetthe needs of a large number of medical interns it is probable that fewdentists were included.
74See footnote 9, p. 107.
75WD Cir 144,16 May 45.
76SG Ltr 48, 23 May 42.
77SG Ltr 32, 5 Apr 41.
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plastic courses to train teams qualified to care for these difficultinjuries. Until the end of 1942 these courses were of 4 weeks' duration.They were then lengthened to 6 weeks. The last course ended in September194378 after a total of 139 dental officers had been qualified.
After 1943 no courses for officers were given at the Army Dental School.
Maxillofacial and Plastic Training, Civilian Institutions. InSeptember 1942 maxillofacial training at the Army Medical Center was supplementedby courses given at selected civilian schools. Twelve-week courses weregiven at Columbia University and 6-week courses at Harvard, Universityof Pennsylvania, Washington University (St. Louis), Mayo Foundation (Minn.),and Tulane University (New Orleans). The last class ended in August 1944,after 287 officers had been trained, including about 148 dental officers.The number of classes given at each school varied from two to seven. Duringthe war a total of 287 dental officers received maxillofacial trainingat military and civilian installations.79
Maxillofacial Training in, Hospitals. In February 1942 it wasdirected that all general hospitals except Darnall General Hospital wouldinstitute training programs for maxillofacial plastic teams.80It was expected that these would mainly provide experience in teamworkfor previously qualified individuals, but if trained personnel were notalready available, authority for instruction in civilian institutions wasgranted.
Refresher Courses, Army Hospitals. In May 1945 refresher coursesin Army general hospitals were authorized for a limited number of dentalofficers who had been on extended administrative duty during the war.81Instruction was to be for a period of 12 weeks in the clinics of the selectedhospitals under the guidance of permanently assigned personnel. Since theprogram was still under way at the end of the war it is not known how manydental officers may have benefited from this training, but the initialresponse was not so large as was expected since most dentists preferredto return to their practices without delay.
Unit Training. Dental officers assigned to tactical units tookpart in the training programs of their organizations, learning by actualfield operations the duties which they would be called upon to performin combat. In order to provide the time for this unit training the bulkof the dental work for tactical organizations in the United States wasperformed by station dental clinics operating under the service commands.However, unit dentists were also assigned to these permanent station clinicsfor part-time duty, both to help with the rehabilitation of their personneland for professional training. In January 1941 it was directed that: (1)unit dental officers would receive train-
78Annual Reports of Technical Activities, ArmyMedical Center, for the years 1942-44. HD 319.1-2.
79Unpublished data obtained from the files of the Training Division,SGO, by the author.
80AGO ltr, 27 Feb 42, sub: Training in auxiliary surgical groups.AG: 353 Med (2-19-42).
81AGO ltr, 1 May 45, sub: Refresher professional training forDental Corps officers. SG: 353.
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ing in medical tactics as auxiliary medical officers and in emergencytreatment of jaw casualties within their respective organizations, and(2) they would receive professional training in camp or hospital dentalclinics under direction of the camp or station surgeon.82 Afterfrequent disputes over how much time should be spent in each type of activityit was finally directed that about half of the unit dentists' time wouldbe devoted to field training and the remainder to clinic training and duty.83Clinic dentists also took part in local training schedules which providedinstruction in military courtesy and customs, conduct of the clinic, property,and reports and returns.84
Dental Consultants. In September 1944 the Dental Division wasauthor ized to contract for the services of qualified civilian consultantsto assist in training and to advise less experienced men in oral surgeryand prosthetics. Fourteen dentists were made available at various times,including 10 prostho dontists and 4 oral surgeons. These men visited dentalinstallations, advised local dental officers on procedures and the treatmentof cases, and made recommendations to the Dental Division, SGO, concerninggeneral conditions noted. Dental consultants were required to demonstratethe utmost common sense and tact, in addition to high professional qualifications,in the performance of their duties. Until they convinced local dental officersof their sincere desire to be of assistance, the latter tended to regardthe consultants as "snoopers" or inspectors, rather than as educators.A few consultants also tended to recommend lengthy procedures which wereadmittedly superior to accepted practices, but which were not consistentwith the necessary policy of "the greatest good for the greatest number."In spite of these difficulties the dental consultants showed an understandingof the problems of the Army and of the local dental officers, and theirconstructive advice helped materially to raise the standards of the ArmyDental Service.
Film Strips and Moving Pictures. Libraries of film strips andmoving pictures were maintained at each service command headquarters, insome sub-libraries at large posts, and in theater headquarters. These trainingaids were available on call from any installation. Moving pictures of importanceto dentists were "Endotracheal Anesthesia for Dental Operations,""Harelip and Cleft Palates" (three films), "Ankylosis ofthe Mandible" (arthroplasty), "Retruded Chin" (cartilagegraft), and "Dental Extraction under Pentothal-sodium ."85A film on "Dental Health, for the general. instruction of militarypersonnel, was completed early in 1945. The basic outline for the filmwas developed by the Dental Division in cooperation with the Bureau ofPublic Relations of the ADA. The scenario was written by Signal Corps specialists,
82AGO ltr, 14 Jan 41, sub: Organization, training,and administration of medical units. AG: 320.2.
83AGO ltr, 31 Jul 42, sub: Utilization of dental officers forprofessional duties. AG : 210.312 (Dental Corps) (7-12-42) QD-A-PSM.
84Training. Dental Bulletin, supp. to Army Medical Bulletin11 : 175-177, Oct 1940.
85TB MED 4, 14 Jan 44.
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and filming was completed in Hollywood under Signal Corps supervision.In 25 minutes the film described, in nontechnical language, the need fororal hygiene, the proper care of the teeth and gums, provention of caries,and the use and care of dentures.86 Film strips were suppliedon first aid for wounds of the face and jaws, bandaging, control of hemorrhage,traction appliances, clearing of the airway, and the construction of splints.8788 At the end of the war a new series of film strips was being preparedcovering diseases of the mouth, dental anomalies, dental caries, periodontaldiseases, cysts, and tumors. These strips were to be accompanied by descriptivebooklets elaborating on the conditions depicted.89
Publication. Three technical manuals pertaining to the Dental Servicewere published during the, war. A handbook for dental assistants and techni-cianswas printed in 194190 and revised in 1942.91 Thismanual contained chapters on the anatomy of the teeth and mouth, prostheticprocedures, dental x-ray technique, oral hygiene, duties of the dentalassistant, and the keeping of dental records. Another publication on therepair and maintenance, of hand-pieces was issued in September 1944.92A third manual on the dental x-ray machine was printed in January 1945.93
A symposium on the treatment of maxillofacial wounds was prepared bythe Army Dental School in 1941, and published under the auspices of thePreparedness Committee of the American Dental Association.94This booklet, entitled "Lectures in Military Dentistry," waspurchased by the Surgeon General's Office for general distribution amongdental officers, and it was also made available to interested civiliandentists through the ADA.
Until July 1943 the Dental Corps sponsored publication of the quarterly"Dental Bulletin, Supplement to the Medical Bulletin," containinginstructions and information on matters of interest to the Dental Service.After October 1943 such material was carried in the monthly Medical Bulletinand publication of the separate Dental Bulletin was discontinued. The Armytook an active part in publication of the "Atlas of Dental and OralPathology," a volume containing descriptions of all of the more importantdental lesions, with micro-photographs and case histories. It had originallybeen prepared at the Army Institute of Pathology and published under auspicesof the ADA before the war. A revised edition was published in 1942.95
86New training films and film bulletin available.Army Medical Bulletin 88: 44, May 1945.
87Film strips approved for release. Army Dent. Bull. 13: 57,Jan 1942.
88Training aids. Army Dent. Bull. 13: 138, Apr. 1942.
89Dental film strips. Army Medical Bulletin 88: 56, May 1945.
90Handbook for the dental assistant and mechanic. Washington,The Surgeon General, 1941.
91TM 8-225, Dental Technicians. Washington, Government PrintingOffice, 1942.
92TM 8-638, Engine, Handpiece, Straight; Engine, Handpiece ,Angle. Washington, Government Printing Office, 1944.
93TM 8-634, Dental X-ray Machine. Washington, Government PrintingOffice, 1945.
94Lectures on military dentistry. Chicago, Preparedness Committeeof the American Dental Association, 1942.
95Committee on dental museum. J. Am. Dent. A. 29: 2260, Dec1942.
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THE WAR AND UNDERGRADUATE DENTAL EDUCATION
In time of peace the Army has customarily relied upon established civilianinstitutions for the undergraduate education of professional officers forthe Medical Department. In both World Wars, however, the Army and Navyhave felt it necessary to initiate special programs to insure the continuedoperation of the professional schools and to provide readily availablereplacements of officer personnel.
In World War II the Army and the Navy became deeply involved in thefield of professional training, and for a period of approximately 1 yearthe majority of the nation's dental students were in military status, studyingunder military contracts with the dental schools. Conflicting needs ofthe Armed Forces for young manpower on one hand, and for a steady supplyof professional replacements on the other, indicate that the Army, Navy,and Air Force must be prepared at least to advise on the deferment of studentsin the health sciences in any future emergency, whether or not they planto take a more direct part in medical education.
Selective Service and Dental Education
In drawing up legislation for compulsory military service Congress consistentlyrefused to provide for blanket exemption of any group on the basis of occupation.During discussions preceding passage of the Selective Service Act of WorldWar II strong pleas for the deferment of professional students were madeby representatives of schools and professions, but the only concessionmade was to permit all university students to complete the current academicyear, with no general deferment authorized beyond 1 July 1941.96(ROTC students were permitted to finish the last 2 years of their courses.)Within 2 days after the Selective Service Act became law, Senator JamesE. Murray introduced a bill specifically deferring medical and dental students,97but it f ailed to receive favorable attention. The Army itself opposedthe measure because it was considered contrary to the spirit of the SelectiveService Act, which contemplated deferment only on the basis of individualessentiality to the war effort.98 Between January and May 1941,similar student deferment legisla-tion was introduced 99 100 101 102but all such bills were defeated.103 The unfavorable responseto these measures indicated that failure to grant blanket deferment toprofessional students was not an oversight, and that the Selective ServiceAct
96Selective Service in Wartime. Washington,Government Printing Office, 1943, p. 232.
97S. 4396, 76th Cong., introduced 18 Sep 40.
98Ltr, SecWar (Henry L. Stimson) to Hon Morris Sheppard, ChmSenate Committee on Mil Affairs, 16 Dec 40. Quoted in Reports of Hearingsbefore the Committee on Military Affairs, U. S. Senate, 77th Congress,on S. 783, 18-20 March 1941. Washington, Government Printing Office, 1941.
99S. 197, 77th Cong., introduced 6 Jan 41.
100S. 783, 77th Cong., introduced 6 Feb 41.
101H. R. 4184, 77th Cong., introduced 26 Mar 41.
102S. 1504, 77th Cong., introduced 13 May 41.
103Selective Service in Peacetime.Washington, Government PrintingOffice, 1942, p. 172.
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correctly interpreted Congress' determination to avoid legislation whichcould be construed as favorable to any special group.
On the other hand, educational facilities for the vital health professionshad long been barely adequate to meet minimum needs in normal times, andit appeared that the long-range interests of the nation required the maintenanceof the medical, dental, and veterinary schools, not only to meet the expandedimmediate needs of the Armed Forces, but to insure adequate health careof the civilian population following the end of hostilities. Also, theschools of arts and sciences could keep in operation with student bodiesmade up largely of women and physically rejected men, while professionalschools with their predominantly male student bodies faced probable closureif all men eligible for military service were removed. Once these complexorganizations were broken up their reconstitution would be a difficultand time-consuming task. Efforts to comply with the letter of the SelectiveService law and at the same time to safeguard essential professional trainingled to some confusion and uncertainty during the early stages of mobilization.
Early Selective Service directives concerning deferment for essentialitydid not specifically mention professional students, and determination oftheir eligibility was left to the discretion of local boards. In February1941, however, those boards were reminded that automatic deferment foruniversity students would end in July, and they were directed to considerthe cases of men in training for critical occupations before that time.104On, March 1941 boards were again reminded that certain students were eligiblefor deferment under existing regulations, and were directed to considereach applicant on the basis of the importance of the occupation, the lengthof time already spent in training, and the probability that the studentwould actually engage in the activity after his education had been completed.105The ADA promptly advised the deans of all dental schools to seek delayin the induction of dental students on the basis of these instructions.106So far as dental students were concerned, however, the effectiveness ofboth of these early directives was lessened by the fact that dentistryhad not been declared a critical occupation. On 22 April 1941 SelectiveService notified its local boards that the Office of Production Management(OPM) had warned that a shortage of dentists might be imminent,107and the position of dental students was materially improved when this tentativeinformation was confirmed a week later.108 On 1 May 1941 theofficial Selective Service news magazine emphasized in very
104Unnumbered memorandum for State Directorsof Selective Service, 13 Feb 41, sub: Classification of students. InMemoranda to All State Directors 1940-43. Washington, Government printingOffice, 1945.
105See footnote 96, p. 129.
106Ltr, C. Willard Camalier to deans of all dental schools,26 Apr 41. SG: 327.22-1.
107Memo, Dir Selective Service, for all State Directors (I-62),22 Apr 41, sub: Occupational deferment of students and other necessarymen in certain specialized professional fields (III). Washington, GovernmentPrinting Office, 1945.
108Telegram, Dir, Selective Service System, to all State Directors,30 Apr 41. On file Natl Hq, Selective Service System.
131
strong terms the need for deferring dental students,109 anda directive of 12 May 1941 stated: "It is of paramount importancethat the supply [of dentists] be not only maintained but encouraged togrow, and that no student who gives reasonable promise of becoming a qualifieddentist be called to military service before attaining that status."110
Under these policies a considerable number of medical, dental, engineering,and physical science students were deferred from military duty after theend of automatic deferment in July 1941. A survey made late in 1941 showedthat 81 percent of all dental students 21 years of age or over were continuingtheir education under occupational deferment, a higher proportion thanin any other group.111 Deferment for other students ranged from80 percent in the medical schools to 46 percent in courses in biology.In February 194:2 the ADA reported that an affidavit of the dean of a dentalschool that an individual was a bonafide student was generally being acceptedby local boards as sufficient reason for delaying induction.112
In March 1942 Selective Service outlined requirements for the defermentof persons in training as follows:113
The applicant for deferment must be in training for acritical occupation essential to the war effort.
A shortage of persons engaged in that occupation mustexist.
There must Dot be sufficient persons already engaged intraining for the occupation to meet future requirements.
The trainee must have advanced sufficiently in his courseto give promise of successful completion.
Since it was ruled that no student could be held to "give promiseof successful completion" of a university course with less than 2years of previous instruction, deferment for professional students wasautomatically limited to those who had completed preprofessional training.In December 1942 Selective Service again emphasized the need for allowingdental students to continue their education, and authorized deferment aftercompletion of the first preprofessional year.114 On advice ofthe War Manpower Commission, Selective Service provisions covering thedeferment of preprofessional students were further liberalized on 1 March1943 to permit delaying the induction of any individual who would be qualifiedto enter a professional school by 1 July 1945 and who held a firm acceptancefor admission to such school.115
109Deferment of students in specialized fieldssanctioned to meet national defense needs. Selective Service, vol I, No.5, 1 May 1941.
110Memo, Dir Selective Service, for all State Directors (I-99),12 May 41.
111See footnote 103, p. 129.
112Dental students and instructors. J. Am. Dent. A. 29: 291,Feb 1942.
113Memo, Dir, Selective Service System, for all State Directors,No. I-405, 16 Mar 42, sub: Occupational classification. On file Natl Hq,Selective Service System.
114Selective Service Occupational Bulletin No. 41, 14 Dec 42,sub : Doctors, dentists, veterinarians, and osteopaths. In OccupationalBulletins 1-44, and Activity and Occupation Bulletins 1-35. Washington,Government Printing Office, 1944.
115Selective Service Occupational Bulletin No. 11, as amended1 March 1943, sub: Student deferment. In Occupational Bulletins1 to 44 and Activity and Occupation Bulletins 1 to 35. Washington, GovernmentPrinting Office, 1944.
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The deferment of actual dental students remained fairly certain duringthe remainder of the war, and it will be noted later that total enrollmentin dental schools materially exceeded peacetime registration. In April1944, however, deferment of predental students was restricted to thosewho would be able to enter a, dental school by 1 July 1944.116The ADA vigorously protested this action,117 and the Director,WMC, asked the Director, Selective Service, to reconsider the order, butthe request was refused. The Director, WMC, then asked the Armed Forcesto give military status to enough preprofessional students to assure continuedfull operation of the, schools, but the latter replied that the immediateneed for manpower should not yield to the possible use of such studentsas doctors in 1949 or later, and they stated further that the current SelectiveService policy had the full approval of the Army and Navy. Attempts ofPAS, WMC, to have the Director of War Mobilization intervene in the matterbrought the reply that the problem was clearly the responsibility of SelectiveService. The PAS estimated at this time that there would be 1,446 civilianvacancies in the dental classes starting in 1945 (the Armed Forces. programs,discussed later in this chapter, were expected to fill 38 percent of theavailable openings), and stated that if predental education were confinedto veterans, women, and physically disqualified males only a small proportionof those vacancies would be filled.118 On 23 June 1944 RepresentativeLouis E. Miller of Missouri introduced a bill to commission 6,000 medicaland premedical students, and 4,000 dental and predental students, but thislegislation failed to pass.119
The fears of PAS were later proved to be well founded, and as a resultof the discontinuance of predental education only 1,197 freshmen were enrolledin dental schools in October 1945, compared with 2,496 a year earlier.120It is clear that if the war had continued indefinitely very few studentswould have been left in the dental schools under deferment policies ineffect in 1944 and 1945.
Deferment of Dental Students Through
the Granting of Reserve Commissions
While Selective Service policies actually permitted a large proportionof all dental students to remain in school, the Office of Defense Healthand Welfare Services, PAS, ADA, and to some extent the Armed Forces, appearnot to have been satisfied that deferment was sufficiently certain underSelective Service regulations. As late as April 1942 the ADA reported continuingdifficulty in insuring student deferment.121 Also, during muchof this period
116Selective Service as the Tide of War Turns.Washington, Government Printing Office, 1945, pp. 79-80.
117Selective Service restricts deferment of predental students.J. Am. Dent. A. 31 : 735, May 15,1944.
118Procurement Service issues statement on dental students.J. Am. Dent. A. 31: 878-880, June 15, 1944.
119H. R. 5128, 78th Cong., introduced 23 Jun 44.
120The supply of dental students. J. Am. Dent. A. 32:1454-1455,Nov-Dee 1945.
121President's Page. J. Am. Dent. A. 29: 653, Apr 1942.
133
predental. students had uncertain protection, and unless a steady flowof replacements into the entering classes could be maintained, a defermentfor actual 7 dental students would eventually become meaningless. Theseconsiderations, and a desire to insure the availability of young dentistson graduation, ultimately led to involvement of the Armed Forces in thefield of dental education.
Even before passage of the Selective Service Act in August 1940, TheSurgeon General was given authority to transfer to the Medical AdministrativeCorps (MAC) Reserve any medical, dental, or veterinary student who helda Reserve commission in another branch and who would therefore be subjectto call to active duty.122 These MAC Reserve officers were retainedin inactive status until their professional education was completed, whenthey were called on active duty in the appropriate corps of the MedicalDepartment. The number of such students was of course small, and it seemsprobable that this action was taken mainly to provide later replacementsin scarce categories rather than because the Army then felt any responsibilityfor the continuation of medical education to meet postwar civilian needs.In Feburary 1941 The Surgeon General requested additional authority togrant MAC commissions to any junior or senior students in the medical,dental, or veterinary schools, basing his plea on probable future needsfor the Army.123 He pointed out that the Navy had already authorizedthe commissioning of medical students and that the Army would soon finditself at a disadvantage in procuring replacements unless it acted promptly.The Adjutant General disapproved this request, stating that exemption fromthe draft could be justified only when it was clear that students wouldbe required in key positions in industries essential to national defense.124
In April 1941 pressure for military action to insure the deferment ofprofessional students came from a new source outside the Armed Forces,and this time the need for safeguarding medical education for long-termcivilian needs, as well as for the more immediate needs of the Army andNavy, was plainly advanced as an important consideration. On the adviceof the Health and Medical Committee of the Office of Defense Health andWelfare Services the Administrator of the Federal Security Agency reportedto the Secretary of War that he felt increasing concern over the problemof "how to insure for our military and civilian needs the requisitenumber of doctors and dentists, both now and in the future."125He noted that the Navy was granting Reserve commissions to junior and seniorstudents, but he stated that it was also necessary to safeguard the twolower classes, and he endorsed a resolution of the Health and Medical Committeecalling for first and second year students to be given the status of "cadets"and for third and fourth year students to
122See footnote 64, p. 122.
123Ltr, Maj Gen James C. Magee to TAG, 18 Feb 41, sub: Commissioningof junior and senior students in the Medical Department Reserve Corps.AG: 210.1.
1241st ind, by TAG, 18 Mar 41, to ltr cited in footnote 123.
125Ltr, Paul V. McNutt to SecWar, 28 Apr 41. AG: 210.1 Med-Res(4-28-41).
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be commissioned in the MAC Reserve. He stated further that even if defermentcould be arranged through Selective Service a continuing supply of medicalpersonnel should not depend upon the understanding of 6,000 local boards,thus giving a clue to the rather surprising decision to approach the problemthrough the military rather than through Selective Service.
The Federal Security Administrator's letter influenced the, Under Secretaryof War to send a memorandum to General Marshall stating that he was keenlyinterested in the problems of the "supply of physicians for the MedicalReserve" and that he hoped the program suggested by the Health andMedical Committee could be put in action.126 It will be notedthat through oversight or intent the reference to dentists, which had beenincluded in the original recommendations of the Health and Medical Committeeand in the Federal Security Administrator's communication, was omittedfrom the letter of the Under Secretary of War. The question of whetheror not the Armed Forces should properly assume any responsibility for medicaleducation to meet purely civilian needs was also avoided. The Surgeon Generaladded his recommendation for the granting of commissions to all medicalstudents, but he failed to mention dental students in spite of the factthat he had requested the same privilege for them less than 2 months before.Since The Surgeon General had been a member of the Health and Medical Committeewhich had drafted the original petition he was certainly familiar withthe situation, and, presumably, favorably inclined toward including dentalstudents in the program, and their omission may have been unintentional,in the thought that "medical students" would include dental andveterinary students as well.127 The problem of preprofessionalstudents was not considered at this time.
The Assistant Chief of Staff G-1 concurred to the extent of approvingthe commissioning of third and fourth year medical students, as prospectiveofficers, but he recommended strongly against going further to includefreshmen and sophomores. He stated that since the Selective Service Actexpired in 1945 no student should be accepted by the military who wouldnot graduate by 1943, to allow for 1 year in internship and 1 year of servicebefore the end of the draft. He added that in his opinion the questionof the total production of doctors was a national one, not coming withinthe province of the, War Department, and that if the Selective ServiceAct endangered medical education it should be revised, rather than resortto the subterfuge of insuring deferment by means of granting semimilitarystatus.128 The commissioning of junior and senior medical studentsonly was authorized on 26 May 1941.129
126Memo, Robert P. Patterson, UnderSecWar,for Gen George C. Marshall, 1 May 41. AG: 210.1 Med-Res (5-1-41).
127Memo, Maj Gen James C. Magee, for ACofS G-1, 10 May 41. AG:210.1 Med-Res.
128Memo, ACofS G-1 for CofS, 14 May 41, sub: Deferment of medicalstudents. AG: 210.1 Med-Res (5-1-41).
129Ltr, TAG to all CA and Dept Comdrs, 26 May 41, sub: Defermentof medical students. AG: 210.1 Med-Res (5-1-41).
135
In January 1942 the Federal Security Administrator asked the War Departmentto reconsider its decision against commissioning first and second yearmedical students, though no additional reasons were given.130Again The Surgeon General supported the request, and this time dental andveterinary students were specifically included in his recommendations.131The Adjutant General again disapproved such action, stating that it wouldgrant certain students deferment for as long as 5 years,132 buthis advice was rejected, and on 11 February 1942 the War Department announcedthat any accepted male matriculant in a medical school could be given aninactive commission.133 Reference to dental students and preprofessionalstudents was again omitted, though the provision for enrolling any "acceptedmatriculant" might have covered premedical students under certainconditions.
Dentistry had been declared a critical occupancy nearly a year before134and in April 1942 the Federal Security Administrator (acting as the Directorof the Office of Defense Health and Welfare Services) again recommendedthat the privilege of accepting inactive MAC commissions be extended todental and veterinary students.135 He stated that the seriousnessof the situation had been called to his attention by the Health and MedicalCommittee of the Office of Defense Health and Welfare Services, the Procurementand Assignment Service, and officials of the professional organizations.He noted that Selective Service boards were still refusing to defer professionalstudents in some instances, and emphasized the need to delay the inductionnot only of actual enrollees in medical, dental, and veterinary schools,but of men preparing for those schools as well. The requests of The SurgeonGeneral and of other bodies responsible for assuring a steady supply ofreplacements in the health services apparently had some influence on theWar Department, and the Assistant Chief of Staff G-1 recommended to theChief of Staff that the Army authorize the commissioning in the Reserveof dental and veterinary students and of students holding acceptances fordental or veterinary schools.136 Approval of the Secretary ofWar was obtained on 14 April and the necessary orders were issued on 17April 1942.137 The interpretation of "students holdingacceptances for dental or veterinary schools" was not specific, andit has been claimed that, in some cases at least, deans "accepted"enough high school gradu-
130Ltr, Paul V. McNutt to SecWar, 6 Jan 42.AG: 210.1 Med-Res (1-6-42).
131Ltr, Maj Gen James C. Magee to TAG, 15 Jan 42, sub: Grantingcommissions to medical students in the Medical Administrative Corps. SG:210.1-1.
1321st ind, 28 Jan 42, SG:210.1-1. TAG to ltr cited in footnote131.
133Ltr, TAG to all CA and Dept Comdrs (except the PhilippineDept), 11 Feb 42, sub: Commissions for medical students. On file AG centralfiles as Tab A to ltr, Brig Gen J. H. Hilldring, G-1 to CofS, 6 Apr 42,G-1/16455-25, sub: Commission of medical and dental students. AG:210.1.
134See footnote 108.
135Ltr, Paul V. McNutt to SecWar, 2 Apr 42. AG:210.1,
136Ltr, Brig Gen J. H. Hilldring to CofS, 6 Apr 42, sub: Commissionof dental and veterinary students. AG: 210.1 (4-6-42).
137Ltr, TAG to all CAs and Dept Comdrs (except the PhilippineDepartment), 17 Apr 42, sub: Commissions for dental and veterinary students.AG: 210.1 (4-6-42).
136
ates just starting predental training to assure adequate entering classes2 years later.138 It has already been noted that Selective Servicedid not grant deferment to predental students until December 1942, andthen only to men who had completed the first year of training.
In anticipation of the inauguration of the Army Specialized TrainingProgram, the granting of new MAC commissions was discontinued in February1943.139 A majority of the 5,383 students already holding Reservecommissions later resigned them to accept active duty in the Enlisted Reserveunder ASTP, but a few retained their commissions until graduation. Bestinformation now available indicates that approximately 1,059 MAC graduateswere taken on active duty in 1943, 111 in 1944, and 16 in 1945, for a totalof 1,186 officers.140
The Army Specialized Training Program
for Dental Undergraduates
(The Army Specialized Training Program, in its general aspects, hasbeen discussed at length in a report by Col. Francis M. Fitts, M. C.141The present discussion will therefore be limited mainly to those phasesof the program having special significance for dental education. Much ofthe material used is from Colonel Fitts' work; his documentation is notrepeated.)
In December 1942 the Armed Forces announced a plan to give militarystatus to students in training for certain essential occupations and tocontinue their education at Government expense.142 The reasonswhich impelled the Army and Navy to take a direct part in medical educationare not clearly documented, but the following were probably most pertinent:
1. It has already been noted that agencies responsible for the healthcare of the nation during the emergency were not assured that SelectiveService could be relied upon to permit continuous education in the healthservices during the war. In spite of Selective Service advice to the localboards the latter sometimes hesitated to consider deferment for studentswhen they were compelled to send other young men to combat. It was alsofelt that Selective Service policies were subject to revision on shortnotice and that they could not be depended upon in establishing long-termcommitments.143
2. The Armed Forces wanted to have sufficient prospective professional
138Info given to author by Maj Ernest Fedor,who was in the Mil Pers Div, SGO, during a large part of the war.
139WD Memo W150-3-43, 8 Feb 43, sub: Discontinuance of appointmentsin the Medical Administrative Corps of accepted matriculants in medical,dental, and veterinary schools and the disposition of those officers previouslyappointed as such. SG : 210.1-1.
140Data computed by Lt Col John Brauer, DC, from statisticsfurnished by the Procurement Branch, SGO; the Appointment and InductionBranch, AGO; the Classification and Assignment Branch, AGO; and the ResourcesAnalysis Division, SGO.
141Fitts, F. M.: Training in medicine, dentistry, and veterinarymedicine, and in preparation therefor, under the Army Specialized TrainingProgram, 1 May 43 to 31 Dec 45. HD: 353 ASTP.
142SOS Cir 95, 18 Dec 42, sub: Establishment of the Army SpecializedTraining Program.
143See footnote 125, p. 133.
137
replacements actually under military control to assure the use of thesewith certainty and without delay as soon as their training was completed.
3. It was feared that students themselves would not he content to remainin school as civilians, even if deferment were assured. Nearly 2,000 formerdental students served with the AEF, alone, in World War I, so depletingthe schools that only 906 men graduated in 1920, compared with 3,587 in1919.144
4. It was probably felt that if professional students were to be relievedfrom the obligation to serve in hazardous assignments, the opportunityto attain student's status should not depend upon individual ability topay the rather heavy costs of university training. Under ASTP the son ofa laborer, or a soldier already inducted, would in theory have the sameopportunity to get a dental education as the son of a wealthy family.
Details of the new program were released in April 1943 as follows:
1. Professional students already enrolled in the Enlisted Reserve wereto be called to active duty under ASTP. Students who held Reserve MAC commissionscould resign them and be placed in the Enlisted Reserve for subsequentcall to active duty, though they were not obligated to do so.
2. Acceptable dental students not in the Reserve (MAC or enlisted) couldvolunteer for induction and transfer to the Enlisted Reserve under ASTP.
3. Predental students would be selected from men already enrolled inpredental classes who volunteered for induction in the Enlisted Reserve,or from qualified individuals already in the Army who requested transferto ASTP. Students not already in predental training would be accepted onlyif they (a) had an Army General Classification Test score of 115 or better,(b) passed an aptitude test for the medical professions, and (c) were approvedby an interviewing board representing both the Army and the dental schools.Another board had to approve advancement from predental. training to adental school. Since the ASTP was necessarily started with men alreadyenrolled in the schools, and since the dental phase was largely terminatedafter 1 year, very few new students were actually selected under the aboveprovisions.
4. Preprofessional training for all the medical sciences was to be givenin a common course of five terms of 12 weeks each. The first two termswere devoted to a general course prescribed for all ASTP beginners, medicaland nonmedical. The remaining three were consumed in a special preprofessionalcourse drawn up by ASF with the assistance of representatives of the medical,dental, and veterinary schools. The entire 60 weeks of preprofessionaltraining included the following required subjects:
English | 8 semester hours |
Physics | 8 semester hours |
Organic chemistry | 8 semester hours |
Biology | 8 semester hours |
144Dentistry as a professional career. Chicago,American Dental Association, 1946, p. 11.
138
5. Dental schools were to continue to give their regular wartime undergraduatecourses, which had been shortened in January 1942.145 Individualschools were to determine their own criteria for passing grades, examinations,and the general maintenance of professional standards.
6. On graduation, students were to be commissioned in the Army DentalCorps and called to active duty.
It was planned to utilize 35 percent of the capacity of the dental schoolsfor the Army, starting about 970 new students every 9 months. With an estimated15 percent attrition, this would provide about 825 potential dental officersevery 9 months. Maximum enrollment was reached in March 1944 when 6,143students in dental schools were enrolled in ASTP. The Navy was expectedto take an additional 20 percent of total capacity, to provide 475 dentalofficers every 9 months, so that the Armed Forces, together, were to accountfor 55 percent of the capacity of the dental schools. In October 1943,however, the 7,775 students enrolled by the Army and Navy amounted to nearly90 percent of the total of 8,888 students in the dental schools.146Since 5,883 dental students had held Reserve commissions in February1943, and since only 6,143 were enrolled in ASTP at its maximum, it isclear that the majority of the dental ASTP enrollees were men who had alreadybeen deferred as members of the MAC Reserve.
It was also planned to start an average of 130 preprofessional students,earmarked for the dental ASTP, each month. It was expected that this numberwould provide 110 new students monthly for the dental schools.
The dental ASTP was activated in the period from May through July 1943.All dental schools in the United States, totalling 39, participated, includingMeharry and Howard Universities for Negro students.
By 1944 the need for additional young manpower to push the war to asuccessful, early conclusion became critical and the Army began to considera reduction in long-term training programs. In March 1944 it was announcedthat the entire ASTP would be cut back from 145,000 men to 35,000, thoughno reduction in the medical or dental programs was anticipated at thattime. A few days later, however, the director of the Military PersonnelDivision advised The Surgeon General that it seemed doubtful that men thenin preprofessional training would ever be used by the Army in view of changesin the general war situation.147 He reflected only current confusionon the propriety of the Armed Forces concerning themselves with medicaleducation for civilian needs when he noted that the Army should not beplaced in the position of agreeing to an interruption of medical education,even when gradu-
145In January 1942 the Council on Dental Education,ADA, had recommended that the dental course during the war be continuous(no summer vacation) and that it be cut to three years instead of four.This recommendation was accepted by all schools. See Accelerationof the dental school program. J. Am. Dent. A. 29 : 287-288, Feb. 1942.
1467,775 out of 8,888 in dental schools are in armed services.J. Am. Dent. A. 31 : 164, 15 Jan 44.
147Memo, Lt Col Durward G. Hall for SG, 28 Mar 44, sub: Medicalsection, Army Specialized Training Program. SG: 353.9-1.
139
ates would not be available until after the emergency, but that theresponsibility properly lay with Selective Service, and that in his opinionthe latter would not act as long as the military were in the field. Herecommended that further procurement for entering classes be terminated.There is no indication that this advice had any direct influence on thesubsequent curtailment of the dental ASTP, but it is of interest as revealingthe trend of thought among officers charged with personnel responsibilitiesin the Office of The Surgeon General.
On 18 April 1944 ASF announced that the Army's share of the classesentering dental schools after 1 January 1945 would be 18 percent insteadof 35 percent, and that no commitments would be made covering classes to,start in 1946.148 At this time the Dental Corps was approachingits maximum authorized strength (see chapters III and IX), and effortsof The Surgeon General to have a significant number of older dental officersreplaced with younger men were meeting with little success; as a resultit was impossible to commission the ASTP graduates of June and early July1944, and they had to be unconditionally released by the Army,149causing much adverse com ment from dental officers and civilians. On 2June 1944 the director of the Strategic and Logistic Planning Unit advisedThe Surgeon General that a demand for continuation of the dental ASTP couldno longer be supported on the basis of military requirements,150and in drawing up recommendations for future ASTP training in the medicalsciences The Surgeon General recommended, on 9 June 1944, that the dentaland veterinary programs be dropped. On the protest of the Director of theDental Division, however, this request was withdrawn on 27 June and resubmittedto provide for a continuation of dental training. In reply, The SurgeonGeneral was advised on 1 August 1944 that the War Department General Staffhad definitely decided to drop the dental ASTP.151 This statementcame as an anticlimax, however, since the termination of the dental ASTPhad already been announced by the War De partment on 18 July 1944.152Under the terms of this latter directive all senior students, numberingabout 1,175 men, were to be allowed to complete their courses, when theywould be commissioned in the Dental Corps. Dental students not in theirfinal year (about 4,810 men), and predental students who would completetheir preliminary training at the end of the current term and who heldacceptances for dental courses beginning prior to 31 December 1944,
148Memo, Brig Gen W. L. Weible for SG, 18 Apr44, sub: War Department policy governing training in medicine and dentistryunder ASTP. SG: 353.9-1.
149Ltr, Col J. R. Hudnall to Comdt, 3930 Service Unit, ASTU,University of Southern California, Los Angeles, Calif., 1 Jul 44, sub:Disposition of senior dental ASTP trainees on date of graduation. SG: 000.8(University of S. Calif.) W.
150Memo, Lt Col Durward G. Hall for Deputy SG, 2 Jun 44, sub:Demand schedule for ASTP graduates. SG: 353.9-1.
1513d Ind, Brig Gen Russel B. Reynolds, 1 Aug 44, on Ltr, ColJ. R. Hudnall to CG ASF, 9 Jun 44, sub: Requirements for ASTP graduatesfor last nine months of 1944 and the year 1945. SG: 353.9-1.
152Ltr, Maj Gen M. G. White, ACofS G-1, to CG, ASF, 18 Jul 44,sub: ASTP dental program. SG: 353.9 (Med).
140
were to be discharged from the Army at the end of the term, to continuetheir education at their own expense. Students who could not meet theserequirements (about 722 men), or who could not pay for their own schooling,were to be transferred to the Medical Department as enlisted men. The dentalASTP was thus limited to senior students in July 1944 and it came to anend with the classes graduating in April 1945.
Cost of the Dental ASTP. It is difficult even to estimate thecost of the dental ASTP since such unknown factors as the expense of providingmedical care for trainees and the potential cost of veterans' benefitsfollowing the war were involved. Some of the more important items, calculatedto 12 October 1945, have been reported as follows:153
Academic cost per student per month (tuition, books, instruments) | $64.90 |
Housing (at institutions) | 9.04 |
Housing (on commutation) | 37.50 |
Food (at institutions) | 31.50 |
Food (on commutation) | 54.00 |
The monthly cost for academic expenses, food, and housing thus variedfrom $105.44 for students housed and fed under contract, to $156.40 forstudents granted commutation for housing and food obtained on their ownresponsibility. To this amount must be added at least $50 per month forsalary, plus an unknown amount for overhead, including the salaries ofmilitary administrators, hospitalization, travel, et cetera. Money receivedfrom the resale of books and equipment after the termination of the programreduced the above cost for academic expenses by about $8.00 per month.
Results of the Dental ASTP. The following tabulation summarizesthe results of the Dental ASTP:
Number of dental schools participating | 39 | |
Number of months in operation | 26 | |
Total dental students enrolled | 7,734 | |
Disposition of 7,734 enrollees: | ||
Graduated | 2,458 | |
Discharged to continue at own expense at end of program | 4,651 | |
Failed | 472 | |
Dropped for other reasons | 101 | |
Transferred to Medical Department as enlisted men | 52 | |
Disposition of 2,458 graduates: | ||
Commissioned in the Dental Corps | 1,914 | |
Discharged for lack of vacancies, June and July 1944 | 113 | |
Commissioned by Veterans Administration, mainly in June and July 1944 | 36 | |
Commissioned by Navy, same period | 269 | |
Disqualified for physical or other reasons | 126 | |
Predental students enrolled | 1,407 | |
Completed predental training | 499 | |
153Statistics relating to the dentalASTP program. Published by the Training Contracts Section, Production andPurchases Div, ASF, undated. HD: 314.
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Discussion, Dental ASTP. The Dental ASTP was bitterly criticizedalmost from its inception until long after it had gone out of existence,indicating the need for a, careful evaluation of the objectives and policiesinvolved in order to avoid similar difficulties in any future emergency.
Probably the most fundamental criticism was based on claims that therewas actually no need for the military to venture into the unfamiliar fieldof undergraduate professional education. The profession, the schools, andthe public were of course interested in maintaining an adequate flow ofdental graduates and in keeping the dental schools operating in a healthycondition. It has already been pointed out that various professional andgovernmental agencies, which apparently did not have full confidence inSelective Service's intentions, had repeatedly requested the Armed Forcesto give students inactive military status to insure their deferment. Butthe professional agencies, at least, vigorously opposed the more detailedinvolvement of the Army and Navy in the administration of dental education,even though the actual instruction was left to the established schools.As early as May 1943 the position of the ADA was stated as follows:154
... recalling vividly the awkward blunder of the administrationof the Student's Army Training Corps in World War I, which, but for theprovidential Armistice in November 1918, would probably have led to thecollapse of higher and professional education, we have hoped profoundlythat dental education might be spared military regimentation during thiswar. With every wish to see competent dentists provided promptly and unhesitatinglyfor the Army and the Navy, as they happily have been, and, we believe,will continue to be, we are concerned about the working out of a systemof dental education "by contract" with, the Army and Navy. Wegravely question whether the common end to be gained, about which thereis no debate, may not be accomplished more economically, more expeditiously,with sounder educational procedure, with greater assurance of a steadysupply of new entrants to dental practice to meet civilians as well aswar service needs with greater safety for the future of the profession,by the conduct of the dental schools free from the inevitable effects ofArmy and Navy regimentation. . . .
After all this military machine does its work, it willtranspire, we predict, that there was really no occasion or necessity fordoing anything. What more do the Army and Navy want than a steady flowof well-trained dentists to meet their replacement needs? The dental schoolscould have gone on and would have gone on cheerfully without any overlordshipor regimentation, and, indeed, without any financial aid. . . . All theGovernment needed to do was to establish a sensible working scheme forthe deferment of enough bona fide high school and liberal arts collegestudents to sustain the present enrollment in dental schools...
In justification of the Armed Forces' decision to place dental studentson active duty, it should be noted that the opinion that professional traineeswould be content to remain in school if they were assured of defermentwas not universally accepted. Even the Secretary-Treasurer of the AmericanAssociation of Dental Schools reported that "the average student ofthe desirable type took a rather dim view of deferment while other youngmen of his age were in
154Dental education in wartime. J. Am. Dent.A. 30: 741-749, 1 May 43.
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uniform, " and he stated that "assignment [to the Armed Forces],as a principle, appeared to be the most desirable, although uneconomicprocedure."155 The feeling that if young men were to begiven deferment from dangerous duty to remain in school the Armed Forcesshould select those to be given that oppose tunity, and that those selectedshould be paid so that such preferred treatment would not be based on economicstatus, has already been mentioned. By the time the dental ASTP was inaugurated,however, it was already reasonably clear that no general voluntary exodusfrom the professional schools need be anticipated in World War II, andthat deferment would in itself be sufficient stimulus to keep a sufficientnumber of dental students in training. Enrollment in the dental schoolshad, in fact, actually increased from 7,184 in 1937 to 9,014 in 1943, whenit was higher than at any time since 1928.156 The contensionthat any qualified individual should have equal opportunity to obtain defermentfor professional education, regardless of ability to pay, was a plausibletheory, but in practice the ASTP had to be set up with students who had,for the most part, already been pursuing their courses for from 1 to 5years, and who were presumably already assured that they would be ableto pay the necessary costs. Thus it was found, when the dental ASTP wasTerminted in 1944 and students were forced to continue at their own expense,that only a little over 1 percent had to drop out. Whether the professionalstudent was entitled not only to deferment in time of war, but to the salveto his feelings which was provided by the fact that he was placed in uniform,is at least open to question.
The belief that the personnel needs of the Dental Services of the ArmedForces could not be met unless dental students were placed under militarycontrol has also been challenged. When ASTP was first being considered,in the fall of 1942, the Army Dental Corps was faced with a procurementobjective of over 7,000 officers for 1943, and there is every indicationthat some difficulty in getting this number of dentists was anticipated.(See chapter III) Selective Service had shown its inability to draft dentistsin significant numbers, and it was apparently felt that dental studentsshould be required to make themselves available for immediate militaryservice on graduation in return for the privilege of deferment. The Directorof the Dental Division stated in August 1944 that:
The Dental Corps at one time had an anticipated procurementobjective of at least 25% more than the maximum level reached...
It has been stated that the Army could have attained allthe dental officers desired without the ASTP, and that the dental schoolscould have produced just as many officers for the Army. This statementin all probability is true, but the fact is that the procurement objectivefor dentists was never reached in many of the states. There was no mechanismwhereby dentists could be drafted except through the normal channels ofSelective Service. That many dentists refused commissions in
155Personal Ltr, Dr. John E. Bulher to ColWilliam Wilson, 11 May 48.
156Horner, H. H.: Dental education and dental personnel. J.Am. Dent. A. 33: 872-888, 1 Jul 46.
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the Army is a fact that nearly every State Dental Procurementand Assignment chairman can testify. Many dentists . . . preferred to havethe other fellow go. These facts, and those associated with the potentialmilitary needs, caused the War Department to include dentistry in the ASTP.
After the war the Director of the Dental Division noted that:
. . . when the ASTP was initiated said program was justifiedfor the reason that it was impossible to predict the length of the warand available dentists in civilian life were limited. It is believed, however,that the Army Dental Corps needs could have been satisfied without theAST Program.157
The ASTP predental training was criticized by dental educators who feltthat the five-term course was inadequate. At the invitation of The SurgeonGeneral representatives of the professional schools met in January 1943to advise on the premedical, predental, and preveterinary courses. Thiscommittee, which included three dental educators, recommended a commonprogram for all branches of medical science and they advised that six semestersof 12 weeks each be allowed for preprofessional schooling. It recommendedfurther that the course include the following minimum requirements:158
English | 6 semester hours |
Physics | 6 semester hours |
Biology | 6 semester hours |
General chemistry | 8 semester hours |
Organic chemistry | 4 semester hours |
An additional 30 hours were to be selected from optional technical subjects,depending upon the facilities of the school and the desires of the student.The curriculum finally approved by ASF has been described in paragraph4, page 137.
The charge that dental educators had not been consulted is certainlyopen to question, though one dental representative on the committee statedlater that they had accepted the final plan in an effort to make the bestof a program which they had personally thought ill-advised, but which hadbeen definitely decided upon by the War Department.159
The effect of the ASTP on the morale of other military personnel wasunfavorable, but difficult to evaluate in respect to degree. The youngmen who had been taken from a school of business administration and sentto New Guinea could not always understand why the able-bodied boy nextdoor was continuing his dental education as before, except that now theGovernment took care of his expenses and paid him a salary. The paratrooper'spride in his skill as a fighting man was apt to be dampened when he heardthat college students at home were wearing uniforms which the general publiccould not distinguish from the one he was currently wearing in a foxholeon the wrong side of the Rhine. This type of "discrimination"was regrettable but unavoid-
157See footnote 9, p. 107.
158Ltr, SG to Dir ASTP, 2 Jan 43, sub: Premedical and medicaleducation. SG: 353.9-1.
159Army specialized training program. J. Am. Dent. A. 31:1149-1154,15Aug 45.
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able if there was to be no break in the training of replacements forvital occupations, but the opinion was widely held and expressed that theArmy had done enough when it guaranteed deferment for professional students,without subsidizing them and giving them the status of soldiers.
Probably the most bitter criticism of ASTP came from dental officersof the Armed Forces, especially when it was announced in 1944 that recentgraduates would be released to civil life. Dental officers on militaryduty were not always in full possession of all the facts concerning theASTP, and the fairly common belief that dental students had been educatedat Government expense and then released to enjoy the lucrative practiceat home is understandable, if not entirely justified. Actually, no dentalstudent received all, or even a major part, of his schooling under ASTP.Juniors entering the program in 1943 received up to 2 years of educationat Government expense; others received a maximum of about 1 year sinceonly seniors were continued in the course after July 1944. Also, in spiteof the Army decision to release graduates in June and July 1944 only asmall proportion entered civil practice. The lack of vacancies at thattime was temporary, and all qualified men graduating from July 1944 untilASTP ended in April 1945 were given commissions in the Army Dental Corps.All but 113 of the physically qualified graduates of the dental ASTP eventuallyentered the Army, Navy, Veterans Administration, or the Public Health Service.160(For a discussion of the reasons why ASTP graduates were not commissionedin the summer of 1944 see chapter III.)
Even a considerable number of the critics of ASTP held that once ithad been established it should have been kept in operation until the endof the war, both to assure continued replacements for civilian practiceand to provide dental officers when it became necessary to demobilize veterandentists after the end of hostilities. Colonel Fitts states in his reportthat:
It is extremely interesting to note that the curtailmentand termination of both the dental and veterinary training programs haveproved to have been premature and ill-advised. The lack of replacementsfor dental officers has required the retention of dentists in the activemilitary service for periods in excess of those required for emergencymedical officers, with resulting criticism and dissatisfaction. The dentalASTP trainees who were discharged in order to continue their studies ascivilians have upon graduation been under no obligation or compulsion toenter the military service either as enlisted men or officers. Effortsat the recruitment of volunteers as replacements among this group haveproved completely futile and on 24 May 1946 the War Department placed aspecial call on Selective Service for the draft of dentists.
Though the Director of the Dental Division and The Surgeon General hadadvised against the termination of the dental ASTP, the War Departmentappeared to feel that it could not justify the program when the DentalService was refusing to accept graduates for lack of vacancies. At thetime the dental ASTP was terminated the demand for combat troops was socritical that
160Memo, Brig Gen J. J. O'Hare, Chief, ManpowerControl Group, to Gen Willard S. Paul, ACof S G-1, 8 May 46, sub: DentalASTP program. SG: 353 (Student training).
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partially trained pilots were being transferred to the infantry, andmedical units overseas were being stripped of able-bodied enlisted men,who were replaced with untrained, limited-service personnel. It may ormay not be held that the action taken was unjustified, but it cannot beargued that the reasons which motivated the War Department were trivial.(See also the discussions of this problem in chapters III and IX.)
The Deferment of Instructors in Dental Schools
The question of maintaining the faculties of the dental schools duringthe war did not at first receive the attention given the maintenance oftheir student bodies. Some increase in the load carried by individual instructorswas possible, and as a group the teachers were less likely to be subjectto induction under Selective Service because of age. The problem eventuallyassumed important proportions, however, and its solution involved the ArmedForces, Selective Service, PAS, and various other organizations and agencies.
Instructors were not mentioned in the first bills introduced in Congressto provide for the deferment of dental students. A modification of theearlier Murray bills, introduced in the Senate in February 1941, directedthe exemption of professional instructors, but this legislation, and latersimilar acts, met the same fate as the various bills to defer students.161Selective Service also omitted consideration of instructors in its earlydirectives concerning occupational deferment, but on 20 June 1941 all StateDirectors were advised that serious consideration should be given to theexemption of individuals found necessary for the instruction of studentsin critical occupations.162
Early in 1943, PAS became interested in this problem and conducted asurvey to determine the actual situation.163 Thirty-eight dentalschools were found to have 2,000 instructors, of whom 1,200 were declaredto be essential by the schools themselves. Fifty percent of the instructorswere under 45 years of age, and 40 percent were under 40 years of age,but no attempt was made to obtain more detailed information on eligibilityfor induction under Selective Service. The medical schools were found tovary greatly in the proportion of instructors declared essential, froma minimum of 10 percent to a maximum of 98 percent; similar figures werenot given for the dental schools, but comparable variation was reportedto exist. PAS recommended that 12 instructors be allowed for the first100 students in professional schools, and that 9 instructors be authorizedfor each additional 100 students, but it was found that few schools approachedthe calculated ideal. Individual institutions varied from a minimum ofonly 40 percent of the recommended total of instructors to a maximum of206 percent. PAS appealed to the schools to adhere to the proposed ratio,but the results of this effort, if any, are unknown.
161See footnote 100, p. 129.
162See footnote 107, p. 130.
163Minutes of committee on Dentistry, PAS, 13 Feb 43. Natl Archives,PAS files.
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The professional press carried numerous discussions of the shortageof dental instructors, but factual data on this subject, beyond that reportedby PAS, have not been revealed. After the war the Secretary-Treasurer ofthe American Association of Dental Schools advised that in any future emergencyit was essential that professional schools be assured an adequate complementof trained teacher personnel, either by deferment or by assignment fromthe military forces after being taken on active duty.164
Summary, Dental Undergraduate Education, World War II
In spite of outspoken criticism of many aspects of the handling of professionalstudents during World War II it is clear that the primary objective, tomaintain the dental schools and to provide a continuing flow of graduates,was attained. Shortly after automatic deferment was ended in July 1941,over 80 percent of all dental enrollees were already being deferred bytheir local boards on an occupational basis. More vigorous action by SelectiveService in late 1941 and in 1942, and the granting of inactive militarystatus by the Armed Forces, not only maintained enrollment, but increasedit by 1943 to the largest figure since 1928. Average registration in thedental schools in the 5 war years, from 1941 through 1945, was 8,416 students,compared with an average of only 7,354 students in the 9 years from 1932through 1940.165
It would seem that World War II policies in respect to the defermentof professional students cannot be criticized for impeding dental education;it is not equally certain that they should not be criticized for actuallyincreasing the number of students registered in professional schools inwartime. The need for a long-term augmentation of training in the medicalsciences cannot be denied, but the propriety of a major increase in enrollmentin dental schools in a time of national emergency, when the desire fordeferment from dangerous military service was presumably a strong motivefor seeking a professional education, is at least open to question. Studentswho were already enrolled in the dental schools, or who had begun theirgeneral university preparation with the specific purpose of entering dentaltraining, were of course above suspicion in this respect, but since averageenrollment during the war exceeded the prewar average by more than a thousandmen it is difficult to escape the conclusion that a considerable numberof men of military age took up the study of dentistry for reasons directlyor indirectly connected with the war. To the extent that these men weremotivated by a desire to escape military duty, rather than by a strongdesire to enter the profession of dentistry, their deferment could hardlybe a cause for satisfaction, either to the profession or to the public.It would seem that agencies responsible for the exemption of professionalstudents should, by voluntary agreement if possible, limit such exemptionto a number consistent with average normal enrollment.
164See footnote 155, p. 142.
165Enrollment data from 1932 through 1945 obtained by authorfrom the Washington office of the ADA, 26 May 48.
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It is true that the end of ASTP in 1944, and the simultaneous terminationof Selective Service deferment for predental students, would have resultedin a serious situation if the war had not come to a close in a short time.In October 1945 only 1,197 freshmen dental students were enrolled, comparedwith 2,496 the year before,166 and it was estimated that asa result there would be only about 1,000 graduates in 1948.167It is highly probable that both the actions which led to this situationwere based on a reasonable belief that hostilities would not be prolongedafter 1944, but the ensuing rapid reduction in freshmen enrollment emphasizedthe need for assuring continuous predental education if the dental schoolsare to continue their operations.
The ideal mechanism for providing deferment for students in essentialoccupations was not found during World War II. Attempts to attain thatend through legislation failed because they conflicted with the basic concept,accepted by Congress, that no group should be granted blanket preferredconsideration under the Selective Service law. Any exception to that policywould probably result in strong political pressure to have the privilegeextended to an ever-widening population. Even if blanket deferment of dentalstudents were authorized, the administration of such a policy would entailserious difficulties; if no restrictions were prescribed the schools wouldsoon be flooded with applicants who were interested mainly in exemptionfrom military duty, and if the number to be deferred were limited, thequestion of determining which men should be accepted would involve knottypolitical and administrative problems.
The Selective Service System was of course charged with formal responsibilityfor determining which individuals should be inducted and which should beallowed to continue in training for essential occupations, and it actuallyauthorized most deferments of dental students until the Armed Forces startedgranting inactive Reserve commissions in late 1941 and early 1942. SelectiveService was again left to carry almost the entire burden of exempting dentalstudents after the Armed Forces abandoned their dental undergraduate programsin 1944, and during all this period a considerable number of professionalstudents who were not eligible for, or who did not desire, military statuscontinued their education under Selective Service policies. It has beenpointed out, however, that in spite of this record many dental educators,members of the profession, and even governmental agencies responsible fornational health, had serious misgivings concerning Selective Service'swillingness and ability to follow a consistent course which would insurethe regular operation of the schools. Selective Service was committed toa policy of placing heavy responsibility on the local boards, on the theorythat they were most familiar with circumstances which affected individualpriority for induction, and critics appear to have felt that the localboards lacked the technical background for
166See footnote 120, p. 132.
167See footnote 156, p, 142.
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selecting dental students and that they could not be relied upon tofollow the general policies recommended by national agencies which werefamiliar with larger aspects of the problem of continuing training in thehealth services. This fear does not seem to have been supported by thefacts since enrollment in the dental schools increased steadily from 1940through 1943, though it was reported that individual boards refused todefer professional students.
The suitability of Selective Service as the agency to defer professionalstudents may be questioned on more fundamental grounds. The entry of themilitary into the educational field minimized Selective Service's problemby the time it became necessary to choose large numbers of new students,and it will be seen later that Selective Service actually delegated muchof its nominal authority to the dental schools. If it had retained fullresponsibility in this matter during the entire war it would ultimatelyhave been faced with the necessity for finding acceptable answers to suchproblems as the following:
1. How many students should be granted deferment each year to take upthe study of dentistry?
2. How should students be allocated geographically and according toschools? Should state quotas be determined? Rural and urban? Racial? Shouldwartime quotas attempt to correct longstanding peacetime imbalances inthe distribution of dentists? How assure that state universities wouldaccept a reasonable proportion of students from adjoining states havingno dental schools?
3. How coordinate the actions of local boards which had no way of comparingthe qualifications of their applicants with those appearing before otherboards?
4. How select approximately 2,000 students each year from some 10,000applicants so as to insure deferment for those who were most likely tosucceed in school and in the practice of the profession? Could this selectionbe left to the schools without risking charges of favoritism? Should SelectiveService set up agencies for investigating scholastic records, giving aptitudetests, and otherwise determining the relative eligibility of thousandsof would-be dental students?
5. Should ability to pay for a dental education be a deciding factorin the selection of students for deferment in time of war?
6. How eliminate applicants who were interested in deferment ratherthan in the practice of dentistry? A similar situation arose very earlyin the war when it became apparent that Selective Service alone could nothandle the problem of procuring physicians, dentists, and veterinarians,on the basis of individual liability for military service, without endangeringthe health services of the nation. In this instance the Procurement andAssignment Service of the War Manpower Commission was established to renderexpert advice, though coopera-
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tion between the two agencies sometimes left much to be desired. Itis possible that with the assistance of some such body of professionalexperts, either in or out of its own organization, Selective Service couldhave handled the question of deferring students with reasonable satisfaction,but it seems probable that a purely lay body would have been on unfamiliarground had it attempted to administer such a highly technical matter unaided.
It is noted above that during the period when it was nominally responsiblefor the deferment of dental students Selective Service actually delegatedmost of its responsibility to the schools. Students already enrolled weregenerally continued in their studies without question by the SelectiveService boards, and the deferment of new applicants was normally basedon acceptance for admission to a dental school. For all practical purposes,therefore, the deans of the professional schools had the final decisionin determining which applicants would be accepted to continue their educationand which would be rejected and inducted into the Armed Forces. It is clear,from published criticisms of the Army and Navy programs, that the dentalschools preferred to select their own students, and that they wanted nothingfrom any governmental agency but deferment of the men chosen.168The Armed Forces entered the situation before the results of this policycould be fully determined in World War II and there is no evidence thatthe deans of the dental schools did not choose applicants as impartiallyas possible, on the basis of their desirability for the profession as interpretedby the deans themselves. It is possible, however, that with the best intentionsin the world both the schools and Selective Service would ultimately havecome in for serious criticism if the matter had not been largely takenfrom their hands by the inauguration of the Army ASTP and the Navy V-12programs.
In the first place, it is doubtful if dental educators, as individuals,were any better fitted than Selective Service to answer such questionsas the following:
1. How many students should be admitted? During the war the capacityof the school was apparently the deciding factor in most cases, and itappears that the schools and the profession escaped criticism for the resultinggreat increase in enrollment only by sheer good luck.
2. Should students be selected purely on the basis of individual qualifications,or should some effort be made to apportion vacancies on a geographicalbasis? If the latter, how?
3. How could a dental school supported by state funds resist strongpolitical pressure to limit deferment to citizens of that state, so asto provide for students who normally came from adjoining states with nodental schools of their own? if vacancies were to be reserved for out-of-statestudents, how should they be apportioned among the many schools which mightbe called upon to accept such students? Who would enforce such apportionment?
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4. If questions of the fair allotment of vacancies could be solved byvoluntary cooperation between schools, how could accepted policies be implementedthrough Selective Service, which alone could grant actual deferment?
5. How select a few thousand new students from the many thousands ofapplicants each year? Educators were presumably best fitted to determinethe scholastic qualifications of applicants, but even the opinions of expertsin this field are notoriously fallible. During World War II the problemwas further complicated by the fact that in order to insure his defermentuntil he could complete predental requirements, a dean often had to "accept"a dental student soon after graduation from high school, long before hiscapacity to absorb highly technical university training had been established.The increasing reliability of aptitude tests also suggests that in thenear future trained personnel administrators may be able to select prospectivedental students with greater accuracy than educators relying upon theirown impressions and upon scholastic records, but neither personal impressionsnor aptitude tests will eliminate the opportunist who is interested indraft deferment rather than in the practice of dentistry.
Such problems can be solved only by an agency which has full informationon national as well as local needs, which has close liaison with the ArmedForces, with Selective Service, with other interested governmental activities,and with the professional organizations; and which has sufficient officialauthority to insure adequate consideration for its recommendations.
Potentially at least, the greatest objection to leaving the defermentof students to dental educators is probably the degree of personal responsibilityinvolved. It has already been pointed out that wartime enrollment in thedental schools exceeded normal peacetime registration by more than a thousandmen, and that Selective Service boards openly charged that the universitieswere "havens for slackers."169 So far as is knownthe corollary charge, that the schools were using the national emergencyto swell their own income, was never made, but the possibility that itwould be was constantly present. it seems highly probable that most deanswere influenced only by a sincere desire to provide needed personnel forthe profession, but the administration of any policy having to do withexempting individuals from dangerous duties in war-time inevitably andproperly receives close scrutiny from Congress, the public, and the press,and the opportunity for misunderstanding is enormous. The objections toallowing any private individual or organization to select men to receivesuch a fundamental privilege as exemption from military service are obvious.It is probable that if the deans had carried this heavy responsibilityduring the entire war they would ultimately have become targets for suchvigorous criticism, and such political and personal pressure, that theywould have welcomed the intervention of some official or semiofficial agencyroughly similar to the Procurement and Assignment Service.
169See footnote 96, p. 126.
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The military were probably least qualified of all agencies to selectnew professional students, and it is difficult to find theoretical or practicaljustification. for the Army and Navy becoming involved in such extraneousmatters in a national emergency. The Armed Forces initiated their WorldWar II training programs with men already enrolled in dental schools orin pre-dental preparation, and had the assistance of dental educators inselecting new applicants during the short time they were directly concernedwith dental undergraduate instruction, but this field was so remote frommilitary activities that it would seem more appropriate to leave it toother agencies. Much can also be said for the early contention of the WarDepartment that the military should not involve itself with any phase ofprofessional education beyond the minimum steps necessary to insure sufficienttrained replacements, and that questions of deferment of professional studentsto meet the needs of the civilian population should properly be the responsibilityof Congress, Selective Service, the Federal Security Agency, the War ManpowerCommission, and other nonmilitary organizations. The fact that at leastsome of these agencies considered it necessary to request the Armed Forcesto assume such an unfamiliar role in World War II emphasizes the need fora clear and enforceable policy on student deferment at the start of mobilization.
The statement of the Director of the Dental Division after the war,that Army requirements for dental officers could have been met withoutrecourse to the ASTP, seems well substantiated.
AUXILIARY DENTAL PERSONNEL
Period Before World War II
Soon after contract dentists were first authorized it was provided thateach would have an enlisted assistant detailed from members of the HospitalCorps and that these assistants would be under full control of dentistsduring duty hours.170 As early as 1904, Dr. Marshall reportedto The Surgeon General that it was difficult to obtain enlisted assistants,and that competent men became dissatisfied with the long hours, confiningwork, and lack of opportunity for advancement incident to assignment tothe Dental Service.171
In World War I, about 5,000 enlisted assistants were on duty with 4,620dental officers. These men were detailed from Medical Department enlistedpersonnel and were largely trained by the officers with whom they worked.
In the period between World Wars I and II, dental auxiliary personnelcontinued to be obtained from the Medical Department though provision wasmade in Army regulations for special detail of enlisted men to the DentalService.172 Men so detailed, on the authority of The SurgeonGeneral, were
170Manual for the Medical Department, 1906.Washington, Government Printing Office, 1906, p. 40.
171Ltr, Dr. John S. Marshall to SG, 16 Feb. 04. Natl Archives:70760-27.
172AR 40-15, 28 Dec 42.
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to be more directly under the control of dental officers for trainingand duty than would those merely assigned, and it was believed thatthis provision would ensure a more stable source of auxiliary dental personnel.In practice few men were ever so assigned and the merits of the plan werenever determined. It was abandoned completely in May 1943.173
Before World War II, it was generally believed by enlisted men of theMedical Department that duty with the Dental Service meant long hours andloss of opportunity for promotion. Dental officers spent months traininglaboratory technicians and chair assistants, knowing all the while thatthe best grade they could offer in their relatively small clinics wouldbe that of private first class or corporal, and that as soon as these menhad sufficient service to be considered for promotion they would have totransfer to the surgical service or medical supply. The alternative wasto accept those misfits who had no ambition or hope for advancement. Seldomcould the Dental Service offer grades comparable to those available inother, larger departments. Further, when the enlisted man of the DentalService was examined for promotion he was questioned on general medicalsubjects in which men assigned in other services had the obvious advantage.As a result, service in the dental clinic came to be regarded as a deadend on the road to promotion. There was very little change in this situationuntil the start of World War II.
Auxiliary Personnel, World War II
Mobilization for World War II brought considerable improvement in theadequacy and status of auxiliary personnel provided the Dental Service.In June 1941, only 1,488 enlisted men and a limited number of civilianswere on duty with dental installations.174 In September 1943,13,851 enlisted men and 2,441 civilians were so engaged,175and by January 1944 the number had in creased to 15,585 enlisted men and2,410 civilians.176 The percentages of men in the various gradesand a comparison with grades held by enlisted men of the Medical Departmentas a whole were as follows:
| Grade* | Dental Service (Total Army) | Dental Service (Continental US) | Medical Dept. (Continental US) |
| Percent | Percent | Percent | |
| Master sergeant | 0.06 | 0.09 | 0.50 |
| Technical Sergeant | 0.48 | 0.61 | 1.50 |
| Staff sergeant and technician 3/c | 4.36 | 3.84 | 5.00 |
| Sergeant and technician 4/c | 13.60 | 12.72 | 11.70 |
| Corporal and technician 5/c | 44.01 | 39.19 | 17.80 |
| Private first class | 20.35 | 23.56 | 23.10 |
| Private | 17.11 | 19.96 | 40.90 |
*308 Wacs in unknown grades are not included in abovepercentages for the Dental Service.
173AR 40-15, C 1, 10 May 43.
174History of the Army Dental Corps, Personnel, 1940-43. HD:314.7-2.
175Ibid.
176Annual Rpt, Dental Div SGO, 1945. HD.
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It is apparent that the enlisted man of the Dental Service had a poorchance of reaching the, top three grades, but he had a better chance thanthe enlisted man of the Medical Service to reach the grades of sergeantand corporal.
By June 1944, enlisted personnel were being replaced somewhat by civiliansand the number of enlisted men on duty had dropped to 14,859 while thatof civilians had increased to 3,446. These figures remained substantiallyunchanged until the start of demobilization.177
When initially assigned to the Dental Service all enlisted assistantshad completed from 8 to 17 weeks of basic military training; many had noother experience in the duties they would have to perform.
Dental Laboratory Technicians. One of the first problems to besolved by the Dental Service in World War II was a severe shortage of dentallaboratory technicians. When the dental requirements for induction wereconsiderably relaxed in October 1942, the disqualification rate for dentalreasons sharply decreased and by the end of 1942 it reached the level of0.1 percent. It remained at about that level for the remainder of WorldWar II.178 To meet the needs of the hundreds of thousands ofmen who would previously have been considered unfit for military duty,the Army was eventually to construct over two and a half million dentures,requiring a mobilization of laboratory facilities on a scale not foreseenin early planning.
To meet this need for increased laboratory facilities, the Army couldcount on inducting only a fraction of the required personnel. A surveyby the Dental Laboratory Institute of America and the American Dental Associationshowed that in 1942 there were only a. little over 12,000 trained dentaltechnicians in the entire United States.179 Many of these wereineligible for induction because of age or dependency, and when it is notedthat about one-third of all men actually called by Selective Service duringWorld War II were rejected for physical and mental reasons, it is apparentthat but a few laboratory men could be taken from the civilian reservoir.It should be noted that civilian demand for dental prosthetic appliancesalso increased greatly during the war because of the rapid rise in generalincome levels. A sample group of laboratories questioned early in 1942reported that they had lost about 18 percent of their technicians.180If this proportion held throughout the country the Armed Forces inductedabout 2,200 laboratory workers from this source.
To make the situation worse, many of the dental technicians taken intothe Armed Forces during the first part of the war were lost to the DentalService.181 The test group of laboratories previously mentionedreported that only 44
177Unpublished data from the files of the DentalDivision. Abstracted by Lt Col John C. Brauer, DC, Dent Div SGO.
178Unpublished data from the Medical Statistics Div, SGO.
179Complete survey of dental laboratory technicians to be undertakenby committee. J. Am. Dent. A. 29: 2060, 1 Nov 42.
180Ibid.
181Proceedings of The Surgeon General's Conference with CorpsArea and Army Dental Surgeons, 8-9 Jul 42, p. 11. HD: 337.
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percent of their inducted laboratory men were sent to duty with theDental Corps. Some were assigned from the reception centers to nonmedicalunits, probably on the basis of mechanical ability; others were assignedas chair assistants because Army classification procedure at first failedto distinguish clearly between laboratory and assistant functions.182The latter mistake was readily correctable, except when technicians takenfrom Zone of Interior laboratories were assigned as chair assistants tounits going overseas, in which case they were often irrevocably lost tothe prosthetic service.
On 23 November 1942, on the advice of the Director of the Dental Division,the chief of the Personnel Service, SGO, asked Army Service Forces to takesteps to insure that dental laboratory technicians would be assigned tothe Medical Department, and requested further that the forces in the UnitedStates be combed for technicians who had already been assigned to otherbranches.183 At about the same time the ADA and the Dental LaboratoryInstitute of America cooperated to make the survey of laboratory manpowerwhich has already been mentioned and to furnish the Dental Division, SGO,with the names of inducted technicians so that a check could be made oftheir current assignments. In January 1943 the Dental Division also requestedthat the practice of assigning laboratory men to chair assistants' dutiesbe stopped.184
In February 1943 it was reported that The Adjutant General was takingthe following steps:185
1. Directing an Army-wide report on dental technicians performing otherduties.
2. Requesting from the Surgeon General's Office a, list of vacancies fordental technicians.
3. Notifying reception centers to send all inductees with laboratory experienceto the nearest Medical Department replacement training center for assignment.
While few dental technicians were assigned outside the Medical Departmentafter the spring of 1943, another critical situation soon arose when ASFdirected that personnel fitted for general overseas assignment would notbe retained in service commands in the United States. Some laboratory menwere of course required overseas, but in April 1943 the Director of theDental Division complained that Zone of Interior installations were beingstripped of dental mechanics who were subsequently being assigned to tacticalunits as dental chair assistants.186 He strongly recommendedto ASF that dental laboratory men be assigned only to those organizationshaving prosthetic facilities. Two
182AR 615-26,15 Sep 42.
183Ltr, Chief, Pers Serv, SGO, to Dir, Mil Pers, ASF, 23 Nov42, sub: Dental technicians. SG: 221 (Technologists).
184Memo, Dental Div. SGO for Pers Serv, SGO, 28 Jan 43. SG :221 (Technologists).
185Memo, Dir Tng Div, SGO, for Pers Serv, SGO, 26 Feb 43, sub:Dental laboratory technicians (067). SG: 221 (Technologists).
186Ltr, Chief, Pers Serv, SGO, to Dir, Mil Pers, ASF, 7 Apr43, sub: Dental laboratory technicians (Dental Mechanics). SG: 221 (Technologists).
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days later The Adjutant General, authorized The Surgeon General to makehis own arrangements to that end with the individual service commands concerned.On 14 April 1943 The Adjutant General notified The Surgeon General thata, separate personnel category (SSN 067) had been reserved for dental technicians,to distinguish them from dental chair assistants (SSN 855), paving theway for a clear definition of the two types of duty in drawing up tablesof organization.187 The new classifications were published ina memorandum from The Adjutant General's Office (AGO), dated 13 May 1943.188
These measures did much to prevent the waste of laboratory men in routinejobs. In January 1944, however, the whole matter was again thrown intoconfusion when ASF placed laboratory men in the "scarce" categoryand directed that they would not be assigned to any overseas organization.189190 This action was apparently designed to prevent the misuse ofsuch personnel, but it overlooked the fact that a limited number of technicianswere needed in theaters of operations, and the Director of the Dental Divisionimmediately recommended modification of the order. A letter was subsequentlyprepared for the Commanding General, ASF, listing the specific units inwhich the assignment of laboratory men was essential,191 andthe misunderstanding was corrected in a War Department circular of 4 April1944.192 A supplementary order of 29 May 1944 directed thatdental technicians would be used only in the duties for which they hadbeen trained.193
Steps to improve the utilization of laboratory personnel proved generallyeffective, but they did not prevent a minor loss of technicians to otherduties. Hospitals sometimes reclassified dental technicians as chair assistantsto avoid an excess of this category over the numbers permitted by tablesof organization, but in such cases the individual usually continued toperform his old duties as long as he remained with the unit. If he weretransferred, however, he was likely to be assigned on the basis of hisspecification serial number. In other cases the authorization for laboratorytechnicians was revoked for certain units, and the men holding laboratoryratings were sometimes reclassified under such circumstances to preventtheir loss to the organization. Keeping dental technicians assigned totheir proper duties was a continuing problem for the Dental Service throughoutthe war.194
A defect of the broad classification of "dental technicians"was that it failed to specify individual special skills or degrees of experience.Both Army and civilian laboratories normally function on a "productionline" basis, with
187Memo, TAG for SG, 14 Apr 43, sub: Dentallaboratory technicians. SG: 221 (Technologists).
188AGO Memo W 615-45-43, 13 May 43, sub: Revision of specificationserial numbers--AR 615-26. SG: 221 (Technologists).
189ASF Cir 26, 24 Jan 44.
190ASF Cir 50, 16 Feb 44.
191Ltr, Chief, Oprs Serv, SGO, to CG, ASF, 3 Mar 44, sub: Dentallaboratory technicians (067). SG: 300.5-5.
192WD Cir 130, 4 Apr 44.
193WD Memo W 615-44, 29 May 44, sub: Critically needed specialists.
194History of the Army Dental Corps, 1 Apr 44-1 May 1944. HD:024.10-3.
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each man carrying out a limited operation. The technician who is qualifiedto perform all duties in a laboratory with equal competence is thereforerare. Under the Army classification a hospital which needed a man to setup teeth was likely to receive a replacement whose specialty was polishingdentures.
Even in peacetime the, number of trained technicians entering the Armyfrom civilian life had been negligible, and the Medical Department hadconducted training for this category of personnel since the founding ofthe Army Dental School in 1922. An average of 18 men had graduated fromthe 4-month course each year in the period 1935-1938.195 Thetraining emphasized laboratory work, but it also included some instructionin administration, x-ray technique, and chair assisting. The course wasexpected to be increased to a full year beginning with the class of September1939, but the outbreak of war caused this class to be graduated in July1940, and thereafter the period of instruction was reduced to 3 months.
The wartime 3-month course for laboratory technicians was really a combinedcourse for laboratory men and chair assistants, though most time was spenton laboratory procedures. It included instruction in dental anatomy andtooth carving, dental materials and metallurgy, dental records, dentalroentgenology, dental hygiene, inlays and crowns, chair assisting, impressions,clasps, full and partial dentures, and actual work in the laboratory. Italso included instruction in the care and maintenance of equipment.196Applicants were required to have the equivalent of a high school educationand must have completed basic military training. The course given at FitzsimonsGeneral Hospital in 1942 was as follows:
Organization | 2 hours | |
Basic dental instruction | 40 hours | |
Dental assisting | 47 hours | |
Chair assisting | 9 hours | |
Army dental records | 6 hours | |
X-ray | 25 hours | |
Fractures | 5 hours | |
Mailing dental materials | 2 hours | |
Prosthetics: | ||
Upper partial dentures | 42 hours | |
Lower partial dentures | 78 hours | |
Full dentures | 128 hours | |
Acrylic splints | 35 hours | |
Total | 283 hours | |
Crown, bridge, and inlay: | ||
Metallurgy | 12 hours | |
Posterior bridge | 92 hours | |
Anterior bridge | 28 hours | |
Total | 132 hours | |
195Annual Reports ... Surgeon General, 1935-38.
196ASP Manual M3, 25 Apr 44. HD.
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The first month was devoted to didactic instruction and the last 2 monthsto actual work in a laboratory under supervision. It was recognized thatcompetent dental technicians could not be trained in 3 months and the coursewas expected to establish a basis for the individual's further progressat his home station. The rating of SSN 067 was conferred at the schoolsonly on the best qualified graduates (40 percent at Fitzsimons GeneralHospital, 1943). More often it was given later, on recommendation of theunit dental surgeon after the student had improved his knowledge by "on-the-job"training. Those who showed little aptitude for laboratory work remainedSSN 855's (chair assistants).
The dental technician training program soon outgrew the Army DentalSchool and courses were given in six general hospitals in 1940. Nine schoolswere in operation during fiscal 1943 and over 5,000 students were enrolledduring that year. Maximum authorized capacity was 600 men a month. Manyof the schools operated double shifts during 1943 to accommodate the augmentedclasses without additional equipment. The program fell off sharply in thelatter part of 1944 and only a handful of students remained after March1945.
Results of the training program for dental technicians are listed inthe following tabulation:197
| Fiscal Year | Enlisted men enrolled | Wacs enrolled* | Elinsted men graduated | Wacs graduated* |
| 1940 | 13 | 0 | 13 | 0 |
| 1941 | 295 | 0 | 121 | 0 |
| 1942 | 1,012 | 0 | 843 | 0 |
| 1943 | 5,438 | 0 | 3,691 | 0 |
| 1944 | 3,361 | 103 | 3,791 | 69 |
| 1945 | 1,007 | 396 | 1,550 | 346 |
| Totals | 11,126 | 499 | 10,009 | 415 |
*In the entire program, from July 1939 through January1946, 511 Wacs enrolled in the dental technicians schools of whom 473 graduated.
The percentage of failures from July 1939 through January 1946 wereas follows:198
Type | Enlisted men | Wacs | All students |
Percent | Percent | Percent | |
| Scholastic | 4.7 | 2.2 | 4.6 |
| Other | 4.8 | 5.3 | 4.8 |
| Totals | 9.5 | 7.5 | 9.4 |
197See footnote 79, p. 126.
198The percentages of failures quoted here were calculated fromfigures of the Training Division, SGO, which show 541 scholastic failuresand 573 other failures out of a total enrollment of 11,847. Of the entireenrollment, 10,713 men were graduated through April 1946 (men enrolledin January did not graduate until April). Since 20 enrollees of the totalnumber are not accounted for in the numbers reported for failures and graduates,it may be that these students did not complete the course during the February-April1946 period. However, if these 20 were to be considered as failures, thetotal percent would only be changed from 9.4 to 9.6.
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Since graduates of the technicians' schools were seldom given specialist'sratings until they had served for some time at their own stations it isnot known exactly how many became laboratory workers and how many remainedchair assistants. In July 1945, 2,494 men, or 17.6 percent of the 14,191enlisted men with the Dental Service, were rated SSN 067.199
The Director of the Dental Division stated in 1945 that the 3-monthcourse had been too short for dental laboratory workers, though he feltthat it was adequate for chair assistants. He recommended a minimum courseof 6 months for technicians, to be extended to one year if possible.200
Use was made of civilian laboratory technicians to replace enlistedmen where possible but civilians were never employed in this work to theextent, that they were as assistants and hygienists, probably due to difficultiesof procurement. By August 1943, 144 civilian laboratory men were on dutywith the Army, but this number declined through 1944.
Prosthetic Supply Clerks. Beginning on 20 March 1944, six enlistedmen of the Dental Service were given 4 weeks of training at BinghamtonMedical Depot to prepare them for duty as prosthetic supply clerks. Thescarcity of personnel capable of handling the many sizes, shapes, and shadesof porcelain teeth stocked in laboratories and depots made this small butimportant course necessary.201
Dental Assistants. With mobilization it became necessary to stafflarge numbers of clinics with assistants in a very short time and moreemphasis was placed on training for this category. In the paragraph ondental technicians it is explained that the dental technicians' coursewas a combined project, including instruction in both laboratory proceduresand the duties of a chair assistant. Those men who did not show mechanicalaptitude for laboratory work eventually went to duty as chair assistants(SSN 855). It is not known exactly how many graduates of Army schools becamedental assistants because the final rating as technician or assistant wasoften made at the home station. In July 1945, 11,697 men, or 82.4 percentof a total of 14,191, were rated as SSN 855.202 Since only 11,625enlisted personnel attended the Army schools through fiscal 1945, and sincethe enlisted auxiliary personnel of the Dental Service numbered over 15,000men at its maximum, we can assume that not more than two-thirds of thechair assistants had formal school training. The equivalent of a high schooleducation and completion of basic military training were prerequisitesfor training as a dental assistant.
In January 1943, the Director of the Dental Division recommended approvalof a request from Camp Pickett for 100 WAC personnel for duty as
199Information from the Strength AccountingBranch, AGO, given the author on 11 Dec 46.
200See footnote 9, p. 107.
201A report of the schooling of enlisted personnel, MedicalDepartment, 1 Jul 39 to 30 Jun 44. In the history of training inthe Army Service Forces for the period 1 Jul 39-30 Jun 44, vol IV, p. 109.HD: 314.7-2.
202See footnote 199, p. 158.
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dental assistants, and at the same time recommended that women be usedto replace male assistants in all large Clinics.203 The SurgeonGeneral approved this request and forwarded it to the Director of the Women'sArmy Corps for action. In June 1943, The Surgeon General estimated, oninformation from the Dental Division, that 1,519 Wacs could he used inArmy dental installations.204 Training courses for Wac dentaltechnicians were established at Army-Navy, Brooke, Fitzsimons, Wakeman,and William Beaumont General Hospitals and at Fort Huachuca, and a totalof 473 female dental technicians, including 9 Negro Wacs, were trainedfrom September 1943 to January 1946, most of these (335) at Wakeman GeneralHospital.205 Three hundred and eight Wac assistants were onduty in January 1944. By June the number had increased to 462.206It is not known how many ultimately went to duty with the Dental Servicebut the figure was certainly far short of the 1,519 which it had been estimatedcould be used.207
The fact that wider utilization was not made of Wac dental assistantswas due mainly to inability to obtain them. There were, however, certaindisadvantages in using women for such work. Requirements for quarters weremore difficult to meet, their sickness rate was higher, and they couldnot be assigned to some types of tactical units. Another objection to Wacassistants was that male clinic personnel had to assume additional workin connection with heavy clinic maintenance. In many places the Wacs scrubbedfloors and worked on an almost equal basis with the men, but there wasa feeling among the males that they were given additional work when a considerablenumber of women assistants were assigned to a clinic. On the other hand,the Wac assistants were not subject to the strict limitations on hoursand type of work which applied to salaried civilian women assistants.
For some years civilian dental assistants had been used in a few largeclinics. As enlisted assistants became harder to replace an effort wasmade to obtain a substantial number of civilians for this duty in fixedinstallations in the United States. In July 1942 The Surgeon General specifiedconditions under which female civilian assistants could be hired.208Civilian dental assistants were to be given the Civil Service grade ofSP-3, paying $1,440 yearly. They were required to have a minimum of 6 yearsgrade school education and at least 1 year of experience as a dental assistant.They provided their own uniforms. Civilian dental assistants were to conformto the rules of conduct prescribed for Army nurses. In January 1943 theadditional grade of "Junior Dental
203Memo, Dir Dental Div, SGO, for General McAfee,5 Jan 43, no sub. SG : 322.5 (Camp Pickett).
204Ltr, SG to CG, ASF, 2 Jun 43, sub: Technical training ofWAAC personnel. SG: 322.5-1.
205See footnote 79, p. 126.
206Ltr, Capt Emily Gorman to Mr. Frank Rand, 11 Oct 44, no sub.SG: 221 (Technicians).
207It is extremely difficult to get information on the personnelon duty with the Dental Service during the war since all enlisted men andwomen were assigned only to the Medical Department; they were placed onspecific duties by local surgeons and might be shifted on short notice.Strength returns from installations did not specify the services to whichpersonnel were assigned.
208SG Ltr 75, 27 Jul 42.
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Assistant," SP-2, paying $1,320 yearly, was established.209The position of Assistant, Junior Dental Assistant was to be filled bypersons with limited experience and was considered temporary until additionaltraining had been completed in the dental clinic. By June 1944, 2,909 civiliandental assistants were oil duty in the United States and 15 had been hiredoverseas. (None were sent overseas from the United States during the actualcombat period.) Later figures are not available, but it is probable thatthe strength given for June 1944 represents about the maximum number onduty during the war as the percentage of the Army on duty overseas increasedrapidly after this time and civilian assistants were not sent abroad.
The use of civilian assistants released a large number of men for otherduties. In general, they were superior to enlisted men in the handlingof patients and in the care of instruments and small equipment. On theother hand, they worked limited hours and were not available for emergencies.They could not be called upon to clean floors and do major maintenancework in the clinic and the rate of absence was generally thought to behigher than for enlisted men, though there are no statistical data bearingon this matter. The use of both enlisted and civilian personnel in thesame clinic sometimes resulted in friction as the women received twiceas much pay for shorter hours. Also, unless janitor service was provided,the enlisted man was required, after the close of the day's operations,to clean not only his own operating room but also that of the civilianassistant. In general, the service rendered by civilian assistants justifiedtheir use, but best results were obtained when civilian and enlisted personnelin clinics were mixed as little as possible.
Dental Hygienists. Before the war civilian dental hygienistswere on duty in only a few of the larger clinics. Training in this workwas given enlisted men in the Army Dental School course and oral prophylactictreatments were generally given by enlisted men or by dental officers.With mobilization it was decided to make wider use of civilian hygienistsand the condi-tions of employment were prescribed in July 1942.210The position of dental hygienist was rated as SP-4, and paid $1,620 yearly.The applicant was required to (1) be a graduate of a course of at least2 years at a recognized school of oral hygiene, (2) have a license froma state or territory, and (3) have practiced 2 years in a clinic or officeof a private dentist. In July 1943 this last requirement was waived.211The position of senior dental hygienist, SP-5, was authorized in clinicswhere five or more hygienists were on duty, or under certain other circumstancesinvolving increased responsibility. The pay of a senior hygienist was $1,800yearly. In January 1944, over 500 hygienists were on duty, a figure whichwas approximately the maximum during the war.212 Soon afterthe declaration of war four civilian dental hygienists were
209SG Ltr 1, 1 Jan 43.
210See footnote 206, p. 159.
211SG Ltr 117, 1 Jul 43.
212See footnote 177, p. 153.
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sent overseas with their organizations and they were allowed to remainuntil returned to the United States under routine, established policies.No additional female hygienists were permitted to leave the Zone of Interior,however, and their places were taken by enlisted men prior to embarkation.The status of dental hygienists during the war was the cause of considerabledissatisfaction on the part of hygienists' organizations. Difficulty wasfirst encountered when dental assistants were occasionally promoted tothe grade of hygienist, SP-4. Such promotion was never authorized, butoccurred with sufficient frequency to make necessary a specific prohibitionagainst the practice in July 1943.213 The Dental Division agreedwith hygienists' organizations that, except for military personnel trainedby the Army itself, the scaling and polishing of teeth should be limitedto persons who had completed the prescribed course of instruction in authorizedschools. With the inauguration of the Women's Army Corps, requests weremade for the incorporation of dental hygienists as officers in that organization.This request was opposed by both the Medical Department and the DentalDivision because of rigid regulations, affecting the utilization of WACpersonnel. These regulations provided that Wacs could not replace civilianemployees and would replace male officers in the ratio of one Wac for onemale officer. It was therefore feared that commissioning of hygienistsin the WAC would entail the loss of an equal number of dental officers.214
Late in 1942 the Medical Department sponsored a bill (H. R. 3790, S.839) to provide commissions for female dietitians and physiotherapists.This step was made necessary by difficulties encountered when organizationsemploying these essential civilians were shipped overseas. The Dental Divisioncalled attention to the fact that hygienists would probably remain a permanentpart of the Army Dental Service and recommended that they also be includedin the pending bill, but this recommendation was returned with the pencillednotation "not now, " signed by the executive officer of the SurgeonGeneral's Office. Organizations representing the hygienists made a vigorouspresentation of their cause in congressional committee hearings, however,and finally succeeded in having a clause incorporated authorizing the Presidentto provide commissions for other "technical and professional femalepersonnel in categories required for service outside the continental UnitedStates."215 But since the bill did not specifically mentionhygienists the Medical Department later held that their services were notrequired outside the United States and that it was not necessary to invokethe provisions of the bill in their interest.216
In July 1944, the Director of the Dental Division called attention todifficulties in obtaining dental hygienists and assistants and noted thatthe Army
213See footnote 211, p. 160.
214Ltr, Maj Gen Norman T. Kirk to Hon Harve Tibbott, 2 Sep 43.SG: 231 (Dental Hygienists).
21556 Stat 1072.
216Ind, Brig Gen Larry B. McAfee to IAS to SG from TAG, 6 Apr43, sub: Dental hygienists not included in Public Law 828, 77th Congress.SG: 231 (Dental Hygienists).
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had no installations with five hygienists where the grade of SP-5 couldbe authorized.217 He recommended creation of the position of"Senior Dental Assistant," SP-4, and a corresponding increaseof rating for hygienists to SP-5 and SP-6, the latter to pay $2,000 yearly.At the end of the war no action had been taken on this recommendation.In September 1944 the Director of the Dental Division again recommendedthe establishment of a Hygienist's Corps, on the basis of 0.3 officersper 1,000 strength of the Army. He recommended that hygienists be limitedto the grade of captain, unless dietitians and physiotherapists were tobe granted higher grades, in which case it was recommended that hygienistsbe placed on an equal status. In 1945 he again recommended the commissioningof hygienists, but advised that only graduates holding a bachelor of sciencedegree in oral hygiene be accepted.218 No action had been takenin this direction at the end of the war. (In 1943 the Navy offered commissionsin the WAVES to hygienists who were graduates of courses of at least 2years. Hygienists with less than this minimum training were accepted aspharmacist's mates.)219
Informal Training, Auxiliary Personnel. One of the most importantaspects of the training of auxiliary personnel was the daily informal instructionwhich such personnel received while performing their duties in dental installations.New men were placed on duty in operating clinics, learned their work underthe supervision of dental officers, and in turn helped teach other menor were incorporated into cadres to form the nucleus of new organizations.This training was continuous during the war and accounted for the onlyinstruction (other than basic training) that at least one-third of alldental enlisted men received.
Course on Care of Equipment. Early in 1942, a course of instructionin the care and minor repair of dental equipment was initiated by a largedental manufacturer. The course lasted 2 weeks and representatives of othermanufacturers were invited to lecture on their particular products so thata wide coverage of the field was obtained. Approximately 180 enlisted assistantsreceived this training.220
Summary, Auxiliary Personnel
Over 18,000 auxiliary personnel were used in the operation of the DentalService by 15,000 dental officers. In wartime, dental officers should notwaste their efforts in work which can be done by less specialized personnel,and considerably more than the above number of auxiliary assistants couldhave been used efficiently if they had been available. It has been estimatedthat the
217Memo, Maj Gen R. H. Mills. for Pers Serv,SGO, 24 Jul 44. SG: 231 (Dental Hygienists). (This communication accompaniesa memo to Col George Kennebeck from Brig Gen Rex McDowell (no subject),16 Mar 45, same file.)
218See footnote 9, p. 107.
219Capt Robert S. Davis discusses problems of Navy Dental Corps.J. Am. Dent. A, 31: 587-589, 15 Apr 44.
220Report of the Dental Division, SGO, for fiscal 1942. HD:319.1-2.
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services of a full-time dental assistant will increase the output ofa dentist from 30 percent (U. S. Public Health Service) to 63 percent (U.S. Navy), but the wartime ratio of 1.2 auxiliary personnel per dental officerdid not permit assignment of a full-time dental assistant to each officerafter provision had been made for hygienists, x-ray technicians, clericalworkers, and laboratory technicians.221
Shortage of manpower in time of war makes necessary the wide use offemale auxiliary personnel, including civilians.
In a mobilization, competent laboratory technicians will not be availablein sufficient numbers from among inducted men, and a program for theirtraining must be anticipated. Every precaution must be taken to insurethat inducted laboratory technicians are assigned to appropriate dutiesin the Army. A course of 3-months duration is not adequate for the trainingof laboratory technicians, but will provide a sufficient basis for further"on-the-job" training in a dental laboratory.
It is evident that there was considerable waste effort involved in givinglaboratory training to nearly 10,000 enlisted personnel when over 80 percentultimately served as chair assistants. The whole period of training wasnot entirely wasted for this group, however, since the course includedsome work important to dental assistants as well as to the laboratory technician.There is also some need, especially in time of peace, for assistants whocan "double in brass" to carry out minor laboratory proceduresat smaller stations having no assigned technicians. But in the opinionof senior dental officers the training for chair assistants in a time ofemergency could profitably be cut to 1 or 2 months and separated from thatgiven prosthetic workers. During World War II it was necessary to senda large number of men to the technician's schools to obtain the few whocould acquire the needed special skills, but aptitude tests developed duringthe latter part of that war should make it possible in the future to selectcandidates for laboratory training with a much higher degree of accuracy.When it can be predicted with fair certainty that students chosen for techniciantraining will be able to complete the course successfully it will probablybe more economical of time and effort to shorten the period of trainingfor assistants and to eliminate from the already overcrowded laboratorycourse all instruction intended for them.
It was the general opinion of dental officers that the Dental Serviceexercised inadequate control of its enlisted auxiliary personnel. The mostserious difficulties were:
1. Clinic personnel were under the direct command of the medical detachmentcommander, acting for the surgeon. They could be, and were, taken fromtheir duties in the clinic for training or other nondental work. When suchwithdrawals were moderate in number and made on adequate notice, they wereannoying but unavoidable. When they were made in large numbers on short
221Army-Navy Register, 21 Sep 46, p. 11.
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notice they were disastrous in a service which had to schedule its workweeks ahead.
2. The fact that auxiliary personnel were not permanently assigned tothe Dental Service was directly responsible for some inefficiency in operation.Months of training were required to qualify a competent dental assistant,and when a skilled man was transferred to other duties because he feltthat life was easier in the surgery, or to increase his chance for promotion,both the Dental Service and the Army suffered.222
3. The f act that promotion of enlisted assistants was in the handsof medical officers was widely believed to have resulted to the disadvantageof dental auxiliary personnel. This belief is not wholly confirmed by comparisonof the grades held by dental and medical enlisted men in the United States.Medical officers did have the authority to promote or demote dental personnelwithout consultation with the dental officers in charge of clinics, however,and though this action was rarely taken, the results, when it did happen,were inevitably detrimental to efficiency and morale.
The following changes were among those most commonly recommended bydental officers:
1. Permanent assignment of enlisted personnel to the Dental Service,with transfer only for significant reasons which would normally justifytransfer between other corps of the Army.
2. Adequate provision for promotion of outstanding enlisted men withinthe Dental Service so that competent men could plan a career in that servicewithout jeopardizing their chances of arriving at the higher grades.
3. Correction of the system whereby dental personnel were examined forpromotion in purely medical subjects, in competition with men who had beenengaged in medical activities in their daily work.223
222See footnote 9, p. 107.
223Ibid.
