2

CHAPTER IV

PERSONNEL

General Statement. While the President in time of war may utilize the Public Health Service in any manner that will promote the public interest,' and while during the War with Germany he made it a part of the military forces of the United States it is essentially a civil organization. Nevertheless, ever since the reorganization of the Marine Hospital Service in 1870 the commissioned medical personnel has been in uniform and has had an organization analogous to that of the Army and Navy. Provision is made for promotion in certain grades after a specific period of service, longevity pay, allowance for quarters, discipline through boards of investigation, and retirement. There is a definite distinction between the commissioned medical personnel on the one hand and the scientific personnel, subordinates, and clerks on the other. The members of the commissioned medical corps are appointed by the President by and with the advice and consent of the Senate, and their salary is fixed by law. There is a further distinction between the regular commissioned corps and the reserve commissioned corps. The regulations affecting these officers differ materially from those affecting all other employees, who are appointed by the Secretary of the Treasury in accordance with Civil Service Regulations.

The regular commissioned personnel system is particularly interesting as it provides for periodic promotion, longevity pay, the elimination of the unfit through examination, and retirement for disability or age. Periodic promotion and the

1 Act of July 1, 1902 (32 Stat. L., 712). 2 Executive Order of April 3, 1917.

elimination of the unfit are provided also for certain of the scientific personnel.

As the executive order of April 3, 1917, constituted the Public Health Service a part of the military forces of the United States in time of threatened or actual war the personnel was exempt from income tax during the period of the war on so much of the amount received as salary or compensation in any form from the United States as did not exceed $3500 (40 Stat. L., 1066). This exemption is granted by the act cited to all persons in the military or naval service.3

Commissioned Personnel. The commissioned personnel consists of the regular commissioned officers and the commissioned officers of the reserve corps. The grades in the regular commissioned medical corps are fixed by statute as those of surgeon general, assistant surgeons general, senior surgeons, surgeons, passed assistant surgeons, and assistant surgeons (37 Stat. L., 309).

Appointment and Promotion. The act of January 4, 1889 requires original appointments in the service to be made only to the lowest grade that of assistant surgeon-and after the applicant has passed a satisfactory medical examination in medicine, surgery, and hygiene before a board of medical officers of the service (25 Stat. L., 639). The regulations require that the applicant must be between twenty-three and thirty-two years of age, a graduate of some reputable medical college, and have had one year's hospital experience or two years in professional practice. Acting assistant surgeons whose compensation is more than $300 and who have served five years continuously preceding the examination, and reserve officers who have had five years' service may take the examination for assistant surgeon, provided they are less than fortyfive years old. All applicants must be examined for physical defects.5

3

Digest of Income Tax Rulings, No. 12, October, 1920, p. 107. * Regulations 1920, Par. 25-27.

5 Ibid., Par. 32.

In order to train the newly appointed officers in the technique of the various branches of the service, they are detailed, when practicable, for the following service: Marine hospital, three months; quarantine station, four months; immigration station, five months; Hygienic Laboratory, six months. The number of assistant surgeons is not specifically fixed, being determined by the amount of money appropriated for the work of the service. On June 30, 1921, the number of assistant surgeons was twenty-nine.

An assistant surgeon can be promoted to the rank of passed assistant surgeon only after four years' service. The regulations provide that not less than thirty days prior to the expiration of four years' service an assistant surgeon shall be given a physical and professional examination for promotion to the grade of passed assistant surgeon. If he fails in the first examination for promotion he is given a second examination after the expiration of one year. If he fails in the second examination he is reported to the Secretary of the Treasury as not qualified for promotion and is requested by the Secretary to tender his resignation. The number of passed assistant surgeons is determined automatically by the number of promotions from the grade of assistant surgeon. On June 30, 1921, the number of passed assistant surgeons, including three on waiting orders, was fifty-seven.

The law specifies that a passed assistant surgeon shall not be promoted to the rank of surgeon without examination (25 Stat. L., 639). The regulations provide that after twelve years' service from the date of his original commission, (or eight years after promotion from rank of assistant surgeon if he passed the first examination) a passed assistant surgeon shall be entitled to promotion to the grade of surgeon after passing the required written and physical examination. If he fails in the first examination he is given a second one at the expiration of a year; if he fails in the second examination he is reported to the Secretary of the Treasury as not qualified 6 • Ibid., Par. 65.

for promotion, and is requested by the Secretary to tender his resignation. The number of surgeons is not limited by law, but is determined by the promotion from the next lower grade. On June 30, 1921, the number of surgeons, including four on waiting orders, was seventy-eight.

The law does not specify how promotions shall be made to the grades above that of surgeon, but the regulations provide that a vacancy in the grade of senior surgeon shall be filled on the recommendation of a board of regular commissioned medical officers by promotion of an officer of the regular commissioned medical corps according to seniority, subject to a physical examination and a review by the board of the officer's record as to fitness. The regulations specify that no officer over sixty-four years old shall be promoted to the grade of senior surgeon. If a surgeon is not recommended for promotion he is reported to the Secretary of the Treasury as not qualified for promotion, and is "placed in the official register of the service as 'not in line for promotion.' " The act of August 14, 1912 (37 Stat. L., 39), limits the number of senior surgeons on active duty to ten. On June 30, 1921, the number of senior surgeons was twenty-one, there being ten on active duty and eleven on waiting orders.

Regular commissioned officers may be temporarily promoted during an emergency when ordered to assume charge of important work by transferring them to the reserve corps at a higher grade. While doing such work they are given such rank in the reserve as in the discretion of the Secretary of the Treasury the importance of the work may require. Unless sooner terminated by direction of the President, the commission in the reserve terminates when the emergency ceases. The temporary transfer of officers from the regular corps to the reserve does not create a vacancy in the grade from which the officer is transferred. At the termination of a temporary com

7 Ibid., Par. 67-9.

8 Ibid., Par. 70.

Ibid., Par. 73.

mission in the reserve the officer returns to the grade and number he would have occupied if not transferred.10

The act of July 1, 1902 (32 Stat. L., 712), provides that commissioned medical officers detailed by the surgeon general for duty in charge of the administrative divisions should be assistant surgeons general. By this act no officer below the rank of passed assistant surgeon may be detailed for this duty. The regulations provide that after the expiration of the detail an assistant surgeon general may be reassigned for an additional period of four years, but after the expiration of the second detail he is not eligible for a third detail unless he shall have served at least four years at some other duty. The regulations are silent regarding the length of the first detail, but in practice the period has been four years. The temporary assignment for duty as assistant surgeon general does not create a vacancy in the grade occupied by the officer; at the end of the detail he returns to the grade and number he would have held if he had not been assigned as chief of division."

Assistant surgeons general at large were first provided for by the sundry civil appropriation act for the fiscal year 1920 (41 Stat. L., 174), which did not specify their qualifications or methods of selection, but simply made money available for pay, allowance and commutation of quarters of "assistant surgeons general at large not exceeding three in number." This authority has been carried in similiar form in subsequent appropriation acts. The regulations provide that a vacancy in the grade of assistant surgeon general at large shall be filled on the recommendation of a board of regular commissioned officers by the promotion of an officer who has served as surgeon general or of an officer of the regular corps according to seniority. The officer promoted is examined physically and his record is reviewed by the board. No officer over 64 years of age is eligible for promotion to such a vacancy.12

10 Ibid., Par. 77-78. 11 Ibid., Par. 16-7.

12 Ibid., Par. 71.