Where did all the doctors come from?

[GlenBanna]

Given that it takes a number of years to train a doctor, how did they mobilise the numbers needed at the front, in hospitals and leave enough for the civilian population?

Glen

[centurion]

how did they mobilise the numbers needed at the front, in hospitals and leave enough for the civilian population?

I don't think they did - I've seen references to both shortages and some very unskilled doctors. Some doctors came out of retirement and some junior doctors got very fast promotion in the profession. Corporal Holmes (A Yank in the Trenches) talks of being treated by young, inexperienced but keen doctors (always a bad combination) that botched his operation. I've also seen accounts of nurses (with much more experience than the doctors they were working under) advising patients not to have some operations. I think that there was a lot of learning on the job which can be painful for the patients.

[SiegeGunner]

I don't know the answer, Glen, but I look forward to finding out as the thread develops, and discovering in particular whether the exigencies of war helped to open the door for more women doctors and candidates from more modest backgrounds.

[Tunesmith]

Someone correct me if I'm wrong, but at the start of the war I think doctors joined the army on fixed-term commissions. This was supposed to make it easier for civil authorities to plan and supply numbers of doctors needed at home (although at much reduced levels compared to prewar).

My impression is based on the experience of my grandfather who became fully qualified as a doctor in November 1914 and immediately signed up on a three year commission. In November 1917, even though he was serving in a busy military hospital in East Africa, he was discharged promptly and brought home straight away.

The fixed-term system didn't work though because the authorities in 1914 evidently did not anticipate the high number of casualties among front-line medical officers. So although he felt he'd done his bit, and before he could take up a post in a civilian hospital, my grandfather was pressured into joining up again and by January 1918 he was a battalion MO in France.

What I don't know is whether fixed-term commissions offered to doctors in 1914 were all 3 years, or if some were longer and others shorter.

Tunesmith

[Sue Light]

There is a whole chapter in volume one of the Official History Medical Services about the recruiting of staff for the RAMC which is well worth seeking out and reading for anyone with an interest. It's a very complex, in depth chapter, but I've tried to precis a few of the main points here which may be helpful.

Recruiting from the civil medical profession to fill the officer ranks of the Army Medical Service presented many difficulties ... re obligations of civil medical practitioners serving under the National Health Insurance Commissioners and other public bodies ...

... ready response of civil medical practitioners to accept temporary commissions in the RAMC at the outbreak of war... led to attempts to regulate the flow of medical men from civil to military life ...

July 1915 - Committees formed to recruit to the Army while safeguarding the needs of the civil population ...

Formation of Central Medical War Committee in October 1915 to organize medical practitioners to serve in whatever capacity was considered best, and to deal with all matters pertaining to the medical profession in wartime...

November 1915 – Lord Derby hands over the recruiting of officers of the RAMC to the above Committee ...

January 1916 ... No medical practitioner under 45 years of age would be employed in RAMC unless he undertook general service, and none over 55 accepted for home service ... conditions slightly different in Scotland...

January 1st 1917 – more than half of the medical profession had been called up for military service ... 12,363 medical officers in the Army, and slightly less in civil practice ... this led to a conflict of interests between the military and civil requirements ...

... Medical students who had taken commissions or had enlisted in the ranks while in their fourth or fifth years of training were released from military service in September 1915 to return to their studies in order to return to the RAMC as commissioned officers... any qualified doctors with commissions in combatant units were transferred to the RAMC (not a popular move with them!)...

Establishments of medical officers in Field Ambulances and hospitals cut to a minimum ...

Situation became more acute as the war progressed and by January 1918 it was estimated that the number left in civil practice was 11,482 compared to 12,720 in military service.

Situation relieved when the USA declared war against Germany, with immediate despatch of six base hospitals fully staffed, and an additional 112 additional medical officers ...

The promptness and cordiality with which the United States Army authorities met in this way the requests of the British in connection with the medical services cannot be too strongly emphasized, or too warmly appreciated

... notwithstanding these invaluable reinforcements, owing to the great and unforeseen casualties in the commissioned ranks of the RAMC, the demands on the civil profession continued and threatened to drain the country of civil medical practitioners...

August 1917 ... Committee of opinion that no more medical men could be called on to take commissions in the RAMC without endangering the civil community ...

A committee went to France in September 1917 but could not suggest any further economies of staff or better distribution of medical officers....

... Part time TF hospital medical officers at home to work more hours daily in addition to their civil practices, thus relieving some men for full-time overseas service...

[Eventually saved by the end of the war, and of course the USA ]

History of the Great War based on Official Documents

Medical Services General History

Volume 1

Major-General Sir W. G. Macpherson

Recently re-printed and published by Naval and Military Press

Sue

[BJanman]

What I don't know is whether fixed-term commissions offered to doctors in 1914 were all 3 years, or if some were longer and others shorter.

Tunesmith

At the very beginning of the war they were offered twelve month contracts.

According to the Official History it was known there would be a shortfall of medical officers in the event of war, and so it was pre-arranged that in the event of war they would advertise to attracted civil practitioners, and immediately war was declared the advertisements appeared. Civil practitioners responded in large numbers, those that were selected were commissioned as temporary Lieutenants in the RAMC and their contracts with the War Office were twelve months.

In August 1915, Sir A Sloggett DGMS with the BEF in France recorded his concerns that there would be a shortfall of approximately 100 Medical Officers below the proper number, this was not only because they were losing medical men as casualties but also because drafts had been diverted to the Dardanelles, and he also expected to lose temporary commissioned Medical Officers because their one year contracts were about to expire.

Barbara

[GlenBanna]

Sue

Thanks for the very interesting summary of events. Was there any evidence of medical courses being shortened or not fully qualified doctors being brought into service. Were nursing staff carrying out pocedures normally done by doctors?

Regards

Glen

[Sue Light]

Glen

I'm not aware of any change in the length of training of doctors during the war, though someone else might know. However, the senior medical students would undoubtedly have had far more responsibility in a situation when there was such a shortage of staff in civil hospitals. Even if they were not actually qualified, I imagine they would have been taking on the work usually carrired out by newly-trained doctors - and presumably those who were newly qualified would be filling gaps further up the chain.

Nursing staff were rather controlled in the duties they carried out by the attitudes of the Commanding Officer of their hospital/CCS and his colleagues. There were still surgeons who were distinctly unhappy about even having nurses in the operating theatre, but on the other hand there were surgeons in special areas (neuro-surgery, eyes, jaws etc.) who would only operate with their own personal team of theatre sister and orderly/technician. But in view of the shortage of medical officers, it was agreed in November 1917 that a selected group of nurses would train as anaesthetists in France and Flanders, thus relieving some of the pressure, and strictly controlled three month courses were started in January 1918, resulting in one hundred nurse/anaesthetists trained and working by the end of May 1918. Of course, that resulted in the depletion of the already thin ranks of the trained nurse in France - hurrah for the Armistice!

Sue

[GlenBanna]

As you say Sue

Hurrah for the Armistice, but it is interesting to speculate what would have happened to the number of nurse/anaesthetists trained if the war had been even more prolonged.

Thanks for your detailed replies

Glen

[SiegeGunner]

I wonder whether wartime-trained nurse/anaesthetists were encouraged/allowed/assisted to train as conventionally qualified anaesthetists after the war?

[Sue Light]

I wonder whether wartime-trained nurse/anaesthetists were encouraged/allowed/assisted to train as conventionally qualified anaesthetists after the war?

I think it's highly unlikely. From notes I've seen, the British women who trained and worked as anaesthetists in military hospitals were not even allowed to retain their certificates of training by the War Office, and therefore would have no proof in civilian life of their training, and I don't believe that post-war doctors would have allowed nurses' incursions into their carefully guarded territory. Some of course might have trained as doctors, which was a different matter. The situation was different for some American nurses who were already trained and working as anaesthetists before the war, which seems to have been accepted practice in the US.

Sue

[Tunesmith]

At the very beginning of the war they were offered twelve month contracts.

Barbara, thanks for clarifying,

Tunesmith

[Will O'Brien]

Can only speak from my own research, the local Doctor in Fenny Stratford Gurney Buxton was a member of the TA & once he had been able to organise a locum for his practice he undertook his military duties. In 1914/15 it's my guess they would have been a heavy reliance on TA medical staff. Dr Buxton unfortunately died at Gallipoli from dysentry.

[british tommy]

I found Lynn MacDonald "The Roses of No Man's Land" very informative as to some aspects of how the medical staff were organised and where a lot of them came from. One part of the book that i did find a surprise was how poor the French were prepared with there medical services and how reliant they were on foriegn medical staff.

The Rose of No Man's Land

I've seen some beautiful flowers

Grow in my garden fair,

I've spent some wonderful hours

Lost in their fragrance rare.

But I have found another

Wondrous beyond compare.

There's a rose that grows on no-man's land

And it's wonderful to see;

Though its place is there it will live for me

In my garden of memories.

It's the one red rose the soldier knows

It's the work of the Master's hand,

It's the sweet word from the Red Cross nurse,

She's the rose of no-man's land.

[seaJane]

Of interest on the American side may be: Answering the call: the US Army Nurse Corps, 1917-1919: a commemorative tribute to military nursing in World War 1 / edited by Lisa M. Budreau and Lt Col Richard M. Prior. (Washington DC: Office of the Surgeon General, 2008).

PS: Apologies for a 2-year absence from the forum, real life bit rather hard.

[edwin astill]

The Germans must have had similar problems. And the Russians....

Edwin

[bruce]

Of interest on the American side may be: Answering the call: the US Army Nurse Corps, 1917-1919: a commemorative tribute to military nursing in World War 1 / edited by Lisa M. Budreau and Lt Col Richard M. Prior. (Washington DC: Office of the Surgeon General, 2008).

PS: Apologies for a 2-year absence from the forum, real life bit rather hard.

Welcome back, Jane.

I hope real life is getting easier.

Bruce

[seaJane]

Bruce, thank you. 2008 was ... indescribably bad. But keeping my head above water.

Back to topic, Max Arthur's Last post includes an interview with Surgeon RN Tom Kirk; Arthur also wrote the obituary in The Independent, which sums up his medical training (or not as the case may be) fairly thoroughly:

http://www.independe...irk-673139.html

[Medic7922]

I know this is more pertinent to the 2nd World War, But when the Nazi extermination & concentration camps where opened due to the large amount of victims needing treatment the RAMC called up 4th year Medical students and sent them into the camps.

This helped free up the regular Medical staff who where still heading into Germany as battles where still raging.

[centurion]

One of the first things that President Wilson did on the USA's entry into the war was to despatch numbers of American doctors to the front to assist the British. They had a new commission with the ink still runny, a bran new uniform and no military experience or training whatever. They were probably the first American commissioned officers to see action in WW1. This suggests a certain desperate need for qualified doctors at the front.

[WilliamRev]

I hadn't come across this thread until yesterday.

My grandfather was just starting his third year as a medical student at Glasgow University when the war broke out in 1914. He was an enthusiastic member of the university OTC, and in early November he was one of at least one hundred students in the OTC recruited into the (Territorial) 5th Scottish Rifles as a rifleman, including a number of other medical students, joining the battalion (part of the 19th Brigade) on the Western Front as one of a draft of 219 men at the end of March 1915.

It amazes me that so many medical students were allowed to join Territorial and New Army battalions as soldiers when they would have been more useful in the RAMC. But perhaps it wasn't known in those early months just how many doctors would be needed and how long the war would last, or perhaps things were just too chaotic?

Although my grandfather did choose to leave the army and return to his medical studies in 1921, qualifying as a doctor in 1924, I got the impression from what he told me that he was intent on being a proper soldier, and was just keen to get to the front and see some action before the war ended.

William

[Longboat]

One of the first things that President Wilson did on the USA's entry into the war was to despatch numbers of American doctors to the front to assist the British.

Ahh! Thank you Centurion. Thus an explanation for Lt J.B Nutt of the 11th Royal West Kent's (U.S.M.C). Although I dont know if that's United States Medical Corps or United States Marine Corps. Can anyone enlighten me?

Stuart.

[seaJane]

Ahh! Thank you Centurion. Thus an explanation for Lt J.B Nutt of the 11th Royal West Kent's (U.S.M.C). Although I dont know if that's United States Medical Corps or United States Marine Corps. Can anyone enlighten me?

Stuart.

Stuart, I have a feeling that the corps was known as the Medical Service Corps - prepared to be corrected, however.

USMC is definitely the United States Marine Corps today.

sJ

[rflory]

I know of at least three Great War Royal Artillery officers whose medical studies were interrupted when they received RA commissions early in the war and who were allowed to resign their commissions in 1917 to resume their medical studies. I would imagine that this was due to the lack of doctors available to both the military and civilians.

Dick Flory

[rflory]

seaJane wrote:

I have a feeling that the corps was known as the Medical Service Corps

Actually it was called the 'Medical Department, US Army'. The Medical Service Corps did not come into being until well after World War II.

Dick Flory