MEDICAL SURVEY PROGRAM
Establishment
As the war progressed and the need for manpower grew more imperative, it became more apparent to all concerned that a method of selection which depended solely upon a brief examination at the induction station that obtained only a cross sectional view of a registrant's personality was an ineffective screening procedure. To facilitate more efficient selection, a longitudinal section or history of the individual's past experiences was needed. The only national organization that was in a position to undertake the task of providing the necessary historical data was the Selective Service System. Thus, after considerable groundwork and research, the Medical Survey Program came into being. The organization and operation of this program was outlined in Medical Circular No. 4, of the Selective Service System, issued on 18 October 1943. As was stated in the introduction of that circular:
The Selective Service System has provided this Medical Survey Program to furnish the Armed Forces induction stations with adequate medical, social, and educational histories on each registrant. The Selective Service System and the Armed Forces want to make certain that the greatest possible care is taken, (1) to accept those registrants whose previous medical and social history indicate their ability to adjust themselves under situations of stress, including those who may be termed "borderline" cases; and (2) to reject those registrants whose condition is such as positively indicates physical or mental breakdown, or failure to adjust themselves to the responsibilities of military service after being inducted.
The circular further stated:
Information regarding a registrant's medical and social history as revealed in health, education, employment, and social records is important in properly determining whether a registrant should be accepted or rejected.
Under section 623.33 (d), Selective Service Regulations24 local boards were charged with the responsibility of assembling pertinent information concerning the medical and social history of registrants. In order to provide the necessary personnel to carry out the gathering of such information, an amendment was made on 4 October 1943, to part 603, of the Selective Service Regulations (section 603.85, Appointment and Duties). These regulations provided for a field agent in each local board and, further, provided: "States may request permission to continue using an established medical survey program."
Details of the Medical Survey Program, as described in Medical Circular No. 4, dealt with procedures for obtaining information on the educational background and the medical and social history of the registrants; also, the forms to be used therefor. For the educational history, the form to be used, DSS 214 (Special School Report), contained space for comments by the registrant's past teachers as to his conduct in school, his adjustment or maladjustment in the school community, and other pertinent facts regarding his school career.
Deficiencies
Of the various forms, DSS Form 212 (Medical and Social History) was the most valuable. The completion of this form depended upon the activity of the medical field agent concerned. Although many field agents, especially in the Eastern States, were well qualified and turned in a creditable job, the vast majority were not prepared to accomplish this mission effectively either from the standpoint of training or from a standpoint of their own educational background. Clearly, trained social workers were needed to perform this task, but such personnel were extremely limited in number, and most were already occupied in either governmental or private enterprise. This scarcity of trained social workers constituted the greatest single handicap to the program.
As a direct result of this deficiency, it became apparent that a majority of forms received at induction stations did not contain much useful information. There seemed to be a marked tendency on the part of schoolteachers to indicate their own appraisal of the individual and to make recommendations. For instance, it was not uncommon to receive a school form with a notation, "I don't think John would make a good soldier." Because even under the best conditions it was rarely possible for a psychiatrist to see a registrant at the induction station for a time longer than 4 or 5 minutes, except for questionable cases, the examining psychiatrists came to believe that it was not worthwhile, from a time standpoint, to open the sealed envelopes and sort out the various forms, only to discover, after reading them, that the information sought for was not to be found. Not only were many blank forms received, obviously without any information whatsoever, but examiners objected to the type of data that were forwarded. In this regard, examiners repeatedly stated that factual material was wanted, not opinions of untrained persons who gather the information. This lack of capable field agents was scarcely amendable to correction as time, funds, and facilities were not available for their training.