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REPORT OF SURG. S. D. BROOKS ON THE MEETING OF THE WASHINGTON STATE
OFFICE OF MEDICAL OFFICER IN COMMAND M. H. S.,
PORT TOWNSEND QUARANTINE,
Port Townsend, Wash., May 13, 1898. SIR: I have the honor to report that I attended the annual meeting of the Washington State Medical Society at Seattle, as directed by Bureau letter of the 18th ultimo (P. M. C.), and returned to duty this morning.
The meeting was quite successfully carried out. At the request of the President, I presented a paper on the necessities for quarantine on the Pacific coast, but practically no discussion was drawn out. Respectfully, yours,
S. D. BROOKS,
Past Assistant Surgeon, M. H. S. SURGEON-GENERAL, MARINE-HOSPITAL SERVICE.
REVISION OF THE REGULATIONS. The revision of the regulations mentioned in my last report, made necessary by the increase in the scope of the Service and the consequent inadequateness of the regulations issued in 1889 has been completed.
The new regulations, much enlarged, comprising some 698 paragraphs, and suited, it is hoped, for the proper conduct of the Service in all its details, were submitted to you for approval, and after such was obtained, received the approval of the President on December 1, 1897, and were immediately printed and promulgated.
INFORMATION FOR THOSE DESIRING TO ENTER THE MEDICAL CORPS OF
THE UNITED STATES MARINE-HOSPITAL SERVICE. The revision of the Service regulations made necessary the issue of the following Department circular, application blank, and specimen set of examination questions. These are now issued to all making application for permission to present themselves before an examining board of surgeons for admission to the corps as assistant surgeons:
Washington, D. C., February 11, 1898. The following extract from the Revised Regulations of the Marine-Hospital Service is hereby published for the information of candidates for appointment into that Service.
The following is the act governing appointments: "Medical officers of the Marine-Hospital Service of the United States shall hereafter be appointed by the President, by and with the advice and consent of the Senate; and no person shall be so appointed until after passing a satisfactory examination in the several branches of medicine, surgery, and hygiene before a board of medical officers of the said Service. Said examination shall be conducted according to rules prepared by the Supervising Surgeon-General, and approved by the Secretary of the Treasury and the President.
"SEC. 2. That original appointments in the Service shall only be made to the rank of assistant surgeon; and no officer shall be promoted to the rank of passed assistant surgeon until after four years' service and a second examination as aforesaid; and no passed assistant shall be promoted to be surgeon until after due examination: Provided, That nothing in this act shall be so construed as to affect the rank or promotion of any officer originally appointed before the adoption of the regulations of eighteen hundred and seventy-nine; and the President is authorized to nominate for confirmation the officers in the Service on the date of the passage of this act."
18. Graduates of medicine desirous of undergoing examination for the position of assistant surgeon in the Marine-Hospital Service of the United States must make an application, addressed to the Supervising Surgeon-General, in their own handwriting, requesting permission to appear before the board of examiners. Applicants for examination should state their age, date, and place of birth, present legal residence, and whether they are citizens of the United States, and name of medical school and college of which they are graduates, and furnish testimonials from at least two persons as to their professional and moral character.
19. Any applicant for appointment who shall submit false testimonials as to his character, or who shall give a false certificate of age, or make any false statement in his application, or to the board of examiners, shall be disqualified for appointment; or, if appointed before such false statement is discovered, shall be dismissed from the Service.
20. No person will be appointed as assistant surgeon whose age is less than 21 or more than 30 years, and, as a preliminary to a recommendation for appointment, the applicant must have been graduated in medicine at some respectable medical college, and must pass a satisfactory physical, academic, and professional examination before a board of commissioned officers.
21. Commissioned officers will not be appointed to any particular station, but to the general service. They will be subject to change of station, as the exigencies of the Service may require, and shall serve in any part of the United States or wherever assigned to duty.
22. A board of commissioned officers will be convened from time to time by the Supervising Surgeon-General for the purpose of examining applicants for appointment. This board shall consist of three or more commissioned officers, of whom the senior shall be chairman and the junior recorder of the board.
23. The board of examiners will make a true report on the merit roll (Form 1936) of the actual and relative standing of applicants and transmit the examination papers, with their recommendation in each case, to the Secretary of the Treasury, through the Supervising Surgeon-General. The maximum mark in any one branch of the examination shall be 100, and no applicant will be recommended for appointment who fails to receive an average grade of 80 in the ratings on the topics named in paragraphs 26 and 28.
24. All academic and professional examinations for appointment shall be conducted by said board of medical officers, and the order of examination shall be: (1) Physical; (2) academic; (3) professional; (4) clinical; (5) personal (including general aptitude and moral fitness).
25. The physical examination will be made according to the rules elsewhere given; the examiners must pay special attention to conditions that may impair efficiency or cause early placing on“ waiting orders," such as hereditary diseases, overstrain of nervous system, impaired vitality from excesses of any kind. Applicants should be required to give an explicit statement of any severe illness or injury, and the cause of death of near relatives, and certify that they believe themselves free from any ailment-mental or physical-or defect which would disqualify them for active service in any climate.
26. The board will examine the applicant orally as to his proficiency in general literature, language, history, and geography of the United States in particular, and such branches of general science as they may in their discretion think pertinent. 27. The written examinations of applicants for appointment will begin with a short autobiography of applicant, in which he will concisely state: Whether married or single; the date and place of his birth; the school, institution, or college at which he received his general education; the several branches studied, including his knowledge of general literature and of the ancient and modern languages; the exact title of the medical school or schools at which he received instruction, and the date of his graduation; the name and place of residence of his preceptor and the time when he commenced the study of medicine: also the titles of the text-books studied on chemistry, anatomy, physiology, histology, materia medica, pharmacy, therapeutics, theory and practice of medicine, principles and practice of surgery, medical jurisprudence, toxicology, obstetrics, hygiene, biology, pathology, bacteriology, and physics; the opportunities he has had of engaging in the practice of medicine, surgery, and obstetrics, or of receiving clinical instruction; and whether he has been a resident physician or interne in a civil or military hospital; and the number of cadavers or parts of cadavers he has dissected while at college or elsewhere. The candidate will append to this statement his name in full, post-office address, and his local address at the date of the examination. 28. The remainder of the written examination of applicants for appointment will consist of questions on: (1) Anatomy; (2) physiology; (3) chemistry; (4) materia medica and therapeutics; (5) practice of medicine; (6) practice of surgery; (7) obstetrics and diseases of women; (8) hygiene; (9) pathology and bacteriology; (10) reports on selected cases at a hospital. These cases will be selected by the examiners so as to give at least two—one medical and one surgical case—to each applicant. • 29. This examination will further consist of such inquiries as may tend to develop the general aptitude of the person for the special duties required of a commissioned officer in the Service and to show his moral qualifications for the position of trust and responsibility which he will assume when appointed. 30. When practicable, applicants for appointment will be required to perform such surgical operations on the cadaver as may be directed by the examiners. 31. The passing of an examination will not be considered as giving assurance of appointment, as, in case there should be more successful candidates than vacancies, the Secretary of the Treasury will select for recommendation to the President those of the highest attainments, as shown by their relative standing on the roll reported by the board of examiners. 32. No qualified applicant will be eligible for appointment more than one year. If not appointed within that time he may be reexamined, unless he has passed the limit of age, as provided in paragraph 20, when, if successful, he will take position with the class last examined. 33. An applicant for appointment failing at one examination may be allowed a second examination after one year if he has not passed the limit of age, as provided in paragraph 20, but he shall not be allowed a third examination. 34. When an applicant for appointment has shown by his papers on the four branches—anatomy, physiology, chemistry, and materia medica—during the progress of his examination that he is deficient to such an extent that it would be impossible for him to reach the required general average in all branches, the board of examiners may, in its discretion, reject this applicant without further examination.
35. Before the applicant has demonstrated his inability to pass the examination the board, in its discretion, may accord the applicant privilege to withdraw, but in this event the applicant shall not be eligible for another examination for a period of one year.
EXAMINATION OF CANDIDATES FOR PROMOTION. 36. A board of commissioned officers will be convened from time to time by the Supervising Surgeon-General for the purpose of examining candidates for promotion. This board shall consist of three commissioned officers, of whom the senior shall be chairman and the junior recorder of the board. The board will make a true report on the merit roll (Form 1936) of the actual and relative standing of the candidates for promotion, and transmit the examination papers, with its recommendations, to the Secretary of the Treasury, through the Supervising SurgeonGeneral.
37. Examinations for promotion will be made chiefly in writing, but may be supplemented, in the discretion of the examiners, by an oral examination on any subject connected with the official and professional duties of the officer. Candidates for promotion, of whatever rank, must show themselves proficient in all the regulations governing the Service. The examiners will also examine carefully the record of the service of the officer as furnished from the Bureau, and shall give due consideration thereto in making their recommendations. No officer will be recommended for promotion who shall be found physically disqualified.
40. When an officer fails to pass the physical examination required for promotion, the board of examiners shall report in detail the physical condition of said candidate, and if it shall appear that his condition is the result of irregular or dissipated habits, the case shall be reported as requiring investigation by a board convened in accordance with paragraph 248. If it is the result of disease or disability contracted in the line of duty, he shall be recommended for “ waiting orders” or special duty of a light character.
42. Assistant surgeons, at the expiration of five years' service, shall be entitled to an examination for promotion to the grade of passed assistant surgeon, as hereinafter specified, and they will be ordered to appear before a board of commissioned officers for this purpose. Failing to pass the first examination, they shall be allowed a second examination, but not until after the expiration of one year, and shall be ordered to appear for said examination as soon after the expiration of the year as practicable.
44. An assistant surgeon, in order to be recommended for promotion, must obtain an average mark of 80 per cent and not less than 70 per cent in any of the following branches: (1) Anatomy; (2) physiology; (3) chemistry; (4) materia medica and therapeutics; (5) practice of medicine; (6) practice of surgery; (7) obstetrics and diseases of women; (8) hygiene; (9) pathology and bacteriology, The examination to be written, and he must satisfy the board that he has been diligent in keeping himself informed of the progress and improvements in the practice of his profession since his appointment into the Service, and, in addition to the above, he must pass a physical examination.
47. A vacancy in the grade of surgeon will be filled by promotion from among the passed assistant surgeons who shall be eligible to promotion to the grade of surgeon in the order of seniority, but such officer will not be promoted until he shall have passed a satisfactory professional examination in writing in the practice of medicine, surgery, hygiene, hospital and quarantine management, and regulations of the Service, in addition to a physical examination. He shall be required to make an average marking of 80 per cent on the above-mentioned subjects.
Passed assistant surgeons who are eligible for promotion to the grade of surgeon shall be ordered to appear before a board of commissioned officers for that purpose. Failing to pass this first examination, they shall be allowed a second examination after the expiration of one year, and shall be ordered to appear for said examination as soon thereafter as practicable.
49. When an officer reports himself or is reported unfit to perform his official duties by reason of disease, injury, or age, he shall be ordered by the Supervising Surgeon-General, if in his opinion it is necessary, to appear before a board of commissioned officers, who shall thoroughly examine him, and if it shall appear that the disability is the result of irregular or dissipated habits, the case shall be reported as requiring investigation by a board convened in accordance with paragraph 248. If it be the result of disability in the line of duty, the board shall recommend him for “waiting orders ” or for special duty of a light character.
70. The compensation of commissioned officers, when not provided for by statute, shall be fixed at a uniform annual rate for each rank as follows, viz: Surgeons shall receive $2,500 per annum; passed assistant surgeons shall receive $2,000 per annum, and assistant surgeons shali receive $1,600 per annum; and after five years' service an additional compensation of 10 per cent on the annual salary for each five years' service shall be allowed commissioned officers above the rank of assistant surgeon, but the maximum rate shall in no case exceed 40 per cent. Said officers placed on “ waiting orders” for a period longer than two months shall receive 75 per cent of the pay of their respective ranks while so placed.
93. When a commissioned officer is serving at a station on active duty where there are no quarters belonging to the Service, he shall receive commutation for quarters at the following monthly rate, allowed medical officers of the Army of the same relative rank, viz: For surgeons, for 4 rooms, fuel, and lights, commutation, $50 a month; for passed assistant surgeons, for 3 rooms, fuel, and lights, $40 a month; and for assistant surgeons, for 2 rooms, fuel, and lights, $30 a month. When on duty on board a revenue cutter or quarantine vessel or on waiting orders officers will not be allowed commutation.
On appointment, the young officers, as a rule, are first assigned to duty at one of the large marine hospitals, as at Boston, New York, Baltimore, New Orleans, Chicago, or San Francisco. Officers traveling under orders are allowed actual expenses. Boards of examiners are usually called once a year, and appointments are not influenced by politics.
Supervising Surgeon-General M. H. S. Approved: O. L. SPAULDING,