by André Sobocinski*
Medical titles for the U.S. Navy were established by the Act of 24 May 1828 for the “Better Organization of the Medical Department of the Navy.” After 1828, a Navy medical officer could serve as a Surgeon, Passed Assistant Surgeon, and Assistant Surgeon. You also see the term “Acting Assistant Surgeon” which usually denoted temporary service (a la contract) or a physician who was serving aboard a ship but has not yet received a commission or been approved by a Board of Naval Surgeons. It should be understood that Naval medical officers were called “surgeons”, but were qualified nominally to practice both medicine and surgery.
The 1828 Act provided that all candidates for appointment needed to be examined by a Board of Naval Surgeons (AKA Board of Examiners). Upon
successful completion of the exam, the newly appointed physician would be given the title of “Assistant Surgeon.” In order to be promoted to
Surgeon, the Assistant Surgeon needed to serve at sea for at least two years and be examined again by the Board of Naval Surgeons. Successfully passing the board did not mean that he was automatically promoted to Surgeon. Until vacancies occurred the Assistant Surgeon would be known as a “Passed Assistant Surgeon.” Medical Officers could serve for years as a Passed Assistant Surgeon. We even have cases of physicians retiring from service as a Passed Assistant Surgeon.
These medical titles did not have an associated rank until 31 August 1846, when new regulations provided for “relative” ranks. Surgeons with more than 12 years of experience held “relative rank” equivalent to Navy line Commanders. Surgeons with less than 12 years of experience held “relative rank” of Lieutenant Commanders, Passed Assistant Surgeons, as Lieutenants, and Assistant Surgeons were considered roughtly equivalent to Lieutenants (junior grade).
On 3 March 1871, the title structure was again altered. The Navy Medical Department now had the additional titles of Surgeon General, Medical Director, Medical Inspector, Surgeon, Passed Assistant Surgeon, and Assistant Surgeon. Each of these conferred additional relative rank (Surgeon General=Commodore (one star), Medical Director=Captain, Medical Inspector=Commander, Surgeon=Lieutenant Commander, Passed Assistant Surgeon=Lieutenant, Assistant Surgeon=Lieutenant (junior grade) or Ensign). In 1899, the Surgeon General/Chief of the Bureau of Medicine and Surgery (“BUMED”) was given relative rank of Rear Admiral (two star).
On 15 August 1918, the concept of relative rank was abolished by General Order 418. Medical Officers were finally accepted in the Naval hierarchy and
looked upon as Naval Officers (the exception to this in 1918 was the Nurse Corps). With this said, the titles Medical Director, Passed Assistant
Surgeon etc continued to be used through 1947, but after WWI were less commonly used. A Medical Director would typically be called Captain, Passed Assistant Surgeon a Lieutenant Commander, etc.
As for Navy’s medicine’s most senior officers, from 1842-1871, the Chief of BUMED was a Surgeon, equivalent to Commander; 1871-1899 the Surgeon General/Chief of BUMED was equivalent to a Commodore (one star); 1899-1918 the Surgeon General/Chief of BUMED had the relative rank of Rear Admiral (two stars); from 1918 to 1965 the Surgeon General/Chief of BUMED had the rank of Rear Admiral. The only exception to this was Ross McIntire who, while serving simultaneously as FDR’s White House physician and Navy Surgeon General, held the three star rank of Vice Admiral. From 1965 to present the Surgeon General/Chief of BUMED holds the rank of Vice Admiral.
The Navy very wisely established Boards of Examiners in a day when medical education in the U.S. was unregulated and quite irregular. To assure a certain level of competence, each candidate for appointment as Assistant Surgeon had to pass a rigorous examination of his knowledge of medicine, surgery, anatomy, obstetrics and gynecology, pharmacy, legal medicine and more. For the convenience of the candidates, the Examining Boards sat at the Naval Asylum at Grays Ferry (Philadelphia), Brooklyn (Naval Hospital/School of Instruction), and later Washington, DC (Naval Museum of Hygiene/Naval Medical School). In the mid to late 19th century examinations were also conducted at Norfolk, VA, New Orleans, LA, and at Mare Island Navy Yard, CA.
Image: http://s277.photobucket.com/user/Sheriff__001/media/USNavyOffier.png.html, accessed 27 May 2015. The modern rank of Rear Admiral (lower half) was known as Commodore in earlier years. The Coast Guard retains the rank of Commodore for its one star flag officers.
*André Sobocinski is the Historian in the Communication Directorate at the U.S. Navy Bureau of Medicine and Surgery in Washington DC (his physical location is in Falls Church, VA). André wrote this article in response to a question about medical officer relative ranks put to the Executive Director of the Society for the History of Navy Medicine, Professor Annette Finley-Croswhite.
©2015 André Sobocinski