Army Medical Department (United States)

The Army Medical Department of the U.S. Army — known as the AMEDD — comprises the Army's six medical Special Branches (or "Corps") of officers and its enlisted medical soldiers. It was established as the "Army Hospital" in July 1775 to coordinate the medical care required by the Continental Army during the Revolutionary War. The AMEDD is led by the Surgeon General of the U.S. Army, a Lieutenant general.

The AMEDD is the U.S. Army's healthcare organization, not a U.S. Army command. It is found in all three branches of the Army: the Active Army, the U.S. Army Reserve, and the Army National Guard. Its headquarters is at Fort Sam Houston, San Antonio, Texas, which hosts the AMEDD Center and School (AMEDDC&S). Large numbers of AMEDD senior leaders can also be found in the Washington D.C. area, divided between the Pentagon and the Walter Reed National Military Medical Center (WRNMMC).

The Academy of Health Sciences, within the AMEDDC&S, provides training to the officers and enlisted service members of the AMEDD. As a result of BRAC 2005, enlisted medical training was transferred to the new Medical Education and Training Campus, consolidating the majority of military-enlisted medical training in Fort Sam Houston.

The current Surgeon General of the U.S. Army is LTG Patricia Horoho. She is also commander of the U.S. Army Medical Command (MEDCOM).

History
Both the AMEDD and the Army Medical Corps trace their origins back to July 27, 1775, when the Continental Congress established the "Army Hospital", which was at that time overseen by the "Director General and Chief Physician". Congress provided an Army medical organization only in times of war or emergency until 1818, at which point it created a permanent "Medical Department". The Army Nurse Corps originated in 1901, the Dental Corps began in 1911, the Veterinary Corps in 1916; the Medical Service Corps emerged in 1917; and the Army Medical Specialist Corps came into existence in 1947.

The Army Organization Act of 1950 renamed the Medical Department the "Army Medical Service" (AMS) and on June 4, 1968 the AMS was renamed the Army Medical Department (AMEDD).

Heraldry

 * See also: Rod of Asclepius and Caduceus as a symbol of medicine

Coat of arms
A regimental coat of arms was devised for the Medical Department, and was most likely first used in 1818. The 20 white stars on a blue background and the red and white stripes represent the U.S. flag of 1818. The green staff entwined with a green serpent combined two symbols: the rod of Asclepius from Classical mythology, symbolic of medicine and healing; and the color green associated with the Medical Corps during the last half of the 19th century. The colors Argent and Gules are those associated with the Army Medical Department. The cross and wreath are adapted from devices authorized for hospital stewards and other medical enlisted men when the Hospital Corps was established in 1887. The seven stars emphasize the elements of the organization: the six officer branches (Medical Corps, Army Nurse Corps, Dental Corps, Veterinary Corps, Medical Service Corps, Medical Specialist Corps) and the Enlisted Medical Specialists. The AMEDD motto "TO CONSERVE FIGHTING STRENGTH" reflects the medical mission.

Branch (corps) insignia
In 1851, "a caduceus embroidered in yellow silk on a half chevron of emerald green silk" was first authorized and worn by hospital stewards of the Medical Department. The caduceus in its present form was approved in 1902. Today, the AMEDD branch corps insignia is a gold color medal caduceus, 1 inch in height. With the exception of the Medical Corps, each Corps is identified by a black enamel letter (or letters) centered on the caduceus indicative of the specific branch. The insignia for Medical Service Corps is silver. Rooted in classical mythology and associated with the Greek god Hermes, the US Army's long-standing use of the caduceus has made it a well known emblem of physicians and medical skill in the United States. (Purists, however, often assert that the rod of Asclepius, with its single serpent, is the more proper medical emblem.)

Regimental insignia (crest)
The design of the AMEDD regimental insignia (crest) is derived from the regimental coat of arms. It is one of the US Army’s 14 regimental corps insignias. These insignias are worn over the right breast pocket on the Class A uniform and signify the service member’s branch of service. The AMEDD insignia was originally approved on 17 April 1986, but it was reduced in size from 1 1/4 inch to 1 inch on 28 August 1986.

Medical special branches
There are currently six special officer branches (corps) in the AMEDD.

Medical Corps (MC)
The Medical Corps consists of commissioned medical officers who are physicians (Doctors of Medicine and Doctors of Osteopathic Medicine) who have completed at least one year of post-graduate training (internship) or have been promoted from O-1 to O-3 following completion of medical school through USUHS or the HPSP. The MC traces its origins to 27 July, 1775, when the Continental Congress created “a Hospital”, essentially a Medical Department and corps of physicians, for the Continental Army. Medical officers in the United States Army were authorized uniforms only in 1816 and were accorded military rank only in 1847. Congress made the designation of "Medical Corps" official in 1908, although the term had long been in use informally among the AMEDD's regular physicians. Today, members of the MC work around the world at all echelons of the Army. The Chief of the MC is a major general, whereas the senior MC officer is the Surgeon General (a Lieutenant general).

Military physicians serve in one of several general career fields. The three main fields are operational field, clinical field, and research field.

Operational Medicine is the field of Army medicine that provides medical support to the soldier and his/her Chain of Command. Many operational physicians serve as Division, Brigade and Battalion level surgeons (the word "surgeon" is used to identify a physician that is assigned to a unit as a primary care provider and not necessarily as a General Surgeon). These physicians are either assigned through the "PROFIS" system or through permanent assignment (PCS). Deployments with units to combat theaters are for the duration of a deployment and the jobs are mostly filled by primary care physicians. A PROFIS provider can expect to be deployed away from their family for a total of 16 months (1 month before deployment, 12 months in theater, and 3 months for "stabilization" after return to the assigned units home station). This means that primary care physicians are deployed for longer periods than most "specialist physicians". A specialist (i.e. General Surgeon, Pulmonologist, Cardiologist, Trauma Surgeon, Rheumatologist) are usually deployed for 6 months. Operational Physicians should expect that more than 60% of their time will be spent in administrative roles and non-patient care. 40% of the operational providers time is spent caring for soldiers or supervising unit Physician Assistants (PA). With the recent Brigade Combat Team (BCT) restructuring, the demand for operational surgeons have increased. It is possible that the low retention rates of Captains and junior Major rank Physicians in the primary care fields are due to the discrepancies in deployment length and deployment frequency between primary care and specialty physicians.

Clinical Medicine is the field of Army medicine in which a physician in uniform performs similar functions to a physician in the civilian arena. These physicians are assigned to a PROFIS unit in one of the various Army MEDCEN (Medical Centers) and MEDDAC (Medical and Dental facilities). Primary care physicians usually deploy to fill battalion level surgeon positions. Medical specialists deploy to support CSH (combat support hospitals)

Research Medicine is filled by a minority of military physicians. Most of these research physicians are based in larger Army Medical Centers.

Nurse Corps (AN)


The Army Nurse Corps became a permanent corps of the Medical Department under the Army Reorganization Act (31 STat. 753) passed by Congress on 2 February 1901. Its motto is "EMBRACE THE PAST – ENGAGE THE PRESENT – ENVISION THE FUTURE" and its mission statement declares "All actions and tasks must lead and work toward promoting the wellness of Warriors and their families, supporting the delivery of Warrior and family healthcare, and all those entrusted to our care and ultimately, positioning the Army Nurse Corps as a force multiplier for the future of military medicine."

Dental Corps (DC)


The Dental Corps (DC) consists of commissioned officers holding the Doctor of Dental Surgery (DDS) degree or Doctor of Dental Medicine (DMD) degree. The chief of the Dental Corps is a major general. Enlisted soldiers may be assigned as dental assistants, although their collar insignia lacks the 'D' and is the same as that worn by medics. Army Dental Corps Officers may train further in the following advanced training programs after Dental School:


 * Advanced Education in General Dentistry
 * Comprehensive Dentistry (2 year AEGD)
 * Endodontics
 * Oral and Maxillofacial Surgery
 * Orthodontics and Dentofacial Orthopedics
 * Pediatric Dentistry
 * Periodontics
 * Prosthodontics
 * Public Health Dentistry
 * Oral Pathology

The US Army currently offers fellowship training in the following areas for Dental Corps Officers (applicants must have already completed a recognized specialty training program):


 * Oral-facial pain
 * Maxillofacial prosthodontics
 * Healthcare Administration
 * Dental informatics

The following ADA recognized specialties are not represented in the US Army Dental Corps:


 * Oral and Maxillofacial Radiology

The chief of the Army Dental Corps is Major General Ming "Ted" Wong.

Veterinary Corps (VC)


The U.S. Army Veterinary Corps was established by an Act of Congress on 3 June 1916. Recognition of the need for veterinary expertise had been evolving since 1776 when General Washington directed that a "regiment of horse with a farrier" be raised. It has evolved to include sanitary food inspectors and animal healthcare specialists.

The Veterinary Corps consists of commissioned doctors of veterinary medicine. Warrant officers are the core of its food inspection service. Enlisted personnel can serve as food inspection specialists and veterinary technicians; enlisted personnel's collar insignia lacks the 'V' and is the same as that worn by medics.

The Chief of the Veterinary Corps is Brigadier General John L. Poppe.

Medical Service Corps (MSC)
The Medical Service Corps consists of commissioned and warrant officers. Members are required to hold at least a bachelor's degree before receiving a commission. The MSC has the greatest range of duties performed by personnel. These may include administrative and support duties such as healthcare administrators, health services officers in operational units, healthcare comptrollers, healthcare informatics officers, patient administrators, health service human resource managers, health physicists, toxicologists, sanitary engineers, medical operations and plans officers, medical logisticians, health services maintenance technicians, and medical evacuation pilots. MSC officers serve in clinical support roles as clinical laboratory science officers, environmental science officers, pharmacists and preventive medicine officers. Medical Service Corps officers serve as commanders of field medical units in garrison and combat environments, and provide healthcare to patients as psychologists (PhD, PsyD), social workers (MSW with state license), optometrists, pharmacist, podiatrists, and audiologists. The Medical Service Corps also functions as a transitional branch, encompassing commissioned medical, dental, and veterinary students who have not completed their training through the Uniformed Services University of the Health Sciences (USUHS) or the Health Professions Scholarship Program (HPSP).

Medical Service Corps officers are drawn from the various Army commissioning sources (USMA, ROTC, and the federal and state Officer Candidate Schools) following a branch-immaterial curriculum. Since a primary function of the Medical Service Corps is to manage combat health support activities, its officers hold general command authority and can compete for company and field grade command of medical support formations and detachments, similar to officers of the "competitive category" branches (infantry, ordnance, quartermaster, etc.). In contrast, Medical Corps and Dental Corps officers are limited to command billets specific to their respective corps (e.g. hospitals, MEDDACs, clinics for doctors; dental clinics, DENTACs for dentists).

The Chief of the Medical Service Corps is Brigadier General Dennis D. Doyle.

Medical Specialist Corps (SP)
The Army Medical Specialist Corps consists of commissioned officers. Members hold professional degrees and serve as clinical dietitians, physical therapists, occupational therapists, and physician assistants. Members of the SP serve all around the world and at all echelons of the Army. The Chief of the SP Corps is COL Theresa Schneider.

Enlisted Medical Career Management Fields (CMFs)
There are currently 17 military occupational specialties (MOSs) for enlisted medical soldiers: Biomedical Equipment Specialist (MOS 68A), Operating Room Specialist (68D), Dental Specialist (68E), Patient Administration Specialist (68G), Optical Laboratory Specialist (68H), Medical Logistics Specialist (68J), Medical Laboratory Specialist (68K), Nutrition Care Specialist (68M), Radiology Specialist (68P), Pharmacy Specialist (68Q), Food Safety Inspector (68R), Preventive Medicine Specialist (68S), Animal Care Specialist (68T), Respiratory Specialist (68V), Healthcare Specialist/Combat Medic (68W, formerly 91A, 91B), Mental Health Specialist (68X), and Chief Medical NCO (68Z). In addition, outside the AMEDD, is the Special Forces Medical Sergeant (18D).