duty during the period between September 16, 1940, and the end of the war, the widow shall be eligible for benefits under the act to the same extent as would inure to the veteran if he were living and qualified for those benefits. Widows who remarry would not so benefit, except that loans guaranteed under the act and made prior to the remarriage would not be disaffected. It would be greatly appreciated if you would transmit my sentiments in this regard to the committee which is working on amendments, and I would be gratified to have this letter become a part of the record.⚫ In my opinion these widows, whose number is relatively small, deserve the utmost in aid, particularly if they have dependents. In this regard, the act needs amending. One of the most important features of S. 866 is that it would make available to widows the same chances for education and retraining their young husbands would have had, had they lived and returned to avail themselves of the opportunities for getting a home or farm, or of entering into business. True, some 90 percent of the servicemen had applied for the maximum $10,000 in national service life insurance. But 5 percent took out insurance only of from $1,000 to $3,000 in such insurance, disregarding advice to take more; and another 5 percent made no application whatsoever for such insurance. If a widow had two children and happened to be without insurance, the case would be grave. But supposing a widow were under 30, and had three children, protected by the maximum insurance. She gets a pension, and insurance payments. She cannot get the $10,000 in a lump sum, of course. Her monthly income on that insurance is $5.51 for each $1,000. Since in this case she is the beneficiary of a $10,000 policy, she gets a maximum $55.10 each month. She also gets a pension of $65 a month for herself and the first child, plus $13 for each additional child; or $91 in the case of our young widow with three children. Her income is $146.10 for herself and her family. She has a reserve of $35.50 for each member of that family, little enough, but only that high because she was fortunate in having the maximum in insurance. Had her husband been alive, he would be entitled to the year's refresher course in education regardless of his age. If he was under 25 when he entered service, he could get another 3 years of education or an approved college term; $500 per school year, and $75 in monthly subsistence for himself and his family. His widow has no such chance. The need exists today. A Seattle woman who wrote to me had heard that the GI bill provided for the refinancing of homes. Her husband was lost when a German torpedo struck the destroyer to which he was assigned. Her pension is $65 a month. She is buying a home, paying $48 on it, and is making an effort to support their 2-year-old child on the balance. I had to tell her that present legislation provides no such security for her. The attached letter is another case in point. The inequity for widows and children whose disallowance results solely from the circumstance that a husband and father was lost in service to his country is self-evident. Those in the War and Navy Departments with whom I have talked believe there is justice in such an amendment. I would appreciate your consideration and that of the committee. In the event there is further information which should be a part of your deliberation, I will be glad to do what I can in obtaining it. Very truly yours, WARREN G. MAGNUSON, U. S. S. VETERANS PLACEMENT SERVICE BOARD, Hon. CARL HAYDEN, United States Senate, Washington, D. C. MY DEAR SENATOR HAYDEN: My attention has been called to the fact that in H. R. 3749, having for its purpose the amendment of the Servicemen's Readjustment Act, section 505 (b) has been eliminated. Section 505 (b) of that act was that section which made a veteran eligible under the Bankhead-Jones Farm Tenant Act to borrow from the FSA on the same basis as a farm tenant. Whether this omission was intentional or not, I am not aware, but I do know that it will eliminate an opportunity for veterans in Arizona which will not be provided at all under the regular farm provisions of the GI bill, because under a farm-ownership loan (FSA) a veteran might borrow up to $12,000, and certainly on $12,000, or even any major proportion of that amount, could start a supporting farm operation here in Arizona, whereas it is highly unlikely that many veterans can float a loan under the normal provisions of the GI bill adequate to start a successful farm operation. I hope that the Senate will see fit to return this provision of the original Servicemen's Readjustment Act to the body of H. R. 3749 before its final passage. Sincerely, W. C. SAWYER, Veterans Employment Representative for Arizona. KANSAS CITY, Mo., October 17, 1945. Senator EDWARD C. JOHNSON, Senate Office Building, Washington, D. C.. DEAR SIR: Regarding the Servicemen's Readjustment Act of 1944, as same concerns the officer-veteran, said act should be amended so that real-estate loans, obligations could be made prior to obtaining discharge while on terminal-leave period subject to honorable discharge. These officers are deprived of contracting for homes during said terminal-leave period. We are making a large volume of veterans' loans, and many men have been handicapped in this way. Thanks for the cooperation that has been given. Very truly yours, R. L. WILLIS & Co. A STATEMENT OF THE SUBCOMMITTEE ON EDUCATION OF PHYSICIAN VETERANS OF THE COMMITTEE ON POSTWAR MEDICAL SERVICE I. THE COMMITTEE ON POSTWAR MEDICAL SERVICE The Subcommittee on Education of Physician Veterans of the Committee on Postwar Medical Service has given study to the provisions of H. R. 3749, an act amending Public Law 346, Seventy-eighth Congress, and respectfully requests that a number of amendments be presented which will insure the application of the provisions of the new law to the education of physician veterans. The Committee on Postwar Medical Service was organized approximately in the middle of the war to prepare for the postwar solution of the Nation's health problems. The committee is formed of representatives of the American Medical Association, the American College of Physicians, the American College of Surgeons, the three national hospital associations (the American Hospital Association, the American Protestant Hospital Association, and the Catholic Hospital Association), and eight of the national agencies in the health field, together with representatives of the Army, the Navy, the Public Health Service, and a number of other Government agencies interested in the national health. The subcommittee on education of physician veterans of the committee just described reports to the general committee. At the present time the subcommittee is made up of Dr. Frederick A. Coller, professor of surgery at the University of Michigan, Dr. Victor A. Johnson, scretary, Council on Medical Education and Hospitals of the American Medical Association, and Alphonse M. Schwitalla, S. J., dean, St. Louis University School of Medicine and president of the Catholic Hospital Association. The Committee on Postwar Medical Service lays claim to complete competence in representing the views of the various agencies whose representatives participate in the committee's activities. It may well be said, therefore, that this committee expresses the viewpoints of by far the larger percentage of the agencies and organizations interested in the Nation's health care. The Committee on Postwar Medical Service desires to restrict its comments on H. R. 3749, the Servicemen's Readjustment Act of 1945 to title II, chapter 4, Education of veterans of the act (p. 11 of the bill as printed). With reference to this section the committee finds that the legislation proposed in the act needs clarification, further definition, or amendment with reference to (a) the recognition of the hospital as an educational institution for the education of residents; (b) the recognition of the resident as a student of medicine, rather than only as a professional person giving service to the hospital or to the patients in the hospital. II. THE HOSPITAL AS AN EDUCATIONAL INSTITUTION The Committee on Postwar Medical Service assumes that it is the intention of Public Law 346 or its future substitute to facilitate the education of returning veterans inclusive of professional persons to whatever extent may be reasonable and conducive to the best interests not only of the veterans but also of the Nation. It is further assumed that it is the intention of this legislation to extend the facilities to the largest possible degree, again within the intent of Congress and within the limits of available finances. Hence, within the intent of the law, the physician veteran deserves the same consideration as any other veteran. Congress has provided that the veteran who is eligible for and entitled to education or training may obtain it "at any approved educational or training institution" (par. 3, p. 13, line 24). In defining the term "educational or training institutions," paragraph 11 extends the meaning to a large number of vastly diverse kinds of institutions inclusive of public or private, elementary, secondary, and other schools furnishing education for adults, business colleges and schools, correspondence schools, scientific and technical institutions, colleges, junior colleges, teachers' colleges, normal schools, professional schools, universities, and other educational institutions which provide apprenticeship or other types of training on the job. In other words, it seems that the intent of the law is to permit the greatest possible flexibility in its application so that each veteran may be able readily to utilize the kind of educational opportunity which best fits his needs or his choice. It should be noted that physician veterans must seek their education, if they choose to supplement their studies after having obtained the M. D. degree, by entering an institution which is not mentioned in this list, comprehensive as this list seems to be. The physician veteran must seek his further education in a hospital, and it is to be regretted that the term "hospital," modified, if thought necessary, by such words as "approved” or “recognized,” should have been omitted from paragraph 11 of the act. With reference to this part of the act, "hospitals" may be distinguished into two classes: (a) Those which are under university control and (b) those which are not under university control. Of the first kind, there are many diverse classes, but they all have this in common: That, to a greater or less degree, a university or school of medicine participates in their administration, and makes itself responsible for the quality of the service given, for the appointments and the professional activities of the members of the staff, and for the excellence of the educational activities which are pursued by various classes of students in such hospitals. The second class of hospitals are those which have no immediate relationship to an educational institution, and which conduct such activities as are characteristic of a hospital under the authority of a board of trustees. It should be emphasized here that in this particular statement there is no question of a group of institutions designated as proprietary hospitals, but only of hospitals "organized not for profit," or, as they are more briefly called, "nonprofit hospitals." In its effort to provide adequate educational opportunities for physician veterans, the Council on Medical Education and Hospitals has, for the last 2 years conducted an intensive educational campaign, requesting that those hospitals which can possibly assume the responsibility, should offer what are called "residencies," so that the greatest possible number of such positions might be made available to the returning physician veteran. Prior to this campaign, there were listed as approved residencies in the hospitals approximately 5,000 such positions. After the appeal for the opening of more of these residencies became effective, no fewer than 7,666 of these positions are at present available. 1 A residency is a position in an approved hospital, occupied by a physician who, after his graduation from a school of medicine and after the completion of a 1 or 2 years' internship, desires to pursue his medical studies for an additional period of from 1 to 3 years or even longer, either because he wishes to prepare himself better for general practice or because he wishes to prepare himself for specialization. During the residency the physician receives a moderate stipend or rather an "honorarium," and generally there is little relationship between the amount he receives and the duties he assumes. His chief care is 1 During the war period internships for deferred medical officers of the Army and Navy have been restricted to periods of 9 months. his education, which he obtains by studying and giving his expert attention to his patients. It must be emphasized that the opening of such residencies is a serious responsibility for the hospital. The hospital must provide a teaching staff; it must, in most instances, provide housing facilities; it must make itself responsible for the development of a curriculum, and for providing continuing and expert supervision of the resident. It must also give evidence that it can supply the requisite laboratory and library facilities, and, in default of such facilities, that it is able and willing to develop the required kinds of library and laboratory facilities. It must give evidence that it has a patient census sufficiently large to afford to the resident a diversified and sufficiently voluminous experience to enable the resident to profit professionally by his contact with these patients. It must at the same time develop contacts with related professions such as those of nursing, laboratory, technology, etc., to insure medical care of sufficient excellence to be recognized as a real educational opportunity. All of this is important,, because the resident presents the experience in the hospital as evidence of his own competence, which he offers to examining bodies, in the various medical specialties, and on the basis of which his eligibility for taking the final examinations of these boards is determined. All of this definitely indicates that any hospital which has developed residencies and is willing to accept residents must necessarily be an educational institution. It seems unnecessary to amplify this thought further, but, if further amplification is needed, it should be recalled that the modern hospital of today educates and prepares for professional qualification such persons as nurses, laboratory technicians, medical record librarians, hospital administrators, radiologic technologists, physical-therapy technologists, occupational therapists, dietitians, medical social workers, besides physicians, both general practitioners and specialists. Another line of evidence to show that the hospital is an educational institution is afforded by the function which the hospital serves in preparing the physician who has graduated for the practice of medicine. As is well known, a physician who graduates from a school of medicine, even if it is an approved school of medicine, is not by that very fact alone entitled to practice medicine. He must be licensed by the State to practice. Before such licensure is given, or in connection with it, several of our States require that the graduate in medicine should have served a year's internship in an approved hospital. Even in those States in which this is not legally defined, the graduate in medicine does serve the internship because it is recognized that the education of a doctor can be rounded out and completed only by such educational experiences as he obtains in the hospital under professional tutorship and supervision. These facts are here stated to show that a hospital, as understood by the medical profession, is an educational agency even when it is not connected with a university, and, therefore, should have been appropriately listed with the numerous kinds of educational agencies mentioned in No. 11 of section 400, chapter 4, title II of H. R. 3749 (p. 18). One other point must be mentioned as confirmatory of the position here taken. The residencies are subject to review by an appropirate educational approving and evaluating agency. The Council of Medical Education and Hospitals of the American Medical Association maintains a list of approved residencies. It has requirements for residencies. Only those residencies in various hospitals concerning which evidence is regarded as satisfactory that they represent sound educational opportunities, are approved. The approval is given on the basis of the hospital's compliance with published requirements for approval. The appropriate paragraph among the requirements reads as follows: "The effectiveness of a residency or fellowship program depends largely on the quality of medical supervision and teaching. It is important, therefore, that methods of instruction be employed which are best suited to the special field. Emphasis should be placed on beside instruction, teaching rounds, departmental meetings or seminars, clinical pathologic conferences, demonstrations, and lectures. The review of medical literature is an essential feature of residency training. Likewise the study of basic sciences as required by specialty boards should be integrated with the clinical experience. In the operative divisions it is desirable that facilities be available for anatomic dissection and experimental surgery on animals or on the cadaver. Additional requirements apply to graduate courses leading to advanced degrees." III. THE VETERAN PHYSICIAN AS A GRADUATE STUDENT OF MEDICINE The returning physician who has served in the armed forces, and who now prepares to return to civil life, regards himself as entitled to all the benefits which the Government is offering to other veterans. The physician, therefore, requests opportunities for his further education. Various classes of veterans must here be considered: (a) The physician who has been called to the armed forces immediately subsequent to his graduation and (b) the physician who has been called out of his private practice into the armed services, after the lapse of various numbers of years subsequent to the completion of his internship. Both of these classes of physicians have already manifested their desire to request for themselves, after their discharge from the service, further educational opportunities for their professional development: The young man just finishing his internship, because he knows that his education as a physician is not sufficiently far advanced to enable him to go into medical practice, or because he has the ambition to become a specialist in any one of the numerous branches of medical specializations; the physician veteran who was called to the colors from his practice, because he knows that during the period of his stay in the Army medicine has progressed literally enormously and he himself has not been able to participate, while in the military service, through study, in applying the new discoveries and the new methods to the patients of whom he will take charge. In other words, practically all physicians leaving the services of the armed forces will desire additional educational opportunities. In a recent study of physicians in the various theaters of operation, only 20 percent indicated that they would not seek additional educational opportunities after discharge. Some of the physicians, approximately 20 percent, will content themselves with refresher courses of varying periods of length, ranging from 3 weeks to 1 year. A larger percentage, however, probably as many as 60 percent, will desire a longer educational experience, many of them seeking such opportunities as a residency in a recognized hospital alone can afford. With reference to the younger physician veterans, that is, the physician veteran who has never had an opportunity to serve as a resident, these men are, or will be, between 24 and 35 years of age at the time of separation from the armed services. There will be no question about their eligibility on the basis of age for GI benefits, nor will there be any question about establishing the fact that their service in the armed forces has interrupted their educational development. With reference to the other group, however, that is, the men who have been in private practice prior to their experience in the armed forces, these men are for the most part above 30 years of age. They have already experienced the earning of a livelihood by their practice, and the question might arise as to whether or not they are eligible for GI benefits. It has been said that they exceed the age limit set for GI benefits and that their education cannot be said to have been interrupted. With reference to these opinions it must be emphatically stated that there should be eliminated from the Servicemen's Readjustment Act in favor of the physician veteran all limitations of eligibility arising from the noninterruption of his education. It must be recognized that among the professions or even, more broadly, among the occupations, physicians are in a unique position. A physician's education is never complete. None of the other learned professions make the same demand for continuous education upon their members as does the medical profession. Constant attendance at medical society meetings and at hospital staff meetings and at clinical pathological conferences and at State and national association meetings and at meetings of the various specialists is urged upon the doctor. Many of the physicians in the armed services have insisted that they have felt themselves "slipping" in their medical practice by reason of their services in the Army. It must be remembered that only a relatively small percentage of the physicians have been employed in actual medical services, at least in the services comparable to those performed by them as civilians. A large percentage of the physicians in the armed service were necessarily performing administrative duties, and these especially consider themselves not fit to return to their civilian practice, whether as private physicians or as teachers, without periods of additional study. In view of the foregoing, it is strongly urged that specific mention should be made in the amended bill to insure educational opportunities to the physician veterans. It is the desire of a large number of the medical profession that these provisions should not be prescribed only in rules and regulations, but that they should be definitely embodied in the law, so that the group of veterans from whom the country desires to derive one of the greatest benefits, after their demobiliza |