Medical residency program authorized 69 years ago- VA Policy Memo No. 2

Within weeks of Congress authorizing VA’s new Department of Medicine & Surgery (DM&S) on January 3, 1946 in Public Law 79-293, development of a medical residency internship program was underway. At the time,  VA was losing hundreds of doctors, dentists, nurses, and other staff who had been temporarily assigned there during World War II. Since the war over, they were being discharged from service and a huge VA staffing crisis loomed ahead.

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The earliest known affiliation in VHA’s history dates to 1890 when VHA’s ancestor, the National Home for Disabled Volunteer Soldiers, partnered with the Wisconsin Training School for Female Nurses to provide graduate nurses to its hospital at the Milwaukee branch (now a VA medical center).  They began with 10 nurses and the results were so successful that female nurses were afterward employed by all of the National Homes. No attempts for a similar arrangement with medical schools was made.

After World War I, medical and nursing staff at VHA’s predecessor, the Veterans Bureau, pushed for creation of a medical corps that never came to fruition;  however, they started to publish internal medical bulletins to facilitate training and its medical  staff were encouraged to attend local medical association/society meetings.

Beginning in 1944, a series of newspapers articles attacked the quality of VA health care under long-time Administrator, General Frank T. Hines. Congress ordered a study and in early 1945, the  medical consultants’ report recommended that VA affiliate with medical and nursing schools.

image001Dr. Paul Magnuson, a Chicago-area orthopedic surgeon, rehabilitation expert, and medical school professor who served as a consultant to the U.S. Army Surgeon-General during World War II, came to work as a consultant at VA around that same time.  Magnuson agreed with the consultants’ findings. President Truman used the report as basis to order an overhaul of the Veterans Administration.  General Omar Bradley was appointed that summer (1945) to replace General Hines and many of Bradley’s co-horts from the European theatre, including its medical chief Dr. Paul Hawley, followed him to VA.  Magnuson did much of the preparatory work to ensure that a medical resident affiliation program became part of the new law that created the VA Department of Medicine and Surgery. Magnuson was a professor at Northwest University and had connections to the University of Illinois and they were the first VA medical school affiliates.

VA Policy Memo No. 2 was issued on January 30, 1946, just a few short weeks after the new VA department was authorized. It took several years to work out a myriad of details relevant to internships which resulted in an amendment in June 1948. Initially the program targeted medical interns, but expanded to include nursing, dental, pharmacy, dietetics, and other students.

At the end of its first year, 1,600 medical residents and 1,800 senior cadet nurses had entered the program. By 1965, there were 681 training programs for doctors with 21 specialties and 5,000 interns in the program.

VA’s medical school residency affiliation program proved to be one of the most ambitious, significant, and transformative pursuits undertaken by the new department. Now, nearly 70 years later, the Academic Affiliation program’s sweeping impact on medical education has stood the test of time as over half of America’s doctors, nurses, and other medical professionals obtain a portion of their training at a VA facility.

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from: Historian, Veterans Health Administration

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