Celebrating 75 years of the Air Force Medical Service

Story by Maristela Romero

Air Force Medical Service

On July 1st, the Air Force Medical Service celebrates its 75th anniversary, marking a significant milestone in its long history of providing medical support to the Department of the Air Force. Established in 1949, the AFMS has played a crucial role in ensuring the health and readiness of Airmen and Guardians, evolving through the decades to operate in dynamic deployed environments and meet the changing demands of military medicine.

Early beginnings

The origins of the AFMS date back to the early 20th century, during World War I. The need for specialized medical care for pilots became evident as aviation technology advanced and the physical demands on pilots increased.

In 1917, Lt. Col. Theodore Charles Lyster was appointed as the first Chief Surgeon of the Aviation Section of the Signal Corps. Lyster advocated for the establishment of a research board to investigate the physical efficiency of pilots and to provide ongoing instruction on their physiological requirements. This initiative laid the groundwork for the development of flight medicine. By 1918, the Army established the Medical Research Laboratory at Hazelhurst Field in Mineola, New York to examine the effects of flight on the human body and to mitigate the loss of flight personnel during the First World War. Within the same year, the Army initiated the first aviation medicine education program for physicians, which later became the U.S. Air Force School of Aerospace Medicine.

Through the 1920s and 1930s, aviation medicine grew as a recognized medical specialty with numerous flight-related research studies. In 1935, then Maj. Malcolm Grow and Capt. Harry Armstrong led the efforts to establish the Aero Medical Laboratory at Wright-Field, Ohio, an institution that spearheaded modern innovation on human flight along with researchers from USAFSAM.

After World War I, advocacy increased among aviation personnel for a separate Air Force military branch along with a separate medical service to address the need for adequate selection, classification, and provision of care for flyers.

World War II and the push for an independent structure

During World War II, the importance of a dedicated medical service for the Army Air Forces became even more apparent. Maj. Gen. David N.W. Grant, named the first Air Surgeon in 1941, led the Army Air Forces medics through the war. He pioneered several key initiatives, including the establishment of rest and recreation centers for aircrew and the development of an aeromedical evacuation program that successfully transported over one million patients, which greatly reduced the fatality rate from battle casualties.

The experiences of World War II highlighted the need for a separate medical service to adequately address the unique challenges of flyers. Despite initial resistance, the push for independence gained momentum. Leaders like Grant and Maj. Gen. Malcolm Grow, the first Surgeon General of the Air Force, championed the cause. Grow emphasized the need for a dedicated supply and logistics system, ”participation in policy formulation, medical service for troop units and installations, a full professional career for its medical personnel, [and] an Aviation Medicine program,” according to a 1991 article by George M. Watson, Jr.

Through Grow’s leadership, aeromedical research on aircrew health and safety led to improved oxygen equipment, operational G-suits, night-vision training programs, amongst additional innovations for high altitude flight.

By the end of the war, these efforts proved to be invaluable in saving thousands of lives and the experience of Army Air Force medics gave further cause for an independent medical service.

Establishment of the AFMS

As Air Surgeon during World War II, Grant had consistently advocated for medical independence to solve the problems of staffing, supply, and access to care across all station hospitals in combat theaters. Though he was unsuccessful, the Army Air Forces were given some medical independence through a reorganization in March 1942 that made the Army Air Forces equal with the Army Ground Forces and Services of Supply. The Army then granted Army Air Forces commander, Gen. Hap Arnold, authority over some medical facilities and staff, although the Army Surgeon General continued to hold jurisdiction over their medical services. By 1943, Grant issued equipment to U.S. air base station hospitals akin to the standard found in Army general hospitals. These stations hospitals provided medical services for Army Air Forces patients who were transported from abroad.

In 1947, the Army Air Forces was reorganized. The U.S. Air Force became an independent branch from the U.S. Army without its own medical service. This set the stage for the establishment of the AFMS. During that year, the Secretary of Defense, James Forrestal, established an interdepartmental medical committee known as the Hawley Board to examine hospital requirements in the armed forces.

Grow, who succeeded Grant as Air Surgeon in 1946, revisited his concerns for providing care to the specific needs of Air Force members and wrote to the Secretary of the Air Force Stuart Symington. He asserted that the lack of medical authority hindered the Air Force mission, noting that the Air Force should be able to adapt its medical services for the specific requirements of its mission instead of being dependent on the Army.

The Hawley Board’s recommendation aligned with Grow’s perspective in a report that said, “the medical service of an armed force is a necessary and integral part of that force. To separate it from the force is wholly or largely to destroy its usefulness.” The plan of action to create a separate medical service received support from the Air Force Chief of Staff, the Air Force Association, and the American Medical Association.

In the summer of 1949, the Air Force Medical Service was officially formed under Air Force General Order No. 35, ensuring that the medical needs of Airmen would be met by a specialized service. Since the beginning, Air Force senior leaders sought to uphold a high state of operational and medical readiness, advocating for an independent medical structure to support its members.

Medical contributions and innovations

Over the years, the AFMS has made significant contributions to military medicine. The recognition of “aviation medicine” as a specialty by the American Medical Association in 1953 and its subsequent change to “aerospace medicine” were pivotal in acknowledging the unique physiological demands of flying at high altitudes and speeds. The Aero Medical Laboratory and U.S. Air Force School of Aerospace Medicine remained critical in pioneering medical training and understanding of aviation medicine to address the physiological and psychiatric problems that surfaced among combat flyers.

In the early stages of AFMS, the service expanded its medical capabilities and personnel to provide sufficient support during the three-year Korean War. In the 1960s, Air Force medical personnel established a presence in Vietnam and Thailand to provide American forces with in-garrison medical care, aeromedical transportation, and humanitarian outreach to local populations.

From the 1970s to 1990s, the AFMS further developed its capabilities, including support for contingency hospitals, rapid deployment of medics, the creation of Critical Care Air Transport Teams, and many other contributions.

The AFMS has been a leader in aeromedical evacuation, preventive medicine, and the development of medical technologies for the safety and health of Airmen. The services emblem, which features the staff of Asclepius, symbolizes its commitment to healing and medical excellence.

Modernization and future outlook

As the AFMS celebrates 75 years, it continues to adapt and modernize to meet the evolving needs of the Air Force. The Service remains dedicated not only to advancing medical science and improving the health and readiness of Airmen, and since 2019, U.S. Space Force Guardians as well.

The history of the Air Force Medical Service is a testament to its critical role in supporting the Department of the Air Force. From its early days addressing the unique needs of aviators to its current position at the forefront of military medicine, the AFMS has consistently ensured that Airmen and Guardians are fit to fly and ready to fight.

AFMS leaders are now looking toward the future intent to build on a legacy of excellence, and continuing to provide world-class medical care and support to the Airman and Guardians and their families.

Editor’s note: Information for this article was adapted from portions of “100 Years of Excellence: The History of the Air Force Medical Service and “Cutting the Umbilical Cord: The USAF Medical Service Achieves Independence” by George Watson.