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Become a member and receive career-enhancing benefits
Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
How the ACS Mobilized American Surgery for WWI—and Why It Matters Today
Jeremy W. Cannon, MD, SM, FACS, and Emma Zimmerman
July 15, 2026
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American Ambulance personnel served near Saint-Gengoulph in support of French and US forces during the Second Battle of the Marne in July 1918.
From its founding, the ACS has maintained close ties with the US military.
During its first 5 years as a professional organization, the ACS appointed Navy Surgeon General Charles F. Stokes, MD, FACS, as a member of the first Board of Regents, recruited thousands of American surgeons to serve in World War I (WWI), and deployed its first president, John M. T. Finney, MD, FACS, to Europe.
These actions represent just a few of the measures taken by ACS founder Franklin H. Martin, MD, FACS, and others to ensure military surgical care met the same rigorous standards they had set for civilian surgical care. The efforts resulted in optimal clinical outcomes on the battlefields of Europe and strengthened medical readiness at home.
Today, the ACS continues to take a leadership role in medical preparedness efforts, maintaining the legacy and advancing the ideals of its early leaders.
Europe Engulfed in War
In June 1914, what started as a flare-up of regional tensions in the Balkans soon erupted into a conflict among the Great Powers, engulfing all of Europe.
A year earlier in Chicago, the ACS held its first Convocation Ceremony concurrently with the fourth Clinical Congress of North America. This formal ceremony inducted the first class of 1,059 surgeons, including the College founders, who successfully met the rigorous requirements for Fellowship.
The ceremony featured a formal procession with inductees outfitted in elegant academic robes reflecting inspiration from The Royal College of Surgeons of England (RCS-Eng). To further underscore this alignment, Dr. Martin arranged for a special guest to be named as the first Honorary Fellow: the sitting president of the RCS-Eng, Sir Rickman John Godlee.
In his acceptance address, Sir Godlee affirmed the mutual goodwill between the fledgling ACS and the RCS-Eng, and formally invited the ACS leaders to hold their next meeting with the Clinical Congress of North America in London. He also presented the ACS with the Lister Gavel, which is still in use today.
In July 1914, the ACS founders and more than 1,000 US and Canadian surgeons arrived in London.
Members of the General Medical Board of the Council of National Defense helped coordinate the nation's medical preparedness during WWI, circa 1917–1918.
Although hostilities had erupted in the Balkans a few weeks prior, most viewed these events as little more than a regional conflict in a troubled corner of Europe. Planned surgical demonstrations at hospitals across London and academic sessions presented at swank hotels continued apace. The proceedings included the Surgeon General of the Army, Major General William C. Gorgas, who was granted Honorary Fellowship in the ACS, a gesture that foreshadowed an invaluable collaboration between both organizations for years to come.
Many conference attendees had intended to visit renowned clinics in Germany and Austria after the Congress, but by the end of the meeting, declarations of war had engulfed the continent, cutting these travel plans short.
European attendees from both sides hurried home while American participants found their return voyages canceled as passenger ships converted to troop transports. Dr. Martin’s quick thinking and political savviness averted a potential crisis. He appealed to the US Ambassador to England for aid in securing transportation home, and he approached his banking friends in New York to extend lines of credit to stranded ACS Fellows.
ACS Influence in Medical Mobilization
Reports from both sides of the European front made clear that modern warfare would require organized surgical capability at a national level, not simply individual expertise to care for these patients. The ACS quickly became the lead surgical society promoting and supporting readiness for the war in Europe. Central to this engagement were three visionary ACS leaders: Dr. Martin, Dr. Finney, and the second ACS President George Crile, MD, FACS.
These leaders assumed distinct but complementary roles in this effort. Dr. Martin engaged policymakers at the highest levels of government while Drs. Finney and Crile applied their concepts of hospital standards and medical organization into US Army and Navy medical mobilization efforts.
Dr. Martin’s Wartime Service
Through a combination of interpersonal connections and deliberate advocacy, the ACS in general, and Dr. Martin in particular, became central organizers of the medical war effort.
Shortly after Dr. Martin and the other ACS attendees returned from London, Frank Simpson, MD, a prominent gynecologist from Pittsburgh, Pennsylvania, and an attendee of the 1914 London Clinical Congress, formed the Committee of American Physicians for Medical Preparedness. ACS members were intimately involved in this committee, including Drs. Martin and Finney.
However, medical readiness concerns struggled to gain traction amidst the rush of other wartime preparations.
This reality changed in April 1916, when Dr. Finney, a personal friend of President Woodrow Wilson and frequent White House visitor, lobbied successfully to have a medical advisor on President Wilson’s wartime council. This led to Dr. Martin’s appointment to the Advisory Commission to the Council of National Defense—a seven-member advisory board that supported President Wilson’s cabinet secretaries in their wartime preparations.
Dr. Martin then transformed Dr. Simpson’s Committee of American Physicians for Medical Preparedness into the General Medical Board, which served as the action arm for all medical readiness efforts.
During his time on the Advisory Commission to the Council of National Defense, Dr. Martin successfully recruited thousands of surgeons and other medical professionals into active and volunteer service, gained formal rank for medical officers through the Owen-Dyer bill and standardized medical equipment for hospital units.
These landmark advances supported our nation’s medical successes once the US formally entered the war in 1917.
Recruiting an Army of Surgeons
With the US Army expanding to 5 million personnel, the military needed to recruit 30,000 surgeons to meet wartime demand. This staffing need represented one of the most pressing and formidable tasks facing Dr. Martin.
To meet this challenge, he gave a series of public addresses starting with an impromptu speech at the American Medical Association in 1917. He also gained the support of the vast majority of medical school deans to add a special military curriculum to their course of study.
Through these efforts, 90% of the 3,795 ACS Fellows volunteered for military duty, and the Volunteer Medical Service Corps grew to more than 70,000 physician members.
Dr. Finney completed his tenure as the inaugural ACS President (1914-1916) and was succeeded by Dr. Crile (1916-1917), an outspoken proponent of military medical readiness.
Starting in 1914, Dr. Crile began raising funds for the Ambulance Américaine, the US volunteer hospital in Paris. In early 1915, he and a team from Lakeside Hospital in Cleveland, Ohio (now part of University Hospitals), staffed the hospital for 3 months. During this tour, Dr. Crile and his team introduced direct blood transfusion and nitrous-oxygen anesthesia to hospital clinicians—treatments that transformed combat casualty care throughout the war.
John M. T. Finney, ACS Founder, first President of the ACS
Following his return to the US, Dr. Crile further fleshed out his concept of a university-based staffing model which he presented at the 1915 Clinical Congress in Boston, Massachusetts.
A year later, at the 1916 Clinical Congress meeting in Philadelphia, the American Red Cross coordinated a full-scale demonstration of Dr. Crile’s 500-bed hospital unit in Fairmount Park. This exercise, complete with simulated patients, proved invaluable both in garnering support for this concept and in revealing some weaknesses that were quickly addressed. A few months later, shortly after the US officially entered the war, the Lakeside Unit from Cleveland, Ohio, was the first US medical unit to deploy.
Leadership on the Front Lines
In the meantime, Dr. Finney, Dr. Crile, and other ACS members worked with Dr. Gorgas to standardize surgical instruments for the imminent US mobilization.
Closer to home, Dr. Finney ardently supported the effort to establish a university unit at The Johns Hopkins Hospital in Baltimore, Maryland. These efforts proved successful, and the Hopkins Base Hospital No. 18 was in the second wave of hospital deployments with Dr. Finney as the unit’s director.
Several months after the team arrived in France, however, Dr. Finney was tapped to take an even bigger role serving as chief consultant in surgery. In this role, he ultimately reported to General John Pershing with whom he met several times. In one such meeting, General Pershing detailed Dr. Finney back to Washington, DC, on short notice to advocate for the general’s pick for the next Surgeon General of the Army, Colonel Merritte Ireland.
Dr. Finney showed up unannounced at the White House and was able to secure an impromptu meeting with his friend, President Wilson. A meeting with the Secretary of War, Newton Baker, soon followed during which the Secretary quipped, “Doctor, you folks who aren’t in Washington have no idea of the amount of political pressure that is being constantly brought to bear upon public officials for one reason or another…the pressure is terrific at times.”
Nevertheless, Baker navigated the political hurdles, and Dr. Finney and General Pershing were able to get their candidate for this important post. To this day, Major General Ireland is widely considered one of the most effective Army Surgeons General of all time. Although he was not a clinical surgeon, the ACS also recognized his talents by making him an Honorary Fellow in 1918, and he went on to become ACS President in 1929.
Wounded US service members are transferred from an ambulance to the USS Siboney at the US Army docks in Bassens, France, on December 24, 1918.
Lessons from the Great War
From its inception, the ACS exercised its advocacy power and engaged with the military to translate the mission of optimizing surgical care at the hospital and physician level to the WWI effort.
Dr. Crile summed up these efforts by stating: “As a consequence of all our efforts, General Gorgas came to the war wholly prepared.” And he was absolutely right. The case fatality rate for hospitalized service members was lower in WWI than in each of the subsequent conflicts: WWII, Korea, and Vietnam.
Through the efforts of Dr. Martin, Dr. Finney, Dr. Crile, and countless other ACS Fellows, the ideals of the fledgling ACS—promoting standards for hospitals and surgeons—elevated the care of the combat wounded. Their work highlights the College’s legacy of leadership in medical preparedness for threats both at home and abroad.
Today, the Military Health System Strategic Partnership American College of Surgeons collaborates closely with the US Department of Defense Military Health System to promote high standards of combat casualty care.
Strengthening National Medical Readiness
Building upon this legacy of combat casualty care support, the ACS Committee on Trauma (COT) has established a new program area to accelerate efforts to establish a National Trauma and Emergency Preparedness System (NTEPS) that links daily acute care needs and emergency response to large-scale events.
As detailed in the NTEPS 2.0 report, this ongoing advocacy effort presents an opportunity for Fellows seeking to support the College’s tradition of strengthening our nation’s medical readiness.
The US continues to face the threat of large-scale combat operations overseas, and the US medical system is ill-prepared to care for the number of injured warriors that could result. Such a conflict could approach the scale of WWI with an estimated 1,000 to 3,000 casualties per day for the first 100 days of combat. In contrast to WWI when most casualties convalesced in Europe, these casualties would likely return to the US. This volume and acuity would quickly overwhelm the capacity of the US military health system.
At the same time, large-scale emergencies can also overwhelm the civilian health system. Although healthcare coverage has expanded significantly in the past century, the COVID-19 pandemic brought to light many gaps in the US’s healthcare infrastructure, particularly the lack of surge capacity and inconsistent coordination between public health agencies, emergency management services, and acute care health systems.
In response, trauma surgeons and emergency medicine physicians established Regional Medical Operations Coordination Centers (RMOCCs) in their states and regions to align these disparate services needed to load-balance patients and resources. These efforts proved highly successful in managing the intense resource demands of the pandemic and informed the development of the NTEPS concept.
NTEPS in Practice
NTEPS is based on an integrated system of high-quality daily trauma care that can surge on demand for mass casualty readiness by leveraging an interconnected network of RMOCCs. By way of analogy, RMOCCs function like air traffic control towers to balance the distribution of patients and resources across a healthcare system. They enable real-time visibility of critical information including emergency medical services (EMS) and transportation resources, hospital bed capacity, and critical resource availability for severely injured and critically ill patients.
During normal operations, RMOCCs coordinate healthcare needs for patients with time-sensitive conditions who may need to move between medical facilities. During critical events, these centers quickly scale up to ensure optimal distribution of large numbers of patients.
Similar to Dr. Martin’s General Medical Board, NTEPS aims to oversee the operations of RMOCCs at the national level organized around five operational pillars. This effort will align with other key stakeholders in this space to fully implement the vision detailed in the 2016 National Academies report, “A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury.”
NTEPS also will strengthen military-civilian coordination in response to warfare-related medical needs.
Estimated casualties will quickly exceed the capacity of the military health system and the Department of Veterans Affairs healthcare facilities, necessitating the use of civilian healthcare facilities. Effectively load‑leveling patients and optimizing resource use across this integrated system will require deliberate planning and real‑time situational awareness.
RMOCCs supported by NTEPS will offer the framework needed to ensure injured service personnel continue to receive optimal care after arriving in the US. This advance preparation offers a dual benefit—optimizing military effectiveness in combat while establishing a framework for translating battlefield lessons into civilian practice.
Legacy of Leadership
Just as the ACS helped prepare American surgery for WWI, the College continues to lead in sustaining national medical readiness today. Through the work of the COT, the ACS has put forth a comprehensive, pragmatic strategy to optimize our readiness for future conflicts and civilian disasters.
Implementing NTEPS will require engagement with multiple departments in the Executive branch of government and strong support from Congress. As in the days of Drs. Martin, Finney, and Crile, advancing this bold agenda will require the full support of the ACS and its many Fellows.
More than a century ago, leaders of the College recognized that surgical preparedness was a matter of national importance. Through the vision of Dr. Martin and the leadership of Drs. Finney and Crile, the ACS helped organize the nation’s surgeons for the challenges of modern warfare.
The ACS helped mobilize American surgery in 1917. Today, it is calling on Congress to act with the same urgency—and on every Fellow to help build the national trauma system that patients deserve.
Dr. Jeremy Cannon is a trauma surgeon and professor of surgery at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.
Emma Zimmerman is the Senior Congressional Lobbyist in the ACS Division of Advocacy and Health Policy in Washington, DC.
Bibliography
Accorsi P, Fazal TM. Military medicine and military effectiveness. Security Studies. 2025;34(4),591–623.
Deussing EC, Post ER, Lee CJ, et al. Advancing systematic change in the National Disaster Medical System (NDMS): Early implementation of the U.S. Department of Defense NDMS pilot program. Health Secur. 2024;22(6):445-454.
