WASHINGTON — With the swearing in of Lt. Gen. Patricia D. Horoho, RN, as the Army’s 43rd surgeon general, for the first time a woman or a nurse has been officially in command of the Army’s largest medical organization. Horoho is both.

Lt. Gen. Patricia D. Horoho, RN

Horoho replaced former Army Surgeon General Lt. Gen. Eric Schoomaker, MD, who has served as commander since December 2007 and will retire this month.

At Horoho’s swearing in and promotion on Dec. 7, she thanked her family and spoke of the importance of Army Medicine’s mission.

“I understand that there are significant challenges ahead and continued operational demands,” Horoho said. “One of Army Medicine’s greatest challenges over the next three to five years is managing the escalating costs of providing world-class healthcare in a fiscally-constrained environment. I see these challenges as windows of opportunity for us to shape the future of Army Medicine, and I am confident, regardless of the environment or the landscape, that we will meet all challenges in true Army fashion.”

At the ceremony, Gen. Raymond T. Odierno, chief of staff of the Army, said the impact of the Army surgeon general goes well beyond the Army to the “national and international level.”

“This position requires a special officer that can lead change and achieve unity of effort in the dynamic, joint interagency and also in a multinational role working with our allies and partners around the world,” he said.

Horoho previously served simultaneously as the U.S. Army deputy surgeon general and 23rd chief of the U.S. Army Nurse Corps.

She earned a Bachelor of Science in Nursing from the University of North Carolina at Chapel Hill and a Master of Science in Nursing as a clinical trauma specialist from the University of Pittsburgh. She is a resident graduate of the Army’s Command and General Staff College and the Industrial College of the Armed Forces, where she earned a second Master of Science degree in National Resource Strategy.

She has earned many awards, including one this year from the University of North Carolina School of Nursing, which selected her as “Alumna of the Year.”

Historical Significance

Horoho’s appointment underscores how far women have come in the military since the mid-20th century.

When the Women’s Armed Services Integration Act was signed into law in 1948, women were given permanent status in the Army, Navy, Air Force and Marine Corps. That act, however, placed a 2% percent ceiling on the number of women in each of the services, restricted promotions to one full colonel or Navy captain as chief of the Nurse Corps and/or service director and severely limited the number of female officers who could serve as lieutenant colonels or Navy commanders. Women also could be discharged without specified cause.

Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD, told U.S. Medicine that Horoho “is an outstanding individual,” and her appointment as Army surgeon general and commander of the U.S. Army Medical Command “represents the institution’s commitment to diversity at the highest levels of leadership.”

Still, a woman or a nurse serving as a surgeon general in the Army, Navy or Air Force is unprecedented. No woman or nurse has permanently served as surgeon general in either the Navy or Air Force.

One other nurse and woman, Gale Pollock, served temporarily as acting Army surgeon general after then-Army Surgeon General Kevin Kiley resigned in the wake of the Walter Reed Army Medical Center scandal in 2007.

A policy change in 1996 made it possible for someone other than a physician to serve as the Army surgeon general, according to the Army Medical Command. The policy states that “the surgeon general may be appointed from officers in any corps of the Army Medical Department and, while so serving, has the grade of lieutenant general.” The MEDCOM is made up of several groups including Nurse Corps, Dental Corps, Veterinary Service Corps and Medical Service Corps.

“Lt. Gen. Horoho’s appointment and assumption of command should give hope to any officer in the Army MEDCOM, not just nurses, that they, too, can rise to the top position in the command and serve on the CSA's staff as the Surgeon General,” an Army MEDCOM spokesperson told U.S. Medicine.

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