United States Public Health Service Commissioned Corps officer rank insignia

Initially, the officer ranks and insignia of the Marine Hospital Service were as follows:

Officers of the Marine Hospital Service wore the same rank devices as officers in the armed forces, apart from the star of the Surgeon General and the bars of Passed Assistant Surgeons and Assistant Surgeons being gold instead of silver.[3]

Effective October 1, 1893, the Supervising Surgeon General wore gold epaulettes in place of shoulder straps, while Surgeons who had formerly been Surgeon Generals were also authorized to wear silver oak leaf insignia regardless of years of service.[5]

The rank structure was further revised with effect from July 1, 1896:[6]

By Act of Congress, on July 1, 1902 the Marine Hospital Service became the United States Public Health and Marine Hospital Service. The rank structure was correspondingly expanded, with the creation of the rank of Assistant Surgeon General.[7]

The rank structure of the new USPHS & MHS was as follows:[7]

The United States Public Health Service was established by Act of Congress on August 14, 1912. In March 1914, the five-pointed gold star worn by the Surgeon General was changed to silver, with the new rank of Senior Surgeon introduced between the ranks of Surgeon and Assistant Surgeon General. The sleeve rank insignia were also altered to match those worn by Navy officers, with shoulder loops replacing straps.[8] With effect from March 20, 1918, the gold bars worn by Passed Assistant and Assistant Surgeons became silver, the same as the equivalent Army and Navy rank insignia.[9] At the end of World War I, the rank insignia of the Commissioned Corps were as follows:

By an Act of April 9, 1930, the grade of Surgeon General was raised to two-star rank.[10]

A further Act in 1943 raised the four existing Bureau Chiefs to the grade of Assistant Surgeon General with the rank of Brigadier General. With the Public Health Service Act of 1944, the grade of Passed Assistant was redesignated Senior Assistant, and the new grade of Junior Assistant established to rank as a second lieutenant or ensign. The 1944 Act further established the grade of Director, to rank with a colonel or captain, along with the one-star graded post of Deputy Surgeon General, also raising Assistant Surgeon Generals to one-star rank.[11][10] At the end of World War II, the ranks and insignia of the Public Health Service Commissioned Corps were:

A further act of February 28, 1948 authorized two grades for officers graded Assistant Surgeon Generals, with not more than half of the authorized number to rank as Major Generals or Rear Admirals (upper half).[10] With effect from October 22, 1965, Public Law 89-288 established the grade of Surgeon General as a three-star rank.[12]