The skill and knowledge level of surgeons on both sides of the war varied greatly. In the North, surgeons had to pass a medical examination board of army surgeons before joining military service. They were then appointed by a state governor or military officer. However, this process was not always carried out in full, due to requirement variations among states. About 7/8ths of the surgeons serving in the war were considered to be qualified physicians.1
Furthermore, medical education in the United States during this time was limited. Medical students had to complete two years of classes and three years of serving under a physician in order to obtain a degree. Classes were given by individual lecturers without much practical application, and the second year of classes was identical to the first. Even if a surgeon had graduated medical school as a qualified physician, he mostly likely had never actually seen the inside of a body or done a major amputation. Especially in volunteer armies, surgeons were general practitioners who were given very little instruction on military treatment or surgery. Their full set of duties was often unclear to even the surgeons.9
Southern surgeons had to undergo a similar appointment and review process to join the Confederate army. Many were talented and skilled physicians that had been trained in medical schools in the North or South. However, Southern surgeons are generally viewed as being less competent. One Sanitary Commission Inspector observed that surgeons of the South were without professional knowledge or social culture.10 In reality, these views are unfounded.