United States Army Hospital Corps was organized in 1886 in order to recruit and retain competent medical enlisted personnel in the United States Army Medical Department for field service in the event of a foreign war.

Promotion to full Hospital Steward (Sergeant First Class) was possible after one year's service in an acting capacity and after having passed a second and more rigorous examination.

[1] The hospital corps was organized in order to enlist and retain competent medical personnel below officer rank.

[13] In 1901, the rank of Lance Acting Hospital Steward was given to prospective hospital stewards during a probationary period, and in 1903 the rank of Corporal was introduced; specifically created for those men who were good leaders but unable to pass the required examinations for promotion.

The accepted candidate then received instruction at a detachment of the Corps, before being transferred to a post where he would be assigned duties as nurse, cook or attendant.

Promotion to full Hospital Steward was possible after one year's service in an acting capacity, and after having passed a second and more rigorous examination.

Instructions were given in cooking, horseback riding, horse care, first aid, anatomy, physiology, nursing and pharmacy.

[36] In 1909, the training contained a basic course of discipline and the duties of a soldier, drill and field work, animal care and horseback riding, anatomy and physiology, first aid and personal and camp hygiene, and nursing for all candidates, and a complete course for those with special aptitude, which added army regulations, cooking, Materia medica and pharmacy, elementary hygiene, and clerical work to the basic course.

[37] Examination for promotion to Acting Hospital Steward tested the candidates knowledge in the principles of arithmetic, in orthography and penmanship, regulations affecting enlisted men, care of sick, ward management, minor surgery, hospital corps drill and first aid, ordinary modes of cooking and elementary hygiene, as well as evaluating the candidates physical fitness, moral character and general aptitude.