After the bombing of Pearl Harbor in December 1941, the United States officially entered the war. U.S. involvement resulted in an increased need for nurses, and on July 1, 1943, the Nursing Training Act was signed into law, officially establishing the Cadet Nurse Corps Program. This program was administered by the USPHS to finance the training of eligible women, at participating schools, to become nurses and part of the war effort. 

Duke facilitated this program by increasing enrollment and shortening the gap between admitting classes from twelve months to nine months. Entering class enrollment peaked at 121 students during this period. 

While the number of nursing students grew, the number of graduate nurses at Duke Hospital shrank from 110 to just 45 from 1942 to 1943, as many went to join the military service. Nursing students were called on to make up the difference, their number swelling from 189 to 275 from 1942 to 1944. Their service in the Hospital added extensive hands-on training to their already rigorous courses. 

The 65th General Hospital Unit is Formed 

Composed of faculty members, active and former Duke Hospital house staff members and nurses from Duke University Medical Center, the 65th General Hospital served on active duty from July 1942 through September 1945. The unit spent one year training at Fort Bragg and helping staff the large Army station hospitals.  

In the fall of 1943, the unit sailed for England, where it began treating casualties from the North African Theater. In February 1944, the 65th was suddenly ordered to a hospital site at Botesdale, Suffolk, to provide care for the 8th Air Force. It was months before the Normandy invasion of France, and the 8th Air Force was the only American force in active combat in western Europe. As many as 10,000 men and 1,000 planes flew near-daily raids over Europe. Casualties were heavy and included wounds from anti-aircraft fire, exploding shells and bullets, frostbite from exposure to minus 60-degree in-flight temperatures, aircraft crashes and accidents. 

In 22 months overseas, the 65th treated 17,250 bed patients and more than 30,000 outpatients. The hospital's mortality rate in the treatment of fresh battle casualties was remarkably low -- 0.4 percent. At the end of the war, the unit was highly commended for its outstanding service by General Dwight D. Eisenhower; General Carl Spaatz, Commander of the 8th Air Force; and the surgeons general of both the Army and the Air Force. 

Duke graduated 302 nurses from 1939 to 1946 and, through the Cadet Nursing Program, had a significant impact on the war effort. The program also influenced nursing education at Duke in the years to come, as the intensive training of nurses during World War II set a precedent for increased training that would continue into the 1950s.