ASSOCIATED PRESS WRITER

MERRILL HARTSON

WASHINGTON (AP)—Dr. Joycelyn Elders, President Clinton’s choice for surgeon general, was confirmed by the Senate Tuesday night, surmounting vigorous opposition from conservatives. The vote was 65 to 34.

Senators debated her nomination for more than six hours on the first day of their return from a summer recess. Elders was not present for the final vote.

Republicans had acknowledged in advance of the vote that the former Arkansas health chief would be elevated to the position of surgeon general, the nation’s No. 1 doctor.

Sen. Wendell Ford of Kentucky, the second-ranking Democrat in the leadership ranks, voted against Elders. Three other Democrats, Sens. Robert C. Byrd of West Virginia, John Breaux of Louisiana and James Exon of Nebraska joined 30 Republicans in opposing her confirmation. Thirteen Republicans voted for Elders.

‘‘I am, by training and temperament, a healer,’‘ Elders said in a statement after the vote.

‘‘It is time to look forward—not back—to a time when all American children are planned and wanted, when all American children are immunized, when all American citizens have the security of quality health care, and when all dread diseases are a distant and haunting memory,’‘ said the statement, released by the Department of Health and Human Services.

Elders said she wanted to thank ‘‘countless individuals who wrote to me in support or who stopped me in the street to tell me to hang in there.’‘

HHS Secretary Donna Shalala said that ‘‘Joycelyn Elders is a sharecropper’s daughter who never met a doctor until she was 16 years old. Tomorrow, she will be sworn in as surgeon general of the United States. She is the embodiment of the American dream.’‘

At the White House, Clinton expressed satisfaction that Elders was confirmed.

‘‘Her dedication to improving the lives of all Americans, especially the children of America, won her the strong backing of a bipartisan majority of the Senate,’‘ the president said. ‘‘I look forward to working with her in confronting the pressing issues facing the public health of our nation.’‘

Conservative Republican opponents had conceded that they lacked the strength to block Elders’ elevation to the post.

Familiar arguments prevailed as debate resumed Tuesday. Democrats praised Elders as an up-from-the-bootstraps fighter whose bluntness would be an attribute at the Public Health Service. Conservative Republicans renewed accusations that Elders’ views on health issues are ‘‘out of the political mainstream.’‘

‘‘I choose to believe that Dr. Elders is foolhardy and that she loves the sound of her own voice,’‘ said Sen. John Danforth, R-Mo. ‘‘But I do not think the republic will fall if our next surgeon general is unimpressive and foolish.’‘

‘‘She is a diamond in the rough,’‘ said Sen. Edward M. Kennedy, D-Mass. ‘‘Her opponents see the rough, but they also miss the diamond.’‘

Conservatives have sought to mount opposition to Elders’ nomination in the wake of a series of controversial statements she made as head of the Arkansas Health Department.

She once characterized anti-abortion Americans as ‘‘very religious non-Christians’‘ and she talked bluntly of reasons for making condoms available to young people.

Elders also caused a commotion with her reference to opposition to abortion by a ‘‘male-dominated’‘ church. This was taken by Roman Catholics as a criticism of their church. And she talked of the need to teach the young how to behave in the back seat, as well as the front seat, of a car.

Elders apologized for the remark about ‘‘male-dominated’‘ churches. But Sen. Don Nickles, R-Okla., said he did not think her remarks were genuine.

‘‘She didn’t apologize for the remarks,’‘ he said. ‘‘She apologized if offense was taken, and that’s a different thing.’‘

Some of Elders’ supporters said they thought her outspokenness would be a plus.

‘‘The president could have picked some physician that no one among us has ever heard about, and it would have gone through like lightning,’‘ said Sen. Paul Simon, D-Ill. ‘‘Is she controversial? Yes. We’re controversial. That’s part of public life.’‘

He said he hoped that Elders would emulate the style of former Surgeon General C. Everett Koop, another controversial nominee who ended up using the office as a bully pulpit to argue for more emphasis on preventative medicine.

‘‘Dr. Elders is the wakeup call we need for the preventative health of our nation—the wakeup call that we sometimes don’t want to hear,’‘ said Sen. Robert Packwood, R-Ore.

Said Sen. Carol Moseley-Braun, D-Ill.: ‘‘The question is whether we’re going to raise the bar to another level, the quotation test, if you take this (nomination) down, to the question of whether a person said, ‘Good morning!’ appropriately,‘’ she said.

Elders would succeed Antonia Novello in the surgeon general’s post. Dr. Robert Whitney has been serving as acting surgeon general in the meantime.