Pershing remained a four-star general (his four-star insignia was gold rather than the traditional silver, though). The five-star designation was created in 1944, but the War Department specified ...

24, 4-star General Mark A Welsh III ... The Coin of Excellence is a small medallion with a service insignia, for the Pennsylvania CAP in this case. They are often given for special recognition ...

This meant that all four-star and five-star generals outranked him ... At that time, the Army Institute of Heraldry designed an insignia for this rank that included six stars.