Proficiency examination of physicians for classifying pneumoconiosis chest films

An examination has been developed to test the proficiency of physicians classifying chest radiographs with pneumoconiosis in accordance with the classification system promulgated by the International Labor Office in Geneva. The examination, prepared by Johns Hopkins University under contract with the National Institute of Occupational Safety and Health, was commissioned to identify physicians qualified to serve in national pneumoconiosis programs directed both to epidemiological research and to the compensation of coal miners and others who suffer from dust-related illness. The examination, consisting of 125 chest radiographs, includes examples of a broad range of disease extending from normal to far advanced pneumoconiosis. An examinee passes or fails by ability to classify the films, within prescribed limits, in the same manner as an expert panel of radiologists. The examination is open to radiologists, chest physicians, occupational health specialists, and other physicians interested in pneumoconiosis. By the end of 1978, the examination had been given to 202 candidates, including 116 radiologists 30 chest physicians, three candidates certified in preventive medicine, two family practitioners, and 51 others. Of the 202 candidates, 118 (58.4%) passed and 84 (41.6%) failed. Among the candidates taking the examination for the first time, 74 radiologists (63.8%) and 18 chest physicians (60%) received passing grades. Of the remainder, 21 physicians (37.5%) were successful. Early experience indicates the examination is quite successful in meeting its primary objectives, which suggests that this type of examination may be applicable in other situations to separate those who meet certain standards of performance in radiology from those who do not.