Henschke C I, Steiner R M, McLoud T, Westcott J L
Department of Radiology, New York Hospital-Cornell Medical Center, NY 10021.
Invest Radiol. 1994 Jan;29(1):48-53. doi: 10.1097/00004424-199401000-00007.
The authors assessed to what extent radiology teaching programs employed dedicated chest radiologists and their functions.
Information regarding the clinical, teaching, and research role of the chest radiologist was available from responses to a survey of radiology departments with residency training programs in the United States and Canada. Emphasis was placed on the role of chest subspecialists, "dedicated chest radiologists" (DCRs), who spent at least two thirds of their clinical time interpreting and directing chest-related imaging studies and procedures.
Among the 171 residency programs that responded, 118 had DCRs. There were 262 full-time and 233 part-time DCR positions, of which 43 were not filled. Among departments with DCRs, 66% were medical school programs while the remaining 34% were independent or medical-school-affiliated programs; 30% were organized by organ system, 5% by technology, and 65% had a combination of both; and 78% had more than 12 residents. DCRs interpreted routine chest radiographs in 96%, critical care radiographs in 94%, chest computed tomography (CT) studies in 72%, and chest magnetic resonance imaging (MRI) studies in 44% of their departments. Departments without DCRs were usually smaller, 70% having 12 or fewer residents. Their designated chest radiologists interpreted all chest radiographs in 21%, all critical care radiographs in 19%, all chest CT studies in 13% and all chest MRI studies in 8% of these departments.
Dedicated chest radiologists were more involved than non-DCRs in all aspects of chest imaging, teaching, and research including analysis of image quality and acquisition of new technology. The highest quality of chest radiology training, defined as programs in which the chest fellowship positions were filled in 1991, was found in departments in which DCRs interpreted all chest radiographs, all chest CT studies, and most MRI studies.
作者评估了放射学教学项目在何种程度上聘用了专职胸部放射科医生及其职能。
通过对美国和加拿大设有住院医师培训项目的放射科进行调查所获得的回复，获取了有关胸部放射科医生临床、教学和研究角色的信息。重点关注胸部亚专科医生，即“专职胸部放射科医生”（DCR）的角色，他们至少将三分之二的临床时间用于解读和指导与胸部相关的影像学检查及操作。
在回复的171个住院医师培训项目中，有118个项目设有DCR。共有262个全职和233个兼职DCR职位，其中43个职位空缺。在设有DCR的科室中，66%是医学院项目，其余34%是独立或与医学院相关的项目；30%按器官系统组织，5%按技术组织，65%两者结合；78%有超过12名住院医师。DCR在其所在科室解读了96%的常规胸部X光片、94%的重症监护X光片、72%的胸部计算机断层扫描（CT）检查以及44%的胸部磁共振成像（MRI）检查。没有DCR的科室通常规模较小，70%有12名或更少的住院医师。在这些科室中，指定的胸部放射科医生解读了21%的所有胸部X光片、19%的所有重症监护X光片、13%的所有胸部CT检查以及8%的所有胸部MRI检查。
专职胸部放射科医生在胸部影像学、教学和研究的各个方面，包括图像质量分析和新技术获取方面，比非DCR参与度更高。胸部放射学培训质量最高的情况，定义为1991年胸部专科 fellowship 职位已满的项目，出现在DCR解读所有胸部X光片、所有胸部CT检查以及大多数MRI检查的科室中。
