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MEDICAL PHYSICS INTERNATIONAL Journal, vol.1, No.1, 2013IOMPPROFESSIONAL AND EDUCATIONAL ACTIVITIESBENEFITS TO MEDICAL PHYSICS FROM THE RECENT INCLUSION OFMEDICAL PHYSICISTS IN THE INTERNATIONAL CLASSIFICATION OFSTANDARD OCCUPATIONS (ICSO-08)P. H. S. Smith 1 , F. Nusslin 21Former Secretary-General, International Organisation for Medical Physics, Aberdeen, UK2 Former President, International Organisation for Medical Physics, Technische Universität München, GermanyAbstract- The occupation of ‘Medical Physicist’ isexplicitly included for the first time in the latest version ofthe International Standard Classification of Occupations(ISCO-08), published by the International LabourOrganisation (ILO), under Unit Group 2111 ‘Physicists andAstronomers’. Both the structure of the Standard and thebackground to the inclusion of medical physicists are brieflyexplained. ILO decided not to classify medical physicistsunder Sub-major Group 22 ‘Health Professionals’ primarilyas classification under Unit Group 2111 best fits theconceptual model of ISCO as the basis of knowledgerequired for medical physics is physics. However ILOrecognises that medical physicists work in health servicesand this is reflected in the inclusion of two notes, one underUnit Group 2111 stating “…..medical physicists areconsidered to be an integral part of the health work forcealongside those occupations classified in sub-major group22, Health professionals…..” and a second one under SubmajorGroup 22 Heath Professionals. The two main benefitsof inclusion of medical physicists in the Standard arereviewed – these are the value for the development ofmedical physics services, particularly in developingcountries, of the formal recognition of medical physics as aprofession, and in the collection data on the number ofphysicists in the health services in different countries.Keywords- medical, physicist, ILO, ISCO- 08,classification.INTRODUCTIONThe International Standard Classification ofOccupations (ISCO) is a tool for organizing jobs intoclearly defined groups according to the tasks and duties ofthe jobs. One of its main aims is to provide a basis forinternational reporting, comparison and exchange ofstatistical and administrative data about occupations. It isprepared and revised by the International LabourOrganization, a United Nations agency [1].The International Organisation for Medical Physics(IOMP) represents the worldwide medical physicscommunity and has as one of its objectives theadvancement healthcare by the adequate provision ofmedical physics services [2]. Whilst not a primarypurpose, ISCO is used by some governments andemployers to determine the status and other factors, suchas salaries, of a particular occupational group. Theinclusion of the occupation ‘medical physicist’ in ISCO,included in the latest version of the classification for thefirst time, is of significance to the profession of medicalphysics, particularly in some countries where the medicalphysicist profession is not formally recognized by eitherthe government or health authorities.10
MEDICAL PHYSICS INTERNATIONAL Journal, vol.1, No.1, 2013ILO AND ISCO-08The International Labour Organization (ILO) has atripartite structure bringing together representatives ofgovernments, employers and workers [1]. The ILODepartment of Statistics to provide users within andoutside the ILO with relevant, timely and reliable labourstatistics, to develop international standards for bettermeasurement of labour issues and enhanced internationalcomparability, and to help member States develop andimprove their labour statistics.The ILO is custodian of the International StandardClassification of Occupations (ISCO) and responsible forits maintenance, updating and revision [3]. ISCO is a toolfor organizing jobs into a clearly defined set of groupsaccording to the tasks and duties undertaken in the job. Itsmain aims are to provide: a basis for the international reporting, comparisonand exchange of statistical and administrative dataabout occupations; a model for the development of national and regionalclassifications of occupations; anda system that can be used directly in countries thathave not developed their own national classifications.The International Standard Classification ofOccupations 2008 (ISCO-08) is the latest version of theclassification and it is a four-level hierarchicallystructured classification that covers all jobs in the world.ISCO-08 is fully supported by the internationalcommunity as an accepted standard for internationallabour statistics [3]. It allows the production of relativelydetailed internationally comparable data. Many countriesare now updating their national classification either basedon ISCO-08 or to improve alignment with the newinternational statistical standard.ISCO-08 classifies jobs into 436 unit groups. Theseunit groups are aggregated into 130 minor groups, 43 submajorgroups and 10 major groups, based on theirsimilarity in terms of the skill level and skillspecialization required for the jobs[3].The main groups of interest to the medical physics areillustrated in Figure 1. Major Group 2 ‘Professionals’ isdivided into 6 sub-major groups, two of which are‘Science and Engineering Professionals’ and ‘HealthProfessionals’. The former has as one of its minor groups‘Physical and Earth Sciences Professionals which in turnhas ‘Physicists and Astronomers’ as a unit group. ‘HealthProfessionals’ has as one minor unit ‘Other HealthProfessionals’, which itself has ‘Health Professionals NotElsewhere Classified’ elsewhere as one of its unit groups.The framework of ISCO is based on two mainconcepts – job and skill. A job is ‘a set of tasks and dutiesperformed …by one person..’. Occupation refers to thekind of work performed in a job. Skill is defined as theability to carry out the tasks and duties of a given job andtwo dimensions of skill are used to arrange occupationsinto groups. These are skill level and skill specializationand one of the measures of skill level is the level offormal education. Four broad skill levels are a used inISCO-08 and Major Group 2 contains only occupations atthe highest ISCO skill level – skill level 4[3].BACKGROUND TO INCLUSION OF MEDICALPHYSICISTS IN ISCO-08The classification system is infrequently updated –approximately every 20 years; the previous one being in1988 (ISCO-88) which did not include any mention ofmedical physicists or medical physics. In 1995 thePresident of International Organization for MedicalPhysics (IOMP), Keith Boddy, formally wrote to ILOrequesting the specific inclusion of medical physics asprofession in the next revision ISCO [4]. Over the nexttwo decades officers of IOMP, together with otherindividuals and organisations, engaged in dialogue withILO [5-8]. ILO twice consulted member countries. Afterthe first consultation ILO concluded that medicalphysicists were not sufficiently numerous to justify aseparate unit group.The second consultation focused on where medicalphysics should be included in the classification andresponses were equally divided between includingmedical physics under ‘Physicists and Astronomers’ andunder ‘Health Professionals’. IOMP, and others,proposed that medical physicists should be classifiedunder ‘Health Professionals [5, 7] and in theclassification system of a number of countries medicalphysicists have been classified under ‘HealthProfessionals’ [8].The ILO finally decided in favour ofclassification under ‘Physicists and Astronomers’ for thefollowing two main reasons [9]: Since the basis of knowledge required for medicalphysics is physics, it is consistent with the ISCOconceptual model to include them in the same Unitgroup as other physicists.The view that medical physicists should be classifiedas health professionals because they work in thehealth system was not accepted as ISCO is not aclassification of industrial activities.Following further discussions involving IOMP two noteswere added to ISCO-08 clarifying the position of medicalphysicists in relation other health professions and the listof tasks under ‘Physicists and Astronomers’ was extendedand modified to include tasks typically undertaken bymedical physicists [3].11
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