Having a parent with a professional occupation makes you six times more likely to become a doctor than if they have a working-class job, new research has found.
It reveals that little had changed between the 1960s and 2010s.
The chances for children of doctors to become doctors can be up to 100 times greater than those of bus drivers, security guards, forklift operators and care workers.
The UK study, published in BMJ Open by researchers from the Faculty of Life Sciences & Medicine, is the most extensive study of the socioeconomic background of doctors actively working in the UK.
It analysed a nationally representative sample of 358,934 working-age respondents to reveal that only 13% of doctors came from working-class backgrounds, as defined by the Social Mobility Commission, compared with 43% of the general working-age population.
Lead author Dr Nathan Cheetham, Senior Postdoctoral Data Scientist, said: ‘We were surprised to find that the chances of people from working-class backgrounds becoming doctors didn’t meaningfully change between the 1960s and 2010s, revealing a stubborn class inequality. In comparison, the share of female doctors dramatically increased from around 25% to 60% over the same period, making the stability of working-class underrepresentation all the more surprising.’
He said: ‘When the majority of doctors come from the most privileged backgrounds and those living in the most deprived areas consistently report poorer quality of care, we must consider whether the class background of doctors has an impact on patient-doctor relationships.
Although our study was one of the largest to examine the socioeconomic background of doctors, the data we looked at only represented a small fraction of the workforce, and so it is just the tip of the iceberg. Only by collecting data on the socioeconomic background of all registered doctors, including information about their role, can we fully track and tackle this class inequality at the heart of the NHS.’
Professor Nicki Cohen, Dean of Medical Education at the Faculty of Life Sciences & Medicine, who was not involved in this research, said: ‘This research underscores the urgent need to tackle the socioeconomic barriers that continue to limit access to studying medicine. At King’s College London, we are proud of our long-standing commitment to widening participation in medical education and of our leading role nationally. Our flagship Extended Medical Degree Programme is the largest and longest-running programme of its type to recruit a new generation of doctors exclusively from non-selective state schools, with 90% of our students the first in their families to enter higher education.
‘Providing support for students from school age through their medical education and beyond is essential to meet the nation’s healthcare needs. Only through sustained, sector-wide action will we create a medical workforce that truly reflects the communities we serve.’
Anton Beka is currently in his penultimate year of the Extended Medical Degree Programme (EMDP) at King’s College London, which aims to broaden participation in medicine with 90% of the intake first to attend higher-education and 100% from non-selective state schools.
He said: ‘It’s so important that people from working class backgrounds are given the opportunity to study medicine. We need a voice within the NHS for these groups of people - to be there to greet patients, to understand some of the struggles that they face. I really cherish this opportunity I have been given.’
On completing the EMDP, Anton plans to specialise in pre-hospital medicine – providing medical care to patients before they reach the hospital.
The Social Mobility Foundation (SMF), a charity that supports high-achieving young people into higher education and careers, and which was not involved in the research, has called for socioeconomic background data to be collected for all doctors across the UK. They have also called for the barriers to becoming a doctor and progressing in the profession to be broken down.
The UK government has pledged to implement the socioeconomic duty in the Equality Act 2010, which would require certain public bodies to address inequalities resulting from socioeconomic disadvantage.
The SMF is calling for all public bodies to be covered, including NHS organisations, which would further strengthen the case for addressing socioeconomic disparities.
Sarah Atkinson, CEO of The Social Mobility Foundation, said: ‘No young person should be prevented from becoming a doctor because of their class background – not least because our health service treats everyone right across our society. But medicine remains the most elitist profession in the UK. Opening up medical careers to a broader talent pool is a win-win: it leads to better patient care and more opportunities for bright young people. The Government, NHS and GMC must work together to start collecting and publishing data urgently, ensuring that it covers all doctors in the UK and is broken down by occupation and seniority. They can then set targets to address the deep-rooted inequalities in medical careers.’
