Medicine, but Not Law, Runs in Families

David J. Kerr, CBE, MD, DSc


December 22, 2021

This transcript has been edited for clarity.

I'm David Kerr, professor of cancer medicine at the University of Oxford. I'd like to pose a question to the wider Medscape community: Does medicine run in the family?

Think about your time spent at medical school. Think about your colleagues. How many of those do you think came from families in which physicians or surgeons were strongly represented?

Well, we have the answer. God bless them, a group of Swedish investigators have looked to evidence gathered from three generations of physicians in Sweden, a retrospective observational study published last year in the Christmas edition of the British Medical Journal. If we look at the abstract, their objective was very clear. It was to examine the occupational heritability in medicine and changes in that heritability over time in a Swedish population.

We know, particularly in the Scandinavian countries, that their population-based databases are extraordinarily useful. We've talked many times before about the benefits of their cancer registration and the linked-up data that we have.

They looked at the physicians born between 1950 and 1990 living in Sweden at some time between 2001 and 2016. Of that larger group, they found almost 28,000 physicians for whom the educational background for both parents was known.

They discovered that across that wide cohort, that wide range, 14% had a parent who was also a physician and 2% had two parents who were physicians. What was most interesting, though, was that the proportion of physicians with at least one physician parent increased significantly over time, from 6% for physicians born between 1950 and 1959 to a startling 20% for physicians born between 1980 and 1990. The P value was .0001, so it was a very significant statistical correlation.

Interestingly, as a quasi-control, they found that the same pattern of increasing occupation heritability across that same time period was not seen for individuals with law degrees. They conclude, I believe correctly, that more than triple the proportion of physicians over the time period discussed had at least one physician parent — fitting in very well indeed with their concept that, yes, indeed, medicine does run in families (certainly within Sweden) but not law.

I'd be really interested in your own stories. What was it like when you were at med school? Were many of your colleagues physician-associated? Were they first in their generation at university, or how did it work?

What we don't have is a correlation with wealth. Putting a child through medical school in the United States is very expensive. In the more socialized university systems that we have in Europe, there's not such a strong link — some link, but not such a strong link — between not only the educational sectors but also the relative wealth of parents of those who tend to become physicians.

It's true: Medicine runs in families. I quite like that, I think. It's something that seems to be increasing. I wonder if you have any reasons or any hypotheses as to why that might be. I'm really interested in your comments, as always. Thanks very much for listening, and please, let me know what you think of all of this.

For the time being, Medscapers, over and out. Let me wish you all a very happy holiday season. Thanks again.

David J. Kerr, CBE, MD, DSc, is a professor of cancer medicine at the University of Oxford. He is recognized internationally for his work in the research and treatment of colorectal cancer and has founded three university spin-out companies: COBRA Therapeutics, Celleron Therapeutics, and Oxford Cancer Biomarkers. In 2002, he was appointed Commander of the British Empire by Queen Elizabeth II.

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