Poor representation of working class people in doctor profession persists

People coming from families with a ‘professional background’ are six times more likely to become a doctor than those from a working class background, according to a new study on social mobility. 

Researchers from King’s College London used 10 years of data from the ONS Labour Force Survey of 358,934 respondents including 2,772 who were doctors.

Analysis of the data showed 1.6% of survey respondents from a professional background were doctors compared to 0.3% of those from working class backgrounds and 0.5% from ‘intermediate’ backgrounds. 

The report concluded: ‘Doctors from professional backgrounds are highly overrepresented within medicine, in particular those coming from households where the main earner was also a doctor, resulting in a workforce of doctors that is highly unrepresentative of the general population in terms of socioeconomic background and occupation.’ 

The proportion of surveyed doctors from professional backgrounds was more than double the overall rate (69% compared to 32%), while the number of working-class doctors was significantly lower than overall (13% vs 43%). 

The survey captured information on a respondent’s household composition, main wage earner, their occupation when the respondent was 14, and the respondent’s own current occupation.  

Respondents whose main earner worked as a cleaner, home carer, security guard, fork-lift truck, taxi, or bus driver, or in a warehouse were among the least likely to be doctors, with adjusted average probabilities of doing so only around 1-in-500 to 1-in-1,500. 

The study also explored how social mobility in the profession has changed over time, observing the prevalence of class groups among doctors according to the year they turned 18. 

This analysis ‘suggested socioeconomic inequalities remained highly stable’ between the 1960s and 2000s, ‘followed by weak evidence of increasing socioeconomic inequalities between 2010 and 2018’.

The report argued greater efforts were needed to boost social mobility of medical school applicants. 

It said: ‘More affluent doctors may be more susceptible to the implicit bias against less affluent patients that has been previously observed.  

‘This is particularly pertinent given the growing focus on holistic care that takes into account social and economic circumstances that impact health, echoing earlier reports by less privileged groups on what makes a good GP consultation … If this hypothesis is true, increasing the number of less privileged doctors as well as giving further training to current doctors may lead to improved care.’ 

The previous Government’s long-term NHS workforce plan, published in 2023, highlighted creating a workforce ‘representative of the communities we serve’ as an aim.

It called on ICBs to work with ‘system partners to maximise how the NHS works as an anchor institution to expand access routes into training in the NHS’.  

The BMA’s ‘Fix our Funding’ campaign advocates for medical students to retain their entitlement to full student finance maintenance funding throughout their years of study. 

Henry Budden and Dr Sophie Mitchell, deputy co-chairs (finance) of the BMA’s medical students’ committee, said: ‘Graduates are leaving university with tens of thousands of pounds of debt and despite this they’d rather see their student loan increased than be left with so much less in their final year. 

‘This situation isn’t sustainable and does nothing to help those from poorer backgrounds or improve participation in medicine.  

‘Medicine is longer than many other degrees for good reason; because we want to ensure doctors working in the NHS have the best possible training. It is only right then that they should receive the appropriate funding to see them through the entirety of their course.’