[圣诞特辑] Does medicine run in the family—evidence from three generations of physicians in Sweden: retrospective observational study [医学在家族中传承吗——来自瑞典三代医生的证据：回顾性观察研究]

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BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4453 (Published 16 December 2020)
Cite this as: BMJ 2020;371:m4453

Authors
Maria Polyakova, Petra Persson, Katja Hofmann, Anupam B Jena

Abstract
Objective To examine occupational heritability in medicine and changes in heritability over time, with Swedish population wide administrative data that allowed mapping family trees of physicians spanning up to three generations.

Design Retrospective observational study.

Setting Individual level administrative registry data from Sweden.

Participants Physicians born in 1950-90 and living in Sweden at some time during 2001-16 (n=47 400).

Main outcome measures The proportion of individuals with a completed medical degree with at least one parent who also trained in medicine, and the change in this proportion across birth cohorts. Additional analyses were conducted among other relatives (grandparents, aunts and uncles, and siblings) and for individuals with a law degree.

Results For 27 788 physicians, where the educational background for both parents was known, 14% had a parent who was also a physician and 2% had two parents who were physicians. The proportion of physicians with at least one physician parent increased significantly over time, from 6% for physicians born in 1950-59 to 20% for physicians born in 1980-90 (P<0.001). The same pattern of increasing occupational heritability was not seen for individuals with law degrees.

Conclusions In recent cohorts of physicians in Sweden, one in five had a parent who was also a physician, more than triple the proportion seen for physicians born three decades earlier. A similar pattern was not seen in lawyers, suggesting that increasing occupational heritability in medicine does not reflect intergenerational persistence of high paying degrees alone. Rather, for physicians in Sweden, medicine might increasingly run in families.