Career choice for a utilitarian giver

Hi Julia,

I have done a lot of research on this topic working with Giving What We Can and Existential Risk Career Network folks. Eventually it is going on highimpactcareers.org, but I would be happy to discuss things with you, including more detailed analysis of medical school, and some alternatives with especially high returns for folk looking at things in a consequentialist light (including entrepreneurship, politics, and foundation/government work). Just email myfirstname.mylastname@post.harvard.edu.

I don't know your mind, but I would predict that in the average person, determination to donate ~100% of earnings to a good cause will not persist for 18 years. If you think there's a pretty good chance that you'll end up changing your mind about that, might as well give the money now while you're still a perfect utilitarian (for which I admire you a huge amount, by the way) rather than give nothing for years and years and end up not giving anything at all.

I'm currently in my last year of medical school pursuing a career in psychiatry. If you have any questions on the process, feel free to ask me by PM or email (scott@shireroth.org).

I doubt that becoming a psychiatrist is the way for you to do the most good. Some thoughts:

1. Influencing a single young utilitarian-inclined person to become a psychiatrist in the immediate future who would not otherwise have would have the same expected impact as you yourself becoming one. (The situation would be different if you had already gone through the schooling and were deciding whether or not to keep doing it or to do something else).

2. I think (but am not sure) that there's plausibly enough low-hanging opportunity for utilitarian networking and activism so that you could have at least the impact described in the above point by focusing on networking and activism. I have some ideas about this; PM me for more if you'd like.

3. As Carl Shulman alluded to, there's the possibility of working at a foundation moving more money than you would make for the rest of your life. I have little sense for what qualifications are required to get such a position, but I would guess that they'd be significantly less than what it would take to become a psychiatrist. On the other hand you wouldn't have arbitrary flexibility over where the money went and so couldn't use it optimally; so there's some sort of trade off that would need to be made.

1. My observation is that when utilitarian types (including myself) consider going through an unpleasant experience for a good cause, they tend to massively underestimate the probability that they'll burn out and underestimate the severity of burnout. See the second and third paragraphs of Carl's comment here. I don't completely identify with the framing but (sadly) have found that in my own experience making large personal sacrifices massively undermines my (ordinarily high) utilitarian motivations. Things can get very ugly when this happens (in the sense that it destroys my self-image and leads to long periods of self-loathing during which I doubt whether I was ever a good person).

2. When causes vary in effectiveness by orders of magnitude, it's almost always more important to pin down the correct cause than it is to maximize one's donated income. If job related stress were to lead you to miss the best cause by an order of magnitude then your effort would have been in vain.

You have my admiration for itemizing so meticulously.

Keep in mind that not only would a divorce increase the probability of burnout, it would also reduce your ability to give. You'd have to pay all the living expenses currently covered by your husband's salary, and it would be advisable to build up savings since relying on only one income you would be more vulnerable to unexpected events (job loss, illness, ect.). Marriage gives you the flexibility to donate all your income now; I think it's reasonable to value it highly even from a purely utilitarian perspective.

I’m not sure about my academic capabilities.

This makes me think you might benefit from taking a single part-time class after work. It lets you get your feet wet and see how you like it. If you crash and burn on that, you know school isn't viable. If you do awesome and feel like you could have done work + 2 classes

You might also benefit from talking to people in the field, and see how far in to your training you'd need to be before you can "tag along" as an intern/apprentice/observer (I don't know if psychiatrists do this? I know nurses and dentists do) - Again, something that lets you get a more hands-on feel without the full commitment.

If you're still in the market for third alternatives, you could also look in to making a second income off of a hobby - freelance writing, code video games for the iPhone, etc.. There's a wide variety of options out there, and you can generally teach yourself the relevant skills.

Lastly, keep in mind that changing your mind is allowed. If you do a year of school and find your marriage fraying, your grades dropping, you can step back, treat it as a sunk cost, and walk away if you need to. It's not ideal, but it's probably a worthwhile risk given the potential gains.

tl;dr: Get an idea of what it's like via easy routes, ease yourself in. If it works, awesome. If it doesn't, you haven't lost as much. Be aware of burnout, and be aware of how BAD the looming burnout might be.

My situation is not dissimilar-- 28 years old and halfway through a second bachelor's in nursing, which now seems not optimal. I'm currently applying to PA schools.

MD programs are also an option I've considered, and though I'm a little older than you I already have all my prereqs done because my first degree was in biochemistry, so we'd probably be about the same age when we finished up. I'm mainly hesitant because, as you say, it takes for fucking ever, and I suspect I'm going to want to have babies less than ten years from now.

PM me if you want to talk more; we could bounce ideas off each other.

ETA: Consider giving yourself the opportunity to fail cheaply: see how you do with your science prereqs, take the MCAT, shadow a psychiatrist to see if you actually want to do that, etc.

You seem to be overestimating social worker salary quite a bit. Social work is one of the worst paying careers.

Payscale.com indicates salaries are $27k to $58k after acquiring 10 to 19 years of experience. More than 20 years of experience places the possibility of 80k you mentioned closer to your reach, but it's worth noting that becoming an MD will actually probably at least triple, and possibly quadruple or even quintuple your lifetime earnings, not double as you estimate.

Do you have advice on powering through an unpleasant experience for a good cause?

Keep pictures and bios of people whose lives you're saving in your wallet/purse/backpack, to refer to when you feel like giving up?

I like your thought process and where you're heading. Good luck.

I sadly don't have any advice for you, but I do want to say that I find you inspiring.

This got me thinking about end of life planning. Should I strive to go into retirement with very little money left, having donated it all to charity, and so avoid the exhorbitant costs of life support at the end?

Good on you!

My only comment is that learning things (particularly but definitely not limited to rote learning) is significantly easier with judicious use of spaced repetition software such as Anki.

If you're seriously considering becoming a psychiatrist & taking on 9 more years of education & training- there are a couple more things to consider. One is, do you plan to have children and how do they fit into that. The 2nd is, while you have the potential to earn much more money, you would first have to take on debt to pay for medical school. Also, you may have to relocate to attend medical school and a residency, which would have an impact on your marriage and husband's career. Boy do I sound like a traditionalist, but they are things to consider.

I think, though, it should come down to whether you really like social work. If you like it and you're good at it, you'll make a difference in your work and give away what you can. If you're not sure if you do, that's another issue and you should explore your options. The training you've had in grad. school could serve you well in psychiatry.

We need good, smart social workers- there's a shortage going into the profession. Please stick with it. If you want to focus on saving lives as a social worker, you can go into development, start new programs, expand existing programs.

I've been on the administrative side of agencies. I can tell you that 1- having good people makes a huge difference in what they accomplish and 2- while they might advertise that a $100 donation will pay for so many vaccines- it doesn't really mean that if you give $100 that many lives will be saved. It's not that simple. There is overhead, program planning. Getting a little more money isn't going to allow them to expand into another city to start giving vaccines to a new population and they aren't spending every dime they take in right away, they need to keep reserves on hand. In other words, you can't really know that you are saving all those lives by giving that much money. You will know what your impact is as a social worker, though. I'd be happy to talk to you more about social work, send me a message if you want to arrange a phone chat.

Honestly?

If you have enough doubt in your mind that it even seems like a faintly good idea to ask for advice before setting out on this path... in my opinion, that constitutes strong evidence that it's the wrong path for you, and the best time to cancel is before you start.