New releases

How can doctors do the most good? An interview with Dr Gregory Lewis

Blog post by · Published August 28th, 2015

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Gregory Lewis is public health doctor training in the east of England. He studied medicine at Cambridge, where he volunteered for Giving What We Can and 80,000 Hours. He blogs at The Polemical Medic. This interview was conducted as part of the research I did for Will MacAskill’s book, Doing Good Better: How Effective Altruism Can Help You Make a Difference. Greg’s story is discussed in the fourth and fifth chapters of that book.

Pablo Stafforini: To get us started, can you tell us a bit about your background, and in particular about your reasons for deciding to become a doctor?

Gregory Lewis: Sure. I guess I found myself at the age of 14 or so being fairly good at science and not really having any idea of what to do with myself. I had some sort of vague idea of wanting to try to make the world a better place, in some slightly naive way. So I sort of thought, “What am I going to do with myself?” And my thoughts were pretty much verbatim, “Well, I’m good at science and want to do good. Doctors are good at science and they want to do good. Therefore, I want to be a doctor.” So based on that simple argument, I applied to medical school, got in, spent the following six years of my life in medical school qualifying as a doctor,

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How to explore in your career

Blog post by · Published August 19th, 2015

Tony Blair tried to make it in rock n roll before going into politics.

We often talk about the benefits of trying out several different paths, especially early in your career. But changing job too often has costs. How can you explore effectively?

Here’s a couple of ideas from our recently updated page on why and how to explore.

Tips for exploring
1. Use your natural exploration opportunities

There are times when, money permitting, society gives you a free pass to do something random:

  • In a “gap year” between school and university, or just after you graduate.
  • In your high school and university summer holidays.
  • In university courses that aren’t your major.

Take advantage of these opportunities as much as you can.

2. Use the “graduate school reset”

After you graduate from university, you can do something unusual and risky for a few years, then go to graduate school, then begin a regular professional career as if not much happened. More specifically:

  • You can take one to two years out before doing a PhD, and by the time you graduate, it probably won’t matter.
  • Sometimes you can use a Masters degree to transition into a new field.
  • You can do a law degree and become a lawyer or go into policy.
  • Consulting, finance and many corporate jobs accept people directly out of MBAs,

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What are the 10 most harmful jobs?

Blog post by · Published August 14th, 2015

We spend most of our time discussing the most helpful careers that you should take.

We just created a three minute career recommender to highlight some of the options with the largest positive social impact for you.

As most of the people we talk to are deciding between reasonable to excellent options, this seems like the right focus.

But which careers are the worst?

Here we try to guess which mainstream jobs are most likely to do significant harm. As almost no one we know is considering careers of this kind we have limited our investment in this research; it’s an initial exploration of the topic, based on general knowledge and a review of the key figures.

Here are the criteria:

  • The job has to be legal. Needless to say, organised crime is a harmful career!
  • More than one in a million people has to work in the job in the OECD, so it can’t be incredibly obscure or specific.
  • It can’t be harmful only if you’re particularly incompetent (for example, being a bad teacher), deliberately trying to do a bad job, or violating the profession’s code of ethics.

It’s easy to think of jobs that are useless and just transfer money from one person to another. But being unproductive alone isn’t enough to make a top ten list. There are also notable industries that cause harm,

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Try the new 80,000 Hours ‘Career Recommender’ – it could change your life

Blog post by · Published August 11th, 2015

We just added a new and very cool feature to our website: the ‘career recommender’.

It takes about 3 minutes to use and might end up significantly changing the course of your career.

Our goal is to ask you just a questions and then tell you in what careers you can have the greatest social impact.

If that sounds ambitious, that’s because it is! But the thousand of people who have already used it during testing it have found it surprisingly useful.

It should at least throw up options you should seriously consider before you do something else. So:

  1. Use the Career Recommender.
  2. Once you’re done, it can email you your suggestions so you can read more about them later.
  3. Share it on social media and perhaps change the lives of your friends and family for the better.
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Would you get these results? Try it and find out!

We expect the career recommender to remain a core part of our career guide in the future. It’s already useful, but it will become much more so over time as our research expands and we:

  • ‘Review’ and rate a wider range of paths, especially those in which people can achieve great things without having to have far above average quantitative or language skills.
  • Change the questions to more precisely measure people’s skills.
  • Check that it gives good answers for any possible set of inputs.

Stay informed of significant updates by signing up to our twice monthly research newsletter.

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4 reasons working at a foundation is better than you think

Blog post by · Published August 10th, 2015

If you’re an all-rounder who wants to make a difference, consider working as a foundation grantmaker. Grantmaking can seem like an unglamorous profession – reviewing hundreds of applications for funding isn’t the most exciting sounding role – but it has some major upsides if you want to make the world a better place.

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Summary of our annual review May 2015

Blog post by · Published August 5th, 2015

We’ve just published our annual review for the period ending April 2015.

In case you’re new to 80,000 Hours, this is what we do: we advise talented graduates on how to maximise the social impact of their careers. Currently, we do this through our online guide and one-on-one coaching. We help graduates find the meaningful careers they want, while moving more talent to the world’s most pressing problems.

The key documents in the review are:

In brief, this year we made major improvements to our online guide, leading to 400% growth in the monthly rate of significant plan changes (our key impact metric). Our President wrote a book that Steve Levitt described as “required reading for anyone interested in making the world better,” we quickly met our fundraising stretch target, and we were admitted to the world’s top startup accelerator, Y Combinator. We did all this despite a smaller budget and two staff with long-term illness.

We also made plenty of mistakes.

In total, to date we’ve caused 188 significant plan changes. As a result of our help, these people:

  • Have founded five professional non-profits that likely wouldn’t exist without us.
  • Have entered careers such as research and politics.

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What’s it like being a nonprofit in Y Combinator?

Blog post by · Published August 5th, 2015

Now the obligatory Tech Crunch article is out, I’m thrilled to announce we’ve been in Y Combinator (YC) since June. YC is widely regarded as the world’s best startup accelerator, and has supported companies such as AirBnB, Reddit and Dropbox. It provides investment and intensive coaching over three months.

I’ve had a lot of questions about YC over the last couple of days. Here’s answers to the most common questions, plus an update on our progress since we were admitted.

FAQ

What do you get as a nonprofit in YC, and why did you join?

Instead of $120,000 of investment, you get a $100,000 donation. Otherwise, you’re treated almost exactly the same as a for-profit. This means:

  • There are two partners who look after you. You meet them once every 1-2 weeks. We’re looked after by Dalton Caldwell and Paul Bucheit, the founder of Gmail.
  • Kate Courteau, head of the nonprofit program also looks out for us.
  • You can also request office hours with any of the other 20 or so partners. We’ve had great office hours with Kevin Hale, the founder of Wufoo, on web design, and Sam Altman, the President of YC, on strategy. We’ve also had some very useful legal help from YC’s lawyers.
  • Paul Graham is retired, but you get to meet him once. Unfortunately, we didn’t yet.
  • There’s a dinner each Tuesday where they bring in a tech leader to talk off-the-record,

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Plans for the coming year May 2015

Blog post by · Published August 5th, 2015

This report explains our strategy and plans for the next year, and is part of our annual review.

Moving from discovery phase to growth phase

We’ve seen the last three years as our “discovery phase” (as explained in our last business plan). We didn’t immediately focus on growth because first we wanted to answer the following questions:

  1. Could we make significant progress on the issue of how best to choose a career with social impact?
  2. Would people listen to our research and change their career plans?
  3. Would they follow through with these plan changes and actually increase their impact?
  4. Could we bring about these plan changes scalably and cost-effectively?
  5. Do we have a working funding model?

Answering these questions took time, especially because it usually takes people a year or so to change their plans, and it takes another year or more to see if they have followed through.

Today, however, we think we can answer “yes” to each question. We believe this means that 80,000 Hours is a project with potentially huge impact: 31% of graduates say making an impact in their work is “essential”, but they have little idea what to do except work in the social sector or give up (“sell out”). So most of their potential impact is wasted.

We can potentially fix that.

As a result, we now intend to move into a “growth phase”.

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Review of progress May 2015

Blog post by · Published August 5th, 2015

In this post, which is part of our annual review, we review our achievements, challenges and mistakes over the year ending May 2015.

Key achievements

Our major achievements this year include the following:

  • We made major improvements to our online guide, leading to 400% growth in the monthly rate of significant plan changes.
  • Our President, Will, wrote a book, which was released last week.
  • We quickly met our fundraising stretch target.
  • We were also admitted to the world’s top startup accelerator, Y Combinator.
  • We did all this with a smaller budget than last year and despite two staff suffering from long-term illness.

Improvements to our online guide

At the start of 2014, our website had little more than a blog – we had just a one page summary of our advice. By April 2015, we had a twenty page online guide with four sections and 16 career profiles.

Following the launch of the new content in September 2014, unique page views of the guide reached 46,000 per month by April. Monthly newsletter sign-ups also went up to 313, twenty times the number from the equivalent period last year.

As a result, we estimate that our online content alone is causing six significant plan changes per month, four times the rate in early 2014. (And that’s before taking account of the fact that significant plan changes will lag significantly behind traffic because it takes time to change your career.)

I think we also made significant improvements to the quality of design and writing,

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Review of program performance May 2015

Blog post by · Published August 5th, 2015

Summary

In this report, which is part of our annual review, we review how our programs performed over the last year (ending April 2015).

The key metric we use to measure the performance of our programs is “significant plan changes”. A significant plan change is when someone tells us that they probably changed the career path they were going to follow because of us.

This year, the number of plan changes caused by our online guide rose from about 1.3 per month at the start of 2014 to about 6.5 per month – 400% growth. The rate of newsletter sign ups per month through the website – our key engagement metric – also grew 1600%.

Due to a shift in focus, we coached about a third as many people in 2014 as we had in 2013, and spent less time per person. As a result, significant plan changes caused by coaching declined from 21 in 2013 to 3 in 2014. They picked up again in early 2015 as we increased time spent coaching.

In total to date, we’ve now recorded 188 significant plan changes, up from 107 at the time of our last evaluation in April 2014. We estimate we’re adding about 10 per month at the margin (6.5 from guide, 2 from other (mainly community) and the remainder from coaching), up from 2 per month near the start of 2014.

The average cost per plan change has been decreasing,

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Can you have more impact working in a foundation than earning to give?

Blog post by · Published July 30th, 2015

Photo credit: Flickr – Refracted Moments

Key points

  • Working to improve grants at a foundation could well be more effective in terms of the impact of the money moved than earning to give. Which is better will usually come down to how good your personal opportunities are to make money, or get a job at a large foundation working on an important cause.
  • If you know of a cause area or organisation that is many times more effective than what any foundations you could work at would make grants to, then earning to give is likely to be better.
  • There are other issues, like the impact on your long-term career trajectory, that you have to consider as well as the direct impact of the money you move.

As soon as we thought of the idea of earning to give, we started thinking of ways to beat it. One idea that was floated in the very early days of 80,000 Hours was working in a foundation to allocate grants to more effective causes and organisations. Since a foundations grantmaker might allocate tens of millions of funding, far more than they could earn, maybe they could have a greater impact this way?

In this post, we provide a model for comparing the impact of foundations grantmaking and earning to give, which some people may find useful for specific scenarios where they have more info on the inputs. We also provide some very tentative estimates using the model to demonstrate how it works.

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‘Replaceability’ isn’t as important as you might think (or we’ve suggested)

Blog post by · Published July 27th, 2015

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Often if you turn down a skilled job, the role simply won’t be filled at all because there’s no suitable substitute available. For this and other reasons we don’t place as much weight as we used to on the idea of ‘replaceability’.

When we started 80,000 Hours, one of the key ideas we presented was the replaceability argument:

Suppose you become a surgeon and perform 100 life saving operations. Naively it seems like your impact is to save 100 people’s lives. If you hadn’t taken the job, however, someone else likely would have taken it instead. So your true (counterfactual) impact is less than the good you do directly.

I still think this is a good argument, but I’m not sure how relevant it is when comparing real career options.

In particular, I see the argument often being used incorrectly in the following two ways:

  1. Ignoring direct harm: Suppose you’re considering taking a job that some people think is harmful (e.g. certain parts of the financial sector) in order to donate, do advocacy or build skills. You reason “if I don’t take the job, someone else will instead, so the potential harm I’ll do directly doesn’t matter”.

  2. Ignoring direct impact: Suppose you’re considering working at a high-impact nonprofit. You reason “if I don’t take the job, someone else will instead, so I won’t have much impact.”

I disagree with both of these claims in most circumstances. Why?

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Update: how many extra donations have we caused?

Blog post by · Published July 26th, 2015

One way 80,000 Hours has an impact is by increasing the amount our users donate to high-impact charities. As part of our annual review, we did a quick update to the figures from our last review. The process we used wasn’t as thorough as we would have liked, but provides some encouraging evidence of our impact.

What we did

We identified the largest donors we know of who (i) have made significant plan changes according to our definition and (ii) say they intend to earn to give.

We asked them the following questions via email:

  • How much have you donated over the last three years?
  • How much do you expect to donate over the next three years?
  • Where to?
  • How much of this is attributable to 80,000 Hours? (meaning what wouldn’t have been given if 80,000 Hours didn’t exist).
  • How much have you pledged to give as part of GWWC or otherwise?

For those people who responded last year, we asked for an extra year of data. You can see the answers and case studies from last year’s review in the appendix here.

We received responses from all ten people asked. Each intends to give to whichever charities they believe to be highest-impact (in practice, this mostly means effective altruist organisations or charities recommended by GiveWell or Giving What We Can). Also included in our results is last year’s highest donor (“A”),

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Is wealth inequality so extreme that it’s OK to be a ruthless trader?

Blog post by · Published July 22nd, 2015

U.S._Distribution_of_Wealth,_2007Wealth inequality globally is incredibly high. Perversely, this can be an argument in favour of working in finance.

Many people are concerned that ‘earning to give‘ in the financial industry is overall harmful for the world, even if you give away most of your income to outstanding charities.

To figure out if this is true, we have been researching the size of the harms, and benefits, caused by finance. (Though please note 80,000 Hours is not just about earning to give and in fact we think it’s the best path for only a small share of our readers.)

One of the concerns we’ve investigated is that certain parts of quantitative finance are a socially-useless competition between traders that only changes who gets some amount of income, not that someone gets it. I think this is the case, but the incredible amount of inequality in the world makes this argument against working in finance fairly weak.

If you are working in ‘low-latency arbitrage’, make a random clever trade on a stock exchange and beat some other trader to a profit by 1 millisecond, whose pocket is this money coming from? A poor African farmer? No, they have no wealth to take. A middle class American family? It’s possible, but most of their wealth, if they have any, is probably in their house or bank account.

We don’t have perfect figures here, but looking at reasonable estimates,

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LinkedIn finds the most common ways in and out of every career

Blog post by · Published July 22nd, 2015

We recently wrote a career profile on medicine which said that one of the most common exit opportunities for physicians was into academia. How exactly did we know that?

LinkedIn has mined their enormous dataset to find the most frequent career transitions for people from a huge range of different professions. It turns out that the most frequent transfer for a physician or surgeon is to become a university professor, presumably studying or teaching medicine itself. Most roles have several common options.

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I strongly recommend playing around with it and reading their analysis. It turns out that ‘sales’ is a huge skill area and one of the most common next steps for people from a very wide range of professions. Almost every business needs some people to work on sales!

You can use this both to see what your natural next career moves are, and figure out what indirect paths you can use to get into a particular different position you have in mind. It doesn’t do the reverse lookup itself yet, so you’ll need to guess which options are most likely to lead you into the one you want.

We’ll be incorporating the wisdom of this tool into our career profiles as we update them.

The broad skill groupings they classified seemed to me to be:

  • Sales, hospitality and logistics (blue)
  • Health and education (red)
  • Information technology (pink)
  • Practical trades,

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Systemic change becomes non-systemic change and vice versa

Blog post by · Published July 21st, 2015

As you might have heard, there is an active debate among the 80,000 Hours community about the effectiveness of attempts to change societal systems – such as laws, institutions or social norms – versus so-called “non-systemic” approaches, such as funding health treatments directly, or becoming a teacher.

Sometimes these debates become quite heated.

To put my cards on the table, I lean towards systemic change being a more promising approach, at least given my skills. Hence, I’ve studied public policy and worked in a Government think tank myself. I also see one of the major long-run impacts of 80,000 Hours to be changing social norms about how people think about how they spend their working life.

But I find it hard to get too passionate with those who lean the other way. One reason for this was well explained in a comment by my friend Catriona Mackay:

I think that people on the whole are biased towards against non-systemic change (i.e if you did a survey asking whether it’s best to treat the causes or the symptoms of poverty, almost everyone would answer ’causes’, even if there were strong evidence that both were effective in terms of increasing net well-being), and so it’s likely that non-systemic causes are more underfunded, so I can contribute more.

On the other hand, I think that scaling up proven health solutions and cash grants and so on are also ways of contributing to systemic/revolutionary change.

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We’ve caused 188 significant plan changes

Blog post by · Published July 21st, 2015

The results of our annual impact survey are in, so we can give an update on the number of significant plan changes we’ve caused as of the end of April 2014.

“Significant plan change” is the key metric we use to track our impact. See a definition.

Results of the annual impact survey

The survey was open from November 2014 to early March this year. We promoted it throughout February, on our newsletter, our blog and social media as well as in-person. To encourage responses, we offered a $200 prize to one randomly selected respondent.

This resulted in 218 responses, of which 85 people answered “yes” to the following question:

“Has your engagement with 80,000 Hours caused you to significantly change your career plans?”

How many of the people who said “yes” count as having made significant plan changes according to our criteria?

First, we removed 13 people who were already captured last year (though worth noting is that five of these people seem to have made a second significant shift in plans due to us).

Second, we removed a further 18 people who didn’t seem to make our criteria. The main reason was that they didn’t list a specific shift in plans, and instead listed an intention to shift in the future or only gave a very vague response. It’s likely that some of these people would count as significant plan changes if we asked for more detail,

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New definition of a significant plan change

Blog post by · Published July 21st, 2015

We’re changing how we define “significant plan changes”.

The “significant plan change” is the key metric we track month-to-month to measure our impact.

It’s related to our total impact as follows:

(Number of significant plan changes) multiplied by (the value of the average significant plan change)

We evaluate the value of a significant plan change once every year or two (see our last evaluation). This means the more difficult judgement calls concerning our impact (such as whether plan changes are really improvements, and the extent to which they would have been caused by other groups anyway) are isolated into a separate evaluation process that we perform less frequently.

Our new definition for a significant plan change is:

A sig plan change =df Someone tells us that 80,000 Hours caused them to change the career path they intend to pursue, in a way that they think increases their lifetime impact.

In practice, this means:

  • They fill out one of our surveys saying “yes” to “has your engagement with 80,000 Hours caused you to significantly change your career plans?”
  • They tell us what path they changed from and what path they now intend to pursue.
  • They tell us what sort of engagement with us caused the change (e.g. reading an article vs. coaching vs. speaking to someone in our community).
  • They believe this will result in greater impact (rather than just higher job satisfaction or other benefits).

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    If you want to save lives, should you study medicine? Probably not.

    Blog post by · Published July 20th, 2015

    About 1 in 200 people become doctors, many of them because they want to cure the sick and generally make the world a better place. Are they making the right decision?

    To help answer that question, we’ve produced an exploratory career profile on medical careers.

    The conclusion of our research is that most people skilled enough to make it in a field as challenging as medicine could have a bigger social impact through an alternative career.

    The best research suggests that doctors do much less to improve the health of their patients than you might naturally expect. Health is more determined by lifestyle factors, and most of the treatments that work particularly well could be delivered with a smaller number of doctors than already work in the UK or USA.

    However, medicine is high earning and highly fulfilling, and we expect there are more promising opportunities to help others through biomedical research, public health, health policy and (e.g. hospital) management.

    Overall, we think going to medical school would be the best way to have a social impact only if someone felt they were a significantly better fit for medicine than the other options we recommend.

    Dr Greg Lewis, a practicing physician in the UK, wrote most of the career profile.

    Key findings

    • Having more physicians in the developed world has a surprisingly small impact on the health of recipients.

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