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

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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Increasing your earnings as a doctor

Making a difference to patient’s lives is a gratifying part of medical work. However, an investigation by Dr Gregory Lewis suggests that doctors may be able to make a greater improvement to people’s lives through their donations than through their practice. In part, this is because the potentially large impact of charitable donations. For instance, research by GiveWell has shown that it’s likely to be possible to save a life for less than $10,000. This raises the question ‘how can doctors increase their earnings?’.

In this post, we explore whether doctors can improve their earnings by:

  1. Moving to a different country.
  2. Choosing a highly-paid specialty.
  3. Pursuing locum (contract) shifts.

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Case study: earning to give compared to medical research

Introduction

Ramit came to us with a simple question: should I try to train as a medic with the aim of doing biomedical research, or should I seek a high earning job in finance and pursue Earning to Give?

He’s currently doing both – working as a quantitative financial analyst giving away more than a third of his salary (he was an early stage funder of Give Directly) and taking pre-med courses part time, as well as other projects!

Ramit’s initial thought was that the biomedical research path would be better. Read on to find out how he came to change his mind, and came up with a new set of next steps.

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In which career can you make the most difference?

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Introduction

Previously, we introduced a way to assess career opportunities in terms of their potential for positive impact, but which careers actually do best on these criteria? In this post, we’ll apply an adapted version of this framework to some career paths that seem particularly promising for recent graduates. Using what we’ve learned over the past two years of research and coaching over 100 people, we’ll provide a ranked list of options.

Summary

  • If you’re looking to build career capital, consider entrepreneurship, consulting or an economics PhD.
  • If you’re looking to pursue earning to give, consider high-end finance, tech entrepreneurship, law, consulting and medicine. These careers are all high-earning in part due to being highly demanding. Our impression is that software engineering, being an actuary and dentistry are somewhat less demanding but also highly paid.
  • If you’d like to make an impact more directly, consider party politics, founding effective non-profits, working inside international organisations, government or foundations to improve them, and doing valuable academic research.
  • If you’d like to advocate for effective causes, consider party politics, journalism, and working in international organisations, policy-oriented civil service or foundations.
  • Some career paths that look promising overall are: tech entrepreneurship, consulting, party politics, founding effective non-profits and working in international organisations.
  • Some paths we think are promising but are largely neglected by our members and would like to learn more about are: party politics, working in international organisations, being a program manager at a foundation, journalism, policy-oriented civil service and marketing.

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A comparison of medical research and earning to give

Introduction and Summary

We recently did a case study with Ramit (see the full case study write up here). He was wondering whether to start a medicine degree, with the aim of going into research, or to continue in finance doing earning to give, where he already has a job as a quant researcher earning in the range of $150,000 per year.

We did an in-depth comparison of the expected impact of the two paths to help him decide. The rest of this post contains our case study research notes on the comparison.

If forced to guess now, we lean in favor of earning to give, though we think it’s very high priority to gain more information. Ramit is going to try to better assess his degree of fit with medical research, perhaps by working as a researcher during the summer, and learn more about his earnings prospects in finance by making applications and speaking to a headhunter. We’ll review our decision when we find out more.

In the rest of the post, we explain our reasoning:

  1. We outline our general approach
  2. We define a number of factors to compare the two options
  3. We evaluate the two paths based on the factors
  4. We make our overall conclusions

Note that there were several potentially important issues we didn’t address, including job satisfaction and which path is best for career capital in careers besides finance and research.

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How many lives does a doctor save? – Part 3 – Replacement

If I become a doctor, I won’t increase the total number of doctors by one. The NHS has a limited budget, so it can’t just hire every qualified person who applies; medical schools have limited places by law, and there are more applicants who are ‘good enough’ than there are places. If I become a doctor, then I’ve just displaced someone else who would have taken the job.

Doctor

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How many lives does a doctor save? – Part 2 – Diminishing marginal returns

Dalysper100000versusdoctorsper100000

In the first post, I worked out an upper bound for the average direct health impact of a doctor in the UK, and found it amounted to producing about 2600 QALYs. We can think of this, very roughly, as saving 90 lives. This doesn’t, however, show how much difference you make by becoming a doctor. There’s already about 200,000 doctors in the UK. How can we take the figure for the average impact of a doctor and work out the impact of an additional doctor?

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How many lives does a doctor save?

It seemed a pretty good career move for a 17-year old wanting to make a difference. Like thousands of others, I applied to read medicine. This is what I wrote on my personal statement: “I want to study medicine because of a desire I have to help others, and so the chance of spending a career doing something worthwhile I can’t resist. Of course, Doctors don’t have a monopoly on altruism, but I believe the attributes I have lend themselves best to medicine, as opposed to all the other work I could do instead.” Was I right? Is medicine a good career choice for someone wanting to ‘make a difference’?
Doctor

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