Careers in medicine - a new path profile from Probably Good and High Impact Medicine

By Probably Good, High Impact Medicine @ 2022-10-18T17:12 (+62)

The teams at Probably Good and High Impact Medicine (Hi-Med) are excited to co-publish a new path profile on careers in medicine! You can find the profile over at both the Probably Good and Hi-Med websites.

Summary

The path profile is an introductory guide to impactful careers within the medical space, primarily aimed at existing doctors and medical students who may not yet be familiar with EA principles. 

One goal for this profile is to provide actionable advice for people who may be more resistant to wholesale career changes. We understand that large career changes can be daunting, especially for people who have spent many years aspiring (and training) to become a doctor. With this in mind, we want to give information for people who may be strongly inclined towards a career in clinical medicine, and want to find ways to increase their impact. The article suggests ways in which medics might increase their impact within clinical careers – for example, by pursuing high-paying specialities and donating to effective charities – as well as pointing out where doctors may be able to get involved with high-impact activities alongside their clinical duties.

However, the profile also makes clear that the highest impact choices for many people will likely lie outside clinical work, and we therefore highlight a few of the most salient high-impact alternatives both in the medical field more broadly, as well as outside medicine, for someone with a medical background. The career paths we discuss include medical research, public health, biosecurity, and nonprofit entrepreneurship.

Below, we’ve included the full introduction to the profile as well as a couple of representative excerpts.

Introduction

The medical profession attracts huge numbers of altruistically-minded people who want to make a difference with their careers. One recent survey, which asked for the career aspirations of over 600,000 teenagers across the world, found that over 10% of them wanted to become doctors. This is great – doctors are vital, and the world is much better because of them. 

But if you’ve gone through medical school, you’ll be familiar with the concept of triage – that is, treating patients according to the urgency of their needs and your ability to help. Sometimes this means making tough calls about who to help first and how to help them. Though triage can be emotionally challenging, it’s vital for saving lives. 

We think it’s possible to apply a kind of triage to the world’s problems – working out which are most urgent and deciding on the most effective ways to solve them. In doing so, we may be able to identify career choices that allow us to achieve even more good than we might do otherwise. 

This kind of career-focused triage can be applied here in two ways. First, we can look for the highest priority paths within clinical medicine, by searching for where doctors are most needed, and what they can do to help most. Secondly, we can look at alternatives to conventional clinical careers to see if we can have more impact on the world through another career route. Perhaps surprisingly, it turns out that there are a number of career paths in which you might be able to do more good than you would as a doctor, either because these paths focus on more pressing problems, or provide larger-scale solutions than treating patients individually. 

In this profile, we'll highlight a few of these possible high-impact career routes – including biosecurity, nonprofit entrepreneurship, medical research, and public health. If one or more of these options could be a good fit for you, then you could have multiple times the impact in these careers than you might as a doctor (at least without further prioritization within clinical careers). And the good news is that a medical degree can serve as a great background for a number of these high-impact career paths. 

If you are committed to working clinically, there are some great things you can do to increase your positive impact. First, you could donate a portion of your income to some of the world’s most cost-effective charities, potentially saving multiple lives per year. Secondly, you could consider splitting your time between clinical work and one of the medicine-related career paths discussed later in the profile. Dividing one’s responsibilities between clinical and non-clinical work is something many doctors do.

And, for those who haven’t yet entered medical school, the profile will also briefly address how you might potentially enter these high-impact paths through routes other than medicine. Though a medical degree could be a useful credential and teach you transferable skills, alternative degrees may allow you to develop the most relevant skills for these paths in less time…

Excerpts from the full profile

Non-clinical path: Careers in Public Health 

Public health focuses on improving the health of large populations of people by preventing and protecting them from ill health and injury. This is a broad career path, which can span various disciplines such as academic research, policy formulation and implementation, operations, advising, and advocacy (and roles often contain a combination of these). Moreover, public health roles can be found in a wide array of organization types, like governments, NGOs, think tanks, universities, and multilateral institutions like the World Health Organization (WHO).

Public health roles can be very promising in terms of impact. One reason is that many public health interventions are highly cost-effective, and some even save money while providing benefits by reducing the need for expensive treatments. Additionally, many public health roles grant large amounts of leverage – influence over where large amounts of resources are spent – compared to clinical roles.

Who might be a good fit?

• Public health roles are often academic or managerial in nature. Because of this, you’ll need to be comfortable in a job that doesn’t entail direct clinical work. Though you may be able to perform public health work alongside a clinical career, the public health work itself is unlikely to involve much (or any) patient interaction.
• Strong communicators are particularly likely to find success in public health roles, particularly roles with a focus on advocacy and advising.

Getting into public health

With a medical degree: Medicine is often regarded as one of the best ways to enter the field of public health, and certain positions (such as some roles in global health orgs like the Gates Foundation) even require clinical experience.

To get into this field, it’s very common to take a master’s in public health (MPH), which typically cover a range of specialities and domains within the broader sphere of public health. And if you want to lean into academic research, you could consider a PhD in either public health or a related subject like epidemiology. 

Without a medical degree: However, you can also enter public health roles through other routes. For example, a degree in economics (or a similar technical subject) provides a great background for epidemiology & other data-driven public health roles, as well as general postgraduate qualifications in public health, whilst also providing the flexibility to move into a host of impactful non-medical paths such as development economics. Other degrees in the natural sciences also provide a good background for public health roles.

Priorities within public health

As with all other careers, applying the importance, tractability, and neglectedness framework can be really helpful for identifying the most impactful paths. This framework entails that, in general, it’s best to prioritize roles that can deploy or facilitate effective solutions to large-scale problems. 

Because of this, working on public health within low- and middle-income countries is likely to be a great option. Health problems are typically much more serious and widespread here than in high-income countries, and there are a variety of effective public health interventions, such as regulating dangerous substances or improving air quality, which could significantly help high numbers of people.

This work could include, for example, working as a health adviser to a government or in a global health advocacy organization. Even if you live in a high-income country, there are ways you can do this, including moving to a relevant region or joining a local office of an international global health organization. If this interests you, take a look at 80,000 Hours’ global health job board, which lists some relevant positions.

But if you’re limited to roles that focus on public health within high-income countries, then it’s likely that the most promising roles are placed at the national level (such as governments, or organizations that aim to influence government) as well as international organizations like the WHO. We’d generally expect that public health jobs that focus on a relatively small geographic area are unlikely to be the best opportunities for impact, particularly in high-income countries. Because these roles are quite common, the variance of impact within public health is high –  so it’s particularly important to seek out the most promising opportunities in this path.

A great example of this path is Stephen Luby, a professor at Stanford University. After getting his medical degree, Luby started a career in academic public health research. He has worked on some highly important problems within public & global health, like improving handwashing practices in low-income healthcare settings, and improving the manufacture of bricks, whose pollution is responsible for tens of thousands of deaths annually in the developing world.

Working in biosecurity-related public health roles is also an incredibly promising option, See more details in our biosecurity section.

Can I do public health work alongside my clinical work?

Because clinical roles are often highly flexible (at least, once you’re fully qualified), you may have the freedom to change your clinical responsibilities to fit other work around it. You might consider, for example, going part time on your clinical work to take a position in a public health think tank or advocacy organization. We’ve heard that organizations in this space are often receptive to taking volunteers, if you’re interested in a low-stakes way to test your personal fit in these careers. Additionally, there are some roles, sometimes referred to as public health physicians, which perform a variety of public health tasks (like developing public health initiatives) alongside more conventional clinical duties. Other specialities may also give some opportunities for public health-related work, like conducting quality improvement studies. However, these are unlikely to be among the most impactful opportunities in public health more broadly.

…

Non-clinical path: Careers in Medical Research 

Another option is careers in medical research. This is a broad field, consisting of various kinds of research in either academia or industry. Some examples of medical research include developing new pharmaceuticals, supplements, diagnostic equipment, improving biomedical tools and processes, and other health interventions.

Medical research has the potential to be a high-impact area of work. For example, improved pharmaceuticals have played a significant part in the increase to life expectancy in the US in recent decades. However, as with public health, there’s a huge amount of variance in how impactful careers in medical research will be. A big reason for this is that lots of research isn’t optimized for impact, as funding often isn't directed to the most important, tractable, and neglected areas. On top of this, medical research careers – especially on the academic side – can be extremely competitive to enter, even once you have a PhD. This will make it both difficult to be a medical researcher at all, and even more difficult to get onto specific projects which look promising in terms of impact. 

Who might be a good fit?

• Those with a very strong passion for scientific research. Research roles often involve fairly banal repetitive tasks, and it can take months or even years to see the fruits of your work. For these reasons, one researcher claims an ‘absolute obsession’ with the subject area is needed, or else the work may be too dispiriting.
• As you advance in your research career, you may find yourself running a lab. Doing so has been compared to operating a small business, requiring strong organizational and managerial skills.
• Some of the impactful work in medical research is data-driven. It’ll be a real help, in terms of the range of research you’ll be able to engage in, if you’re comfortable with numbers, and are able to develop competency in statistics (including coding in languages like R or Python). 

Getting into medical research

With a medical degree: A medical degree, alongside some research experience in medical school or afterwards, can be sufficient for landing some kinds of research roles in both academia and industry. For more mathematical areas of medical research, like bioinformatics, you may need to be able to demonstrate experience working with numbers and statistics, or have completed a separate qualification in a math-heavy subject.

Whilst it’s not necessary to have a PhD to get into research work, it can be required for more senior research roles, particularly in academia. So, if you’re confident you want to pursue a medical research career, then a PhD may be a strong help. It’s fairly common to complete a PhD whilst staying in clinical work should you wish – some PhD fellowships are explicitly designed for this (like this one from the Wellcome Trust in the UK), though they are generally very competitive. However, as we mentioned above,  getting a long-term academic position, even with a PhD, is not guaranteed.

If you’re completing a medical degree, there are likely opportunities within your medical school for participating on research projects. There might be opportunities as part of the degree itself (such as elective research projects), or they may be extra-curricular. This can help you test your personal fit for research and give you the chance of getting your name on an academic publication. This will make you a more competitive candidate for research-oriented positions, like clinical research fellowships, later on.

Without a medical degree: Degrees in the natural sciences are typically a good platform for research in medical science. This can be followed by a PhD or a master’s degree – neither of these are strictly necessary for taking roles in science, but should be considered strongly preferred for the most senior roles (and a PhD is almost always a requirement for conventional research within academia). The growing popularity of applying AI and machine learning to medicine also means there’s scope for working in this area of medical research with a more technical background, such as in computer science.

Priorities within medical research

It’s hard to know what kind of research is going to be impactful. After all, if we knew which drugs and interventions worked, then we wouldn’t need to do the research. However, there are some rules of thumb you can use to identify more promising opportunities in this space. Some helpful questions here include: What is the total global health burden of this disease or condition? How many people does it affect? Is there existing research which indicates that some new approach is more likely than others to work? As an example, we’d generally expect that working on a new treatment for a neglected tropical disease would be more promising than developing a new treatment for Athlete’s Foot.

Alongside developing new drugs and treatments, you may also want to work on more foundational research on the nature of different diseases, or developing new tools and techniques to improve future biomedical research. Such work is more likely to take place within academia than industry. Although this kind of research might not directly save lives, it can be hugely important for developing effective drugs and treatments in the future. 

Take the example of Katalin Karikó, a research professor who played a leading role in developing messenger RNA (mRNA) technology later licensed by Pfizer and Moderna for their Covid vaccines, saving many thousands of lives. Ugar Sahin and Özlem Türeci, both former medics, also played an instrumental part in this. However, it’s worth noting that these people are outliers – the chances of contributing to something as impactful as RNA-vaccine technology is quite low (though perhaps still worth trying!).

Can I do medical research alongside my clinical work?

It’s very common for clinicians to assist in clinical research for new pharmaceuticals and other medical interventions, particularly in hospital settings. In fact, some roles explicitly contain both research and clinical responsibilities. Because of this, there are likely a fair number of opportunities to work on research alongside clinical work.

Having said this, the sorts of research activities you might be able to undertake within high-income settings alongside clinical work are unlikely to be focused on the most important and neglected areas within medicine. Nonetheless, it could still be a good way to add some impact on top of your clinical duties – though other options (like biosecurity, or particularly good opportunities in public health) may often be better.

You can read the full profile over at Probably Good or Hi-Med.

Do you have EA or career related content that you’d like to see from Probably Good? We’re eager to hear what types of content would be useful to the broader community and/or to specific groups. Let us know by leaving a comment or by emailing contact@probablygood.org.

Are you a medical student or a doctor interested in doing the most good with your career? High-Impact Medicine helps medical professionals to increase their impact by providing various resources, fellowships, and community events. If you are interested, visit our website and consider joining one of our local community chapters, as well as apply to receive one-to-one advice for your career.