Career choice for a utilitarian giver

I’m a util­i­tar­ian con­tem­plat­ing a ca­reer change. I cur­rently give all my in­come to in­ter­na­tional de­vel­op­ment (which is pos­si­ble be­cause my hus­band sup­ports us both fi­nan­cially). I don’t have any spe­cial gift for sci­ence, etc. that would help save the world, so I think dona­tions are the best way I can help.

I’m 26 and halfway through so­cial work school. I en­joy so­cial work and am rea­son­ably good at it, but the most I’ll ever earn is prob­a­bly $80K/​year. I’m now think­ing more about the moral im­per­a­tive to earn more and thus give more.

Most high-earn­ing ca­reers are not ones I think I would en­joy. That means I would be fight­ing burnout for the rest of my ca­reer. (I’m open to sug­ges­tions if you think oth­er­wise.) The ex­cep­tion is psy­chi­a­try, which I do think I would en­joy and be mod­er­ately good at. But I would need about nine years of school and res­i­dency to be­come a psy­chi­a­trist.

If I go to med­i­cal school and be­come an av­er­age psy­chi­a­trist, I’d dou­ble my ex­pected life­time earn­ings com­pared to so­cial work (even af­ter pay­ing for school). I could give about 2 mil­lion dol­lars more, which GiveWell thinks turns into about 2,500 lives saved. No amount of in­con­ve­nience on my part com­pares with that many lives.

So what I want to do is figure out whether I could be pro­duc­tive as a psy­chi­a­trist or some other pro­fes­sion, or whether there’s a good rea­son I should stay on my cur­rent course.

Some con­sid­er­a­tions:

I’m fairly smart but not com­pet­i­tive-na­tured. I think this would make me bad at a lot of ca­reers that pay well but don’t re­quire ex­tra school, be­cause there’s more com­pe­ti­tion for those jobs.

I’m not sure about my aca­demic ca­pa­bil­ities. I haven’t taken a real sci­ence course since high school. It’s also been a long time since I had to do the kind of rote mem­o­riza­tion that I be­lieve is needed in law or med­i­cal school. I’m wor­ried that I would get into one of these and then find I wasn’t up to the work.

I have no in­ter­est in chem­istry. Also, I don’t do well when sleep-de­prived. Both of these might make me a ter­rible med stu­dent.

I’ve had bouts of de­pres­sion in the past, but never ones that crip­pled my abil­ity to study/​work. If I were bus­ier, they might crip­ple me more.

I would need at least a year of post­bac sci­ence classes be­fore I could go to med­i­cal school. This would bring the time to be­come a psy­chi­a­trist to nine years, plus at least a year to ap­ply. That seems like for­ever, though I know when I’m older it won’t seem as long as it does now.

In­vest­ing that time in more school has an op­por­tu­nity cost. If I stick with so­cial work, I could start donat­ing again in one year. If I be­come a psy­chi­a­trist, it would be more like twelve years be­fore I could donate again. I don’t know what effect that de­lay would have. Psy­chi­a­try earn­ings would over­take so­cial work earn­ings about 18 years from now.

I know I should count my use­less un­der­grad­u­ate ma­jor and one year of so­cial work school as sunk costs. But adding a lot more school on top of the eigh­teen years I’ve already done feels ex­haust­ing, and I think I’m more likely to fail now than I would have been if I’d started plan­ning ear­lier.

Med­i­cal school would mean nine years of giv­ing up many of the things I en­joy – spend­ing time with my hus­band, cook­ing, gar­den­ing, read­ing. This gives me an in­cen­tive to burn out, be­cause it would mean I could do those things again.

I’m mar­ried. I don’t want to be­lieve it ap­plies to us, but statis­ti­cally, me go­ing to med­i­cal school would in­crease our risk of di­vorce. This study says 51% of mar­ried psy­chi­a­try stu­dents di­vorce dur­ing or af­ter med­i­cal school (about dou­ble our cur­rent statis­ti­cal risk). I don’t think my mar­riage is more im­por­tant than 2,500 peo­ple’s lives. But I do think see­ing it die would make me much worse at school. Even if we didn’t ac­tu­ally di­vorce, I would ex­pect our re­la­tion­ship to be sig­nifi­cantly stressed be­cause I would be gone or busy so much of the time.

If I quit or fail out of med­i­cal school, I’ve wasted a lot of time and money.

If my cowork­ers are high earn­ers, con­vinc­ing any of them to donate effec­tively would have a larger im­pact than con­vinc­ing so­cial work­ers to do the same. How­ever, I’ve had zero luck per­suad­ing any­one I know (ex­cept my hus­band), so this may be ir­rele­vant.

The questions

Do you have ad­vice on pow­er­ing through an un­pleas­ant ex­pe­rience for a good cause? Is nine years too long to power through? Are there other ca­reers I should be con­sid­er­ing?

Up­date, May 2012: I de­cided not to try med­i­cal school, be­cause I thought I would hate it. I finished so­cial work school and am look­ing for jobs in psy­chi­a­tric so­cial work, which I was do­ing this last year and re­ally en­joyed.