Yeah so our fellowship kind of dives into ways that medics can increase their impact, and EA cause areas where they might be particularly suited/have some comparative advantage. Some specific and non-exhaustive examples
For those interested in global health and development, medics might have a comparative advantage in working in the space due to clinical knowledge of area, respect and career capital
For those interested in health security/ biosecurity, there seems like there is an increasing role for medics who might act as a conduit between researchers and policymakers, as well as doctors and other public health professionals who are implementers on the ground.
Within clinical medicine, there might be robust ways to improve the amount of good people do e.g. through where they choose to work—i.e. LIC vs HIC, earning to give.
There are lots of skills that medics have (triage and prioritisation, systematic approach to problems, generally strong people skills) that make them a good fit for things like operations roles or careers advising e.g. at 80K ;)
If you are interested, happy to send you across our course curriculum!
Hi Greg,
Thank you for your comment.
Big picture, I wanted to clarify two specific points where you have misunderstood the aims of the organisation (we take full responsibility for these issues however as if you have got this impression it is possible others have too).
1. We do not necessarily encourage people to apply for and study medicine. We are not giving any advice to high school level students about degree choices and paths to impact. To quote what you wrote, “medicine often selects for able, conscientious, and altruistic people, who can do a lot of good if they turn their hand to something else.” We think this is likely true, which is why we think specifically performing outreach to, and helping people who are already studying and practicing medicine find highly impactful careers, is likely to be an appealing option.
2. We foreground transparency in all our communications with our members—and am sorry this is not something you agree with when you write that our reasons are opaque, but I think this is a strong claim to make . We aim to talk honestly about the impact of clinical medicine; discussing the articles that you have written throughout the fellowship as well as other pieces on the issue e.g. Dr Launer’s article referencing yours in the BMJ. We do not have a specific ideology we want to sell anyone on—we want to present people with important information and allow them to form their own conclusions through discussions. Disagreement with EA or existing articles is not something to be feared, but to seek out in order to improve our understanding of impact. We think this is reasonably important for community building
Specifically, I think our difference in opinion is the way we approach the idea of impact in medicine—this involves some specific disagreements (below) but also general framing and outlook.
On some of the specific points:
1. High Impact Medicine not a misnomer- I disagree with your assessment of the situation; yourself, and all the people who you mention in the article, were or are doctors, and fit under what we would define to be High Impact Medics. When you are conducting outreach, I think it makes sense to describe the profession that someone currently has, even if you were to recommend jobs ‘tangential to or wholly apart from’ jobs in that profession.
2. On the career capital and skills of medical degrees for opportunities outside medicine- I think I have addressed the above somewhat in reframing the purpose of our organisation away from pushing students into medical degrees. However, I would push back further on your claim that several years of training and practice as a medic is not good experience for several highly impactful careers. I think that it is quite difficult to attribute how much highly impactful people who are medics can attribute their career success to medicine. For someone like yourself, it might be reasonably easy to say very little.; however, I think there are very likely other individuals for which this is not the case (In our experience, and in having interviews with lots of folk doing highly impactful things, this is the case. In fact, it rings true for several of the medics you mention).
3. For the case of Alice who seeks to maximise her impact as a doctor - I think Alice would disagree with you here and there are a bunch of high impact opportunities within medicine that we foreground:
Health policy work, which is often: 1. taken alongside clinical work 2. in some instances can be done well from a bottoms up approach while working in a clinical setting, 3. Often earmarks and wants the perspective of clinicians.
Effective giving and earning to give- I think doctors in a lot of countries, especially with growth of private medicine, have quite a high earning capacity. Especially for those medics who are further along or who really love their clinical work, earning to give within medicine seems like it might be the best EtG option
Working in a LIC, particularly if you are also involved in training local healthcare workforce, likely has 2-3 orders of magnitude more impact than being a junior doctor in a big metropolitan city (happy to send the studies that support this). I think you and I may disagree on the object level about whether this reaches the bar of “other EA jobs”- I think it might. In addition, if you take into consideration that not everyone has the capacity or capability to do other EA jobs, in a lot of cases, doing some of the above might be the highest impact opportunities for that person.
4. To address your concern about whether our messaging might lead someone to think that clinical practice in a LIC or a giving pledge are equivalently good to the other individuals you cite. Firstly I think this is highly unlikely given the content of our fellowship (with case studies from some of these individuals) and podcast (a number of these individuals are interviewed) and we make clear that there is a range of impact possible from a medical background. Secondly, in circumstances for which that is not feasible or realistic for an individual, or in which that is unlikely to be the case for them, we still think it is robustly good for them to increase their impact 2-3 orders of magnitude in the ways described above.
This is part of ‘big tent’ effective Altruism as we discuss above and may not be something you value as highly as we do. In general though I think this approach is likely to engage a whole lot more people initially than a ‘door in the face’ approach and that encouraging initial steps e.g. pledges or working in a LMIC will increase the likelihood of subsequent change, rather than feeling you have achieved your impact quota. We are reasonably confident that we portray the relative impact of different career options and decisions with high transparency, and enable people to maximise their impact as much they can—though perhaps we emphasise personal fit more than you would.
Speaking to all fellows at a 1:1 level after the fellowship and from the resources they have read over the fellowship, we think the risk we have lost ‘potential impact’ through individuals conflating different career options as equivalently good is very low—and rather the impact of individuals choosing to make impactful career decisions downstream predominates (hence this article).
Happy to chat more about all of this and thanks for your thoughts!