Hey everyone,

I'm a 22-year-old from Germany about to graduate with a history degree, and I'm feeling pretty worried and unsure about my next steps. I picked history because it caught my interest in school, but I didn't have much guidance from family, relatives or teachers while making that decision. It was a more or less random and not well considered step.

During my studies, I learned a lot about different philosophies and eventually discovered utilitarianism. It resonated deeply with me and I noticed what truly matters to myself is reducing suffering and improving well-being in the world. This realization led me to adopt a utilitarian mindset, and eventually, I found the amazing resources offered by 80000 Hours and the effective altruism community.

As graduation is just around the corner, I'm trying to figure out the best direction for my career. While I was still studying, I already explored other fields and managed to secure a spot in the medical school of Vienna, Austria. My initial thoughts were that a medical career could lead me to opportunities in public health, research, or clinical practice, which seem to have high potential for doing good (except clinical practice which might only be useful for earning to give). I've also been toying with the idea of leveraging my medical knowledge to start a company that addresses global health challenges.

But there's this nagging feeling that maybe I'd make a bigger impact if I pursued a career in AI policy or AI technical research instead. I know this path would demand a lot of time and effort, like getting a degree in computer science, math or physics and maybe even earning a PhD from a top-tier university.

While I believe I have the potential to succeed, I'm really concerned about spending too much time on preparation and facing setbacks, because I already “wasted” 5 years of my life with a more or less useless degree. The only useful thing during this time was the orientation process and even that could have taken place in a couple months with better guidance.

What's making this decision even harder is the fact that I've already invested lots of time and energy into securing the spot at the Austrian medical school. It's tough for me to think about changing directions now.

So I'm reaching out to you all, hoping for some advice to help me navigate this challenging decision. I know that I am in an immensely privileged situation to even ask this question and have so many options to consider.

Thanks in advance for your understanding and help. Your insights will be truly appreciated!




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I found it notable what wasn't clearly stated in your post -- most notably, do you find AI-related topics and/or medicine interesting and engaging? Do you know what working in those fields often entails as a practical matter on a day-to-day basis, and does that sound like a life you want to live? If neither is a solid yes, are there fields that you would be definitely excited to work in? How do you think your strengths, weaknesses, and other characteristics line up with these fields (or other candidate fields)?

Going into a field because you feel you are "supposed" to do it usually doesn't lead to either a happy life or an effective professional life -- whether the "supposed to" is coming from one's parents, one's community, EA websites, etc.

(Edit: typo)

Fantastic was going to say the same thing! 

It's great that you're thinking so carefully about how you can use your career to help others! And it's important to note that this is a good problem to have: you have multiple promising paths ahead of you. I think asking for thoughts here could be useful, plus getting advice from other sources (e.g. your family and friends, people from the different paths you’re considering, 80,000 Hours, Probably Good, etc.). 

I finished my MD last year, and spent the final few years knowing that I did not want to clinically practice. I knew there were higher impact paths, and very little of the content I was learning in those years helped me for those paths. At that stage though I concluded it was best to finish off the degree. I sympathise with feeling compelled to continue having gotten over the hurdle of getting in, but would warn against making a Sunk Cost fallacy - what is in the past can't be changed. What matters for making a decision is how your future goes based on your current situation, not how well it justifies your past actions. 

I'm not saying medicine is or isn't the right call for you - I really don't know. But if you strongly believe you won't clinically practice, there are probably faster, cheaper, easier, and more direct pathways to pursue to wherever you want to get to. Cheap/quick tests can be handy here - maybe you could try internships at organisations that excite you, or short-term research projects mentored by someone you look up to. That could give you a taste of other options. 

You've got a great problem on your hands, and you don't have to solve it all straight away! Talking with someone can be super helpful for these things, even just as a sounding board for you to work out what you think and feel. If you need someone for that, I'd be happy to listen! Just send me a DM. Cheers!  

I would advise you to read in detail this recent post by someone who switched careers to AI and deeply regretted it, to see if a similar thing might occur to you. You're no help to anyone if you burn out, and I've rather have an excellent public health person on our side than a medicore/burned out AI person. 

The threat of burnout is very real, and as a result you have to balance impact with what actually makes you happy. If it turns out the whole AI threat was overhyped this entire time (a very real possibility), will you look back with regrets at your choices? 

Warning: brutally honest take that's critical of your plans

It doesn't seem like either of those paths is the most impactful for you based on the information presented. There doesn't seem to be any evidence that you'd be an especially good fit for either. It seems like you have little background or capabilities relevant to either medicine or AI. 

Don't get me wrong, you're evidently very capable; it's outrageously difficult to get into graduate medicine.

I can't comment on AI, but I've worked in global health. What proportion of the most impactful people in global health have medical degrees? I'm not familiar with anyone suggesting this as being an efficient way to get into global health. We don't know much about your situation, so generic advice is the best I've got - here are some paths worth considering:

* found, work at, or volunteer for a global health startup
* do a global health masters 
* work at WHO / UN to build connections
* apply to Charity Entrepreneurship
* do internships to figure out the conditions under which you do your best work

I'm open to feedback from disagreevoters

In my view, the response makes a lot of assumptions and would have been better asking for -- rather than assuming -- information about fit, background or capabilities before providing a "brutally honest take that's critical."

The admission into a graduate medical program (and the steps it takes for that to happen) implies at least some information of that sort is available.

Good point. Thank you!

My personal view is that it is worth spending some more time to think about cause prioritisation, while at the same time building up career capital (see: https://80000hours.org/articles/career-capital/) that is robustly useful across a range of likely options. One way to narrow down your option set is to think about the type of work which you prefer: policy vs. research vs. operational vs. technical work. If you prefer policy/strategy/managerial kinds of work, a graduate degree in AI or medicine may not be required.

You might be able to get some work experience in one such type of work with your history degree, while thinking about cause prioritisation on the side. If possible, you may also want to try to find a job that is medicine/public health or AI-related, so you can also build up some knowledge of these fields while assessing your own personal interest. Grad school is one of the most useful ways to make a "career switch", so I think it would be wise not to rush the decision.

(unless you think AGI would be developed in the next 2 years or something and you should therefore aim for impact straightaway)

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