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.