A little over a year ago Deron Burton was one step away from living the American dream. Burton was an attorney in a large and prestigious firm in Washington, shared with his wife an apartment in the northwest section of the city and took home a sizable salary. So it came with the territory that Deron and his wife, Courtney, started to talk about buying a house and raising a family.

"I wanted kids, my wife wanted kids. Basically we wanted to settle into a stable and adult life," says the 28-year-old Burton. "We thought, this is it; we could just settle down and wait for the picket fences to pop up."

"I knew I was ready to give up the stable and steady career to do something long term that would be more rewarding for me." Deron Burton, a former practicing attorney, who is now a first-year medical student

That is when Burton told the dream it would have to wait.

He wasn't getting cold feet about starting a family but was coming to terms with the fact that his job as a lawyer was not as satisfying as he had hoped it would be. So, after less then a year with the firm, he began thinking about changing careers. Burton, who had majored in aerospace engineering as an undergraduate, says that he missed the sciences and wanted to find a career that would apply science to the human experience. He thought back to his first choice for graduate studies, which was going to medical school. But the thought of putting himself through more years of education made Burton think twice.

Unlike many people changing careers midstream, perhaps going for a two-year master's degree, those choosing medical school are making an even greater time commitment: four years of school work and a three-year residency, which for someone in his 40s, 30s or even late 20s is a considerable investment. Also, students are required to assimilate a wealth of science information, which for someone with a background in humanities can seem overwhelming. Then there is the nature of the study, which requires dealing with such things as cadavers and the terminally ill, matters for which it is difficult, if not impossible, to prepare.

Frank Herlong, associate dean for student affairs at the School of Medicine, says for many the decision can certainly be an anxiiety-filled one when they take into account all that is required of them.

"People ask themselves, 'Am I going to be prepared? Am I going to be able to complete my academic responsibilities and will I find taking care of sick patients rewarding?'" Herlong says. And, he adds, the first year can be particularly challenging for somebody changing careers.

"For a student who might have been a lawyer or in community service, it can be more difficult," Herlong says. "There is a large volume of material to learn in the first year, with a heavy focus on basic science. And those with less exposure to the sciences may have to do more background reading than those who were studying some of these topics in their undergraduate career."

David Trabilsy, assistant dean for admissions, says, "We do expect that their preparedness in the sciences is current. If they have not taken a science class in the past four years, we would encourage them to take additional work."

The school has accepted Peace Corps members, landscapers, teachers, photographers, ballet dancers and, this year, even a former professional football player.

Those who manage to make the leap to medical school still face the pressure of getting reacquainted with a classroom setting.

"It is somewhat difficult getting back to a regimented schedule," Herlong says. "They are sometimes going from less-structured careers to spending time in a lecture setting taking notes."

Yet the class schedule does ease the transition, according to Herlong. Just a few years ago, students were required to take afternoon courses and were generally on campus later into the day; the current schedule permits the medical students to leave after their classes end at 1 p.m. Herlong says this allows students to spend time with their families, work to supplement their income or get caught up with their studies.

Lynette Todd says she can use all the free time she can get.

Todd, who entered the School of Medicine this past fall, jokingly refers to herself as somewhat of a masochist. Following graduation from the University of Oklahoma with a bachelor's degree in chemistry, Todd decided to pursue a doctorate in medicinal chemistry. She had thought of going to medical school, but her husband was terminally ill and she felt this option would allow her to spend more time with him, while still satisfying her love of science and medicine.

Todd says she, in essence, was just kidding herself.

"I thought about medical school almost every day. I knew this wasn't the right thing for me. I wanted to have interaction with others, and it just wasn't happening in the lab," she says.

Todd spent the next six years completing her degree and then accepted a postdoctoral position dealing with the analysis of anti-cancer drugs. She says she took the position to make certain drug research was a career she could live with. But a year later she decided, "I'm outta here."

Todd's husband had passed away, and she again began to think about medical school. She decided to apply to Hopkins, and because of her history, she felt her application needed to sell to the admissions committee that she wasn't worn out from all those years of school.

"I didn't want them to think I was career hopping, that I wasn't committed. I wanted to come across as passionate about my desire to enter medical school," Todd says.

Deron Burton says he felt the same way.

Burton's college career began in aerospace engineering at the University of Maryland at College Park. "I had an Air Force ROTC scholarship for an undergraduate school," Burton explains. "I thought I wanted to go to flight school or become an astronaut."

In order to receive the scholarship Burton had to pass a physical, and he was told that his history of respiratory problems as a child would limit what he could do in the military. The scholarship was denied.

"I was disappointed originally, but once I got into the [aerospace engineering] program, I enjoyed it and was very interested. I just wasn't sure what I wanted to do with it anymore," Burton says.

This led him to think more broadly about what he wanted to do. Later, he picked English as a second major, deciding he would take as much course work as he could and "just see where it leads."

Ultimately, he had to decide what he was going to do after college. His first choice was going to medical school. "[But] my sister was in medical school back then and was not enjoying various aspects of it," Burton says. "Plus it was the beginning of the mass of negative PR about the change in the medical system and what future there would be for those with medical degrees. All those things concerned me somewhat and dissuaded me from going to medical school."

Burton's second choice, as he had taken some undergraduate courses in law and enjoyed them, was to be a lawyer like his father. He entered law school at the University of California at Los Angeles, where he studied for three years and also met his wife. "Academically I was reasonably interested and stimulated, but I was not riveted. Pretty early on I knew I was missing science as a component of my studies," he says. "But I knew there were fields such as patent law or environmental law that would bridge the gap for me. Also, people kept telling me that practicing law is much different from law school. So I told myself that, no matter what, I would finish law school and practice law for a certain amount of time."

He followed through on that promise, graduating and taking a judicial clerkship in the U.S. Court of Appeals for the Washington Circuit. The law firm with which he decided to go a year later, Burton says, had a very good reputation, and with more than 300 attorneys, it also had a diverse field of practices.

He began his career in the firm working on cases dealing with environmental law. He says the cases were interesting intellectually but his research didn't allow him to meet the clients, which left him feeling "lonely and unsatisfied."

After much soul searching, and discussions with his wife, Burton came to the realization that he wanted to go to medical school. This time around he knew he had to be 100 percent certain, so he decided to spend some time on a volunteer basis "shadowing" a doctor at the National Institutes of Health in Bethesda.

"I didn't want to pick medicine because of this abstract, esoteric thought process. I wanted to see what doctors do. I didn't want to get [to medical school] and be surprised," Burton says.

Trabilsy says Burton did exactly the right thing. In a school that last year accepted only 120 students from a pool of more than 3,000 candidates, students have to show they are committed to a career in medicine.

"The basis of their motivation is a very important consideration, particularly for those making a career change," Trabilsy says. "We want them making the change because of the appeal of medicine rather then being something they can just move into because they no longer like the work they are currently in."

Burton was well aware of this when he was preparing his application. "I knew when I started applying to medical schools that I had to explain my history lest they think I was some fly-by-night jumping from one thing to another, and I would just leave medicine, too," he says.

Burton began classes in the fall semester and says of all the things he was hoping to find, he has "found it in spades."

In regard to having students like Burton who are older and coming from other careers mixed in with the younger ones, Trabilsy says it brings an added dimension to the classroom.

"We like the additional experience they bring. It's very positive. It allows them to make unique contributions to medicine," says Trabilsy, citing how someone with a background in business or economics may ultimately use that knowledge to help deal with the pressing economic issues prevalent in the world of medicine.

As for Burton's delayed American dream, he and his wife currently live in an apartment in Pikesville, and she works to support the two. He says he is financing school primarily through loans.

Burton admits that he sometimes thinks about where he was a year ago but he knows entering medical school was the right decision for him.

"Being married has really helped me make this choice. She was there as a sounding board and to offer words of encouragement," he says. "I knew then I was ready to give up the stable and steady career in order to do something long term, something that would be a more rewarding and enjoyable career match for me." He pauses. "And this is it."