THREE years ago, Molly Grassini was living the life of a struggling actor, landing roles in small theater productions, acting in a Web series and bouncing between auditions in Los Angeles. The closest she came to a career in health care was a featured part in a Vitamin Water ad.

So it may seem a leap that the onetime actress, at 26, has her sights set on medical school. But the death of her older brother had ignited an interest in medicine, and a wish to “honor” him. “I couldn’t live that fantasy anymore,” she says of acting. “I wanted work that would ground me in the world at large.”

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Ms. Grassini is about to accomplish Step 1 in her professional transformation. In May, she will complete a post-baccalaureate pre-med program at Columbia University, where she has progressed through a tightly scripted roster of every foundational science and math course that she did not take while singing, dancing and acting her way through an undergraduate degree in fine arts at New York University. With these prerequisites in hand, Ms. Grassini expects to gain admission to medical school in 2013.

Like Ms. Grassini, many older students (mean entry age: 28) are relying on post-bac programs to resuscitate — or initiate — dreams of practicing medicine. More than 15 percent of last year’s new crop of medical students had gone through such a program, according to the Association of American Medical Colleges, and the number of programs has mushroomed. Today, there are about 135 listed with the association, an increase of more than 45 percent over 2009.

Dr. Darrell G. Kirch, who heads the A.A.M.C., says that post-bac programs fill a critical role in the medical field. “In the absence of these programs, a number of people who would be great doctors would give up,” he says.

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“Post-BAC pre-med” can refer to any of a number of programs of study taken up after a student has earned a bachelor’s degree. Some are master’s level and assume some proficiency in prerequisite science courses. But the most popular and fastest-growing programs are like Columbia’s, which delivers a rigorous lineup of prerequisite undergraduate courses with wraparound support, including MCAT preparation, advising and health care volunteer work. They hope to help would-be doctors (and dentists and veterinarians) put forward the best package of grades and experience when applying to medical schools.

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At Columbia, enrollment grew to 606 students last year, from 282 in 2000. Washington University in St. Louis introduced its post-bac in 2006; since then, enrollment has tripled. Goucher College received 400 applications for 30 spots in its 2012 class.

The programs can be expensive — usually the same rate as the undergraduate per-credit tuition. For Columbia’s two-year program, that means $57,000 in tuition, plus an estimated $43,000 for room, board and expenses. At the University of Connecticut, tuition for a full-time, two-year post-bac program will total $21,884 in the fall.

Students can take courses on their own, of course. If they do, Dr. Gerald Soslau, vice dean of the Drexel University College of Medicine,recommends that students take two science courses per semester, at a four-year college, to show medical schools they can handle the academic load.

What a student misses by going alone, however, is the support provided by an academic adviser who will act as sounding board, guide and writer of the all-important letter of recommendation to medical school committees. Some programs have agreements with medical schools that offer qualified post-bac students early admission.

Columbia created the first post-bac program, in 1955, in its School of General Studies, intended for a postwar generation that was re-creating itself professionally.

Forty years ago, Southern Illinois University and Wayne State University in Detroit were pioneers in the profession’s efforts to recruit and train minority students who show promise in undergraduate pre-med curriculums but do not have the G.P.A. or MCAT scores to get them into medical school. Of the programs listed on the A.A.M.C. site, about 40 identify themselves as for “groups underrepresented in medicine.”

But in the past decade, it has been the older student looking for a second career in medicine that has driven the growth in the number and profile of the pre-med post-baccalaureates: about 80 programs are listed specifically for career-changers who lack science prerequisites; about 80 are labeled “academic record enhancers,” for recent graduates who took math and science but did poorly, or failed to get into med school the first time around. The programs are not interchangeable: programs intended to enhance grades assume a second pass at the material, and undergraduate and post-bac grades in those subjectsare usually melded to present to medical schools.

Students with none of the undergraduate courses that medical schools require should expect to take a minimum of two semesters each of chemistry, organic chemistry, biology and physics. (Post-bacs are typically full time and run 11 months to two years; some programs, like Drexel’s, offer evening classes; Northeastern University has an online option.)

Among the post-bac A.A.M.C. categories, career changers are the most academically successful, with matriculants earning an average MCAT score of 30.5 (out of 45); students in record-enhancer programs average 27.5. By contrast, the mean MCAT score for all pre-med matriculants is 31.1.

The laggard economy (what else?) is at least in part responsible for the post-bac boom. It is no coincidence, for example, that Columbia’s post-bac applications and ranks grew with former financiers and lawyers when the banking industry started its downward spiral. Or that many enterprising schools created programs (some better than others, experts warn) to tap into demand from the downsized looking for career fulfillment.Or that applications to medical school hit a record last year — almost 44,000 for less than half as many spots.

As Betsy Merideth, director of Goucher College’s 28-year-old program, points out, many enrolling in medical school are banking on job security. “I know unemployed lawyers,” she says, “but there’s no such thing as an unemployed doctor.”

But those focused solely on finances are not necessarily the candidates who will make it into the selective post-bac programs that medical schools like to see on applications. Neither are they likely to get rich in practice given the current state of health care.

As Ms. Grassini notes, the time and money needed for a post-bac is worth it only if you are getting into medicine for altruistic reasons. “Health care as a career choice can be good if you want to help people,” she says. “If you are looking for notoriety or the big bucks, that’s a tougher road and maybe you should have been a doctor at a different time.”

Ms. Grassini’s motivation — the “inciting incident” that led her to medicine — is rooted in her 26-year-old brother’s medical tragedy. He had been treated at an alcohol rehabilitation center and given a drug that landed him in a hospital emergency room with a near-fatal allergic reaction. It was supposed to be removed from his prescription list, but once back at the center, it was mistakenly given to him again. That dose killed him. The negligence had outraged her.

The theater world had begun to feel “fake,” she says. “I would leave auditions and ask myself, ‘What am I doing?’ ” — especially when compared to the “real-life medical drama” she had lived. She started to reconsider her choice of acting.

To test the waters, she volunteered at Children’s Hospital Los Angeles. That experience made up her mind.

The transition has not been easy. Adapting to a rigorous and unrelenting courseload of physics, math and science was at first a stretch compared to writing the papers and scripts that had dominated her time as an undergraduate. “It was not how my brain was wired,” she says.

Still, she had a love of science, and figured out how to process and memorize a lot of information quickly. After isolating herself the first year to focus on studies, she has since loosened up. She has even found art in chemistry class, where she has employed her drawing skills.

“Some of the compounds are really beautiful,” she says.

The post-bac ranks are filled with stories like Ms. Grassini’s. Medical schools like what older students can bring to a class and to the profession. “In general, they are more self-aware, more focused, more empathetic because of the rich experiences they had before medical school,” says Dr. Rafael Rivera, director of admissions at N.Y.U. School of Medicine. Their personal stories and motivations, he adds, “weigh heavily” on an admissions committee’s considerations.

“We spend a lot of time with these applicants trying to clarify ‘Why medical school, and why now?’ ” he says. But an interesting life story and noble intentions alone are no guarantee of admission. Medical training is a long journey — often 10 years can elapse between medical school, internships and fellowships before one is a practicing physician. Unlike the medical student straight out of college, older students often must work out sacrifices in established personal lives and finances once they embark on medical education.

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And, to be blunt, they have fewer years to practice than their traditional counterparts.

There are no surveys on admit rates for students coming from post-bac programs, but consider: At N.Y.U., of 698 post-bacs who applied for the class entering in 2011, 24 were accepted — a 3.4 percent admit rate. That compares with a 5.6 percent admit rate for those not from post-bac programs. This year applications to N.Y.U. medical school from post-bacs are up 25 percent from two years ago — 18 have been accepted and the school is awaiting their responses.

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“The post-bac is a big risk to take,” says Marissa Lipton, who at 26 is in her second year of med school at the University of Connecticut, where she also completed her post-bac. As a psychology major at Tufts, she thought about medicine but did not want to be hemmed in by the prerequisites, which would have taken up about a quarter of her schedule.

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Facing graduation, Ms. Lipton thought carefully about how best to maximize her odds of getting into med school before starting down that path. A Connecticut native, she was aware of the post-bac program at UConn and its reputation for placement, especially into its own med school.

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“I didn’t want to spend two years of very hard work without the reward,” Ms. Lipton says. “If I was going to go back and do that, I wanted to make sure my goal was attained.”