I had one of those moments last Wednesday night. Somehow the stars aligned, and I closed my eyes and saw an incredibly clear picture of my future. After two and a half years of being most definitely not pre-med, I have decided to be a doctor, to foster the resilience of at-risk kids as a developmental pediatrician in an urban hospital. It felt amazing and so very decisive.

And yet, by Saturday, medical school was already slipping out of focus, despite all that time deciding. And I couldn't be happier.

Let me explain. Early last week, I was into the med school idea in my hard core Tiger kind of way. I searched every website out there and diligently recorded lists of med school requirements, saw a summer of organic chemistry in my immediate future and was even genuinely excited about it (well, mostly).

Thinking it through, I caught sight of students dressed to kill as summer recruiting interviews peaked. The successful ones would pull down 100-hour weeks spent I-banking in New York; I dismissed the option as materialistic and very far removed from the goals that motivated my decision to pursue medicine.

These thoughts crowded my head as I made my way through the snow early last Saturday. I deftly jumped snowdrifts in a suit and heels of my own; I was on my way to a conference on "social enterprise." We discussed how to infuse a community with the resources necessary for growth, how to build sustainable partnerships, how to merge expertise from the for-profit and nonprofit sectors to build more effective programs. I was particularly struck by a call to action delivered by Andrea Silbert, director of the Center for Women and Enterprise. She asked us if we were idealists--did we believe in the ability to achieve social change?

Thinking about my heady decision to enter the hospitals of neglected American cities, I thought, "Yes, I am an idealist and I know that we can catalyze incredible change." To my surprise though, some of the folks that I had seen on their way to I-banking interviews earlier in the week were sitting next to me and responding "yes" as well.

The goal of social entrepreneurship is to harness individual, family and community strengths to utilize scarce resources in the most beneficial ways. I have always been a person who gets enraged when anyone says that all we need to do for the poor is give them more money. Failing to differentiate among the many programs and agencies formed to help families is synonymous with acceptance of mediocrity. Ineffective, inefficient nonprofits are a waste of resources and a waste of creative energy--I would go as far as saying they can, at times, do more harm than good. In contrast, social entrepreneurs are practical idealists because they employ every possible strategy to translate their personal commitment to social justice into action.

I thought back to my earlier proclamation about my future as a developmental pediatrician, and then I looked around at those who would gain valuable experience in consulting and I-banking this summer. The conference helped me realize that my vision of myself as a pediatrician in an urban hospital was part of my continued commitment to society. But I also learned that this principle can be (and needs to be) applied within virtually any field.