This paper explores dynamics of students' critical consciousness development in the context of a thematically organized service-learning sociology course titled Health, Illness, and Community. The integrated components of the course were designed to cultivate critical consciousness by framing the study of health in terms of social justice issues that were demonstrable across three community partner organization sites. Analyses of writing assignments and qualitative interviews at the end of the semester reveal that student development of critical consciousness was demonstrated through analytic engagement with structural and systemic forces framing health inequities as well as reflexive consideration of the limited extent to which well-meaning efforts and intentions of individuals can significantly impact lasting social change. The combination of these two processes simultaneously cultivated students' ideological commitments to ongoing social justice work and subverted student self-efficacy with regard to the operationalization of those commitments.