I had (have?) the same kind of problem... So many of the things I want to do require a huge committment and process before they yield any tangible results (i.e. go to med school)--makes it hard to stay motivated on a day-to-day basis. What I've figured out is that there's a lot of little ways to keep yourself motivated if you look hard enough. For example, apart from a brief period during my freshman year, i've never been a traditional college student, and consequently, never developed any real sense of community at school. Getting involved in a few activities helped that--in my case, its a job running study groups.

The other thing I have to do is keep track of mini-milestones along the way. Instead of focusing on an A in the course (which lets me shrug off a B or C because "I can always bring it up later"--until there's no more later, of course!) I focus on an A on each test, and keep a running tally of my grades as kind of a "if today was the last day of class what would my grade be?" experiment.

And I've found routines to be very helpful--when I stick to a routine, i tend to do better in all areas of my life and stay more upbeat and focused. I guess its kind of like putting yourself on autopilot so you can focus your mental energy where you need it.