Increasing diversity in the physician workforce is critical to eliminating healthcare disparities (Abelson et al., 2018; Washington et al., 2017). Although there are many proven benefits to increasing racially and ethnically diverse medical faculty, representation of these groups remains relatively low compared with their White counterparts and disproportionate to the racially and ethnically diverse populations they serve. Orom et al. (2013) suggest that underrepresented in medicine (UiM) faculty improve learning experiences and environments, provide social support and mentorship for students and trainees, and support scholarly opportunities and research collaborations. Yet, strategies for hiring and retaining UiM faculty are minimal, even though these strategies may improve the presence of this population in academic medicine. Thus, the purpose of this qualitative interpretive study was to describe the organizational dilemma involved in recruiting, hiring, and retaining UiM physicians in academic medicine, and exploring strategies to support these efforts. This study was guided by three research questions focused on key practices and dispositions, gleaned from the perspectives of different stakeholders. Three participant groups were purposefully selected for this study: (1) UiM faculty (N=5) from American Association of Medical Colleges (AAMC) member medical schools, (2) department chairs and chiefs of service (N=5), and (3) affiliated stakeholders (N=3). Follow-up reflective questionnaires (N=13) and extant documents (N=25) comprised the secondary data sources. Interview and reflective data were analyzed using Boyatzis' (1998) thematic approach; document analysis followed Krippendorf and Bock's (2009) content analysis strategy. Six major themes emerged from this study: (1) Racism and bias hindered my advancement, (2) None of the faculty hired identify as UiM, (3) Mentorship is key, (4) Promotion plays a big role in my retention, (5) Your work and home life suffer, and (6) We need better support and infrastructure to make progress. Results may guide the development of targeted strategies designed to recruit, hire, and retain UiM faculty, in support of the ethnically diverse populations they serve. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]