This paper concerns the fact that physician workforce diversity in the USA has not keep pace with rapidly increasing minority populations and their needs. Minorities comprised 26.4% of the population in 1995 and are expected to comprise nearly half by 2050. The paper argues that medical schools must enlist greater numbers of minority physicians and train all physicians to provide culturally responsive care. The paper highlights the pipeline and minority recruitment programmes put in place by the University of Washington School of Medicine (UWSOM), in its attempt to meet the needs of its five-state region (Washington, Wyoming, Alaska, Montana, and Idaho), rectify primary care shortages, and meet increasing regional demands for underserved populations. The paper’s authors describe the various programmes at the UWSOM that actively recruit American Indian/Alaskan Native applicants to medical schools and what is in place to retain those students in medical training. The paper concludes that medical schools have an important part to play in resolving the barriers faced by indigenous medical students, by continuing to provide pipeline programmes, retention programmes, and minority faculty development that can make a difference.