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Educating a physician workforce that reflects the increasing racial and ethnic diversity of our nation is an ongoing challenge of urgent concern. Many medical school kindergarten through 1 2th grade (K-12) pipeline programs focus on "enriching" underrepresented minority (URM) students using strategies to change or "improve" individual students. This discussion raises concerns over longstanding racial and ethnic inequities in America's public schools that, in part, result in the predictable and systematic underachievement of URM students. These insidious processes can disqualify URM students from successful participation in the medical school pipeline at its earliest stages. The paper also discusses the cultural challenges URM students often face in aspiring to exceptional academic achievement within America's schools. Finally, this paper highlights the need for illustrative examples of medical school-public school partnerships that pursue an agenda of equity to balance the current downstream focus on the enrichment of individual students.