This explanatory sequential mixed methods study was designed to understand how underrepresented minority medical students perceive their interactions and relationships with their medical education faculty and how these perceived interactions associate with their academic self-efficacy. Data from URM medical students across medical schools based in the United States were analyzed to determine the answer to two quantitative and two qualitative research questions. Phase I of this study utilized two instruments, the Classroom Academic Self-Efficacy Scale (CASES) and the College and University Classroom Environment Inventory (CUCEI), to explore students' academic self-efficacy and perceptions of the classroom environment, respectively. This phase found varying degrees of statistically significant positive correlation between all domains of the CUCEI and CASES, as well as significant correlations between CASES and students' identified gender, race/ethnicity, and medical school year. Phase II employed semi-structured interviews to explore the lived experiences of URM students and further understand which barriers have impacted their journey into medicine. Three themes emerged from the findings: (1) Grit counter narratives: URM students have developed an alternative to the traditional deficit models that emphasizes persistence over deficit; (2) Lack of access: URM students overwhelmingly expressed their lack of access to proper pre-medical training, the ability to afford college prep and or college in general and the overall negative relationship with finances throughout childhood and college; (3) Perceptions of discrimination: URM students felt strongly that the lack of diversity within medicine negatively influences classroom dynamics and the way student learn. Overall, the study findings suggest a critical need to increase faculty diversity, implement cultural competency and anti-bias training in faculty development, and conduct a major overhaul of student's services to better support URM students upon matriculation. [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://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]