The Flexner Report (1910) established the assessment that provided the standards of medical education. Although the American Association of Medical Colleges (AAMC) has updated standards to increase the diversity of medical students throughout the years, the percentage of Black medical students identifying as women has not increased as expected. There is an underlying culture, known as hidden curriculum, in medical schools that is not known to all students but is visible in institutional policy, assessment and evaluation, funding, and institutional verbiage. During the summer 2022, five Black medical students who identified as women participated in this Interpretative Phenomenological Analysis (IPA) study that explored how Black medical students who identify as women experience hidden curriculum during their pre-clinical years of medical education. The research questions focused on how this student population made meaning of their experiences and how it impacted them in their pre-clinical years of medical school. The results indicated that hidden curriculum is similarly experienced by the students even though their individual experiences vary. Data analysis produced six themes, including (1) the whole ecosystem that impacts a student's perceptions, (2) the real pressure on students resulting from the minority tax, (3) fear of ramifications associated with being vulnerable, (4) cultural influence on the student's pursuit of medical education, (5) semantics and actions used to communicate, and (6) the uniqueness/specialness of working on behalf of all Black medical students who identify as women. [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.]