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A persistent lack of diversity in medical education is of growing concern as research mounts on the importance of a diverse physician workforce for providing high quality healthcare to various populations, and especially to underserved people and/or areas. Despite the growing recognition of the necessity to admit more diverse candidates in order to better meet the needs of the profession, medical schools continue to struggle with this challenge. This study uses a mixed-methods approach combining survey and interview-based data in order to help shed light on the unique experiences of first-in-family (FiF) medical students as they reflect upon the opportunities, choices, and social connections which led them to pursue medical careers from often-underrepresented backgrounds.