The goal of neonatal–perinatal training is to expose and prepare trainees for a successful career in academic medicine as defined by publication of peer-reviewed journals, securing of grants, membership in national societies and visiting professorships. These activities denote peer recognition and lead to promotion and tenure. Other important factors in a successful career are effective teaching and mentoring as well as developing models of clinical excellence. Obviously, the ultimate career goal is personal satisfaction. For underrepresented minority physicians (URM), these goals are sometimes more daunting and difficult to achieve. This paper will attempt to define the reasons why this may be the case.