In order to increase the number of health care providers in underserved communities, numerous efforts are being made to increase the number of Black students in the health professions. Research supports the idea that individuals from minority populations seek doctors of the same race or culture. In an effort to provide increased health care to minority communities, researchers and educators endeavor to understand the factors that prevent Black students from matriculating in and graduating from professional schools. In this study we explored how students persist in health professions, despite academic and social challenges. Specifically, the career persistence of four Black pre-health students was explored using semi-structured interviews. Career persistence and motivation were investigated using the framework of self-determination theory (SDT). Results indicate that the SDT framework does not fully incorporate the motivational experiences of these students. Further, we propose an expansion of the current SDT model. (Contains 1 table, 4 figures, and 15 footnotes.)