Purpose: This paper aims to build insight into how the local community impacts an organization’s ability to develop an inclusive culture. The paper offers a framework of inclusion discontinuities between an organization and its community, then using the case of teaching hospitals, aims to empirically demonstrate how individuals and organizations perceive and deal with inconsistencies in responses to diversity at the organizational-and community-levels. Design/methodology/approach: A multi-method qualitative study was conducted in hospitals located in the same city. Focus groups were conducted with 11 medical trainees from underrepresented backgrounds and semi-structured interviews were conducted with 10 hospital leaders involved with diversity efforts at two hospitals. Data analysis followed an iterative approach built from Miles and Huberman (1994). Findings: The findings demonstrate how discontinuity between the organizations efforts to create an inclusive environment and the community’s response to diversity and difference creates challenges for leaders in retaining and supporting minority individuals, and for trainees in feeling like they could build a life within, and outside of, their organizations. Based on findings from the data, the paper offers insights into how organizations can build their capacity to address these challenges. Research limitations/implications: Future research should build upon this work by further examining how inclusion discontinuities between communities and organizations impact individuals and organizations. Practical implications: The paper includes in-depth insight into how organizations can build their capacity to address such a deep-rooted challenge that comes from a less inclusive community. Originality/value: This paper contributes to an understanding of how forces from the community outside an organization can shape internal efforts toward fostering inclusion.