Introduction The transition from preclinical to clinical training represents a pivotal stage in medical education, offering opportunities for transformative learning and professional identity formation. This study aims to explore how medical students reflect on their initial clinical learning experiences during the first week of clinical training, and how these reflections reveal early shifts in their professional identity, using Mezirow’s transformational learning framework. Method A qualitative descriptive study was conducted at VinUniversity, Hanoi, Vietnam. 47 fourth-year medical students from a single cohort submitted reflective writings after their first week of clinical training. Thematic analysis was performed, with emergent themes mapped against the dominant phases of Mezirow’s transformational learning framework. Results Thematic analysis revealed four main themes: (1) disorientation and emotional adaptation, (2) bridging theory and practice, (3) learning from the clinical environment and (4) personal and professional growth. Reflections revealed both emotional and cognitive shifts, highlighting students’ early adaptation and growth. Findings emphasised the need for enhanced mentorship, emotional resilience training and tailored bilingual communication strategies to optimise the transition. Conclusions Reflective writing captured students’ first impressions of clinical training and highlighted the critical role of emotional adaptation, mentorship and experiential learning in supporting identity formation. These insights offer practical implications for enhancing student support strategies and curriculum design in medical education.
