Introduction: The aim of clinical immersion during medical studies is to train doctors to be autonomous on their first day of residency, as advocated by the competency-based medical education (CBME) reform and Entrustable Professional Activities (EPAs). However, students often face challenges in achieving autonomy. While several factors have been discussed in theoretical work, to our knowledge, they have never been explored through an ethnographic approach, which offers a perspective closer to the trainees’ reality.

Methodology: Our ethnographic study was conducted by a student during the first year of clinical immersion. The data collected included her observations, a diary of her daily supervisory experiences as well as testimonies from other students in the same cohort. This was supplemented by semi-structured interviews with a clinician and educator.

Results: Our study took place from December 2022 to November 2023, including 990 hours of clinical immersion in six clerkship rotations. An inductive thematic analysis was performed on the 14 hours of recordings made during the 22 fortnightly interviews. We identified three factors that facilitate the acquisition of autonomy for students in clinical settings: feeling welcomed, feeling useful, and feeling like a learner. This study examined clerkship experiences and their impact on learning, allowing us to provide recommendations.

Conclusion: The ethnographic approach provides a better understanding of the impact of experiences throughout internships on student learning. As this cohort of learners mainly belongs to Generation Z, our findings were put into perspective with their characteristics and expectations. The opportunities identified, aligned with the specificities of this generation, enable us to make recommendations to improve learning and promote the acquisition of autonomy.