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Clinical training relies heavily on immersion experiences, which can both foster and inhibit learning, depending on how students make sense of new events. However, little is known about this student sense-making. This photo elicitation study explored medical students’ experiences of transition from classroom to clinical environment. 30/54 third-year medical students submitted ~10 photos with narrative captions representing transition experiences. Clinical “firsts” emerged as a dominant theme in 49 student photos. Students' emotional characterizations of these experiences ranged from thrilling to disappointing. The relationship between emotional stance and learning appears to be complex. The implications for curriculum planners are to develop curriculum interventions that focus attention on learning behaviours generated from individual student’s emotional responses to challenging experiences.