How to use Reflection in your Portfolio Entries
Reflection is a regular part of GP training, especially for GPST1 and GPST2 trainees using the e portfolio. Many trainees find reflective writing difficult, forced or unclear. If you have ever struggled to write reflection for a portfolio entry, this guide is for you.
Doctors reflect naturally every day. You think about cases, conversations and decisions all the time. The challenge in GP training is turning that thinking into written reflection that works for the e portfolio and meets training requirements.
In this blog, I explain how to approach reflection in a simple and practical way. You will learn what reflection is meant to show, common mistakes that weaken portfolio entries and how to make reflective writing quicker and less frustrating. I then share three clear tips that GP trainees can use straight away when writing e portfolio reflections.
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What is Reflection?
Reflection is something you already do, often without realising it. It usually starts with a feeling. A moment that made you pause. A case that stayed in your mind after work. It might come from a patient encounter, a difficult conversation, a learning event or something you read.
At its core, reflection is about asking yourself a simple question. What did this experience add to my development as a doctor in GP training?
Like many trainees, I used to dislike the word reflection. As a trainee, seeing reminders such as “three reflections outstanding” or “portfolio entries to complete” felt draining. Reflection felt like an extra task rather than a useful process.
That changed during my ST3 year after a single patient encounter. I saw a young patient with vague abdominal pain. He looked well. Examination was normal. Observations were reassuring. I was close to sending him home with a working diagnosis of gastroenteritis. Something made me pause. I cannot clearly explain why, but appendicitis crossed my mind. I discussed the case with the surgical team and arranged admission. The following day he underwent surgery for acute appendicitis.
When I spoke to my trainer about the case, I admitted that I could not clearly explain what triggered my decision. My trainer’s response surprised me. They said that was good reflection and encouraged me to write it up for my e portfolio.
That moment clarified what reflection really is. It is not about choosing a case and describing what happened. It is about noticing why something stayed with you. It is about exploring your thinking, uncertainty and decision making. The learning comes from understanding your response to the situation, not from retelling the clinical details.
Reflection works best when you allow the experience to come to you, rather than forcing reflection to fit a template. This shift makes reflective writing more natural, more meaningful and far easier to sustain during GP training.
Key Idea Number 1: Let the Experience Come to You
The most important starting point with reflection is this. Let the patient or the event come to you.
Do not go searching for a case because you feel you need to write a reflection. That usually leads to forced entries that feel artificial and hard to write. Instead, think back over your clinic or shift, often the best time is on the journey home. Ask yourself a simple question. Which patient stayed in my mind?
It might not be the case you expect. You may assume the best reflection would come from a dramatic presentation, such as chest pain sent to hospital. But your thoughts may keep returning to something that seemed routine. A child with a viral illness. A brief consultation. A decision that felt simple at the time.
If a case keeps returning to your mind, that is the reflection starting. The key question then becomes why. Why did this patient stand out? What made you pause, feel uncertain or think differently? Why did this encounter stay with you when others did not?
Once you begin exploring that question, you are already reflecting. Writing it down becomes much easier because you are describing real thoughts rather than trying to invent learning after the fact.
This approach makes reflective writing more natural and far less time consuming. It also produces portfolio entries that feel genuine and meaningful, which is exactly what GP training looks for.
Key Idea Number 2: Start With Three Words
Once a patient or event is in your mind, pause and think about three words that describe your response to it. These are usually emotions or reactions. They might be guilt, frustration, uncertainty, relief, pride or feeling out of depth. There is no right or wrong set of words.
These three words are the foundation of your reflection. They explain why this case stayed with you. They also give you a clear starting point for writing.
Instead of beginning your portfolio entry by describing what happened, begin with how the experience made you feel. When you build your reflection around those three words, the rest of the entry flows more naturally. You are no longer trying to force learning points. You are explaining your thinking.
What you can do in practice:
– Write the three words at the top of your portfolio entry
– Use each word as a short paragraph heading
– Explain why that feeling arose in this case
– Link each feeling to what you learned or what you would do differently next time
This approach removes the pressure to write in a formal style. It also leads to more genuine reflection, which is exactly what assessors look for in GP training portfolios.
Key Idea Number 3: Write From the Bottom Up
Once you have your three key words in mind, change the way you write the entry. Start from the bottom and work upwards.
Most trainees do the opposite. They open the portfolio, start at the top and carefully describe what happened. Vital signs. Examination findings. Drug history. Referrals. By the time they reach the later sections, they are already tired of the case. The reflection becomes rushed or superficial.
This happens because all your effort goes into description. You end up rewriting information that already exists in the clinical notes. Supervisors can read that elsewhere. That is not where the value of reflection sits.
The most important parts of the entry are at the bottom. What did you learn? What changed in your thinking? What would you do differently next time? How did the situation make you feel? These sections show development. They show insight. They are what trainers look for.
If you start with these questions, the entry feels very different. You put your energy into reflection rather than retelling the story.
What you can do in practice:
– Begin by answering the learning and reflection questions first
– Use your three words to structure these sections
– Write about how your thinking changed or what you would do next time
– Only then go back and add a brief description at the top
By the time you reach the descriptive section, most of the work is done. The description can be short and factual. A few lines are enough to give context.
This approach keeps the focus where it should be. On learning, insight and development rather than documentation.
In Summary
Reflection does not need to feel difficult or forced. With the right approach, it becomes quicker and far more useful.
Keep these three points in mind when writing portfolio reflections:
– Let the experience come to you. Do not search for the perfect case. The ones that stay in your mind usually matter most.
– Start with three gut reactions or feelings. These give your reflection direction and make writing easier.
– Write from the bottom up. Focus on learning, insight and change first, then add a short description at the end.
When you use this method, reflection becomes less of a chore and more of a habit. It also produces portfolio entries that clearly show learning and development, which is exactly what GP training is looking for.
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Author Bio - Dr Aman Arora
Hi! I’m Dr. Aman Arora, a Portfolio GP with over a decade of clinical and teaching experience, dedicated to helping doctors achieve their goals with confidence. Having had the privilege of supporting more than 50,000 doctors worldwide across exams such as MRCGP AKT, SCA, MSRA, PLAB 2 and PLAB 1, I understand the challenges you face and the strategies needed to overcome them. Through personalised face-to-face sessions, engaging online courses, mocks, audio and a vibrant social media community, we’re here to guide you every step of the way.
Whether you’re looking to pass crucial exams or take the next big step in your medical career, we’re here to help you succeed. Feel free to get in touch with any thoughts, questions, or ideas — I look forward to working with you and being part of your journey.
Author Bio - Dr Pooja Arora
Dr Pooja Arora is a GP with a background in Medical Politics, where she passionately focuses on improving the opportunities and working conditions for junior doctors. She is proud to hold FRCGP (Fellow of Royal College of General Practitioners).
You can find out more about Pooja’s previous roles and qualifications here.
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