Narrative writing has been used to promote reflection and increased self-awareness among physicians. The purpose of this study was to determine the impact of prompted narrative writing on reflection. Thirty-two interns at 9 internal medicine residency programs participated in a year-long qualitative study about personal growth beginning in July of 2002. Interns wrote narratives every 8 weeks. At study completion, interns wrote a final narrative describing the affect that being in the study had on them. Responses were reviewed and organized into domains. Writing throughout the year resulted in reflection and encouraged interns to reconsider their core values and priorities. Some found that the exercise promoted greater self-awareness and provided an emotional outlet. Writing about difficult experiences coupled with reflection motivated some interns to want to improve. Prompted narrative writing led to reflection among interns and promoted self-awareness. Educators may consider incorporating narrative writing into residency education.