Student journals are used at all levels of education to facilitate academic and personal learning. This paper describes the experience of journal writing from both a student and teacher perspective, in a communication skills course for first-year medical students at Queen's University, Kingston, Ontario, Canada. As one of the requirements of the course, students described their individual reactions to each weekly session in a journal. Teachers responded to each journal entry. Guidelines for journal usage in this course are described. The content of the journals includes topic-related information, comments concerning the student's individual experience of the course, and personal thoughts related to life experiences and becoming a doctor. A summary of evaluations of journal writing by teachers and students is presented. We have observed that journal writing facilitates a personal and reflective perspective to the first-year medical curriculum for both students and teachers. Journal writing appears to initiate and encourage self-awareness by providing a safe place for students to describe their experiences and relationships and to question their own values and beliefs. In the journal, through a mutual sharing of thoughts and feelings, barriers between students and teachers are diminished, leading to enhanced rapport and communication.