What to Expect in Your First Coaching Session
You Are Probably Overthinking This
If you are a physician about to sit down for your first coaching session, there is a good chance you have been mentally rehearsing it for days. You have been wondering what you should say, whether you will sound foolish, and whether the whole thing is going to feel like a performance review dressed up in softer language. I get it. Starting physician coaching means stepping into unfamiliar territory, and physicians do not love unfamiliar territory.
The fact that you feel uncertain walking in is not a problem. It is a sign you are taking it seriously. So let me walk you through what happens in a first coaching session so the unknowns shrink a little.
The First Few Minutes Are Just Conversation
There is no clipboard. No intake questionnaire you fill out while sitting on a paper-covered table. Most first sessions start with something remarkably simple — I ask you what brought you here. Not in a clinical sense. In a human one.
Sometimes the answer is precise. "I just got promoted to division chief and I have no idea what I am doing." Sometimes it is vague. "Something is off and I cannot name it." Both are fine. Both give us somewhere to start.
The opening minutes are about building enough trust that you can say what is actually going on instead of what you think you should say. If you have spent decades in academic medicine performing competence, that shift takes a minute. That is expected.
We Will Clarify What You Want — Not What Is Wrong With You
Coaching is not diagnostic. I am not looking for what is broken. I am looking for where you want to go and what is getting in the way.
In Co-Active Coaching, Karen Kimsey-House and her co-authors describe the coaching relationship as one built on the belief that the client is "naturally creative, resourceful, and whole." You are not showing up as a patient. You are showing up as someone with goals, competing demands, and a brain that has been trained to solve everyone else's problems before your own.
I will ask questions that help us both understand what success would look like for you. Not success on someone else's scorecard. Yours.
Expect to Do Most of the Talking
This surprises people. Physicians are used to meetings where someone with authority does most of the talking — the department chair, the division head, the senior investigator. Coaching reverses that dynamic.
I will ask questions. Some will be straightforward. Some will make you pause. That pause is where the work lives. A good coaching session is not about the coach being brilliant. It is about the right question landing at the right time so you can think more clearly than you did before.
If you leave your first session thinking, "I did not expect to talk that much," you are in good company.
There Will Be No Homework Assignment (Probably)
Some coaches assign reflection exercises or action items after a first session. I tend not to. The first session is about establishing a foundation — understanding your world, your goals, and how you think. Piling on tasks before we have that foundation is like a pitching coach redesigning your windup before watching you throw a single pitch.
That said, you will likely leave with something. Not a worksheet. More like a question that follows you around for a few days. Something you said out loud for the first time that keeps echoing. That is the work starting, even though it does not look like work.
It Is Normal to Feel Weird Afterward
I want to normalize this because nobody else will. After your first coaching session, you might feel energized. You might feel unsettled. You might feel both at the same time. You just spent an hour in a conversation entirely about you — what you want, what you are afraid of, what you have been avoiding. For most physicians, that is unfamiliar.
That slight discomfort is not a sign that something went wrong. It is a sign that something shifted. That is how coaching starts.
You Do Not Have to Commit to Anything After One Session
A first coaching session is not a binding contract. It is an experiment. You are testing whether this conversation is useful, whether the coach is someone you can be honest with, and whether the process fits how your brain works.
If it clicks, great. If it does not, that is information too. You spent an hour thinking carefully about your own career, and that alone is time well spent.
If you are curious about what starting physician coaching might look like for you, check out our individual coaching options.
