End of life is a profound and culturally charged human dimension. Bioethics and palliative medicine have promoted a shift from the traditional biomedical model toward person-centered care that preserves dignity through the dying process. Physicians-in-training live in continuous contact with illness and death, yet are rarely invited to reflect on their own finitude. Reflection on one’s own mortality has been linked to greater comfort discussing prognosis, more patient-centered end-of-life decision making, and reduced avoidance behaviors in clinical encounters with dying patients; however, most training programs address death only as a technical or bioethical topic, rarely as a personal experience requiring processing. This study explored the end-of-life expectations and meaning-making of first-year medical residents at a Mexican general hospital, considering the influence of medical culture and sociocultural discourse. A qualitative phenomenological design was used. Data were collected through asynchronous, self-recorded video interviews guided by five open-ended questions addressing illness and death, family, autonomy, medical care at the end of life, advance directives, and euthanasia. Purposive sampling included twenty-eight first-year residents (2024–2025 cohort) who had previously completed coursework in medical ethics, giving the final sample of twenty-eight participants. Data were analyzed using an interpretive phenomenological approach supported by ATLAS.ti. Open coding of experiential meaning units was followed by iterative hermeneutic interpretation. Participants described the end of life through two tensions: an idealized, peaceful death surrounded by family, and a pragmatic view shaped by clinical exposure to suffering and futile treatment. Participants uniformly favored palliative care and expressed a preference for dying at home in the case of a terminal illness. Attitudes toward euthanasia ranged from support as an individual right to religious/ethical opposition, frequently anchored in personal grief experiences. Advance directives were positively valued but rarely formalized. Emotional overflow, including tears, occurred in some interviews. Despite clinical experience, medical residents are not immune to the emotional and existential tensions surrounding death. Findings suggest that integrating reflective, narrative-based pedagogical strategies into residency training may help to process death-related distress and strengthen person-centered, dignity-preserving end-of-life care.