Purpose
As artificial intelligence tools enter clinical education, students are not just passive users but active participants navigating uncertainty, trust, and decision-making. This study aimed to explore how Indian medical students experience personal agency when using AI tools in clinical learning, particularly their sense of control, confidence, and autonomy in making clinical decisions alongside or through AI systems.

Methods
This interpretive phenomenological study was conducted with Year III and IV undergraduate medical students who had access to AI-powered clinical decision tools during ward rotations. In depth interviews were conducted to explore their lived experiences of using AI in real or simulated clinical settings. Participants were encouraged to describe moments when they either followed, questioned, or resisted AI suggestions. Data were analyzed using interpretative phenomenological analysis (IPA), focusing on how students made sense of their agency in these interactions.

Results
Two major experiential patterns emerged. First, agency under negotiation described how students often oscillated between trusting AI and asserting their own judgment. Many described moments of hesitation, double checking, or deferring decisions due to perceived technological authority. Second, growing with guidance reflected how AI was sometimes seen as a learning partner that built confidence by offering structured reasoning or reinforcing clinical patterns. Trust was not static but built over time through repeated use and feedback.

Conclusion
Students are actively shaping how AI fits into their clinical thinking. Their experiences reflect a dynamic balance between reliance and independence. Medical education must create intentional opportunities to help learners critically engage with AI, preserve clinical judgment, and feel empowered rather than overshadowed. Building student agency is key to preparing ethically aware, confident clinicians in a tech enabled world.