Abstract: Objective During public health emergencies, resident physicians face enormous physical and mental challenges. This study aims to systematically analyze the changes in work adaptation characteristics and learning needs of resident physicians during the transitional period of emergency response, so as to provide empirical evidence for building a support system that promotes their mental health and enhances their emergency response capacity. Methods Taking the adjustment of COVID-19 prevention and control policies in December 2022 as a starting point, an questionnaire survey was conducted to retrospectively collect data on the work adaptation and learning needs of resident physicians at two time points: the early stage (strict prevention and control period, December 2019-November 2022) and the transition period (policy adjustment period, December 2022). Using snowball sampling, a total of 213 valid responses were collected from 18 provinces, autonomous regions, and municipalities across China. Statistical analyses included chi-square tests and multivariate logistic regression. Results The proportion of resident physicians who reported ″adjustable psychological stress″ increased significantly during the transition period compared with the early stage [67.1% (143/213) vs. 46.9% (100/213), P<0.001], but depressive tendency did not show a concomitant increase. Gender difference analysis revealed that during the transition period, the detection rate of depressive tendency was significantly higher in male than in female resident physicians [33.3% (30/90) vs. 17.1% (21/123), P=0.006]. Multivariate logistic regression analysis indicated that male gender (OR=2.585, 95%CI: 1.099-6.084, P=0.030), longer working hours (11-12 h/d: OR=4.594, P=0.033;13-14 h/d: OR=4.359, P=0.034; >14 h/d: OR=4.952, P=0.033), and insufficient research time (OR=3.479,95%CI:1.477-8.192, P=0.004) were independent risk factors for depressive tendency, whereas having a mentor′s guidance (OR=0.326, 95%CI:0.123-0.865,P=0.024) was an independent protective factor for the postgraduate/postdoctoral cohort. Conclusions During the transition period of public health emergency response, resident physicians universally experienced a sharp increase in stress, yet the risk of depression was higher in males than in females. Male physicians, those with extremely long working hours, and those with low research time input are associated with higher risk for depression, while mentor guidance can significantly buffer psychological risk. It is recommended that mentor-guided strategies be incorporated into the standardized residency management system to enhance the psychological resilience of resident physicians in emergencies.

Key words: Questionnaires, Public health, Resident physicians, Psychological well-being, Mentor guidance