Abstract: Objective From the perspective of standardized residency training (SRT) trainees, this study preliminarily aims to assess the current status of standardized child and adolescent psychiatry training for pediatric residents, analyze clinical needs and training gaps, so as to inform the improvement of the SRT system. Methods A questionnaire survey was conducted in May 2025 among pediatric and pediatric surgery residents from three SRT bases affiliated with Shanghai Jiao Tong University School of Medicine, selected by convenience sampling. The questionnaire was developed based on a review of domestic and international literature and SRT syllabi, and revised after consultation with experts in pediatrics, psychiatry, and medical education. It covered residents' general information, current training status, and needs regarding child and adolescent psychiatry. Data were analyzed using the chi-square test and t-test. Results A total of 154 residents participated in the study. A majority of 70.8% (109/154) residents had encountered children or adolescents with mental disorders during rotations, with higher exposure rates among second- and third-year trainees. Nevertheless, only 21.4% (33/154) had received relevant training, primarily through lectures (78.8%, 26/33), and 58.4% (90/154) felt stressed when managing such patients. The proportion reporting stress was higher among residents with a bachelor's degree or below (67.2%, 45/67) compared to those with postgraduate degrees (51.7%, 45/87), and stress levels were higher among female residents (3.45±0.76) than male residents (2.92±0.86), all P<0.05. In addition, 88.3% (136/154) believed that training in child and adolescent mental health knowledge should be increased, with second- and third-year trainees expressing stronger demand than first-year trainees (P=0.025). Among various training formats, ″outpatient/ward follow-up″ received the highest recognition score (3.73±0.96). Training needs differed by specialty: pediatric residents more frequently preferred adding new rotations [36.0%(40/111)] or ″rotations plus courses″ [38.7%(43/111)], while pediatric surgery residents were more inclined to enhance content within the existing curriculum [46.5%(20/43)], P=0.035. Conclusions This survey reveals significant deficiencies in child and adolescent psychiatry within the current pediatric SRT system: the coverage rate of systematic training is low, but the proportion of clinical contact with children and adolescents with mental and psychological disorders is high. Most resident physicians feel a lack of confidence and pressure when consulting such patients, and there is a high demand for residential training in child and adolescent psychiatry. Therefore, it is recommended to systematically integrate core knowledge and practical skills-such as the identification, initial management, and referral of common child and adolescent mental disorders—into the training curriculum. A tiered and progressive training pathway should be established based on trainees' seniority and specialty differences, coupled with strengthened clinical practice and multidisciplinary collaboration, to systematically enhance pediatric residents' competencies in recognizing, initially managing, and appropriately referring common child and adolescent mental health disorders.

Key words: Pediatrics, Standardized residency training, Child and adolescent psychiatry, Training needs