Objective To understand the current situation and main influencing factors of confidence in being a doctor among senior students in traditional Chinese medicine (TCM) universities, and to provide reference for the TCM teaching reform. Methods In March 2021, 450 senior students who had participated in clinical practice in 3 TCM universities were selected as the sapmle. Questionnaire survey was used to investigate the status quo and influencing factors of their medical confidence. Descriptive statistics and Pearson correlation analysis were used to analyze the data. Results Totally 55.1% (248/450) of the students have insufficient confidence in medical profession, and the main reason is the lack of clinical ability [80.0% (360/450)]. Weak clinical thinking ability [75.3% (339/450)] and weak practical ability [70.9% (319/450)] are the main factors affecting students' clinical independent diagnosis and treatment ability. 85.1% (383/450) of the students think that the explanation of theoretical knowledge of traditional Chinese medicine should be closely related to clinical practice. Conclusions The senior TCM students lack confidence in medical profession, and the main influencing factor is the lack of clinical practice ability. Universities should deepen the reform of clinical teaching of TCM, improve students' cognition of the development of grass-roots medical treatment, and strengthen humanistic care for students, so as to improve students' clinical practice ability and strengthen their medical confidence.