Objective Exploring the effectiveness of the teaching activity specification manual for residency training (hereinafter referred to as ″the Manual″) in residency training. Methods Using a non-simultaneous control method, 196 resident trainees from Shanghai Oriental Hospital in 2020 and 2021 were selected as the research subjects, 95 trainees of the 2021 session were selected as the study group to carry out teaching activities in accordance with the Manual, while 101 trainees of the 2020 session were selected as the control group to adopt a traditional residency training program to arrange teaching activities. Differences between the two groups of trainees in the evaluation of teaching activities, completion of teaching activities and pass rates of teaching activities were compared. Statistical methods such as t-test and χ² test were used to process the data. Results Compared to the control group, participants in the study group rated the mini-lecture better [(99.06±2.85) points vs. (97.88±4.23) points], the completion and pass rates of difficult case discussions were higher [98.8% (497/503) vs. 97.1% (602/620), 98.4% (495/503) vs. 89.8% (557/620)], and teaching supervisors rated the teaching activities of the study group higher [mini-lecture ratings (95.89±1.10) points vs. (89.43±2.33)] points], all P<0.05. Conclusions The Manual improves the teaching management system of standardized residency training, optimizes the process, and contributes to the improvement of teaching effect.