Objective To understand the establishment and implementation of the clinical practice guarantee mechanisms of the standardized training bases for residents in Guangdong Province, and to provide a basis for the relevant departments and training bases to further adjust the management system and teaching methods of residency training. Methods From April to July 2023, 60 residency training bases in Guangdong Province were enrolled, and the creation of their clinical practice guarantee mechanisms, the passing of physician qualification examination, the registration of practice, the acquisition of prescription right, the clinical frontline duty, and the authorization of healthcare system authority were investigated through questionnaires, and the impact of different batches, different sizes, and whether or not they are affiliated with university hospitals on the establishment and implementation of the clinical practice guarantee mechanisms were statistically analyzed by using non-parametric tests. Results Ten training bases have formulated a clinical practice guarantee system for residents, and all 60 training bases have realized the ″one person, one account″ medical system account management with corresponding authority. Across the province, the percentage of residents who have passed the medical qualification examination out of the total residents in training is 62.31%, with the first batch at 64.60% and the second batch at 68.80%, significantly higher than the third batch at 48.42%, all P<0.05. Furthermore, training bases with 11-20 specialties have a pass rate of 69.15%, and those with 21 or more specialties have a rate of 63.67%, both higher than bases with 1-10 specialties, which have a rate of 53.82%, all P<0.05. Affiliated hospitals have a significantly lower percentage of residents with prescription rights who have passed the medical qualification examination (40.70%) compared to non-affiliated hospitals (64.67%), P<0.05. Conclusions The training effect of the standardized residency training system has initially become evident, but the construction of clinical practice assurance mechanisms at various training bases needs further strengthening. This includes timely professional registration, prescription rights approval, and management of front-line clinical duty. The implementation of clinical practice guarantees at training bases still requires regulatory standardization at the legal level, systemic advancement by provincial administrative authorities, and targeted management improvements at the training bases.