To investigate the performance of residents who took the 2025 clinical practice competence graduation examination for standardized medical ultrasound training in Beijing, and to provide evidence for optimizing examination design, addressing training gaps, and improving clinical competency.

A cross-sectional survey was conducted using an electronic questionnaire distributed to 114 candidates. The questionnaire covered basic information, frequency of independent ultrasonic operation in six subspecialties (abdomen, heart, obstetrics and gynecology, superficial organs, peripheral blood vessels, and emergency) during residency, self-assessment with of examination performance, perceived question difficulty, and evaluation of examination duration. Data were analyzed in conjunction with the examination results.

The overall pass rate was 93.0% (106/114), and the valid response rate was 80.7% (92/114). During residency, the frequency of independent ultrasound operation was relatively high in three subspecialties: abdominal, superficial organ, and peripheral vascular ultrasound, with 97.8%, 97.8%, and 92.4% of residents performing at least once per week, respectively. The frequency was lower for cardiac and obstetrics/gynecology ultrasound (66.3% and 64.1%, respectively), and lowest for emergency ultrasound (39.1%). Overall satisfaction with the graduation examination was high, but satisfaction with the standardized patients for the hands-on examination was relatively low (54.3%). Moreover, 50.0% of the candidates considered the obstetrics and gynecology case analysis difficult, and approximately 69.6% reported insufficient time for hands-on operation examination.

The clinical practice competence graduation examination for residents in standardized ultrasound training in Beijing was well organized, with high pass rates and overall acceptance. However, deficiencies remain, including uneven hands-on intensity across subspecialties and a lack of standardization in the use of standardized patients. It is recommended to strengthen practical training in cardiac, obstetrics and gynecology, and emergency ultrasound to improve residents' operational proficiency and clinical responsiveness, thereby enabling them to better adapt to examination requirements and demonstrate authentic clinical competency.