ObjectivesThis was the first study to systematically landscape and examine China's nationwide standardized residency training in radiology.MethodsIn this retrospective cross-sectional study, we used data from the 2019 national survey of the first two cohorts of 3679 radiology residents who completed training in 2017 and 2018 across all 31 provinces in China. A total of 1163 (32%) residents participated in the survey. Multivariable logistic regression was used to examine the implementation frequency of 24 identified training tasks (categorized into six competencies) by region, demographics, and other residency information.ResultsAmong the 1163 respondents, 592 (51%) were trained in the more developed eastern region. Of the 24 identified training tasks, 15 were implemented significantly differently across regions, while the frequency of the most frequently conducted tasks (e.g., CT, MR, and radiograph interpretation and reporting) was consistent. The top 10 tasks all fell into the patient care and medical knowledge competency domains, while other competencies tended to be neglected. We found region and marital status were the most influential factors of training task implementation frequencies. Respondents trained in the northeast and the west were more likely to report, for instance, radiological examination recommendation (OR=1.91, 95%CI=1.27-2.88), as "very frequent." Married respondents were more likely to report first-line night shift as "very frequent" (OR=1.71, 95%CI=1.29-2.26).ConclusionsDespite the fast-win achievements of developing a national radiology residency training program, there is a gap to train quality and homogeneous radiologists across regions. Future improvement should be more tailored to residents' personal characteristics and emphasize some "soft" competencies (e.g., communication skills).