Objective The purpose of this study is to examine pre-exam anxiety and depression among participants in the standardized training program for resident physicians in Guangdong Province.The study aimed to identify the influencing factors and provide suggestions and countermeasures to reduce psychological pressure before exams.Methods The Zung's self-rating anxiety scale and the Zung's self-rating depression scale were released through questionnaire star to conduct a survey and analyze the anxiety and depression levels among trainees at various training bases in Guangdong Province from May 19 to August 9,2023.Results A total of 205 valid questionnaires were collected.The incidence of anxiety was 16.6%(34/205),of which 11.7%(24/205)was mild anxiety and 4.9%(10/205)was moderate anxiety.The standard score for anxiety was 39.51±10.27.The incidence of depression was 20.5%(42/205),of which 16.6%(34/205)was mild depression and 3.9%(8/205)was moderate depression.The standard score for depression was 38.98±11.49,and the severity index of depression was 0.37±0.11.There were statistically significant differences in anxiety levels of students before the three major examinations(H=7.312,P=0.026).The pressure faced by partici-pants during the medical practitioner qualification examination was significantly greater.There were significant differences in the degree of depression among students with different sources before facing the three major exams(P<0.05).Full-time professional graduate students were more likely to experience pre-exam depression.There was a significant correla-tion between anxiety,depression,and exam stress(r=0.651,P<0.01).Conclusion The results indicate that trainees are prone to anxiety and depression before exams.Therefore,it is crucial for standardized training bases of residents to give priority to the mental health of students while paying attention to the examination.