OBJECTIVE: This study aims to assess the satisfaction levels of clinical fellows based on the Importance-Performance Analysis (IPA) method. METHODS: From January 2020 to July 2023, a cross-sectional descriptive study was conducted targeting clinical fellows in a tertiary comprehensive hospital in Guangdong Province. By combining a review of the existing literature with the current conditions of hospital training, we developed a clinical fellow training satisfaction assessment system consisting of 4 primary and 22 secondary indicators. The data gathered through the IPA-based questionnaire survey were then scrutinized. RESULTS: A total of 255 questionnaires were circulated, with 213 proving to be valid, leading to a response rate of 83.5%. Of the participants, 54.5% were male. The factors holding the highest rankings in both importance and satisfaction were the "expertise and theoretical knowledge of mentor teachers," "adherence to medical ethics and educator morality," and the "standardization of guidance provided by mentor teachers." These factors received importance scores of (4.94 ± 0.26), (4.93 ± 0.25), and (4.91 ± 0.32) respectively, alongside satisfaction scores of (4.95 ± 0.21), (4.93 ± 0.25), and (4.92 ± 0.31) respectively. Significant disparities were observed in the importance and satisfaction scores regarding "reasonable training expenses," "sustained interaction between departments and physicians," "execution of training blueprints," "research skill development training," and "the teaching demeanor of departmental medical personnel" (P < 0.05). The IPA disclosed that the areas warranting concentrated enhancement include "implementing robust position training," "refining and executing training agendas," and "offering abundant practical clinical opportunities." CONCLUSION: To enhance the training satisfaction levels of clinical fellows, it is noteworthy to strengthen hospital clinical teaching management, further develop the teaching workforce, improve and implement training plans, provide ample clinical practice opportunities, and enhance life support services.