Structured AbstractPurposeTo investigate the current status of regional disparity of surgical residency training between urban and regional hospitals.MethodsBased on a nationwide online questionnaire survey for newly certified surgical trainees, the responding residents were divided into two groups according to the size of the city where they had trained: an urban city (>1 million, UC group) versus a regional city (<1 million, RC group). These groups were compared regarding surgical education and work environment.ResultsThe UC group (n = 317, 42%) included surgeons with more post-graduate years, older age, females, and full-time working partners compared to the RC group (n = 439, 58%). More residents in the UC group were from urban areas, while the RC group had more residents from regional areas. No differences were observed in the number of experienced surgeries, published papers, opportunities for off-the-job training, or satisfaction with the surgical residency training program. Except for a higher income in the RC group, no differences were observed for other factors regarding the work environment.ConclusionsThere was little regional disparity regarding the impressions of surgical residency training between urban and regional cities including surgical education and work environment.