Abstract Background Mentorship is a cornerstone of professional growth within medical training, yet the role of formal mentorship in career advising for medical residents remains understudied. In 2020, our Paediatrics Residency program introduced the role of faculty advisors as part of the Competence by Design framework, with a mission to guide academic growth, professional development, and excellence in patient care. However, it is unclear to what extent career advising is occurring in this advisor-advisee relationship. Objectives The primary aim of this study was to complete a needs assessment for Paediatric residents to inform faculty advisor roles and responsibilities and effectively support paediatric residents in their career development. This included examination of the current state, identification of the ideal state, followed by a gap analysis and recommendations to create a comprehensive advising program. Design/Methods This study utilized a mixed methods approach, using quantitative and qualitative survey methodologies. The survey questions (n=20) were designed from background literature and pilot testing. An anonymous survey was administered through the Qualtrics platform to the Paediatrics residents (n=59). The protocol was submitted for REB review and was granted an exemption as a quality improvement project. Thematic analysis of the qualitative content was completed by two investigators, utilizing the Braun & Clarke six-phase framework. Results The response rate for the survey reached 34% (n=20) with the final sample including 16% PGY1, 42% PGY2, 16% PGY3, and 26% PGY4 residents. Alarmingly, most residents (63%) did not have a well-defined plan for monitoring career goals. No residents claimed to have sufficient career mentorship at present (0%), with majority (84%) expressing their interest in regular career planning sessions. A significant proportion (79%) also underscored the importance of considering life context when setting career goals. Our thematic analysis revealed that career advising currently follows a non-formal, self-initiated process, with time constraints as the primary obstacle. Primary themes elicited emphasized career exploration (n=15), networking (n=7) including discussions around life context (n=6), mentorship (n=6), and advisor role clarity (n=6). Conclusion Our findings affirm a compelling need for enhanced career development within our Paediatrics Residency program. In response, we propose a multi-faceted approach advocating for structured formal career development. This entails scheduled information sessions, resident goal setting, and formal mentorship. We recommend creating opportunities for networking to enable personalized career development considerations. Exploring an adjunctive role to faculty advisors may be necessary to ensure the success of these recommendations in optimizing resident career education.