ObjectiveAssess resident physicians’ training experiences and self-reported application of motivational interviewing (MI) skills. MethodsA cross-sectional nationally representative survey of internal medicine and medicine/pediatric residents from October 2021 - May 2022. Residents reported their MI skill training settings: lectures, standardized patients, role plays, group exercises, direct observation of patient encounters, and a full day or more course. Respondents reported frequency of using specific MI skills in the prior six months during behavior change conversations with patients. ResultsThe response rate 71.2% (202/281). Respondents received MI training in medical school (67.7%), residency (27.2%), both (22.7%), or none (23.5%). Respondents reported MI training through formal lectures/information discussion (77.5%), MI exercises (77.5%), direct observation of a real patient encounter (38.7%), and one or more full-day workshops (8.5%). Most respondents never or only sometimes elicited change talk statements (73.2%), responded to a patient’s sustain talk (64.3%), and developed discrepancies in behavior between individuals’ current actions and desired behaviors (75%). ConclusionsSignificant training gaps exist within resident MI education, which may reduce the application of MI skills. Practical implicationsBehavior change is crucial to many aspects of patient health outcomes. This lack of knowledge may impact future physicians’ ability to comprehensively care for patients.