Background <p>The objective of this study was to investigate the satisfaction levels of undergraduate students majoring in psychiatric medicine at Chongqing Medical University. Additionally, it aimed to examine the differences in satisfaction among students of different grades to assess the impact of curriculum reforms implemented since 2017.</p> Methods <p>A self-designed questionnaire, validated by the Delphi method (CVI = 0.90), was utilized to survey undergraduate students from the 2016 to 2019 grades. A comparative analysis was conducted between the pre-reform cohort (2016 grade) and post-reform cohorts (2017–2019 grades). Multivariate logistic regression and mediation analysis were employed to identify factors associated with career intentions.</p> Results <p>A total of 284 valid questionnaires were collected. The overall satisfaction of students in the 2017–2019 cohorts was significantly higher than that of the 2016 cohort (<i>P</i> &lt; 0.001). The post-reform cohorts showed significantly higher satisfaction with mentorship (<i>P</i> = 0.004) and clinical practice (<i>P</i> = 0.003). Multivariate analysis indicated that the curriculum reform was independently associated with willingness to pursue a career in psychiatry (OR = 2.28). Mediation analysis suggested that improved satisfaction with mentorship partially accounted for the association between the reform and career intentions.</p> Conclusion <p>The curriculum reform and mentorship appear to have strengthened professional education, enhanced student satisfaction, and were associated with greater willingness to pursue psychiatric careers.</p>