CONTEXT: The district residency program (DRP) was introduced by the National Medical Commission to enhance practical training for postgraduate medical residents in India. Irrespective of their specialty, residents have to undergo 3 months DRP program and is a critical component of the postgraduate curriculum. AIM: This study evaluates the effectiveness of the DRP in Kerala, focusing on knowledge improvement, implementation of national health programs, challenges faced, and satisfaction levels. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 59 postgraduate medical students in Kerala. Data were collected using a structured questionnaire and analyzed. STATISTICAL ANALYSIS USED: Data was analyzed using SPSS version 25. RESULTS: Fifty-nine responses gathered. The mean age was 29.64 years (standard deviation = 2.148). The majority were females (61.0%) and enrolled in 2022 (54.2%). Thirty-seven (62.7%) performed general clinical duties, 44 (74.6%) outpatient and inpatient services by 40 (67.8%). Fifty-seven (96.6%) reported logbook maintenance and supportive supervision. 17 (28.8%) received hands-on surgical training. Forty-seven (79.7%) suggested continuing DRP is useful, though 22 (37.3%) opined is of excess duration. Adequate lodging and food arrangement were reported by (35%-59.3%) and 42 (71.2%), respectively. CONCLUSIONS: DRP enhances the practical experience, understanding health services, and secondary-level care delivery. Improvements in surgical training and lodging are required. Duty allocation during night and emergency is needed.