The standardized residency training in China is continuous medical education for postgraduates, which is designed to master basic knowledge, theory, and clinical skills. Case-based discussion (CBD) is one of the main formative curricula used in standardized residency training. The aim of this study was to assess the impact of a novel CBD curriculum on residents' participation, satisfaction, and confidence in clinical skills. This was a prospective study that included 28 internal medicine residents. The traditional CBD contents were adjusted. The innovative approach let residents at different stages prepare and organize the CBD cases by themselves according to different levels of complexity. The surveys were designed to measure conference occurrence and residents' attendance, participation, and satisfaction, as well as their confidence in their clinical skills. Faculty could further engage the residents at any point to deepen the discussion and learning. The surveys indicated that the residents had a high satisfaction rate with the novel-staged CBD teaching method. Our curriculum improved conference occurrence, attendance, and participation; increased residents' self-report of participation in learning; and raised their confidence in their clinical skills, so the CBD was well received by residents and faculty preceptors. In addition, this study demonstrated that the staged CBD increased the knowledge and evidence usage of internal medicine residents. We expect wider application of this kind of CBD in clinical practice, medical education, residency training, and patient education in the future.