The transition from preclinical to clinical medical education represents a critical shift in training, yet many medical students report feeling underprepared for pediatric clerkships. Preclinical curricula are largely focused on adult medicine, which may limit the development of pediatric-specific competencies, including physical examination skills, communication with children and caregivers, and clinical reasoning in pediatric contexts. A narrative literature review was conducted to evaluate the role of preclinical pediatric education in preparing medical students for pediatric clerkships. Multiple databases, including PubMed, CINAHL, EMBASE, and Google Scholar, were searched from 2015 through 2026 using keywords related to pediatrics, preclinical education, curriculum development, and clinical competence. Articles were screened by multiple reviewers using predefined inclusion and exclusion criteria. Three major themes emerged: early pediatric exposure, active learning strategies, and persistent skill gaps. Early exposure to pediatric patients and clinical environments was associated with improved student confidence and preparedness. Active learning methods, including simulation and experiential learning, enhanced clinical skills, communication, and knowledge retention. Despite these advances, significant gaps remain in pediatric physical examination skills, communication with pediatric patients and families, and documentation. Additionally, discrepancies between preclinical instruction and clerkship expectations highlight a lack of curricular continuity. Targeted interventions such as longitudinal pediatric programs, bootcamps, and flipped-classroom models demonstrated improvements in student preparedness and clinical competence. Preclinical medical education remains predominantly adult-focused, contributing to gaps in pediatric preparedness. Integrating structured pediatric curricula, increasing early clinical exposure, and incorporating active learning strategies may enhance student readiness for pediatric clerkships. Standardization of pediatric training across institutions is needed to better align preclinical education with clinical expectations and improve competency development in pediatric care
