To describe preconception care health literacy among medical students and examine knowledge–behaviour gaps across academic years and by future parenthood intention.

Cross-sectional online survey.

Kawasaki Medical School, Japan.

Medical students in years 1–6. A total of 613 students were included in the analysis.

Preconception care health literacy was assessed using a validated Japanese preconception care-specific scale comprising a knowledge domain (13 true/false/do not know items; total score 0–13) and a behaviour/skills domain (25 4-point Likert items; total score 25–100). Domain scores were compared across academic years and future parenthood intention groups. Multivariable linear regression analyses were performed adjusting for age.

The mean age of participants was 22.53 years (SD 2.19). The mean knowledge score was 9.99 (SD 2.60) and the mean behaviour/skills score was 73.66 (SD 12.25). Knowledge scores increased with academic progression (year 1, 8.47 (SD 3.00); year 6, 11.14 (SD 1.34); p

Integrating skills-based training and reflective life-planning components into medical curricula may help strengthen preconception-related behaviours in medical students and may have indirect implications for their future readiness to support preconception care.