 The objective of this study was to identify the current needs and gaps in medwifery clinical training in Sierra Leone. This study used mixed methods, including surveys, focus group discussions, interviews, and review of maternal medical records. The results revealed several areas where improvements are needed, such as labour and delivery management, record keeping, triage processes, clinical education for students, recent graduates and perceptors, and lack of infrastructure and resources. These findings can be used to inform the development of medwifery clinical training programs in Sierra Leone and other low-income countries facing similar challenges. This article was authored by Mustafa Sonny, Frederica Keller, Amy Stern, and others.