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Despite ongoing curriculum reform in biochemistry, students report that preclerkship biochemistry poorly prepares them for clerkships. This disconnect could be framed as poor transfer of learning between the classroom and the clinical workplace. We conducted interviews with clerkship students to elicit perceptions about how their biochemistry knowledge connects to patient care activities. According to students, preclerkship emphasis on clinical relevance and concepts helped prepare them for patient care. Students reported infrequent use of biochemistry in workplace patient care activities, though explicit and implicit connections to clinical problems were noted and were often driven by clinical supervisors. This points to opportunities to direct tools and faculty development toward supporting clinical educators in optimal teaching for transfer of foundational science knowledge.