<p>Large-language models (LLMs) show promise for clinical note information extraction, but deployment challenges include high computational costs and privacy concerns. We used synthetic data distillation to fine-tune smaller, open-source LLMs to achieve performance comparable to larger models while enabling local hardware deployment or reduced cloud costs. Using Llama-3.1-70B-Instruct, we generated synthetic question-answer training pairs to fine-tune smaller Llama models. We evaluated performance across three tasks: synthetic clinical trial criteria, the i2b2 2018 Clinical Trial Eligibility Challenge, and apixaban trial criteria questions. The 8B-parameter model achieved high accuracy across all tasks and sometimes outperformed the 70B-Instruct teacher model. Fine-tuning with only the most challenging questions still improved performance, demonstrating the value of targeted training. Results from 3B- and 1B-parameter models showed a clear size-performance tradeoff. This work demonstrates synthetic data distillation’s potential for enabling scalable clinical information extraction.</p>