supplemented with online sessions. • Peritoneal dialysis In-person assessments and PD clinics. Transition to telehealth-based clinic delivery and patient assessment on as-needed basis. • Transplant Donor and recipient assessments, management of short- and long-term complications for admitted in-patients as well as routine clinics. Solid organ transplant on hold during peak period. Online sessions; further development of virtual curriculum if ongoing limited exposure to core concepts. • Procedures Procedural rotation and longitudinal opportunities for HD line and PD catheter insertion and removals. Rotation on hold. Procedural exposure as able with appropriate PPE. • Pathology Laboratory-based rotation viewing cases alongside renal pathologist. Rotation on hold. Supplemented with virtual slide bank, teleconferenced biopsy rounds, and online resources. • CKD and longitudinal clinics In-person clinics. Primarily telehealth clinics. Scholarly activities • Conferences Travel to major academic meetings Transitioning to virtual platforms • Research projects Learning the research process and completing a project. Virtual meetings; encourage online collaboration with other sites • Journal club Held in person Virtual journal club Teaching • Academic half day Afternoon small group session Shorter lunchtime talks over Zoom Evaluation and feedback • Competence by design EPAs Continue; supplement with virtual cases if unable to directly observe skills Wellness • Resident-led events Group gatherings for social events Virtual session sponsored by Resident Doctors of BC with reimbursement New objectives • Virtual health Learning to adapt to online platforms for delivery of care and trainee education • COVID-19 specific Participation in committees to better understand provincial and local structures Note. CKD = chronic kidney disease; PD = peritoneal dialysis; HD = hemodialysis; PPE = personal protective equipment; EPAs = entrustable professional activities. 4 Canadian Journal of Kidney Health and Disease allow for this. Research meetings, manuscript writing, peer review, critical appraisal, and other academic pursuits can be conducted remotely with ease. In an effort to promote this idea, trainees are now required to complete a case report over the course of the academic year. We have transitioned our journal clubs to be held over Zoom as well, which allows screen-sharing presentations and facilitates audience involvement by microphone or the provided text box. The first online journal club was very successful in engaging nephrologists from across the province, whereas typically only Vancouver-based physicians and trainees would be in attendance. Virtual Learning Rather than the traditional weekly academic half day, we transitioned to twice weekly Zoom sessions at lunch hour, during which staff nephrologists present a topic of their choosing based on a list generated by the fellows. These presentations are partly didactic with slide presentations, though there is ample time allotted for case-based discussion around advanced management, which has been particularly helpful for topics such as glomerulonephritis and cardiorenal syndrome. Moving forward, though some aspects of clinical care have adjusted with the reduction in daily cases and the so-called “flattening” of the curve, we hope to retain elements of this teaching model considering the positive reviews from trainees. In recent months, we have adopted a virtual academic half day more similar to the pre-COVID era, though it is now conducted over Zoom. Although this is a nephrology-focused curriculum, we have incorporated COVID-19 content in the teaching sessions and online modules, including epidemiologic principles, resource allocation (particularly for hemodialysis), crisis response, public health policy, ethics, and palliative care. Participation in meetings and teleconferences has enriched trainee understanding of operations on a program, regional, and provincial level. This has promoted a continual review of nephrology-relevant COVID-19 literature and development of a pocket guide highlighting the changes to our usual practice. Access to technology has generally been free of issues. At home, all fellows have adequate internet access and personal computers with webcams to participate in sessions. However, the equipment at the hospital did not necessarily facilitate physical distancing, particularly when multiple trainees need to access a broadcasted session. Recently, we have upgraded the audiovisual equipment in the fellows’ room to include a large flatscreen television with a tablet to provide Zoom access, and all computers in the room are now webcam-equipped. Online learning resources are available to all trainees to supplement learning when scheduling permits, for instance during predominately outpatient-focused weeks (Table 2). Evaluation and Feedback We have continued with the Competence by Design evaluation model as outlined by the Royal College, though certain EPAs require more effort to complete due to the current Monday Tuesday Wednesday Thursday Friday AM 8am – 10am: Virtual Research Meeting (Zoom) 11am: Regional COVID-19 Teleconference 9am – 12pm: Peritoneal Dialysis Clinic (Telehealth) 8am – 10am: Online renal pathology course modules 10am – 11am: Review case slides (diabetic