cognizant of foreseeable new and potentially serious problems related to the nature of these changes, including “Zoom fatigue” and burnout due to increased clinical workload. For this reason, we have maintained frequent informal check-ins with co-fellows during weekly meetings and have revised the call schedule numerous times according to group preference. Virtual learning offers unique advantages, considering that travel between different hospital sites is no longer required to attend academic half day and individuals can participate in lectures or teaching sessions from home, which allows for more flexible personal time throughout the week. During times when restrictions lighten, we plan to incorporate distanced in-person social events if safe and allowable. Outcome and Future Directions Adaptations to our usual program format were needed to enable robust trainee education. These have been made iteratively and in real time. We have synthesized them, reflected upon them and suggest using versions of this curriculum for the upcoming 6 to 12 months to enable educational goals to be met. The response to these changes were not formally quantified, though we elicited feedback regularly from both trainees and faculty during academic half day and weekly Zoom check-ins, at Residency Program Committee meetings, and informally upon introduction of new components. A unique aspect of our local approach is significant flexibility, both in terms of individual trainee schedules and ability to adjust the curriculum in real time as constraints of the pandemic ebb and flow. This has been highlighted during informal discussion with trainees in other Canadian programs. We also anticipate that documenting our experience may enrich the collective understanding of available resources and encourage similar knowledge-sharing from sites across the country. Increasing contact with individual nephrologists via clinical encounters and weekly didactic sessions has been a valuable addition that we plan to maintain. The current iteration of this curriculum has garnered positive feedback from trainees and staff alike. We expect ongoing curricular transformation as the status of this pandemic evolves, particularly since future waves are expected to bring higher patient caseloads again, which in turn requires flexible modification of our educational plan. Indeed, patient care and medical training may be forever altered by this situation, which presents a unique challenge. This is an unparalleled opportunity to transform the educational landscape by continuing the most successful new aspects of our daily routine, including ongoing use of telehealth, regular nephrologist-led case-based discussions, and trainee participation in select division meetings where appropriate. It is an exciting chance to update teaching methods and explore potential implications of these changes for the future of nephrology training. We encourage trainees to take an active role in proposing potential solutions for filling these gaps. Strong leadership, effective communication, and teambased innovation are assets now, and in the case of any future pandemics, during which today’s trainees will be at the helm. Within this framework, there is room for further evolution. For instance, clinical rotations can be rearranged to avoid missing essential experiences when COVID-19 case numbers increase. The role for expanded virtual learning can be explored, particularly for transplantation and renal pathology. Experiences which typically come later in training, such as research time and rural electives, could be rescheduled on short notice when there are lulls in the caseload. Recently, there is increasing uptake for the innovative use of technology to enhance medical education, including artificial intelligence and virtual reality.15 This could be applied to procedural training, as can simulation-based learning. Social media may also have a role, given the increasing popularity of “medical Twitter” which includes real-time COVID-19 and nephrology-related updates. Conclusion It is possible to develop a flexible curriculum which allows nephrology education to continue within the context of a pandemic, while limiting the physical interactions and group activities that were previously its cornerstone. Formal evaluation of these changes in terms of knowledge acquisition and examination performance has not yet been undertaken. Next steps will include assessing and documenting the impact of this curricular transformation to further optimize scheduling, educational yield, and trainee wellness. In this era of COVID19, it is necessary to ensure ongoing high-quality education for future nephrologists. These changes to formal training in BC will be tailored as the pandemic evolves, and we anticipate them to have lasting impact on the way we structure our program in the future. Standardization and harmonization of Cunningham et al 7 modified curriculum may be possible across Canada with sharing of these learnings. Ethics Approval and Consent to Participate No ethics approval or consent was required. Consent for Publication All authors consented to the publication of this manuscript. Availability of Data and Materials Please contact corresponding author with any requests for additional information. Acknowledgments The authors sincerely thank the Nephrology fellows and staff physicians at the