The COVID-19 (coronavirus disease 2019) pandemic has prompted rapid changes to medical education. Across the United States, graduate medical education programs have had to navigate abrupt declines in outpatient medical care, marked fluctuations in inpatient volume and acuity, and a rapid shift to online education.1 Through our shared experiences across nephrology fellowship programs in 3 different US regions, we identified 3 domains in which we faced the greatest challenges: changes in care delivery models, curricular adaptation, and fellow wellbeing.