In the shadow of the public health emergency, the Association of American Medical Colleges (AAMC) called for an unprecedented move: the withdrawal of medical students from in-person activities. This is significant because in the typical 4-year medical education program in the US, the second portion of training is spent in clinical environments, working side-by-side with practicing clinicians to learn multiple clinical specialties and do associated “on the job” coursework. Unlike the first half of training, which is focused on structure and function of the human body, diseases, and diagnosis and treatment, the second half of training is a “real world” immersion. The clinical years involve interprofessional collaboration with people outside of the medical school to develop the mindsets needed for team-based care, and students have the opportunity to apply basic science to direct patient care. The far-reaching impacts of removing students from clinical environments are yet to be fully realized. We will explore some of the challenges faced and how medical student education was able to pivot to continue to meet students’ educational needs. As schools struggled with remote education, known structural inequities and mental health issues faced by students across the US worsened (Walters et al. Acad Med 97:S40–8, 2022).