Background: The African continent currently experiences 25% of the global burden of disease with only 1.3% of the world's healthcare workers. The COVID-19 pandemic has caused unprecedented disruption to medical education systems, increasing the strain on already-vulnerable regions. Our study examines the impact of COVID-19 on medical students across 33 countries in the African continent. Methods: A 39-item anonymous electronic survey was developed and distributed to medical students across

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... a through social networks to assess the impact of the COVID-19 pandemic on medical education. The survey assessed the domains of: class structure changes and timing, patient interactions, exam administration, learning environment satisfaction, mental health impacts, and volunteer opportunities/engagement.Results: 694 students across 33 countries participated. 88% of respondents had their classes suspended for varied lengths of time during the pandemic, and from these students 51% of them resumed their classes. 83% of students felt they were in a supportive learning environment before the pandemic, which dropped to 32% since the start. The proportion of students taking exams online increased (6% to 26%, p<.001) and there was a corresponding decrease in the proportion of students seeing patients as a part of their education (72% to 19%, p<.001).Conclusion: COVID-19 is harming medical students in Africa and is likely to worsen the shortage of the future's healthcare workforce in the region. Pandemic-related impacts have led to a degradation of the learning environment of medical students. Medical schools have shifted online to differing degrees and direct patient-care in training of students has decreased. This study highlights the urgent need for flexible and innovative approaches to medical education in Africa