While the COVID-19 pandemic still rages on in the United States, leaving in its wake hundreds of thousands of infected patients, families shattered by the untimely death of their loved ones, an economy in free fall that hit all-time highs barely a few months ago, and a fearful citizenry unsure of what the future holds, the effect it has had on residency and fellowship training programs across the country may appear inconsequential to the general populace. However, if you are a graduating

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... confronted with this unusual set of circumstances, fear of the virus is not the only thing that is foremost in your mind. Methods: Literature review. Results: We discuss the unique challenges our pain fellowship program continues to deal with during this pandemic and particularly its impact on our fellows. It is entirely likely these concerns are mirrored in academic programs all over the United States. Limitations: A narrative review with paucity of literature. Key words: COVID-19, pain fellowship, interventional pain, graduating trainees, pain clinic, medical education during a pandemic