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Hello there, I am 2nd year pre-clerk and my medical education has been about 90-95% virtual since we started. Over the last few months things began looking up, and we actually started receiving full clinical skills teaching sessions and in-person family medicine clinical placements. Unfortunately with Omicron, we have gone back to completely virtual learning once again for the foreseeable future. It is not my place to say how things should be run, and whether or not this is the best course of action, and so I wont. But, I am genuinely concerned about my complete lack of physical exam skills and physical clinical knowledge and capabilities. We also have not had any OSCE or physical exam evaluation to-date since starting medical school. Unfortunately, we have never even been taught how to take a manual blood pressure in-person. Everything has been either drastically cut down from the curriculum or converted completely to virtual (yes... I have been learning what heart murmurs sound like over zoom, and how to do a hip and knee exam virtually...lol). For current clerks in this position last year, did you feel ill-prepared to start clerkship? And for residents, did learning these skills during pre-clerkship actually help, or did the real learning begin in clerkship anyways? Will we genuinely be okay to continue on in our medical education after pre-clerkship with this large gap in our teachings? Currently I am hoping for the best, and preparing for the worst. I'd love to hear some thoughts or advice from upper years who have been through medical school before or during the pandemic and how we can maybe overcome these short-comings in light of recent events.