Medical school equips students with the tools to begin life as a doctor: eliciting histories, noting signs on examination, forming differential diagnoses and considering next steps. It offers ample opportunity to hone these skills and, in addition, to develop capacity for compassion, empathy and professionalism in difficult situations, such as end-of-life care. It does not, however, prepare us for the reality of facing death in the context and volume witnessed during the COVID-19 pandemic. The scenes witnessed by medical students across the country while working on the front line have brought these shortcomings sharply to light. Like many students across the globe we have stepped in to help our community as part of health care teams to manage patients receiving treatment and end-of-life care as a consequence of COVID-19. We hope to express the need for increased transparency about the almost taboo concept of death as part of medical education, with an emphasis on the realities faced by the dying and the bereavement of loved ones left behind. Death is lonely in the face of COVID-19. Hospitals around the UK adopted new regulations, prohibiting families from visiting relatives admitted with COVID-19.1 Consequently, at the time of writing, family members of dying patients have not been allowed into hospitals to say their final farewells. Death is lonely in the face of COVID-19 One of our roles has been to give families the opportunity to say goodbye to their loved ones via video calls. An emotionally taxing task and one that we have, understandably, not been prepared for. Hearing the cries of patients’ families, it is difficult to balance emotional involvement and professional detachment. Relationships are made with patients and pleas – ‘I'm suffocating please just kill me now’ – are etched into memory. The hypotheticals of the classroom soon feel like distant history. The ideals of palliative care that we prepared for, approaching death with grace and dignity, feel irrelevant and naive. Medical school doesn't prepare you for the impossible task of balancing caring for a patient's clinical needs whilst filling in emotionally for their loved ones. Hearing the cries of patients’ families, it is difficult to balance emotional involvement and professional detachment ‘Proning’ ventilated patients, a term to describe positioning patients into a prone position, has become a mainstay of treatment to improve ventilation.2 A delicate process, and a particularly testing moment for one of the authors involved a patient desaturating during ‘de-proning’. The urgency and sense of being in the way, compounded by a doctor's comment: ‘the family have been warned’. On reflection it was clear that the emotional impact was tied-up with a feeling of being responsible for a direct, negative impact on someone's health. The importance of reflection and debriefing within the health care team has been established as a process that improves emotional well-being.3 A senior doctor organised debriefing groups of 10 medical students working within the hospital. A similar system is now being employed by our university to ensure those in a COVID-19 setting have the space to debrief via an online platform, allowing a safe environment to reflect and share with peers and senior staff. We feel that an equivalent system could be introduced to extend past the pandemic, specifically for traumatic events occurring during clinical placements. This could be expanded to medical schools across the UK, bringing together students in different hospitals. Comparable interventions are already in place throughout areas of health care: debriefing after clinical incidents, and doctors discuss patient cases, focusing on doctor–patient relationships.4 However, health professional students may not have this opportunity, or feel uncomfortable sharing in these situations, outside their peer groups. We believe that extending similar sessions to student-focused groups and the use of impartial mediators, not associated with appraisals, fosters an environment for students to feel comfortable talking about the difficulties of dealing with dying patients. Death is a human process and each patient's experience of dying is unique. We recognise that this cannot be simulated. We still feel that medical schools in the UK lack a focus on end-of-life issues, however. This difficult topic is explored within the world of clinical education, which looks to integrate learning the emotional and personal aspects of dying, and advocates that learning should not focus exclusively on the medicalisation of death.5 There is, oddly, very little that is medical about dying, and we appreciate the impossibility of teaching students to face it. Nevertheless, there is scope to help us develop tools to be transparent about death, and its emotional impact. Doctors and students should make efforts to pass on their honest thoughts about their interactions with dying patients. Witnessing senior doctors partaking in difficult conversations may encourage respect for current staff and create a path that prepares students that is not a trial by fire. … there is scope to help us develop tools to be transparent about death, and its emotional impact Preparation for the traumatic scenes encountered during the COVID-19 crisis is near impossible but we believe that the taboo and opacity about death, especially unexpected and painful death, must cease to exist. The COVID-19 pandemic is hopefully a once in a lifetime event, but death is still apparent and an important professional activity. Building preparedness and educating future health professionals for such taxing responsibilities should not be underestimated.