Cytopathology Area of Focused Competence (AFC) Program overview 

Program length: One - two years

Session dates: July 1 – June 30 

Program structure: Series of hospital based rotations 

Evaluation methods: In-training assessments, training portfolio  

Program Co-Directors: Dr. Zeina Ghorab, Dr. Joerg Schwock

Certification: Diploma of the Royal College of Physicians and Surgeons of Canada 

AccreditationRoyal College of Physicians and Surgeons of Canada 

Based at the University Health Network (Toronto General Site and Sunnybrook Health Sciences Centre), the AFC Cytopathology Diploma Program meets the increasing demand for specialist cytopathology expertise.

You will attain the necessary skills to contribute and oversee the operations of a state-of-the-art cytopathology laboratory at a medical, organization and procedural level.

You will gain the in-depth knowledge and expertise to become leaders in your field. 

More about education in Cytopathology

AFC Cytopathology Program in the News

The Canadian Area of Focused Competence (AFC) in Cytopathology experience: the first four years. Weir MM, Boerner SL, Auger M.  J Am Soc Cytopathol. 2016 Nov-Dec;5(6): 309-312 

Cytopathology fellowsip paving new paths for future learners. The Pathology Report. UHN. 

Program structure

The fellowship provides training in: 

  • diagnostics with access to specimens from essentially all organ sites 
  • specimen acquisition and rapid evaluation in fine-needle clinics and on-site assessment 
  • the fundamentals of modern specimen preparation, triage, processing and ancillary testing 
  • continuous quality improvement and laboratory safety 
  • interpersonal skills in patient interaction and communication with clinical colleagues and laboratory personnel 
  • clinicopathological research through trainee-led scientific project(s) 

With focus in: 

  • diagnostic proficiency 
  • quality assurance 
  • specimen triage and preparation techniques 
  • performance of ultrasound- and palpation-guided FNAs 
  • on-site assessment for EBUS/EUS, fluoroscopic, CT- and U/S-guided sampling 
  • ancillary studies (immunohisto/cytochemistry, flow cytometry, HPV testing, molecular testing, fluorescence in-situ hybridization 
  • academic research project 
  • graded clinical responsibility 

Supported through: 

  • Combined annual specimens: ~45,000  
    • Papanicolaou tests (SurePath, ThinPrep): ~22,000 
    • Fine needle aspirations: ~8,000 
  • Consultation cases: 1,000 - 2,000 

How you are assessed

You will be expected to maintain a training portfolio consisting of: 

  • structured case log 
  • in-training examinations (slide-based, digital image-based, oral) 
  • documented training assignments (consultation, critical results, quality, health policy etc.) 
  • documented ancillary test result analysis and reporting 
  • documented contribution to clinical and educational rounds/seminars 
  • evidence of scholarly activity 

At the end of the program, you will submit your completed training portfolio to the RCPSC for assessment and, if successful, will obtain a diploma in official recognition of your subspecialty training. 

Eligibility and how to apply

To be eligible, you must:

Application process 

Application deadline for July start: September 1 of the prior year (for example, September 1, 2020 application deadline for July 2021 start date). 

To apply, follow the same process for Clinical and Research Fellowships


The fellowship is funded in an amount consistent with the funding requirements set by the Fellowship Education Advisory Committee of the Postgraduate Medical Education office.