Cytopathology Area of Focused Competence (AFC) Program overview

Program length: One year
Session dates: July 1 – June 30
Program structure: Hospital-based rotations with graduated responsibility
Evaluation methods: In-training assessments, training portfolio
Program Co-Director: Dr. Zeina Ghorab
Program Co-Director: Dr. Joerg Schwock
Certification: Diploma of the Royal College of Physicians and Surgeons of Canada

The AFC Cytopathology Diploma Program’s goal is to provide dedicated subspecialty training for pathology residency graduates interested in pursuing a career in this area of diagnostic pathology.

Based at two academic hospitals, the University Health Network/Toronto General Hospital and the Sunnybrook Health Sciences Centre, the program aims to meet the increasing demand for specialist cytopathology expertise.

The training will provide you with the skills necessary to contribute to and oversee the operations of a modern cytopathology laboratory in Canada at a medical, organization and procedural level.

Find out more about Cytopathology

Cytopathology: Training for a Field of the Future An interview with Dr. Joerg Schwock soon after he graduated from the program.

Watch a short video from the Medical Laboratory Professionals' Association of Ontario (MLPAO) about the UHN Cytopathology team

Program structure

The fellowship provides training in: 

  • Cytodiagnostics with access to cytological specimens from essentially all organ sites
  • Specimen acquisition and on-site evaluation including a pathologist-led fine-needle clinic
  • Current techniques in specimen triage, processing, evaluation and ancillary testing
  • Up-to-date methods in quality improvement, laboratory performance and patient safety
  • Communication skills in interaction with patients, relatives, laboratory and hospital staff
  • Clinicopathological research and training through scientific project(s) and teaching

We focus on:

  • Diagnostic proficiency
  • Quality assurance and improvement techniques
  • On-site assessment for EBUS/EUS, fluoroscopic, CT- and U/S-guided sampling
  • Performance of ultrasound- and palpation-guided FNAs
  • Ancillary studies (Immunohisto/cytochemistry, Flow cytometry, HPV testing, Molecular testing, Cytogenetics)
  • Academic research and peer teaching
  • Trainee participation in program planning and improvement

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: 

  • Continuous in-training evaluation
  • 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 educational peer activities
  • Evidence of scholarly activity

At the end of the program, your portfolio will be assessed by the AFC Competence Committee and the Program Co-directors and, if successful, you will obtain an RCPSC diploma in official recognition of your subspecialty training.

Competency training requirements for the Area of Focused Competence in Cytopathology

See the requirements from the Royal College of Physicians and Surgeons of Canada (RCPSC). (PDF)

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.  

Who we are

We are a team of Cytopathology faculty at the University Health Network and the Sunnybrook Health Sciences Centre and are looking forward to welcoming you!

Contact us at to find out more about the program or speak to a Co-Program Director or past trainee.

The UHN Cytopathology team

University Health Network team

(left to right)

Paula Nixon, LMP ​Postgraduate Education Officer

Dr. Joerg Schwock

Dr. Hyang Mi Ko

Dr. Si Kei Lou

Beatrice Wong, LMP Clinical and Professional Program Assistant

The Cytopathology team at Sunnybrook Health Sciences Centre

Sunnybrook Health Sciences Centre team

(left to right)

Dr. Anna Plotkin

Dr. John Wong

Dr. Zeina Ghorab

Dr. Jelena Mirkovic

Our graduates

All our trainees now work in hospital laboratories in Canada.


Year completed training

Now working in Cytopathology in...

Si Kei Lou 


Toronto General Hospital/University Health Network, Toronto, ON

Blerta Starova 


William Osler Health Centre, Brampton, ON

Svetlana Carrigan 


Orillia Soldiers' Memorial Hospital, Orillia, ON

Lorna Mirham


North York General Hospital, Toronto, ON

Philippe Stephenson 


Centre hospitalier de l'Université de Montréal, Montreal, Quebec

Joerg Schwock 


Toronto General Hospital/University Health Network, Toronto, ON

Program Co-Director for Cytopathology


More about education in Cytopathology

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 

Auger M, Schwock J, Weir MM, Brimo F, Boerner S, Zeman-Pocrnich C, Myles N, Sekhon H, Gorombey S, Islam S. Area of Focused Competence in Cytopathology: An empowered version of Fellowship Training in Cytopathology in Canada. Canadian Journal of Pathology. 2021 Canadian Journal of Pathology.