Area of Focus Competence (AFC-CYTO)


  • The Area of Focused Competence (AFC) status was developed by the RCPSC
    to provide “a mechanism to formally recognize disciplines that meet a legitimate societal health need, but that do not meet the current criteria for a primary specialty or subspecialty”
    and this by providing advanced training within an additional or highly specific and narrow scope.
  • As of November 2018, there are 24 approved disciplines, of which 11 have at least 1 accredited program: Adult Cardiac Electrophysiology, Adult Echocardiography, Adult Interventional Cardiology, Adult Hepatology, Adult Thrombosis Medicine, Brachytherapy, Cytopathology, Clinician Educator, Solid Organ Transplantation, Transfusion Medicine and Trauma General Surgery.
  • In April 2012, RCPSC made the decision to assign the newly developed status of AFC to Cytopathology, which is the first discipline in pathology to acquire AFC status in Canada
  • Trainees can come from either Anatomical Pathology (AP) or General Pathology (GP) background, but must be Royal College-certified (or eligible); this requirement limits accessibility of pathology residents who are not trained in Canada.
  • AFC training is typically 1 year in duration and is competency-based
    • no Royal College exams at the end.
    • based on satisfactory completion of portfolio
    • assessment of milestones is based on the demonstration of the competencies rather than the number of procedures performed or cases reviewed
    • if all the competencies are successfully demonstrated by the trainee, the trainee obtains a “Diploma” certificate from the RCPSC: “DRCPSC”
  • AFC program has two principal documents for training
    • Competency Training Requirements
    • Portfolio: the portfolio has six goals each linked to one or more key milestones
      which are in turn linked to assessment tools where the candidate demonstrates the competencies. The six goals are:

      • Interpretation of specimens
      • Management of the laboratory
      • Performance of fine needle aspirates
      • Selection and interpretation of ancillary studies
      • Advancement of Cytopathology through scholarship
      • Engagement of government, other physicians and health care professionals in emphasizing the importance of Cytopathology in patient wellness and care


Available Programs
Western University, London
Program Director: Dr. Michele Weir. Email:

McGill University, Montreal
Program Director: Dr. Manon Auger. Email:

University of Toronto, Toronto
Program Director: Dr. Scott Boerner, AFC Director. Email:

University of Calgary, Calgary
Program Director: Dr. Steve Gorombey. Email: