Cytopathology

The Cytopathology Fellowship at Montefiore Einstein is an ACGME-accredited, one-year program with comprehensive training in FNA and cytopathology diagnostics, covering a broad and complex range of cases.
 
Established in 1977 by Leopold G. Koss, MD, one of the founding figures of modern Cytology, the program draws diagnostic material from three hospital divisions, encompassing a diverse and high-volume case mix. The fellowship was accredited in 1992,

In 1985, the training program was strengthened by the introduction of a fellow-led aspiration biopsy service, modeled on the technique developed by Torsten Lowhagen of the Karolinska Institute in Sweden. This hands-on service gives fellows extensive experience in both bedside and outpatient settings, with each fellow performing approximately 300–350 superficial aspirates using palpation or ultrasound guidance.

Montefiore’s large oncology and immunocompromised patient population, combined with an extensive community referral network, ensures that fellows gain exposure to a broad spectrum of disease. In 2023, the Cytology Division processed more than 64,500 specimens, including 32,256 cervical Pap tests, 32,265 non-gynecologic specimens, 6,184 fine needle aspirations (FNA), and 1,570 rapid on-site evaluations (ROSE).

Fellows lead the FNA biopsy service, work closely with radiologists on deep CT- or ultrasound-guided aspirates, and assess specimen adequacy in real time. They are responsible for initial diagnostic impressions and comments before attending sign-out. Fellows also review consultation slides and participate in multi-headed scope discussions.

The program fosters close collaboration with Surgical Pathology, Flow Cytometry, and Molecular Genetics, facilitating meaningful tissue correlation and advanced diagnostics. Educational opportunities include a daily slide conference, access to extensive archival materials and specialty labs, and interdisciplinary case discussions with clinicians.

Research is encouraged, particularly in breast, pulmonary, and gynecologic cancers, and many fellows present cases or publish during their training. The program maintains a board certification pass rate of over 90%, with graduates going on to successful careers in both academic and community settings.