The Cytopathology fellowship at Duke is a one-year ACGME-accredited fellowship. It is a fast-paced program with comprehensive exposure to a range of cases and procedure types. We welcome up to two fellows to the team annually. Fellows rotate on the core cytology service for 10 months, which includes Fine Needle Aspiration (FNA); Rapid On-Site Evaluation (ROSE); and exfoliative cytology. They have two months of electives. 

Our program has an established FNA clinic at the Duke Cancer Institute, where fellows learn to perform both palpable and ultrasound-guided FNAs. Fellows can expect to perform over 100 FNAs during their fellowship year. Learning ROSE is an integral part of becoming a cytopathologist, as it is requested on many cases performed by bronchoscopy, endoscopy, Computed Tomography (CT)/Ultrasound (US) and interventional radiology. We have a strong group of cytotechnologists, who cover many of these cases, but fellows rotate at different hospital sites a few days per month. They initially work with the cytotechnologist or cytology faculty, then assume more responsibility as they gain experience throughout the fellowship.

In addition to becoming proficient at performing and evaluating FNAs, and evaluating ROSE immediate assessments of image-guided procedures, fellows have another advantage of learning from our busy fluid and pap (exfoliative) Cytology service. Fellows are taught by our excellent group of Cytopathology faculty. Additionally, fellows learn about patient safety, quality improvement and lab management. There is ample opportunity for teaching both within and outside of the Pathology Department. We encourage and support participation in national scientific meetings and clinical research projects. The Division of Cytopathology accesses over 24,000 gynecologic cases, 5,000 non-gynecologic cases, and 3,300 FNA cases annually.


To contribute to the future of cytopathology through excellence, patient-centered care, and evidence-based practice.

Program Aims

Upon completion of the training program, trainees will be able to: 

  • Be adaptive, life-long learners capable of practicing Cytopathology in a variety of practice settings (academic, community practice, or industry/corporate laboratory) 
  • Provide excellent patient-centered care using evidence-based medicine 
  • Perform palpable and ultrasound-guided fine needle aspiration biopsies competently 
  • Serve in a leadership role on inter-professional diagnostic cytopathology teams 
  • Have the skills necessary to function as a Cytopathology Laboratory Medical Director


Commensurate with the year of postgraduate training.

How to Apply

Submit the following requested documents:

  1. College of American Pathologists Standardized Application for Pathology Fellowships with signature (Click here for application
  2. Personal statement
  3. Curriculum Vitae
  4. Cover Letter
  5. ECFMG certificate (if applicable)
  6. Copies of USMLE/COMLEX transcripts
  7. Three letters of recommendation addressed to Dr. Rachel Factor (including one from residency Program Director)

Email your application package to Program Coordinator Brittany Harris.

Application Timeline

  • Accepting applications July 1-Sept. 1, 2024 (All interviews will be conducted virtually)

Eligibility Requirements:

Applicants must have completed an ACGME-accredited pathology residency program and be Board Certified or eligible in AP/CP or AP. The Department of Pathology sponsors J1 Visa applications.

Types and Numbers of Appointments: Two positions annually. 

Selective Service System Registration:

  • All male applicants (as determined by gender assigned at birth for purposes of this requirement) who are US citizens or immigrants must have registered with the Selective Service System within 30 days of their 18th birthday, or arrival date into the USA.  Individuals are eligible to register until the age of 26.  Failure to register is a violation of federal law, and can face significant penalties, including loss of eligibility for citizenship for immigrants.  Individuals who have not registered are not eligible for a variety of benefits including federal student aid, federal job training, and any job in the Executive Branch of the government (e.g. VA, Medicare, federal prisons), and are not allowed to work in federal facilities even as a resident or fellow.
  • Most Duke GME programs require rotations at federal facilities such as VA hospitals or prisons.  All trainees in those programs must be eligible to work at those facilities.  All applicants should ensure that they have registered for the Selective Service System if appropriate.  If they have not registered, they should discuss this with their potential program director. Additional details can be found at

Links Pertaining to Eligibility Requirements

American Board of Pathology:

Duke GME:


North Carolina Medical Board:

Current Fellow

Alexandra Balaban MD

Alexandra Balaban, MD
University Of Miami LM Miller School Of Medicine


Danielle Elliott Range, MD

Danielle Elliott Range, MD
Director of Cytology

Rachel Factor, MD,MS

Rachel Factor, MD MS
Program Director

Sarah Bean, MD

Sarah M. Bean, MD
Associate Program Director


Raj Dash

Raj C. Dash, MD



Wen Chi Foo

Wen-Chi Foo, MD

Sara Jiang

Xiaoyin "Sara" Jiang, MD

Avani Pendse

Avani Pendse, MD_PhD