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In several countries in East Africa clinical officers are health care providers. After three years of training, they receive a diploma in clinical medicine, surgery and community health. Clinical officers work either independently or with a medical officer to provide healthcare services to largely rural populations.

Training

In Kenya, the training is under the Ministry of Health through the Clinical Officers Council, which sets the syllabus and accredits training institutions. The Kenya Medical Training College (KMTC), also under the Ministry of Health, has campuses all over the country and trains the majority of clinical officers. St. Mary's School of Clinical Medicine in Mumias was the first private institution to train clinical officers. The students sit the same examination as their counterparts at the KMTC and are examined by consultants from the public service.

The first university to train clinical officers was Egerton University^[1] in 1999. Other universities followed suit and currently the program exists at Jomo Kenyatta University of Agriculture and Technology^[2], and Kenya Methodist University^[3] (KEMU). These universities follow their own curriculum approved by their senates and the clinical officers council.

Registration

After the three years of training, students sit for the national final qualifying examination (FQE) which is administered by the Clinical Officers Council. On passing the FQE they are expected to apply for provisional registration by the Clinical Officers Council before proceeding for internship in accredited hospitals. The internship lasts one year and involves three-month rotations.

The Clinical Officers (training, registration and licensing) Act Cap 260

This Act of Parliament came into force in 1989 and is the legal basis for the practice of clinical officers. It establishes the Clinical Officers Council whose functions are: "(a) to assess the qualifications of clinical officers (b) to ensure the maintenance and improvement of the standards of practice by clinical officers and to supervise the professional conduct and practice of clinical officers (c) to register and license clinical officers for the purposes of this act (d) to colloborate with other bodies such as the medical practitioners and dentists board, the central board of health, the nursing council of Kenya, the pharmacy and poisons board, in the furtherance of the functions of the council and those bodies; and (e) to consider and deal with any matter pertaining to clinical officers including prescribing badges, insignia or uniforms to be worn by clinical officers".

The chief clinical officer is the highest level one can attain in the public service and is appointed to the council by the minister of health.

References

External links

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-In [[Sub-Saharan Africa]], '''clinical officers''' are [[health care provider]]s.  After three years of training, they receive a diploma in clinical medicine, surgery and community health.  Clinical officers work either independently or with a [[medical officer]] to provide healthcare services to largely rural populations. The basic training is roughly similar. However the scope of practice is as varied as there are countries in africa because each country adapts them to local situations and needs during internship. For example in Malawi those with a basic diploma are trained to perform routine surgical and obstetric operations such as laparatomy and caeserian section whereas in Tanzania one must undergo additional training to become an [[Assistant Medical Officer]] before undertaking such responsibility.
+In several countries in [[East Africa]] '''clinical officers''' are [[health care provider]]s.  After three years of training, they receive a diploma in clinical medicine, surgery and community health.  Clinical officers work either independently or with a medical officer to provide healthcare services to largely rural populations.
-==[[Kenya]]==
-The training is under the Ministry of Health through the Clinical Officers Council (COC), which sets the syllabus and accredits training institutions. The Kenya Medical Training College (KMTC), also under the Ministry of Health, has campuses all over the country and trains the majority of clinical officers. St. Mary's School of Clinical Medicine-[[Mumias]], which falls under the [[Roman Catholic]] [[diocese]] of [[Kakamega]], was the first private institution to train clinical officers. The students sit the same examination as their counterparts at the KMTC and are examined by consultants from the public service.
+==Training==
-Unlike other countries, clinical officers in kenya are a constitutionally recognised profession. They are required to sign legal documents such as medical certificates, death certificates, [[P3]] forms etc and to present medical evidence in a court of law eg in cases of rape and assault.
+In Kenya, the training is under the Ministry of Health through the Clinical Officers Council, which sets the syllabus and accredits training institutions. The Kenya Medical Training College (KMTC), also under the Ministry of Health, has campuses all over the country and trains the majority of clinical officers. St. Mary's School of Clinical Medicine in Mumias was the first private institution to train clinical officers. The students sit the same examination as their counterparts at the KMTC and are examined by consultants from the public service.
-The '''Clinical Officers (Training, Registration and Licensing) Act Cap 260''' of the laws of Kenya is an act of [[parliament]] that came into force in 1989 and is the legal basis for the practice of clinical officers. It establishes the Clinical Officers Council whose functions are:
-"(a) to assess the qualifications of clinical officers
-(b) to ensure the maintenance and improvement of the standards of practice by clinical officers and to supervise the professional conduct and practice of clinical officers
-(c) to register and license clinical officers for the purposes of this act
-(d) to collaborate with other bodies such as the medical practitioners and dentists board, the central board of health, the nursing council of Kenya, the pharmacy and poisons board, in the furtherance of the functions of the council and those bodies; and
-(e) to consider and deal with any matter pertaining to clinical officers including prescribing badges, insignia or uniforms to be worn by clinical officers."
+The first university to train clinical officers was [[Egerton University]]<ref>[http://www.egerton.ac.ke]</ref> in 1999. Other universities followed suit and currently the program exists at Jomo Kenyatta University of Agriculture and Technology<ref>[http://www.jkuat.ac.ke]</ref>, and [[Kenya Methodist University]]<ref>[http://www.kemu.ac.ke]</ref> (KEMU). These universities follow their own curriculum approved by their senates and the clinical officers council.
-Before this act there were many sub-cadres within the profession such as Registered clinical officer (RCO), certified clinical officer (CCO), medical assistant etc who had different kinds and levels of education. All these were abolished by the act in 1989  in favour of a uniform Clinical Officer (CO) cadre. However the title RCO has persisted even in official publications.
-Although traditionally a non-university qualification, this has changed. The first university to train clinical officers was [[Egerton University]]<ref>[http://www.egerton.ac.ke]</ref> in 1999. Other universities followed suit and currently programs exist at [[Jomo Kenyatta University of Agriculture and Technology]]<ref>[http://www.jkuat.ac.ke]</ref>, [[Kenya Methodist University]]<ref>[http://www.kemu.ac.ke]</ref> (KEMU) and [[Mt. Kenya University]]<ref>[http://www.mku.ac.ke/academics/healthsciences]</ref>. The latter is the only one offering a four-year [[Bachelor of Science]] degree in Clinical Medicine and community health and uses a curriculum borrowed from Kampala International University which is a patner institution. The rest award a three-year diploma in Clinical Medicine and surgery. These universities follow their own curriculum jointly approved by their senates and the clinical officers council.
-The training is rigorous and follows a compressed medical model. The first year is dedicated to learning the basic sciences, some experience in a diagnostic medical laboratory, nursing and clinical skills. The second year focuses on the clinical subjects whereas the third year is spent almost entirely rotating in every department of a teaching hospital where they attend ward rounds, clerk patients and present cases, perform deliveries and as first assistants in major surgical operations. they also attend clinical meetings and write prescriptions which at this stage must be countersigned by a supervising clinician.
-'''Registration'''
-After three years of training, students sit for the national final qualifying examination (FQE) which is administered by the Clinical Officers Council. Those who trained outside the country sit a separate paper. On passing the FQE they are expected to apply for provisional registration by the Clinical Officers Council before proceeding for internship in accredited hospitals. The internship lasts one year and involves three-month supervised rotations in the major clinical departments namely [[Emergency department|casualty]], [[medicine]], [[paediatrics]], [[surgery]], [[obstetrics]] and [[gynecology]].
-'''Career advancement'''
-Qualified clinical officers with three years experience qualify to enrol for a [[Higher National Diploma]] at KMTC which leads to a specialist qualification in various specialty fields<ref>[http://www.kmtc.ac.ke/clinical_medicine.htm KMTC - Clinical Medicine - "Post-Basic Courses in Clinical Medicine and Surgery"]</ref>. Many clinical officers now enrol for medical degrees at various universities within and outside the country whereas others enrol for related degree courses such as [[sociology]], [[psychology]], [[statistics]] and [[public health]]. Some universities had in the past admitted higher diploma holders directly to [[Master of Public Health]] degree programs, but this route no longer exists and all applicants must have a bachelor's degree.
-[[Kenyatta University]] introduced a four-year Medical degree in 2004 that was meant to up-grade practicing clinical officers to be doctors. However this was stopped half-way and converted to a traditional six-year medical degree due to registration issues with the Medical practitioners and dentists board. However this is set to be a non-issue as universities start to issue academic degrees to clinical officers as happens in countries that train [[DO]]s.
+==Registration==
+After the three years of training, students sit for the national final qualifying examination (FQE) which is administered by the Clinical Officers Council. On passing the FQE they are expected to apply for provisional registration by the Clinical Officers Council before proceeding for internship in accredited hospitals. The internship lasts one year and involves three-month rotations.
-'''Kenya Clinical Officers Association (K.C.O.A)'''
-This is a professional body whose membership encompasses registered clinical officers. It is represented on the Clinical Officers Council by three of its members who must be in private practice.
+==The Clinical Officers (training, registration and licensing) Act Cap 260==
-==[[Uganda]]==
-The training is under the ministry of education and takes place in clinical officer training schools. Programs last three years. Internship is not required for one to be registered.
+This Act of [[Parliament]] came into force in 1989 and is the legal basis for the practice of clinical officers. It establishes the Clinical Officers Council whose functions are:
-[[Kampala International University]] offers a [[Bachelor of Science]] degree in clinical medicine and community health. High school graduates take four-and-a-half years to complete this degree while practicing clinical officers take three years.
+"(a) to assess the qualifications of clinical officers
+(b) to ensure the maintenance and improvement of the standards of practice by clinical officers and to supervise the professional conduct and practice of clinical officers
+(c) to register and license clinical officers for the purposes of this act
+(d) to colloborate with other bodies such as the medical practitioners and dentists board, the central board of health, the nursing council of Kenya, the pharmacy and poisons board, in the furtherance of the functions of the council and those bodies; and
+(e) to consider and deal with any matter pertaining to clinical officers including prescribing badges, insignia or uniforms to be worn by clinical officers".
+The chief clinical officer is the highest level one can attain in the public service and is appointed to the council by the minister of health.
-==[[Tanzania]]==
-Training is under the ministry of health. There are numerous clinical officer training schools and programs last three year. Internship is not required for registration.
-Experienced clinical officers may enrol for a advanced diploma in clinical medicine which takes two years to complete. This qualification is regarded as equivalent to a first degree in medicine by universities in the country. The graduates are then known as [[Assistant Medical Officer]]s. A further two years training leads to a specialist qualification in [[anaesthesia]], medicine, surgery and radiology etc.
-==[[Mozambique]]==
-After qualifying, Clinical officers in Mozambique and surrounding countries can train to become surgical/obstetric technicians, and carry out many emergency surgical and obstetric operations and procedures.
-==[[Malawi]]==
-{{Unreferenced section|date=March 2009}}
-Clinical officers train for three years and undergo one year internship whereas Medical assistants train for two years and undergo one year internship. Medical assistants can then enrol for a 18 month up-grading course to become Clinical officers. The upgrading course takes place at Malamulo and Malawi College of Health Sciences[http://www.mchs.edu.mw].
-In this country the Clinical officers have almost entirely replaced doctors who are in short supply or based in the urban areas. They are trained to carry out all the routine functions of a doctor at a district hospital hence are able to perform routine surgical and Obstetric Operations such as Caesarean Sections, Hysterectomies, Orthopedic care,Burr holes,Lumbar Punctures, and other important Life saving Surgical procedures.
-Limited opportunities exist for career progression beyond the basic diploma. Hence most clinical officers join non-clinical degree courses in Management,Health Sciences, Education, and Biomedical Sciences. The main limitations are encountered because the country has only one medical school. Lack of sponsorship for training in neighbouring countries, lack of political will and bureocracy in the the country's medical training system further compound the problem.
-There is a Bachelor of Science in Mental Health Sciences at St. John of God College of Mental Health Sciences that has admitted some Clinical Officers, but the majority are still finding it hard to access bigger academic opportunities, due to the local educational system, and reasons cited above.
-Despite these, some Clinical Officers in Malawi have excelled, and have attained Doctor of Medicine Degree, Masters of Sciences Degree, Doctor of Philosophy Degrees in Universities in Europe and America.
-==[[Sudan]]==
-After a devastating civil war that left much of the southern part of this country in ruins  a delicate peace agreement was reached which resulted in the creation of a semi-autonomous state. The resultant impact on healthcare will be felt for years to come. Due to the shortage of health workers [[AMREF]] pioneered the training of clinical officers in this region by setting up [[Maridi National Health Training Institute]][http://www.amref.org/what-we-do/train-health-workers/clinical-officers].
-==[[Ethiopia]]==
-Health officers are trained in universities. All hold bachelor's degrees and therefore can progress to master's level training and education e.g in emergency surgery.
-==[[South Africa]]==
-South Africa recently started training [[Clinical associates]]. They are to be trained for three years in district hospitals after which they will be awarded a bachelor of clinical practice degree. The first program was launched by Health Minister Tshabalala Msimang on 18 August 2008 at the [[Walter Sisulu University]] in Mthatha. Programs also exist at the [[University of Pretoria]] and will commence at the [[University of Witwatersrand]] and [[University of Limpopo]] in 2009.
-==International==
-*[[Physician assistant]]s in the united states were initially trained in four-year community colleges. This has however changed and currently most training institutions offer a masters degree or are transitioning from offering a bachelors degree. One institution even offers a doctorate in the same.
-*The [[United Kingdom]] has in recent years employed physician assistants from the United States on a trial basis as it plans to introduce this cadre into their health care system. Several universities are already offering a post-graduate diploma in Physician assistant studies. However there are already other mid-level care providers known as [[Emergency Care Practitioner]]s and [[Operating department practitioner]]s.
-*In [[India]] the [[Madras Medical Mission]]- Chennai, colloborating with [[Birla Institute of Technology]] and [[Frontier Lifeline]] has since 1992 offered a bachelor of science degree in Physician Assistant studies. The program duration is four years comprising three years classroom and laboratory coursework then one year compulsory internship.[http://www.prlog.org/10072585-bits-pilani-has-collaborations-with-top-healthcare-institutions-in-india-today.html], [http://www.bits-pilani.ac.in/dlp-home/degrees/collab/collab.html], [http://www.iapaonline.org]
-==See also==
-*[[Healthcare in Kenya]]
-*[[Clinical associates]]
 ==References==
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 ==External links==
 *[http://www.health.go.ke/Clinical%20Sevices.htm Clinical officers - Ministry of Health, Kenya]
 *[http://www.kmtc.ac.ke/clinical_medicine.htm Kenya Medical Training College - Clinical Medicine Department]
-*[http://www.kcmc.ac.tz/Amo.htm Kilimanjaro Christian Medical College- Tanzania]
+*[http://www.kcmc.ac.tz/Amo.htm College of Tumaini University - Clinical Medicine Tanzania]
 *[http://www.egerton.ac.ke/academics/fhs/dip_climed.php%20 Egerton University (Kenya) - Diploma in Clinical Medicine and Surgery]
 *[http://www.kemu.ac.ke/?q=node/156 Kenya Methodist University - Department of Clinical Medicine]
-*[http://www.mku.ac.ke/academics/healthsciences Mt. Kenya University]
-*[http://www.mchs.edu.mw/page4.html Malawi College of Health Sciences]
-*[http://www.amref.org/what-we-do/train-health-workers/clinical-officers Maridi National Health Training Institute- Maridi]
-*[http://www.iapaonline.org Indian Association of Physician Assistants]
 *[http://www.kenyalaw.org/kenyalaw/klr_app/frames.php Kenya Laws Online]
+{{med-stub}}
 [[Category:Healthcare occupations]]