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In ], '''clinical officers''' are ]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 ] to provide healthcare services to largely rural populations. The basic training is roughly similar. However the scope of practice is as varied as their are countries in africa. For example in Malawi those with a basic diploma are able to perform routine surgical and obstetric operations such as laparatomy and caeserian section whereas in Tanzania one must undergo additional training to become ]s before undertaking such responsibility. | ||
| ==]== | |||
| ⚫ | 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-], which falls under the ] ] of ], 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. | ||
| Unlike other countries, clinical officers do not operate under delegated powers but are constitutionally recognised profession. The '''Clinical Officers (Training, Registration and Licensing) Act Cap 260''' of the laws of Kenya is an act of ] 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: | |||
| ==Training== | |||
| ⚫ | "(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." | ||
| Before this act there were many sub-cadres within the profession such as Registered clinical officer (RCO), certified clinical officer (CCO), medical assistant etc. All these were abolished in 1989 in favour of Clinical Officer (CO) when the act came into force. However the title RCO has remained even in official publications. | |||
| ⚫ | |||
| The first university to train clinical officers was ]<ref></ref> in 1999. Other universities followed suit and currently |
Although traditionally a non-university qualification, this has changed. The first university to train clinical officers was ]<ref></ref> in 1999. Other universities followed suit and currently programs exist at ]<ref></ref>, ]<ref></ref> (KEMU) and ]<ref></ref>. The latter is the only one offering a four-year ] 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 ], ], ], ], ] and ]. | ||
| ⚫ | '''Career advancement''' | ||
| ⚫ | Qualified clinical officers with three years experience qualify to enrol for a ] at KMTC which leads to a specialist qualification in various specialty fields<ref></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 ], ], ] and ]. Some universities had in the past admitted higher diploma holders directly to ] degree programs, but this route no longer exists and all applicants must have a bachelor's degree. | ||
| ] 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 ]s. | |||
| ⚫ | |||
| ⚫ | '''Kenya Clinical Officers Association (K.C.O.A)''' | ||
| ⚫ | After |
||
| ⚫ | 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 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. | |||
| ] offers a ] 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. | |||
| ⚫ | |||
| ==]== | |||
| ==The Clinical Officers (training, registration and licensing) Act Cap 260== | |||
| 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 ]s. A further two years training leads to a specialist qualification in ], medicine, surgery and radiology etc. | |||
| This Act of ] 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 |
||
| ⚫ | (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. | |||
| 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. | |||
| ==]== | |||
| ⚫ | |||
| {{Unreferenced section|date=March 2009}} | |||
| ⚫ | This is a professional body whose membership encompasses registered clinical officers. It is represented on the |
||
| 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]. | |||
| Due to the severe shortage of doctors Clinical officers are trained to carry out all the routine functions of a doctor at a district hospital hence are allowed to perform major surgical and Obstetric Operations such as Caesarean Sections, Hysterectomies, Orthopedic care,Burr holes,Lumbar Punctures, and other important Life saving Surgical procedures. | |||
| However there are limited academic and career progression pathway beyond the basic diploma. This therefore leads many to 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. The situation does not seem to improve in the next couple of years.There might be many professionals, especially in the academical circles, who are irked with this sad state of affairs but very few are taking practical steps to address the Clinical Officers problems. | |||
| There is a Bachelor of Science in Mental Health Sciences at St. John of God College of Mental Health Sciences that has provided some relief to some Clinical Officers, but the majority are still finding it hard to move on to big academical 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. | |||
| ==]== | |||
| 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 ] pioneered the training of clinical officers in this region by setting up ]. | |||
| ==]== | |||
| 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 recently started training ]. 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 ] in Mthatha. Programs also exist at the ] and will commence at the ] and ] in 2009. | |||
| ==International== | |||
| *]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 ] 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 ]s and ]s. | |||
| *In ] the ]- Chennai, colloborating with ] and ] has since 1994 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., . | |||
| ==See also== | |||
| *] | |||
| *] | |||
| ==References== | ==References== | ||
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| ==External links== | ==External links== | ||
| * | * | ||
| * | * | ||
| * | * | ||
| * | * | ||
| * | * | ||
| * | |||
| * | |||
| * | |||
| * | * | ||
| {{med-stub}} | |||
| ] | ] | ||
Revision as of 19:10, 30 March 2009
In Sub-Saharan 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. The basic training is roughly similar. However the scope of practice is as varied as their are countries in africa. For example in Malawi those with a basic diploma are able to perform routine surgical and obstetric operations such as laparatomy and caeserian section whereas in Tanzania one must undergo additional training to become Assistant Medical Officers before undertaking such responsibility.
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.
Unlike other countries, clinical officers do not operate under delegated powers but are constitutionally recognised profession. 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."
Before this act there were many sub-cadres within the profession such as Registered clinical officer (RCO), certified clinical officer (CCO), medical assistant etc. All these were abolished in 1989 in favour of Clinical Officer (CO) when the act came into force. However the title RCO has remained even in official publications.
Although traditionally a non-university qualification, this has changed. The first university to train clinical officers was Egerton University in 1999. Other universities followed suit and currently programs exist at Jomo Kenyatta University of Agriculture and Technology, Kenya Methodist University (KEMU) and Mt. Kenya University. 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 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. 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 DOs.
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.
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.
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.
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 Officers. 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
 | This section does not cite any sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (March 2009) (Learn how and when to remove this message) |
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].
Due to the severe shortage of doctors Clinical officers are trained to carry out all the routine functions of a doctor at a district hospital hence are allowed to perform major surgical and Obstetric Operations such as Caesarean Sections, Hysterectomies, Orthopedic care,Burr holes,Lumbar Punctures, and other important Life saving Surgical procedures.
However there are limited academic and career progression pathway beyond the basic diploma. This therefore leads many to 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. The situation does not seem to improve in the next couple of years.There might be many professionals, especially in the academical circles, who are irked with this sad state of affairs but very few are taking practical steps to address the Clinical Officers problems.
There is a Bachelor of Science in Mental Health Sciences at St. John of God College of Mental Health Sciences that has provided some relief to some Clinical Officers, but the majority are still finding it hard to move on to big academical 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.
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 assistants 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 Practitioners and Operating department practitioners.
- In India the Madras Medical Mission- Chennai, colloborating with Birla Institute of Technology and Frontier Lifeline has since 1994 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., .
See also
References
External links
- Clinical officers - Ministry of Health, Kenya
- Kenya Medical Training College - Clinical Medicine Department
- Kilimanjaro Christian Medical College- Tanzania
- Egerton University (Kenya) - Diploma in Clinical Medicine and Surgery
- Kenya Methodist University - Department of Clinical Medicine
- Mt. Kenya University
- Malawi College of Health Sciences
- Maridi National Health Training Institute- Maridi
- Kenya Laws Online