clinical officer clinical officer a clinical officer (co) is a gazetted officer who is qualified and licensed to practice medicine. clinical officer (co)occupationnames clinical officer (co) - kenya, malawi, uganda, rwanda, south sudan and somalia assistant medical officer (amo) - tanzania and malaysia medical licentiate (ml) - zambia physician assistant (pa) - liberia, ghana, india, netherland, germany, australia, canada and the united states (us) physician associate (pa) - the united kingdom (uk) and the united states (us) integrated emergency surgical officer (ieso) - ethiopia clinical health officer (cho) - somaliland clinical associate (ca) - south africa community health officer (cho) - sierra leone and nigeria medical extension officer (medex) - guyana medical assistant (ma) - fiji sub-assistant community medical officer (sacmo) - bangladesh assistant doctor (ad) - china and botswana occupation type healthcare professional activity sectors primary care infection prevention and control triage patient safety emergency medicine public safety forensic medicine medical ethics human rights reproductive health mental disorders patient advocacy pharmacovigilance disease surveillance community diagnosis contact tracing immunization palliative care clinical nutrition food safety pain management clinical supervision health service management sanitation internal medicine family medicine geriatrics paediatrics neonatology obstetrics gynaecology surgery orthopaedics traumatology oncology critical care medicine gastroenterology toxicology nephrology anaesthesiology otolaryngology ophthalmology dentistry neurology radiology psychiatry dermatology venereology respiratory medicine cardiovascular medicine haematology transfusion medicine tropical medicine community health environmental health rural health epidemiology occupational medicine clinical pharmacology therapeutics human anatomy medical physiology medical biochemistry molecular biology cellular biology medical genetics pathology medical microbiology medical parasitology sub-specialties health systems management quality assurance and quality control health technology health economics global health disaster management international health descriptioncompetencies venipuncture medical history taking physical examination point-of-care testing medical diagnosis laboratory investigations radiological investigations medical ultrasound medical prescription medical procedures medical photography rehabilitation preventive healthcare health information management medical classification medical education health promotion health advocacy education required diploma in clinical medicine and surgery (3 years) + internship (1 year) + clinical supervision (3 years), total 7 years or 331 weeks or 13240 hours bsc. clinical medicine and surgery (4 years) + internship (1 year) + clinical supervision (3 years), total 8 years or 376 weeks or 15040 hours higher diploma in clinical medicine and surgery (18 months or 68 weeks or 2700 hours) msc. clinical medicine and surgery (2 years or 90 weeks or 3600 hours) phd. clinical medicine and surgery (4 years or 180 weeks or 7200 hours) fields ofemployment public service government agencies kenya defense forces nonprofit organizations humanitarian organizations health management organisations universities/colleges hospitals clinics private practice teaching clinical research related jobs assistant physician in the us nurse practitioner (us and canada) anesthesiologist assistant (us) pathologists' assistant (us and canada) dental hygienist (us) in kenya the basic training for clinical officers starts after high school and takes four or five years ending on successful completion of a one-year internship in a teaching hospital and registration at the clinical officers council where annual practice licenses are issued. this is followed by a three-year clinical apprenticeship under a senior clinical officer or a senior medical officer which must be completed and documented in the form of employment, resignation and recommendation letters before approval of practising certificates and master facility list numbers for their own private practices or before promotion from the entry level training grade for those who remain employed. a further two-year higher diploma training which is equivalent to a bachelor's degree in a medical specialty is undertaken by those who wish to leave general practice and specialize in one branch of medicine such as paediatrics, orthopaedics or psychiatry. unique master facility list numbers are generated from a national who-recommended database at the ministry of health which receives and tracks health workload, performance and disease surveillance data from all public and private health facilities in the 47 counties. clinical officers also run private practices using a license issued to them by the kenya medical practitioners and dentists council. career options for clinical officers include general practice, specialty practice, health administration, community health and postgraduate training and research in the government or the private sector. many clinical officers in the private sector are government contractors and subcontractors who provide primary care and hospital services to the public in their own private clinics or in public hospitals through contracts with the national government, county governments or other government entities such as the national health insurance fund (nhif). kenya has approximately 25,000 registered clinical officers for its 55 million people. history in her books, "beyond the state: the colonial medical service in british africa" and "indian doctors in kenya, 1895 - 1940: the forgotten history", the author anna greenwood notes that before 1923 there were twice as many indian doctors as there were european doctors working in the colonial medical service. the indian doctors had migrated to british africa along with the coolies who came to work on the uganda railway. the indian doctors faced discrimination and were not appointed to nor paid at the same rank as medical officers (european doctors). instead, they were designated as assistant or sub-assistant surgeons despite having attended similar 3 - 4 year indian medical schools that were recognized by the general medical council in the uk and performing clinical and administrative duties that were largely identical to those of the european doctors. from the mid-1920s the indians were removed from the colonial service as they were not deemed to be the proper face of the imperial services in africa. the indian assistant and sub-assistant surgeons were thus replaced with similarly qualified africans who came to be known as clinical officers when the authorizing legislation was passed in 1988 abolishing the assistant and sub-assistant surgeon and similar positions. kenya in kenya, the origin of the clinical officer can be traced back to around 1888 when sir william mackinnon, 1st baronet founded the imperial british east africa company. the company was granted royal charter by queen victoria and was used by the government of the united kingdom to establish its influence in the east africa protectorate (present day kenya). as the influence grew a healthcare system developed to meet the medical needs of the colony. in 1901 kenyatta national hospital was established as the native civil hospital and later renamed the king george vi hospital after king george vi of the united kingdom. in 1958 the european hospital (present-day nairobi hospital) was established in the same area to serve the european settlers. the need for qualified medical staff who would provide preventive, promotive, curative and rehabilitative services in hospitals and communities led to the establishment of the first formal training programme for clinical officers at kenyatta national hospital in 1928. the programme initially admitted experienced nurses and took them through a one-year certificate course which prepared them for advanced practice. the nursing pathway was discontinued and new students had to study clinical medicine and surgery and sit and pass continuous assessment tests and final qualifying examinations for three years which covered basic medical sciences, medicine, surgery, paediatrics, obstetrics and gynecology, community health, rural health and health service management before admission into a compulsory one-year hospital internship programme and completion of a further three-year period of clinical supervision.. recognised qualifications for clinical officers in kenya as per the scheme of service for clinical personnel, 2014 knqf levelrecognised qualificationduration knqf level 1: kenya certificate of primary educationsubjects: english/kiswahili mathematics science social studies religious studies 8 years knqf level 2: kenya certificate of secondary educationpre-requisites: english/kiswahili biology/biological sciences chemistry/physical sciences mathematics/physics 4 years knqf level 6: diploma in clinical medicine and surgerycourses taught and examined by the kenya medical training college: human anatomy human physiology parasitology microbiology clinical microbiology community health pharmacology clinical pharmacology clinical methods general pathology clinical pathology clinical practice medicine surgery orthopaedics obstetrics and gynaecology paediatrics rural health health service management community medicine 3 years pre-registration internship (compulsory)subjects examined by the clinical officers council before issuing internship licenses/rotations completed during internship: medicine rotation (3 months) surgery rotation (3 months) paediatrics rotation (3 months) obstetrics and gynecology rotation (3 months) community health rotation (1 month) health service management rotation (1 month) rural health rotation (1 month) complete internship assessment booklet hospital's internship completion letter required for registration and licensing by the clinical officers council and membership of the kenya clinical officers association. 1 year apprenticeship employment letter employer's clearance/recommendation letter required for private practice or specialization 3 years knqf level 7: higher diploma clinical medicine and surgery (anaesthesia) clinical medicine and surgery (ear, nose and throat / head and neck surgery) clinical medicine and surgery (dentistry) clinical medicine and surgery (nephrology) clinical medicine and surgery (family health) clinical medicine and surgery (ophthalmology and cataract surgery) clinical medicine and surgery (orthopaedic surgery and trauma medicine) clinical medicine and surgery (reproductive health - (ob-gyn)) clinical medicine and surgery (paediatrics and child health) clinical medicine and surgery (psychiatry and mental health) clinical medicine and surgery (chest medicine) clinical medicine and surgery (dermatology and venereology) clinical medicine and surgery (emergency and critical care medicine) clinical medicine and surgery (oncology and palliative care) clinical medicine and surgery (addiction medicine) clinical medicine and surgery (cardiology) clinical medicine and surgery (chronic diseases) occupational health and safety health promotion audiology medical ultrasound medical education health systems management community health epidemiology 1.5 years bachelor's degree: pre-requisites (upgrading) diploma in clinical medicine and surgery higher diploma in clinical medicine and surgery - bachelor's degree: pre-requisites (direct entry) kenya certificate of secondary education - knqf level 7: bachelor's degree bachelor of science (clinical medicine) direct entry 4 years knqf level 7: bachelor's degree bachelor of science (clinical medicine) upgrading bachelor of science (ophthalmology and cataract surgery) upgrading 2.5 years pre-registration internship (compulsory) medicine rotation (3 months) surgery rotation (3 months) paediatrics rotation (3 months) obstetrics and gynecology rotation (3 months) community health rotation (1 month) health service management rotation (1 month) rural health rotation (1 month) complete internship assessment booklet hospital's internship completion letter required for registration and licensing by the clinical officers council and membership of the kenya clinical officers association 1 year apprenticeship employment letter employer's clearance/recommendation letter required for private practice or specialization 3 years knqf level 8: higher diploma clinical medicine and surgery (anaesthesia) clinical medicine and surgery (ear, nose and throat / head and neck surgery) clinical medicine and surgery (dentistry) clinical medicine and surgery (nephrology) clinical medicine and surgery (family health) clinical medicine and surgery (ophthalmology and cataract surgery) clinical medicine and surgery (orthopaedic surgery and trauma medicine) clinical medicine and surgery (reproductive health - (ob-gyn)) clinical medicine and surgery (paediatrics and child health) clinical medicine and surgery (psychiatry and mental health) clinical medicine and surgery (chest medicine) clinical medicine and surgery (dermatology and venereology) clinical medicine and surgery (emergency and critical care medicine) clinical medicine and surgery (oncology and palliative care) clinical medicine and surgery (addiction medicine) clinical medicine and surgery (cardiology) clinical medicine and surgery (chronic diseases) occupational health and safety health promotion audiology medical ultrasound medical education health systems management community health epidemiology 1.5 years knqf level 9: master's degree master of clinical medicine (oncology) master of clinical medicine (forensic medicine) master of clinical medicine (accident and emergency) master of clinical medicine (family health) 3 years knqf level 10: doctor of philosophy degree ph.d. (clinical medicine and surgery) 4 years the training expanded after kenya's independence in 1962 through to 1970 when the newly created university of nairobi started its own medical school and also used kenyatta national hospital as its teaching hospital. legislation to regulate medical practice by clinical officers was passed in 1988 thus creating the clinical officers council in 1989. in 1990 the kenya medical training college was established by the government with campuses in all major towns and in 1996 the roman catholic diocese of kakamega established st. mary's school of clinical medicine at st. mary's hospital in mumias which become the second and third institutions to offer the training in kenya. by this time clinical officers had to complete an accredited four-year programme of study, practicals and internship in clinical medicine and surgery and have their names entered in the clinical officers register which was cleaned annually and taken to the government printer to be published in the kenya gazette. private practice by clinical officers who had left government service after working for a minimum of 10 years was now allowed. clinical