officers scope of practice in kenya as per the scheme of service for clinical personnel, 2014 job groupscope of practice hentry and training grade. works under the guidance of a senior officer. duties and responsibilities include taking history, examining, diagnosing and treating patients' common ailments at an outpatient or inpatient health facility, implementing community healthcare activities in liaison with other health workers, guiding and counselling patients, clients and staff on health issues, sensitizing patients and clients on preventive and promotive health, carrying out minor surgical procedures as per training and skill, collecting and compiling clinical data, and referring patients and clients to appropriate health facilities. jproviding clinical outreach and school health activities, assessing, preparing and presenting medico-legal reports korganizing health management teams and convening health management committee meetings lhistory-taking, examining, diagnosing, treating and managing diseases and conditions in an outpatient or inpatient health facility, coaching and mentoring students on attachment, conducting ward rounds, reviewing and making appropriate referrals, carrying out surgical procedures as per training and skills, offering specialized clinical services including ear, nose and throat/audiology, orthopedics and trauma, child health and paediatrics, reproductive health, ophthalmology, anaesthesia, lungs and skin, dermatology and venereology. mproviding clinical services in a health facility, compiling and analyzing clinical data, carrying out disease surveillance and recommending appropriate control measures. nimplementing clinical service procedures, guidelines and quality assurance standards in the provision of clinical services, providing clinical and family healthcare in health institutions and communities, implementing medico-legal standards and guidelines, undertaking disease surveillance, control and management, undertaking research on critical health issues and emerging trends, monitoring patients, making appropriate referrals and providing necessary guidance and counselling, providing specialized services including epidemiology, coroner and forensic medicine, medical education, health economics and policy, health systems management, psychology, family and community health services, and providing emergency clinical care during disasters. pimplementing clinical services policies, procedures and guidelines, maintaining stanfards, ethics and quality assurance systems in the provision of clinical services, providing clinical and family health care services in health institutions and communities, reviewing medico-legal standards and guidelines, undertaking research on critical health issues and emerging trends, implementing referral strategies and guidelines in liaison with other stakeholders, identifying skills mix and training for quality service provision in the relevant specialized service areas including, ear, nose and throat/audiology, ophthalmology and cataract surgery, child health and paediatrics, anaesthesia, orthopedics and trauma, epidemiology, lung and skin, reproductive health, dermatology and venereology, coroner and forensic medicine, medical education, health economics and policy, health systems management, psychology, family and community health services, capacity building for disaster preparedness and emergency response, and coaching and mentoring staff. q- r- sco-ordinating the clinical services function by formulating, developing, implementing and reviewing policies, procedures and guidelines for clinical services, setting standards, ethics and quality assurance systems in the provision of clinical services, ensuring proper provision of clinical and family health health care services in health institutions and communities, formulating, developing and reviewing medico-legal standards and guidelines, facilitating research and innovation on critical health issues and emerging trends, overseeing development and review of referral strategies and guidelines in liaison with other stakeholders, providing technical advise, planning and budgeting, managing resources and budgets, capacity building and performance management for the department. professional degrees in clinical medicine and surgery were first offered by egerton university and other universities as from 2006 and in 2012 the commission for university education act no. 42 of 2012 removed the accreditation role from all regulatory bodies such as the clinical officers council (coc) and the kenya medical practitioners and dentists council (kmpdc) making the commission for university education (cue) the only authorized accrediting body for all university degrees in kenya including the degree in clinical medicine. in 2017 the old legislation was repealed and the clinical officers council reconstituted by the clinical officers (training, registration and licensing) act no. 20 of 2017 which requires each clinical officer, clinic or medical centre to be registered by the council and to maintain a current practice license and a current practising certificate in order to operate legally within the scope of medicine, dentistry, orthopedics or health work. a clinical officer may, with respect to patients - examine, diagnose, order laboratory and imaging investigations, prescribe treatment and perform procedures as per their scope of training. clinical officers are members of the kenya clinical officers association and the kenya union of clinical officers. in june 2020 the public service commission approved the revised scheme of service for clinical personnel which was issued by the state department for public service to define the clinical officer's career structure, job description, standards for recruitment, training and advancement, and career planning and succession management within the civil service. the scheme is administered by the ministry of health through the cabinet secretary and the principal secretary in conjunction with the public service commission and the county chief officer for health in each of the 47 counties of kenya. clinical officers and medical officers government public service grades in kenya - from the revised scheme of service for clinical personnel, 2014, revised scheme of service for medical officers, 2016 and the competency framework for the public service, 2017 job groupcsgclinical officer (4-year non-degree training)clinical officer (5-year degree training)medical officer (6-year degree training)consultant (postgraduate degree training) h11registered clinical officer iiin/an/an/a j10registered clinical officer iin/an/an/a k9registered clinical officer iclinical officern/an/a l9senior registered clinical officersenior clinical officern/an/a m8chief registered clinical officer iichief clinical officermedical officern/a n7principal registered clinical officer iiprincipal clinical officersenior medical officern/a p6principal registered clinical officer iassistant director of clinical servicesassistant director of medical servicesmedical specialist ii q6n/asenior assistant director of clinical servicessenior assistant director of medical servicesmedical specialist i r5n/adeputy director of clinical servicesdeputy director of medical servicessenior medical specialist s4n/adirector of clinical servicessenior deputy director of medical serviceschief medical specialist t3n/an/asenior deputy director of medical servicessenior chief medical specialist u2n/an/adirector of medical servicesn/a clinical officer is a professional designation established by the government through the clinical officers council (coc) which has jurisdiction and responsibility for the clinical officer's training, registration and licensing and each officer must (1) study clinical medicine and surgery or clinical medicine and community health for three or four years (2) graduate from a government-accredited medical training college (3) sit and pass a government licensing examination (4) complete an internship year at a teaching hospital (5) be registered as a clinical officer (6) have a medical practice licence (7) complete a three-year period of clinical supervision under a senior clinical officer or a senior medical officer (8) have a practising certificate if they have a private practice which allows one to provide general medical services on their own directly to the public (9) undergo one or two additional years of specialized training (optional) and (10) become a trainer. clinical officer (co) is a protected professional title and its use by unregistered persons is prohibited by law and punishable by up to five years in jail with or without a fine. globally, the title may not have legal restrictions and can refer to a job grade rather than a medical qualification such as junior assistive clinical staff (e.g. in zambia and tanzania), licensed medical professionals (e.g. in kenya and malawi) or high-level corporate officers, directors, and managers (e.g. chief clinical officers in europe and the united states). a clinical officer observes, interviews and examines sick and healthy individuals in all specialties to determine and document their health status and applies relevant pathological, radiological, psychiatric and community health techniques, procedures and findings needed to classify diseases and related health problems and to establish a provisional or final diagnosis upon which to prescribe, initiate, carry out or terminate treatment or therapy based on their specialized knowledge, skills and experience in clinical pharmacology, use of clinical guidelines, best practices and disease patterns as well as individual patient and community characteristics while being actively pharmacovigilant to prevent, identify, minimize and manage drug reactions, drug errors, side effects and poisoning, overdiagnosis, overscreening, overtreatment and futile care. a clinical officer performs general and specialized medical duties such as diagnosis and treatment of disease and injury, ordering and interpreting medical tests, performing routine medical and surgical procedures, referring patients to other practitioners and managing health departments, institutions, projects and systems. clinical officers, medical officers and medical practitioners are the only officers who are gazetted and licensed to practice medicine in kenya. they work under oath and generate credible health data and information within communities and health institutions and cascade the same to the county and national governments, government agencies and third parties through standard recording and reporting tools from the ministry of health which are used to capture data on disease outbreaks, physical injuries and deformities, mental illness, drug resistance, disability, nutritional disorders, births and deaths among others. overview to practice medicine and surgery or dentistry as a clinical officer one requires at least four years of full-time medical training, supervised clinical practice and internship at an accredited medical training institution and hospitals and registration with the relevant medical board in their country. after a prescribed number of years in active practice, one may complete a further one or two-year residency programme in order to specialize in any approved branch of clinical medicine and surgery such as anesthesia or pediatrics, or get an advanced medical qualification from the university. there are no pathways (post-basic or post-graduate entry-level conversion programs) for nurses and other health workers hence it takes at least eight years of specialised medical training and experience for a clinical officer to graduate with a post-basic qualification. "clinical officer" in some countries such as tanzania and zambia refers to a different cadre of health workers, comparable to "medical assistants" in malawi, who have less than three years of training but who may upgrade to a similar level by becoming assistant medical officers (amos) or medical licentiates (mls)."medical assistants/sub assistant community medical officer" in bangladesh, a four year medical diploma course conducting state medical faculty of bangladesh under ministry of health and family welfare. a clinician can specialize in any other field that is deemed appropriate by them and not just clinical medicine. china also has masters of clinical medicine. in countries like tanzania, uk, and other countries, clinical medicine is regarded as a medical course and graduates are allowed to apply to masters of medicine specialties. no significant difference has been demonstrated in studies comparing treatment decisions, patient outcomes, quality of care provided and level of knowledge about diseases between a clinical officer and a medical officer (a non-specialist physician) except in countries where nurses were mistakenly assessed as clinical officers. however, because of the nature of practice, populations served and resources at ones disposal, a clinical officer is less likely to administer expensive treatment, prescribe expensive (but not necessarily better) drugs or engage in futile care. the success of hiv/aids prevention and treatment initiatives in africa is mostly attributed to use of clinical officers to diagnose the disease and provide comprehensive medical care. access to emergency obstetric care through greater deployment of the clinical officer is one way of attaining the millennium development goals 4 (reducing child mortality) and 5 (improving maternal health). worldwide, patients are seen by many other practitioners other than the traditional doctor such as: osteopathic physicians, podiatrists, optometrists and anesthesiologist assistants in the united states emergency and clinical officer pakistan physician assistants in the united states, united kingdom, netherlands, liberia and ghana assistant doctors in china, surgical care and emergency care practitioners in the uk, assistant physicians in saudi arabia, health extension officers in papua new guinea medical assistants/sub assistant community medical officer in bangladesh medical assistants in fiji assistant medical officers in malaysia surgical technologists in mozambique clinical associates in south africa. scope of practice a clinical officer takes the hippocratic oath and, depending on jurisdiction, may be registered by the same statutory board as physicians (in the southern countries such as zambia and malawi) or a separate board (in the eastern countries such as kenya and uganda). the broad nature of medical training prepares one to work at all levels of the health care system. most work in primary care health centres and clinics, and casualty departments in hospitals where one will diagnose and treat all common diseases, including serious and life-threatening ones, in all age groups; and stabilise then admit, discharge or refer emergency cases. in smaller hospitals one may