Product Code Database
A clinical officer ( CO) is a gazetted officer who is qualified and licensed to practice medicine.
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 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 who provide primary care and hospital services to the public in their own private or in 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.
| + Recognised qualifications for clinical officers in Kenya as per the scheme of service for clinical personnel, 2014 | |
Subjects:
| 8 years |
Pre-requisites:
| 4 years |
Courses taught and examined by the Kenya Medical Training College:
| 3 years |
Subjects examined by the Clinical Officers Council before issuing internship licenses/rotations completed during internship:
| 1 year |
| 3 years |
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| 1 year |
| 3 years |
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| 3 years
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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 officers scope of practice in Kenya as per the Scheme of Service for Clinical Personnel, 2014 |
| Entry 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. |
| Providing clinical outreach and school health activities, assessing, preparing and presenting medico-legal reports |
| Organizing health management teams and convening health management committee meetings |
| History-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. |
| Providing clinical services in a health facility, compiling and analyzing clinical data, carrying out disease surveillance and recommending appropriate control measures. |
| Implementing 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. |
| Implementing 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. |
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| Co-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 Hospital to be registered by the council and to maintain a current Medical 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 |
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| N/A |
| N/A |
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| Medical Specialist II |
| Medical Specialist I |
| Senior Medical Specialist |
| Chief Medical Specialist |
| Senior Chief Medical Specialist |
| N/A |
Clinical officer is a designation established by the government through the Clinical Officers Council (COC) which has jurisdiction and responsibility for the clinical officer's College, Professional and Medical license 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 license (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 Health care 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 Management (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 Pathology, Radiology, Psychiatry and Public 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, and Epidemiology as well as individual patient and community characteristics while being actively pharmacovigilant to prevent, identify, minimize and manage , drug errors, and Toxicology, 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 Medical license 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.
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).University of Birmingham. Major analysis shows value of non-physician clinicians for maternal health in sub-Saharan Africa. Posted on 20 May 2011.
Worldwide, patients are seen by many other practitioners other than the traditional doctor such as:
A clinical officer's scope of practice depends on one's training and experience, jurisdiction and workplace policies. In Malawi, for instance, a clinical officer performs all routine surgical and obstetric operations such as exploratory laparatomy, emergency orthopaedics and Caesarean section. However, in Kenya, Tanzania and Mozambique one has to undergo further specialized training in order to perform such major operations safely.
In rural and small urban health facilities a clinical officer is usually the highest medical care provider and works with minimal resources, relying on the traditional medical history and physical examination, often with little or no laboratory facilities, to make a diagnosis and provide treatment. In bigger and better equipped facilities a clinical officer generally acquires superior knowledge, experience and skills and provides high quality and a wider range of services in district, provincial and national hospitals, universities and colleges, research institutions and private medical facilities.
A clinical officer is usually the lowest entry-level cadre in the medical hierarchy but with years of experience and/or further training one can rise to the same or a higher grade than a physician. In most countries, however, wages are usually low compared to training and responsibilities and career progression is usually restricted by awarding terminal degrees and diplomas, training students who have not attained the minimum university entry grade and, in some countries, not awarding any degree or recognition for advanced training. In such countries, this usually results in a demotivated and low quality workforce and resulting poor health indicators.
The United States' Centers for Disease Control and Prevention and other international health and research institutions make extensive use of COs in their projects in Africa and clinical officers have been the backbone of HIV care and treatment enabling the rollout of ARVS to even the most rural hard to reach areas in Africa.
Research done by the University of Birmingham and published in the British Medical Journal concluded that the effectiveness and safety of caeserian sections carried out by clinical officers did not differ significantly compared with doctors. Better health outcomes including lower maternal mortality rates were observed where COs had completed further specialised training particularly in anaesthesia.
In the multi-country study, poor outcomes were observed in Burkina Faso and Zaire - the only countries where the procedure was performed by trained nurses. Higher rates of wound infection and Wound dehiscence in these countries was thought to be due to the nurses' poor surgical technique and need for enhanced training. ≠
As a British colony in 1928, Kenya started training a select group of natives to practice medicine and care for the local population who were increasingly accepting and seeking western medicine. After independence from Britain in 1963, medical training in Kenya initially adopted the four-year medical school system used in the US rather than the six-year UK model. This was heavily influenced by the Kennedy Airlift which followed initial funding by the African-American Students Foundation (AASF) in 1959 and led to hundreds of young Kenyan students getting scholarships to study in American institutions: These students came back to Kenya after their studies and joined the civil service in the early post-independence Kenya. It was also around this time that the first DOs were accepted as medical officers by the US civil service and by 1967 the structure and duration of medical training in Kenya was similar to the US MD training. When the University of Nairobi split from the University of East Africa and became the first university in Kenya in 1970, it continued to teach the six-year British degree which led to the creation of two statutory bodies: the Kenya Medical Practitioners and Dentists Board in 1978 which had jurisdiction over medical officers and physicians, and the Clinical Officers Council in 1989 which had jurisdiction over clinical officers. Instead of residency for the clinical officer, the higher diploma in paediatrics, ophthalmology and other specializations was introduced in the late 1970s as a post-basic course for those who had worked for three or more years and, after ten years of service, one became a Senior Clinical Officer and qualified for a licence to practice under his own name as a private medical practitioner. The Medicine degree was later introduced in 2006.
Clinical officers play a central role in Kenya's medical sector today. There were 8,600 clinical officers on the register in 2010 compared to 7,100 medical officers. They are trained by the universities, the Kenya Medical Training College (KMTC), St. Mary's School of Clinical Medicine and other private institutions. The Ministry of Health, through the Clinical Officers Council (COC) regulates their training and practice, accredits training institutions, and approves the syllabi of the universities and colleges. The Kenya Medical Training College (KMTC), also under the Ministry of Health, has campuses in regional teaching hospitals and trains the majority of clinical officers. St. Mary's School of Clinical Medicine and St. Mary's Mission Hospital in Mumias, owned by the Roman Catholic diocese of Kakamega, was the first private institution to train clinical officers. It admits students who got the minimum university entry grade in high school and have passed a written examination and oral interview. The students sit the same examination as their counterparts at the KMTC and are examined by consultants from the public service.
On 28 October 1981 lawmakers addressed the National Assembly as follows:
The dual diploma in clinical medicine and surgery plus an internship year is the standard qualification for clinical officers which is awarded on completion of a four-year training programme which started as various programmes that were used to train medical practitioners in the East Africa Protectorate in the 1920s and which now resembles the North American four-year MD and DO medical school programmes (including being structured in 9 trimesters over 3 years to meet the minimum 130 weeks of instruction recommended by the Liaison Committee on Medical Education) instead of the more recent six-year MBChB programme that was introduced in the 1970s and is more common in European and Commonwealth countries:
Medical Officers training:
Clinical Officers training:
The current training follows international guidelines and the two qualifications are awarded jointly on successful completion of a comprehensive nine trimester programme of full-time study, practicals and examinations which are covered over three years leading to a fourth mandatory year of internship in a teaching hospital. A fifth and sixth residency specialisation years are undertaken after registration by the Clinical Officers Council and three years of work experience in general medicine which leads to the award of a general degree in clinical medicine or a specialist diploma in pediatrics, orthopedics, psychiatry, anaesthesia, reproductive health and other specialties.
A clinical officer is therefore able to graduate and join the workforce in a minimum of four calendar years and provides medical services within the full scope of Family medicine and emergency medicine or within a narrower scope depending on their area of specialisation.
Registration by the Clinical Officers Council (COC) entitles one to render medical services in any public or private medical institution or to practice medicine independently as a private practitioner. Registration also qualifies one to join and participate in the affairs of the Kenya Clinical Officers Association (KCOA), including its annual KCOA Scientific Conference, and the Kenya Union of Clinical Officers (KUCO). As per the government's Revised Scheme of Service for Clinical Personnel (2014) a clinical officer works at any of 8 grades depending on ones seniority. As gazetted officers all registered clinical officers are legally authorized to prepare, sign, issue and keep safe custody of official state documents such as medical examination reports, , postmortem examination reports and death certificates and to appear in courts of law as expert witnesses. For this reason, a clinical officer is the officer in-charge of a health center or a district hospital and is part of the medical team in bigger hospitals where one may head a department or work under a senior clinical officer or a physician.Mullan F, Frehywot S. Non-physician clinicians in 47 sub-Saharan African countries. Lancet; 2007, 370: 2158–63.AMREF. Clinical Officers. Accessed 2011-04-06.
Clinical officers are direct healthcare providers who manage and administer health institutions, medical schemes and projects in primary healthcare (PHC) settings and are frontline stakeholders in Universal Health Coverage in Kenya which is one of the key pillars of the government's 5-year development plan under Uhuru Kenyatta. The four pillars of the 5-year development plan are 1. Manufacturing 2. Affordable housing 3. Universal Health Coverage and 4. Food security.
Like the term medical officer, the term clinical officer is a protected title whose use without the authority of the Clinical Officers Council is prohibited and a punishable offense under Kenyan laws. Court rulings uphold that a registration certificate or a licence issued by the council automatically confers the status of a medical officer or a qualified medical practitioner to a clinician and the titles are used interchangeably in medico-legal documents because a qualified clinical officer has a recognized medical qualification and is eligible for registration as a medical practitioner under Section 11(1) of the Medical Practitioners and Dentists Act in addition to being expressly authorized to practice medicine, surgery or dentistry by Section 7(4) of the Clinical Officers Act Criminal Appeal 198 of 2008 - Kenya Law Criminal Case 6 of 2004 - Kenya Law CAP. 249
From the Anatomy Act, the legal definition of a medical officer is any public officer who is entitled to be registered as a medical practitioner if he applied under any law in the country: Section 14(1) of the Medical Practitioners and Dentists Act and Section 7(4) of the Clinical Officers Act are the only two laws that can authorize one to practice medicine and render medical or dental services in the public sector if they hold a registration certificate or in the private sector if they hold a current licence as well. The Public Health Act further defines a medical officer of health as a public officer who is responsible for health nationally (the Director of Medical Services and the Director clinical services) or regionally (the county or sub-county Medical Officer of Health and the county or sub-county Clinical Officer).
Like his counterparts in the public service, a clinical officer in the private sector has the same practice rights and privileges as a medical officer and both are authorized to work independently and specialize in any approved branch of general or specialised medicine. The Competition Act No.12 of 2010 directly prohibits and addresses multi-sectoral abuse of dominance, consumer welfare, exemptions, cartels and unwarranted concentration of economic power among practitioners.
A register of active clinical officers and medical institutions is available online on the Clinical Officers Council and Ministry of Health websites.
Students study the biomedical and clinical sciences such as anatomy, physiology and pathology in the first year followed by the clinical subjects (medicine, surgery, , and gynecology) in the second year. The third and fourth year involves supervised clinical practice and internship in teaching hospitals where they rotate in all the departments, receive beside lectures, attend consultants' ward rounds, clerk patients and present medical histories, perform deliveries and first-assist in major surgery. They also attend clinical meetings and write prescriptions which at this stage must be counter-signed by a supervising clinician.
There is special emphasis on primary care with modules on community health taught throughout the course. Before starting their internship after the third year, clinical officers spend at least one month in a Provincial Rural Health Training Centre where they immunize children, examine pregnant women and offer family planning services in mother and child health clinics. They also treat in-patients and out-patients under the guidance of qualified Clinical officers and organise outreach services where they venture into remote rural villages, seeing patients and immunising children. During this time they complete a project in community diagnosis.
They also learn Health Service Management which prepares them for their management and leadership roles in health centers and other institutions.
The Higher Diploma in Clinical Medicine and Surgery requires at least three years of working experience and lasts twelve to eighteen months leading to a specialised qualification and re-designation as a specialised clinical officer in one of the medical specialties such as paediatrics, reproductive health, anaesthesia, Otolaryngology, ophthalmology and cataract surgery, orthopaedics, psychiatry/clinical psychology, skin and chest diseases, epidemiology, pathology and Community medicine. A specialised clinical officer provides advanced medical and surgical care including invasive procedures in their specialty such as caeserian section, cataract surgery, tonsillectomy, psychotherapy and administration of anaesthesia.
The graduates supplement the efforts of COs trained in neighboring countries, e.g. Kenya, Uganda and Tanzania, most of whom work for international humanitarian agencies. Since 2014, Juba institute of Health Sciences and Ayii University 2021 have now joined in production of competent cadres in the Health in the Republic of South Sudan.
Experienced clinical officers may enrol for an 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 and the Ministry of Health in the country. The graduates are known as Assistant Medical Officers which no longer exist since 2017 so a clinical officer can upgrade by studying a bachelor's degree in clinical medicine in any East African country for three years or study it in Tanzania for four years and graduate as a doctor equivalent to an MD graduate even in salary and job opportunities or can study the Medical Doctor(MD) which is a 5-year course plus 1 internship year making 6 years and can add 1 year to be Medical bachelor and Bachelor in Surgery (MBBS) if interested.
A further two years training from the Clinical Officer level leads to a specialist qualification in [[anaesthesia]], medicine, surgery and radiology etc.
Kampala International University has opened a campus in Dar es Salaam where it is now offering its Bachelor of Clinical Medicine and Community Health.
Kampala International University offers a Bachelor of Clinical Medicine and Community Health. Kampala International University , Uganda High school graduates take four-and-a-half years to complete this degree while practicing clinical officers take three years.
Many studies show that trained COs provide quality medical and surgical care with outcomes similar to physicians' providing similar care in the same setting. However, nurses re-trained to become COs have been associated with more adverse outcomes as shown in a study using 2004-2005 hospital data from six regions of Burkina Faso, which associated them with higher maternal and neonatal mortality when they performed caesarian sections. The observed higher fatality rate pointed to a need for refresher courses and closer supervision of the nurses.
In 2016, the PA-Anaesthesia group broke away and became certified registered anaesthetist (CRA) according to the Health Professions Regulatory Acts 857 which addressed them as certified registered anaesthetist. PAs are qualified by graduation from the PA educational programme and certification by the Ghana Medical and Dental Council. Newly qualified PAs who are successful in their licentiate examinations by the MDC are issued with provisional registrations to enable them undertake one-year internship in an accredited institution, a prerequisite for permanent registration which would also serve as national service but without pay for the twelve months.
PA students in all PA training schools belong to the Physician Assistant Association of Ghana (PASAG). In order to foster unity, camaraderie and bond among members of the association, and to promote excellence in the discharge of their professional mandate, quiz competitions are held every year. The maiden edition was won by the Presbyterian University College, Ghana. After permanent certification, among other things, PAs diagnose and treat illnesses, conduct physical examinations, counsel individuals on preventative health issues, and order and interpret laboratory tests. In addition, PAs are first or second assistants in major surgery, and provide pre- and post-operative care, and for that matter are trained and well versed in surgical skills. Thus, PAs play roles in preventive Medicine, as well as in educational, research, and administrative activities. The physician assistant is part of the medical team and is placed above the nurse but below the medical officer They perform tasks originally performed by doctors. Some call PAs as "village doctors" or "chiefs." To the patient, a PA is a doctor, since the PA practises medicine just as a doctor
The Ghana Physician Assistant Association-Medical at their last annual delegate congress, voted for a name change from the current name Physician Assistant to Clinical Officer. The members of the association believes that the Assistant attached to their name is limitation to what the PA actually does. The PA is not an assistant but an independent medical professional trained and licensed to practise medicine and dentistry. The association has therefore presented a new job description and the new name clinical officer to the Ministry of Health. The meeting which was chaired by the chief director of the ministry of health Dr. Afisah Zakariah who promised to address the grievances of the PAs soon to be known as Clinical Officers
After independence, and on the recommendation of the bhore committee in 1946, the training of licentiate doctors was stopped and their qualifications converted to MBBS degrees. They were then grandfathered into the Medical Council of India.
The plan was to train enough doctors who would serve the whole country. However, the plan has not borne fruit and doctors generally leave their rural posts after their internship for more lucrative and glamorous careers in the big cities.
As of 2009, the Indian government plans to introduce a three-and-a-half-year Bachelor of Rural Medicine and Surgery (BRMS) degree to train doctors who will work in remote Indian villages. On graduation they will undergo a one-year internship period at a regional hospital before being licensed. Those with five years' experience will qualify for post-graduate studies on equal standing with their MBBS counterparts.
In India, the Madras Medical Mission in Chennai, collaborating 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. Several other universities offer similar courses in partnership with US universities. PAs in India can pursue masters and doctor of science degrees.
In 1914 the State medical Faculty of Bengal was established to conduct trained Licentiate of Medical Faculty doctors (LMF Doctor) for four years Mid-Label Diploma Physician. They were then registered with the General Medical Council of Britain. Most of them worked among the rural population providing medical care. At independence East Pakistan had five medical schools:
From 2009 session Medical Assistant Course developed 4-year course (3 year Institution + 1 year Internship). Nowadays Medical Assistant Course conducted in 8 public institution & 146 private institution.
About 65% rural population receive primary medical treatment from Sub-Assistant medical officer (medical assistant). Medical Assistant no scope of Higher education & promotion. But Bongobondu sheike mujibur rahman government The First Five year plan1973 page 520 & 521 brief details on Medical Assistant (After passing medical assistant course & 3 year service rural area in national service entering qualification of medical college for MBBS course).
There are 146 Private Medical Assistant Training Schools.
A registered Assistant Medical Officer can pursue their sub-specialty training (Post Basic certificates and Advanced Diploma) in various fields such as Emergency Medical and Trauma care, Primary Healthcare, Orthopedic, Cardio thoracic, Clinical Neuro-physiology, Sport Medicine, Anesthesiology, Diabetic care, Infection Control, hemodialysis, and many more. Assistant Medical Officer could also join the MBBS /MD after completing the undergraduate study by applying for those programs in either public or private institutions. Those who want to serve and continue as Assistant Medical Officer could further their study in a special programs for Assistant Medical Officers such as Bachelor of Science in Emergency Medicine with honors and Bachelor of Medical and Health Sciences with honors. Unlike Physician Assistant / Associate (PA) and Clinical Officer (CO), Assistant Medical Officer in Malaysia is also involved in Pre-Hospital Care as part of their job scope. Postgraduate programs available for Assistant Medical Officer includes Master in Medical Science (Public Health), Master in Risk Disaster Management, Master in Medical Science (Emergency Medicine), Master in Hospital Management and Health Economics as well as PhD in clinical or medical sciences fields.
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