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.

[8] 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).

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.

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.

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.

[10] 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).

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 work as a hospitalist and one who has specialized in a clinical field provides advanced medical and surgical care and treatment such as administering anesthesia, performing general or specialised surgery, supervising other health workers and other administrative duties.

In Malawi, for instance, a clinical officer performs all routine surgical and obstetric operations such as exploratory laparatomy, emergency orthopaedics and Caesarean section.

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.

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.

In Kenya's public health system, a clinical officer is an alternative practitioner who is trained and authorized by law to perform any technical, administrative or legal duties that require a medical doctor.

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.

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 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.

The internship involves supervised rotations in the major clinical departments namely casualty, medicine, paediatrics, surgery, obstetrics and gynecology.

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, ENT, 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.

Kampala International University has opened a campus in Dar es Salaam where it is now offering its Bachelor of Clinical Medicine and Community Health.

In Burkina Faso, as elsewhere in sub-Saharan Africa, the use of non-physician clinicians began as a temporary measure while more doctors were trained, but has become a permanent strategy in the face of a crisis in health human resources.

[26] Health officers training programs across Ethiopia require that students have some of the highest scores in National University Entrance Examination to be admitted.

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.

[49] 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.

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[53] In Liberia, the Tubman National Institute of Medical Arts (TNIMA) was established in 1945.

Those with a post-secondary healthcare qualification such as registered nurses and paramedics can access the programme via a Graduate Certificate in Physician Assistant Studies; as long as they have at least five years full-time working experience.

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.

[59] 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.

In 1962 Health Minister Monem Khan introduced Condensed MBBS Course for LMF Doctor at Sir Salimullah Medical College, Dhaka from 1963 to 1972.