A clinical officer (CO) is a gazetted officer who is qualified and licensed to practice medicine.
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.
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 track was discontinued and new students had to complete a medical course and sit and pass continuous assessment tests and final qualifying examinations which covered the biomedical sciences, medicine, surgery, paediatrics, obstetrics and gynecology, community health and health service management. 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. Undergraduate degrees in clinical medicine 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 offi reference
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