From European Training to African Practice: An Autoethnographic Study of Clinical Competency Transfer and Therapeutic Innovation in Resource-Limited Settings

Abstract Background: Medical education in resource-limited settings continues to face persistent structural barriers, including limited specialization opportunities, insufficient clinical mentorship, and fragile institutional support. How advanced competencies acquired through European postgraduate programs translate into clinical and pedagogical outcomes in Sub-Saharan Africa remains underexplored. This study investigates how a Sorbonne-trained osteopath’s clinical practice in rural Cameroon evolved into an informal teaching institution, revealing the mechanisms through which individual expertise becomes an instrument of local medical education and system-level innovation. Methods: Using an analytical autoethnographic approach, the author documented 18 months of clinical activity, maintaining over 400 pages of reflexive professional journals, comparative treatment outcomes from 47 women with chronic low back pain, and geographic migration data. Thematic analysis combined these multiple data sources to identify patterns of competency transfer, contextual adaptation, and emergent pedagogical mechanisms. Results: Patients travelled up to 1,000 km to access osteopathic care, transforming a single consultation room into an informal regional training and referral hub. Quantitative analysis demonstrated superior outcomes for osteopathic interventions compared with standard physiotherapy: pain reduction (–61.8% vs –38.9%, p=0.001), functional improvement (–57.6% vs –38.3%, p=0.002), and reduced treatment sessions (9.7 vs 14.2, p<0.001). Three conceptual mechanisms emerged: Embodied Training Institution — the practitioner assuming institutional pedagogical functions; Proprioceptive Training Transfer — adaptation of sensorimotor integration techniques to contextual realities; Contextual Competency Validation — informal credentialing through clinical effectiveness. Conclusions: European postgraduate training can produce sustainable educational and therapeutic ecosystems in African contexts when redeployed through adaptive, embodied, and culturally resonant practice models. Findings highlight the need to integrate manual therapy into medical curricula, reform credential recognition, and promote strategic regionalization of expertise within African health education systems.