Umechanganya mambo,Hakuna chuo chochote cha Afya kinacho toa kozi kwa Evening program,Isipokuwa kuna vyuo vinatoa distance learning kwa wale wanao upgrade tu,siyo fresh from school.Kwa nursing vipo vyuo kama BUGANDO,KAIRUKI,TANGA NA IFAKARA wanatoa kozi ya distance learning kutoka certificate kwenda Diploma.
Kwa clinical Medicine,vipo pia vyuo vinavyotoa distance learning siyo evening kwa CA kwenda CO,Mfano IFAKARA,Musoma,Maswa ,Sumbawanga na Maweni