Problem Statement Residency programs that emphasize clinical reasoning and manual therapy can provide a means to optimize the outcomes of physical therapy without the need for or access to expensive equipment. The residency format of continuing education could allow physical therapists in developing countries access to specialty training and ongoing mentorship. However, there are limited studies that investigate the influence of residency training on the progression of clinical reasoning, professional development, and career advancement. Purpose The purpose of this study was threefold. The first objective was to describe the outcome of a post-graduate orthopaedic manual therapy residency program on development of knowledge and clinical reasoning skills by physical therapists in Nairobi, Kenya. The second objective was to explore the influence of the residency program on the participants’ professional development and career advancement. The last objective was to explore the residency experience from participants’ perspectives. Methodology This mixed methods study utilized a sample of convenience that included residents in the third (n=14) and fourth (n=13) cohorts of the orthopaedic manual therapy residency program in Kenya. Data collection included an assessment of clinical reasoning through a live patient examination, a survey on professional and career development, and qualitative interviews. Results There was a significant improvement in clinical reasoning development as measured by an assessment of a live patient examination (p Discussion The residency program in Nairobi, Kenya may serve as a framework for the formation of post-graduate education programs in other developing countries. The development of residency programs that can influence the ability of physical therapists to provide treatment efficiently and effectively may ultimately assist in serving community physical therapy needs.