The Doctor of Health Administration or D.H.A. degree was started in the U.S. in the late 1990s at the Medical University of South Carolina as an advanced professional doctorate in health leadership. The founding director and chief architect for the degree was Dr. James A. Johnson. Prior to this the only D.H.A. diplomas were awarded in Canada and Europe. The American version of this doctoral degree focuses on advanced professional knowledge and applied research in health administration, policy, and leadership. Two new programs have been instituted at other universities providing substantial amounts of online coursework. This includes Central Michigan University. Most D.H.A. students are working health professionals who seek doctoral education. The three year degree typically requires two years of coursework beyond the master's degree (i.e. M.H.A., M.P.A., M.S.A., or M.P.H.) and an applied dissertation to be completed in the third year.