On 10 October 2010, the former Netherlands Antilles was dissolved politically; Curacao and St Maarten became autonomous countries, while Bonaire, St Eustatius and Saba (the 'BES islands') joined the Netherlands with the status 'special municipalities'. At that time there was one medical school on each of the BES islands, providing medical education to students predominantly from the United States and Canada. A process was instigated for recognition and accreditation within the Netherlands system of the education provided by these schools. This article provides an overview of this process, and investigates its consequences, including admission and registration requirements, student mobility and financial aspects. The current location and status of the different educational programmes will be explained.