This article examines the institutional arrangements, practices and outcomes related to the recognition of skills, knowledge and competencies (SKC) of non-EU foreign nationals in the Netherlands (commonly referred to as Third Country Nationals (TCNs)) with specific reference to the Dutch healthcare sector. Although the national infrastructure for foreign recognition of educational and professional qualifications is well-developed by international standards, the system has a number of flaws as interviews with TCNs and experts in the field reveal. TCNs often discover that their qualifications are not considered equivalent to the relevant Dutch qualifications. Given the limitations of formally recognising the educational qualifications or work experience of TCNs, Dutch policies have supported other measures, including the accreditation and recognition of prior learning (RPL). However, expert interviews show that it remains a challenge to commit education providers and employers actually to validate these learning experiences. We consider various implications for policy-making and theory from this research.