Between 1997 and 2003, the LCR quality guidelines are widely implemented, but implementation can still be improved. To further improve the quality of travel clinic staff, the LCR recently started certification of basic and refresher courses for physicians and nurses working in travel medicine and now registers those completing such courses.

Opening a register for travel health professionals has led to a large increase of professionals who follow courses and register as travel health professionals. A positive association was found between the quality of the questions and the registration of the responsible physician. The quality of travel health advice given in general practices needs increased attention.

Most Dutch travel health nurses aspire to prescribe and feel competent for the supplementary approach, but require further education before the approach is implemented in travel medicine.