The purposes of this research were to examine medical education accreditation practices around the world, with special focus on the Caribbean, and to explore the association between medical school accreditation and graduates' examination performance. In addition to other requirements, graduates of international medical schools seeking to enter postgraduate training positions in the USA must pass the United States Medical Licensing Examination Step 2 Clinical Skills. First-attempt pass rates were calculated for all graduates of international medical schools (approximately 58,000) who took the examination from 2006 to 2010. After controlling for personal variables, better examination performance, on average, was achieved by individuals who attended an accredited institution. Because substantial resources are needed to successfully implement oversight processes, these results provide some positive evidence that accreditation of educational programmes is associated with the production of more highly skilled physicians.