Abstract The Belgian medical profession clearly suffered from a lack of internal coherence in the nineteenth century. The interests and objectives of, for example, the Royal Academy of Medicine, the provincial medical boards and the Fédération Médicale Beige, were by no means homogeneous. And even within the Federation itself, there tended to be a split on every question of tactics. In this article, two general trends will be described: the legal unification of the profession and its institutional development. In the third section, attention will be focused on the impact of the professional associations on medical education and on the control of medical practice. Each section begins with a survey of the state of the Belgian medical profession prior to the Belgian independence in 1830. Finally, some concluding comments are given.