I thought I might share my personal experience to add to this discussion.
 I've been a LLL Leader since 1977.  When I first started to think about
becoming IBCLC, I asked an IBCLC of eight years to allow me to shadow her.
 My shadowing quickly turned into my being her assistance and paperwork
administrator.  She paid me for my administrative work only.  I worked in a
capacity of her apprentice (or intern) for eighteen months before taking the
IBCLC exam.  During the internship, I observed her work with clients as well
as my working with clients while she observed me.  I gained valuable hands on
experience from my expert mentor.  She tells me that I already had the skills
to be a LC  that she just taught me to touch breast. But, the truth is she
has taught this long time, seasoned LLL Leader a lot.  Now, I'm her partner
and I'm still learning from her and the mother/baby dyads we see.

I don't feel it would be advantageous to have a separate exam for LC students
or intern. Instead, I would be inclined to support having an additional
supplementary pathway where those working on contact hours would be given
extra hours if they do so many hours under the internship of an experience
IBCLC.  I realize that this would not be beneficial for those living in areas
where there are no IBCLC, but it would be a helpful pathway for some and I
believe a beneficial one to the individual and the profession.

I like the suggestion of having specific areas of "practice hours"  to
provide a greater scope of experience with emphasis on clinical (hands on
experience).  Years of telephone counseling help to build counseling and
listening skill and can give great opportunity to gain breastfeeding
knowledge. But, actually working with the  mother/baby dyad when you can see
and  touch them affords the best opportunity to learn the necessary skills of
a LC.

I'm thankful for the knowledge and experience I gained from my mentor.
 (Thanks Debby!)

Warmly,
Pat Lindsey, IBCLC
Chuluota, FL