Karin, and anyone sitting for the exam,
 
I feel your pain. A written exam, multiple choice yet, on a set of  
behaviors and a relationship like breastfeeding, simply has untold limitations.  I 
have voiced my concerns for years on this. An exam on the science of 
lactation  is one thing, but breastfeeding is something so much more intuitive, 
complex,  interrelated and organic. When I sat for my Physical Therapy boards, 
there was a  written component and a practical component, on its own day, 
which involved  working through 2-3 different scenarios in front of a panel of 
several  experienced therapists. There was interaction and if this/then 
that kind of  stuff, which I think is SO key to how we help mothers and babies 
when they are  struggling. This must be completely impractical for an 
international exam (  my boards were statewide). I've taken the test twice now ( 
having been  IBCLC coming up on 13 years) and I do think the exam has been 
improved in  several ways, but it will always fail to measure a lot of what 
the most  compassionate and knowledgeable helpers know and do. I felt like I 
had learned  so much in the 10 years between sitting it the first and second 
times, and my  score was only slightly higher the second time. I will leave 
you with two ideas:  1. pass, just pass. If you have worked with moms and 
babies, and are  studying/reading/keeping up with things you should do fine, 
and that is all that  needs to be done for an exam like this. Your compassion 
will not be measured,  nor will your true ability to do the needed if 
this/then that and the give and  take that happens when we work with moms and 
babies in crisis. As long as  you have those things anyway, you will be a great 
help to families and that is  what we need: professional competence and 
human interrelational caring.  Some people who do not have them will pass the 
test, and that is sad, but true.  Sometimes I know I gave the answer I knew 
the test wanted, knowing I would not  do that in real life. 2. You are not 
alone in your frustration! I know I will be  thinking about all the caring, 
nervous/anxious/even  angry people ( from  having to deal with this kind of 
exam...:) on Monday and I bet others will be  too. May all of you who care so 
much and work so hard be able to do what the  exam needs to get out there 
and follow this calling. 
One small caveat: bring socks and a sweater...:) I wore sandals and my feet 
 were freezing! 
 
Peace,
Judy  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA  

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA


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