I have taken nursing boards in Canada, US, ICEA exam for certification as a
childbirth educator, IBLCE and graduated from an associates degree and
bachelors program in nursing.  Nursing grads could not pass the IBLCE exam
unless they met the criteria to sit it.  Therefore its my opinion that the
value in taking the exam is in "the journey".  Today, I tell others that
just sitting the exam signify's the greatest achievement has already
occured, that of taking time and effort to learn and grow (so even if you
fail the exam, you still have succeeded!).  Commitment to continuing
education also is very significant. Not everyone should be compelled to sit
the IBLCE.  Each individual must follow his or her own path.  Taking the
exam was a personal challenge and forced me to study what I knew from hands
on, expanding that base of knowledge.  Paying the fee for the exam is
certainly a motivator.  Of all the exams I have taken the IBLCE was the
hardest and the most practical.   So, I strongly disagree with those who
say, "Make it harder".  What are you trying to do?  Eat your young?  Will it
advance the profession?  Will it lead to reimbursement?  NO.  We need as
many LC's and breastfeeding counselors as we can get in order to achieve
baby friendly.  After certification, the learning is really just beginning
(and never ends - that's the beauty of it).  The test has many questions
related to not only lactation but human relations- high tech and high touch!
Its definitely not entry into practice for sure, but in getting certified I
felt more personally assured  of practicing on par with peers.  As always
there are many roads and many journeys.  Whichever path you choose, "may the
road rise up to meet you and the wind be always at your back !"