As someone at the starting end of the IBCLC credentialing process, I don't think that a harder exam or a college program are the answer. As a non- clinical PhD, I would not be interested in much more formal schooling, and I think I have the skills to pass an exam no matter how much more difficult it was (not boasting, just a good test-taker). However, what I would like to see is someone else vouching that I have the necessary skills. It does bother me that I can take a 40 hour class, do private work as a CLC or maybe volunteer at the hospital or do my WIC work or whatever it takes to get my hours, and nobody will ever have to watch me working directly with a breastfeeding dyad for me to get my IBCLC. I liked the idea of Pathway F, and I think it's been a good step in the right direction. If someone has excellent knowledge and skills, are 2000 hours really necessary? Or, if someone needs a lot of work, maybe 500 isn't it enough. These are hard questions. But I think the component of being observed by someone is essential - and observed multiple times on a wide variety of skills. Just like medical residency, or nursing clinical competencies, or any other profession where there is direct patient contact. I do hope that IBLCE is giving more thought to emphasizing new pathways that require checking competencies. Now - who does the checking? Will there need to be a IBCLC-Training certification given? Will it just need to be someone who has recertified? Will they receive any compensation? (the advantage of an institutional program is that your instructors do get paid...) For now, maybe the Pathway F mentorship model is the best answer - because I do believe (as was posted) that "over- schooling" the education misses out on the value of the apprenticeship process - and agree about medically educated midwives. How do we combine the necessary medical knowledge and training with that "feel" for the work that only comes with time and experience??? I like this discussion - and look forward to hearing more. (Even if I do confess that I like hearing Bette Midler's advice to Britney Spears too...) I know that IBCLE is working on this issue - maybe someone from that organization could enlighten us on the alternatives being discussed? Kirsten Berggren www.workandpump.com Vermont Breastfeeding Promotions Coordinator, WIC Program Faculty, UVM School of Nursing Taking the Healthy Children CLC course in October Jack of All Trades, Master of None *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html