Just a note...in New York state, pediatric nurse practitioners are required to re-certify every 2-3 years. It is a lengthy test (part of it open book!)...but they study a great deal in preparation. My family physician told me that he has to re-take his boards every 7 yeARS. Our standards are consistent with others well respected groups. ..................................... Anne Andrianos, MSN, IBCLC 4340 Young Road, Syracuse, NY 13215 (315) 492-6437 [log in to unmask]