Even though I mostly lurk ( because I don't particularly like to write and barely have enough time to read lactnet) I just had to add a few fractured thoughts to this thread. Although nursing has certain requirements to graduate from school you than have to pass the RN boards. Most hospitals have a preceptor program for new grads usually from 4 weeks to six months. I can tell you from personal experience that even after your preceptor program, most new grads are not anywhere close to being able to perform to the competency that I can now with 13+ years experience as an RN. I think it takes 1-2 years in any one specialty to be fairly competent. There are things that I may just know by instinct that take new nurses years to know. I believe it is the same with LC's. But you have to start somewhere. I think the problem with LC's is somewhere along those lines. Even with the hours we obtain for IBCLC status most of the hours are not supervised by another IBCLC. Being an RN with 9+ years Newborn, special care nursery and OB experience it is not to difficult to build up the hours needed to sit for the exam but as Jan Barger discussed, it is not well rounded. The experience I have gotten after the neonatal period has been mostly personal and dealing with friends who have called me for advice. Luckily for me and those I council I am an avid reader and read anything I can get my hands on about Lactation. I especially enjoy reading Lactnet for the vast amount of knowledge and opinions I am exposed to. It would be nice to get more well rounded experience but where I live there are only a handful of IBCLC's around who I didn't even know or hear of until I became an IBCLC. Possibly more formal hands on programs would help. The other problem then at this time would be that those type of programs would be costly to set up at this time because at least in my area (central NJ), there aren't many jobs for LC's. Even in private practice in this area, many people are not yet willing to pay. Maybe it will be better if we can get 3rd party reimbursement. I guess I don't have an answer, but I just wanted to put in my $.02. Have a Happy Healthy and Prosperous New Year! Caren