I don't know if it helps for you all to know this, but the "slide" part of the exam is no longer slides, but photos in a printed booklet. This gets around the notorious lighting variability, and also allows candidates to go back and look at things again. As someone who has participated in editing the exam, I can assure candidates that great care is taken to try to find photographs of situations one will really be dealing with in clinical practice. Care is also taken to chose clear, easy to see photos. The photo bank started out small when the test was new, and is growing thanks to people's willingness to contribute their clinical slides to IBLCE for use on the exam. The visual quality is much better, the format is more workable, and the IBLCE feels that the expanded photo section gives greater validity to the test because it requires more real world knowledge. Just a personal comment. I can't recall who said it, but I agree with the person who remarked that a "consultant" is by definition an expert by virtue of both education and experience. Perhaps we need to consider different terminology for those who are just entering the field by passing an entry level exam. I know that as I emerged from a volunteer background and began practice as a newcomer in a new field, I was scared all the time. I was constantly seeing things I'd only (maybe) read about it books. It humbled me to think people were paying me when it was clear to me my training was incomplete. I had to think real hard about every suggestion, and I made hours worth of free phone follow-ups (and often free subsequent visits) following my clients to assess their outcomes. This was so that if I was making stupid suggestions which didn't work I could change strategies. No one calls or pays a consultant to straighten out a problem for which free and effective help is readily available thru NMAA or LLL or a book. We see the really complicated cases (train wrecks) and usually there are three or four things going wrong simultaneously. I say, again, we need to have a university pathway to train LCs as other health care professionals are trained. This does not negate the value of "putting more troops on the ground" in terms of peer counselors, more volunteers in the mother-to-mother groups, or giving "lactation initiator" credentials to entry level people who function as RNs or RDs etc. But for the person who is going into a clinical practice situation, there still needs to be more in the way of both didatic and clinical practice education. I'd be interested in people's comments on the idea of a two-tier system of credentialing. Barbara Barbara Wilson-Clay, BS, IBCLC Private Practice, Austin, Texas Owner, Lactnews On-Line Conference Page http://moontower.com/bwc/lactnews.html