Barbara says << Require that candidates document a
 specific number of hours acquired in counseling, anatomy and physiology,
 oral-motor function and dysfunction, drugs and bfeeding, latch-on technique,
 clinical issues, etc.   >>
This seems very sensible to me.  Perhaps the CE component could be expanded,
i.e. require more CE hours, so much in each area.  The counseling hours could
be under the tutelage of an IBCLC or (if none available in the area) another
approved mentor.  Or require more CE for that person.  Perhaps IBLCE could
have regional "asst directors" who would approve such things.
The way I became IBCLC: I was a 79 BSN nurse, many yrs in NICU and certified
by AWHONN. I was a BF counselor in NICU.  Then I went to grad school,
Parent-Child Health Nursing.  Our program allowed you to set up your own
clinical site as long as your "preceptor" was a master's prepared RN.  I
worked at 2 sites, under MN/IBCLC mentors.   I graduated MN in 91 and sat the
exam in 92.  Of course I attended as much CE as I could and read everything I
could.
Laurie Wheeler, Rnc, Mn, Ibclc