Your discussions regarding people who take the extended training, return to their jobs & work as LCs without sitting the exam, led me to the following speculation: 1) How many of these people are already RNs and were sent by their employers, with the course paid by their employers? 2) How many paid for the course themselves to earn promotion / added / changed duties upon their return? 3) Now that they are working as LCs and using their training as long as they and their employers wish them to, I am thinking that THEY may see no additional benefit from paying $350 & studying for several months to get certification from another organization, and then have to continually earn CERPs to maintain it. This can only be resolved by Time & Marketing of ideas, relating it to DRs & RNs & others who go to school, earn the diploma, but still have to sit the Boards to be able to work. Some day, Board certification for LCs will hold the same value and be required for private practice credibility, or a minimum qualification for employment. It's just my opinion. Am I on track or completely off on a side road? Phyllis Adamson, BA, IBCLC Phoenix, AZ