ASHA specifies that specialty training in professional areas, such as FEES, MBSimp, Lee Silverman, and McNeil Dysphagia Training Program, is “certificate program” training, and not to be confused with “professional certification,” i.e. Certificate of Clinical Certification (CCC). A certificate is awarded “certifying” training for the specialty area has been satisfactorily completed, and usually for a specified number of hours and continuing education credits. It usually is signed by the training providers. This specialty credential is not a certificate of attendance, is not a renewable credential, and is not sanctioned or governed by any certifying organization, such as ASHA, DRS, or state authority. Proof of specialty training credentialing may be required by some state licensing boards or by employers. Some state licensing boards require proof of formal training in addition to proof of supervised endoscopy training before approving an SLP to perform endoscopy, flexible or rigid.