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A Candidate’s Handbook for
Understanding Certification Examinations
in Ontario
2023
Released 1/01/2023
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A Candidate’s Handbook for Understanding Certification
Examinations in Ontario
2023
This handbook includes the policies and procedures for the Massage Therapy Certification
Examinations in Ontario. Although accurate at the time of publication, subsequent changes may
take place without prior notice. The College and Prometric will attempt to advise candidates of
important changes but reserve the right to make any changes necessary at any time without
advance notice.
Please visit the Prometric website www.prometric.com for the most current version of A
Candidate’s Handbook for Understanding Certification Examinations in Ontario and for new or
revised policies.
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Table of Contents
Table of Contents ................................................................................................... 3
1 General Information and Legislation ............................................................... 5
1.1 The College of Massage Therapists of Ontario .............................................................5
1.2 Registration with the College .......................................................................................5
1.3 Examination Regulation ...............................................................................................6
2 The role of Prometric ...................................................................................... 7
3 Eligibility for the Certification Examinations .................................................... 7
3.1 Education Requirement ................................................................................................7
3.2 Language Fluency Requirement ...................................................................................7
4 Communicating with Prometric....................................................................... 7
5 Privacy Policy .................................................................................................. 8
6 Confidentiality and Security of Examination Materials .................................... 8
7 Rules of Conduct ............................................................................................. 9
8 Protocol in the Event of Suspected Cheating ................................................. 10
9 Occurrence Reports ...................................................................................... 11
10 Inappropriate Touch of a Client by a Candidate during the Objectively
Structured Clinical Evaluation (OSCE) ................................................................... 12
11 Prohibited Items / Articles............................................................................. 14
12 Examination Content and Item Development ............................................... 15
12.1 Objectively Structured Clinical Evaluation (OSCE) ................................................... 15
12.2 Multiple Choice Question (MCQ) Examination ......................................................... 18
12.2.1 Conflicts of Interest .................................................................................. 19
12.2.2 In the Stations .......................................................................................... 20
12.2.3 Timing of the OSCE ................................................................................. 20
12.2.4 Standardized Clients ................................................................................ 20
12.2.5 Examiners ................................................................................................ 20
12.2.6 OSCE Stems ........................................................................................... 21
12.2.7 Props ....................................................................................................... 21
13 Certification Examination Scheduling ............................................................ 23
13.1 Table 1: Certification Examination Fees .................................................................... 23
13.1 OSCE Dates and Scheduling .......................................................................................... 24
13.1.1 Official Graduation List............................................................................. 24
13.1.2 OSCE Examination Schedule .................................................................. 24
13.1.3 OSCE and MCQ Scheduling Policies ...................................................... 24
13.2 OSCE Scheduling Considerations .............................................................................. 25
13.3 OSCE Examination Scheduling Availability .............................................................. 26
13.4 MCQ Examination Scheduling .................................................................................. 26
14 Certification Examination Application Process .............................................. 27
14.1 How to Create an Examination Application ............................................................... 27
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14.2 How to Schedule the MCQ and OSCE Exams ........................................................... 28
15 Withdrawing and Rescheduling from Scheduled Exam Sessions ................... 33
15.1 Withdrawal/Rescheduling .......................................................................................... 33
15.2 MCQ and OSCE Withdrawal and Rescheduling Process ............................................ 33
15.2.1 MCQ and OSCE Withdrawal and Rescheduling Process ........................ 33
16 Examination Sites .......................................................................................... 35
16.1 OSCE Site: ................................................................................................................ 35
16.2 MCQ Sites: ................................................................................................................ 35
17 Identification and Name Requirements ......................................................... 35
17.1 Name Changes ........................................................................................................... 36
18 Certification Examination Scoring ................................................................. 37
19 Examination Results ...................................................................................... 38
19.1 OSCE ........................................................................................................................ 38
19.2 MCQ ......................................................................................................................... 39
20 Accommodation Policy and Process .............................................................. 39
20.1 Requests for Accommodation .................................................................................... 39
20.2 Exceptions ................................................................................................................. 41
21 Certification Examination Review Request Policy .......................................... 41
22 CMTO’s Certification Examination Content Outlines ..................................... 43
23 Appendix A: Health History Form .................................................................. 44
24 Appendix B: Written Consent Form ............................................................... 45
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1 General Information and Legislation
1.1 The College of Massage Therapists of Ontario
The College of Massage Therapists of Ontario (CMTO or the College) is dedicated to protecting
the public, guiding its registrants, and promoting the safe and ethical practice of Massage
Therapy. The College, one of this province's health regulatory bodies, exists to protect the
public interest and to regulate the profession of Massage Therapy.
As part of its responsibility to the public, the College sets minimum entry-to-practice
requirement and promotes continuous improvement of Massage Therapists’ knowledge, skills,
and abilities through the Quality Assurance Program.
The College also promotes research and development of expertise in the Massage Therapy
profession.
Candidates are expected to read, understand, and comply with all requirements of the
Regulated Health Professions Act, 1991, Massage Therapy Act, 1991 and its Regulations, as well
as the Standards of Practice, Code of Ethics, policies, by-Laws, and guidelines of the College.
For more information, please visit the CMTO website.
1.2 Registration with the College
There are several requirements that must be met to become registered with the College. These
include successfully completing an appropriate Massage Therapy education program and
successful completion of the CMTO Certification Examinations. This guide focuses on the
Certification Examinations. More information about the full registration process is available on
the College website.
There are two examinations that must be successfully completed for registration: the
Objectively Structured Clinical Evaluation (OSCE) and the Multiple-Choice Question (MCQ)
examination.
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1.3 Examination Regulation
The Examination Regulation under the Massage Therapy Act, 1991
1. In setting the examinations to be taken by applicants to the College for registration,
the College shall specify the general areas of competency to be examined and shall ensure that
the examinations provide a reliable and valid measure of a candidate’s competency in
knowledge, skills and ability for the practice of massage therapy in Ontario.
2. Written and practical examinations shall be offered at least twice yearly and at such
other times as the Council considers necessary.
3. (1) Subject to subsection (2), a candidate who fails the examinations may apply for re-
examination.
(2) In every case where a candidate has failed the examinations three times after
obtaining a diploma from a massage therapy program acceptable to the Registration
Committee, the candidate is not eligible to apply to take the examinations again without
obtaining another diploma from a massage therapy program acceptable to the Registration
Committee.
4. Ontario Regulation 712/93 (Examinations) made under the Act continues to apply
to a person who had, before the revocation of that regulation, applied to take the examinations
for the purpose of applying to the College for registration.
Please note that section 4 of regulation means that Candidates who paid for their first
attempt at the registration examination prior to Aug. 26, 2004 are subject to the revoked
regulation (Ontario Regulation 712/93) which provided as follows:
(3) A candidate who fails the examinations may apply for re-examination twice. A
candidate who fails a third attempt of the examinations must submit, to the Registration
Committee, proof of remediation and upgrading in accordance with policy guidelines issued by
the College before the candidate may retake the examinations. A candidate who fails the
examinations may retake them not more than two years after the failure, but if the candidate
presents to the Registration Committee proof of remediation and upgrading in accordance with
policy guidelines issued by the College, he or she may retake the examination more than two
years after the failure.
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2 The role of Prometric
CMTO has entered into an agreement with Prometric LLC (Prometric) to develop and
administer both the OSCE and MCQ examinations. CMTO must approve the examination
content outlines on an annual basis and will receive examination results directly from Prometric
only after a candidate has successfully completed both exams. CMTO works collaboratively with
Prometric to ensure the examinations are developed and delivered in valid, objective, and
reliable way, and all policies and processes related to the examinations are transparent,
objective and fair.
3 Eligibility for the Certification Examinations
3.1 Education Requirement
An examination candidate educated in Ontario must have obtained a diploma in Massage
Therapy from a program recognized by the Ontario Ministry of Colleges and Universities. These
programs may be offered at a Private Career College or a College of Applied Arts and
Technology in Ontario.
Candidates educated outside of Ontario and internationally should contact CMTO for more
information.
If the required education was completed more than three years prior to the date of the
examination, the candidate must have successfully completed a CMTO Refresher Course no
more than 15 months prior to the exam date. Candidates should contact CMTO at
registrati[email protected] for more information if they need to complete a Refresher
Course.
3.2 Language Fluency Requirement
Candidates must meet the requirements outlined in CMTO’s Language Fluency Policy to
participate in the Certification Examinations. CMTO’s Language Fluency Policy is available on
CMTO’s website.
4 Communicating with Prometric
Prometric encourages candidates to seek information relating to the Certification Examinations
in A Candidate’s Handbook for Understanding Certification Examinations in Ontario (this
document). This is required reading for all candidates who participate in the Certification
Examinations. As an examination participant, we encourage you to be aware of the policies,
processes and procedures outlined in the Handbook that apply to you as you proceed through
the Certification Examination process. Prometric welcomes inquiries from candidates seeking
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clarification of an examination or registration process. Answers to specific questions on the
examination process can be found on Prometric’s CMTO webpage, and specific questions on
the examination registration process should be sent to SMT-Ope[email protected].
To protect your privacy, e-mail inquiries must originate from the e-mail account that your
Massage Therapy education program or CMTO has provided to Prometric. Response times can
vary depending on the nature of the inquiry and the volumes managed at the time but are
generally replied to within one to three business days. Please include your e-mail address in
your correspondence or voicemail message.
Prometric usually communicates with applicants by e-mail, including but limited to:
• Informing applicants when the examination application process is available;
• Examination application queries;
• Confirming receipt of an examination application;
• Communicating about application acceptance or deficiencies (outstanding information);
• Confirming examination registration;
• Providing notification of examination scores;
• Providing notification of Certification Examination process changes;
• Informing applicants of an examination Occurrence Report.
Candidates are expected to conduct themselves at a professional level and directly manage
scheduling of their OSCE and MCQ exams.
To respect your privacy and to ensure that you receive clear and accurate information,
Prometric communicates directly with you, the applicant, unless Prometric receives written
consent from you to communicate with another party.
5 Privacy Policy
Personal information collected about you is used only by Prometric for the purposes of
administering CMTO’s Certification Examinations. All information collected by Prometric may
be shared with CMTO for the College’s regulatory purposes. To review the privacy code, please
see the Prometric website for further information.
6 Confidentiality and Security of Examination Materials
The security measures for the Certification Examinations are aimed at eliminating unfair
advantages among candidates and ensuring the examinations continue to provide a valid,
objective, and reliable assessment of competency. Security measures also help avoid the high
human and financial costs of replacing examination materials should security be breached.
Prometric endeavors to maintain the strictest security of the examination content at all times.
All examination materials are protected by copyright.
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Prometric has security measures in place to protect examination materials during all phases of
development and administration including during the development and review of examination
materials; during reproduction, transportation, and disposal of examination materials; and
during the presentation of examination material on examination days. If you have any
questions about the security processes, please visit the Prometric security webpage:
Commitment to Security.
7 Rules of Conduct
Each candidate who attempts a Certification Examination, by his or her act of participating in
the examination(s), agrees to the following Rules of Conduct.
• Candidates acknowledge that the Massage Therapy Certification Examinations and
the items therein are the sole property of the College of Massage Therapists of
Ontario (the College) and/or Prometric.
• Candidates acknowledge that they cannot remove or attempt to remove from the
test site, copy or discuss with anyone any part of the examination nor can they give
or receive assistance during the examination.
• Candidates acknowledge that their behavior before, during and after the
examinations must be such that it does not disturb other candidates or cause them
anxiety. This includes inappropriately challenging examination policies and
procedures, disruptive comments about the examination, or any other behavior that
in the opinion of the examination site staff could disrupt the examination process or
disturb other candidates.
• Candidates acknowledge that their participation in any act of cheating, as described
below, may be sufficient cause for the Prometric to terminate their participation in
the examinations, invalidate the results of their examinations or take any other
action deemed appropriate by Prometric, including refusal of future registration
applications.
• Cheating refers to any act or omission by a candidate that could affect the result of
that candidate, another candidate, or a potential future candidate. Cheating
includes, but is not limited to the following acts:
• Having a non-registered individual pose as a registered candidate;
• Bringing any outside material into the examination;
• Giving or receiving assistance to or from anyone, including other
candidates, during the examinations;
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• Removing, copying, photographing, or recording any examination
material, including memorizing questions or scenarios, or attempting to
do the same at any time;
• Providing or receiving information verbally, electronically, or physically
about the MCQ or OSCE examinations either before or after the
examination. (e.g., information about questions such as assessment,
tasks or activities requested during the exam.) Note: this includes
discussing station information or examination question content with
other candidates, educational instructors or future registration
candidates before or after the examination;
• Possessing any electronic devices, even if they are not in use.
Each candidate will be asked the following attestations when registering for the certification exams:
• I understand that I cannot remove or attempt to remove any part of the
examination from the test site. This includes copying, memorizing, or recording any
part of the examination.
• I understand and acknowledge that my participation in any act of cheating as
described in the Candidate’s Handbook for Understanding Certificates Examinations
in Ontario, may result in one or more of the following:
• Having my exam stopped and being asked to leave the exam location
• Invalidation of the results of my exam
• Refusal of a future application for the examinations
• Refusal of a future application for registration as an RMT
• Any other action deemed appropriate by Prometric and/or CMTO.
If a candidate requires an exception to any of the Rules of Conduct as an accommodation of a
disability, the candidate must request the accommodation when completing the application.
See Section 20 (Accommodations Policy and Process).
8 Protocol in the Event of Suspected Cheating
1. If, during an examination, the examination staff suspect a candidate of
participating in any form of cheating, they may confiscate a candidate’s test
materials, as well as any other document, object or materials that could be used
for cheating, and require the candidate or other persons to leave the test site.
Prometric reserves the right to use electronic monitoring and surveillance
technologies during examination administrations to detect and document
cheating. In addition to on-site monitoring, additional analyses of candidate data
may be performed at any time if cheating is suspected.
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2. Examination staff may identify possible cheating at any time before, during
and/or after the examination, including any time after examination results have
been released. Prometric conducts periodic psychometric/ statistical analyses of
all testing data and scores, which are instrumental in identifying instances of
cheating.
3. The examination staff will report any suspected cheating to the Registrar of the
College.
4. Prometric shall conduct appropriate investigations of the alleged
cheating/security breach. The candidate will be given 30 days to respond in
writing to the allegations of cheating.
5. If Prometric determines that cheating did not occur, the candidate’s score shall
be released if the candidate completed the examination, or the candidate shall
be permitted to sit the next available examination without charge.
6. If the Prometric determines that cheating did occur, Prometric will work with the
Registrar of the College to determine next steps. These may include one or
more of the following as appropriate to the circumstances:
• deem the candidate to have failed the examination;
• deny any parties involved in the security breach from future access to
the examinations;
• take special measures at the candidate’s expense at any repeat
examination to prevent the reoccurrence of cheating;
• report findings to the Registration Committee;
• prosecute or sue the candidate in court;
• investigate the security breach, and widen the inquiry to any others
who may have been involved including other candidates, educators or
registrants;
• seek damages from any and all persons found to have participated in
the security breach, including the costs of investigating the incident
and the costs of generating new examination materials;
• take other action appropriate in the circumstances.
9 Occurrence Reports
If a Prometric staff member observes an event involving you that takes place during the
performance of your OSCE or MCQ examination, it will be documented by that person using an
Occurrence Report. Events that would result in an Occurrence Report could include, but are not
limited to:
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• Computer/technical issue/concern;
• Standardization concerns (including issues with the examination environment);
• Communication concern;
• Unprofessional or troubling conduct/behavior;
• Suspected act of cheating;
• Client safety concern (OSCE only); and/or
• Other.
If a Prometric staff member witnesses an event involving you, an Occurrence Report will be
created. You will be provided with information about the content of the report immediately
following the issuance of your examination score report. Depending on the nature of the event
described in the Occurrence Report, you may also be contacted by Prometric to discuss the
matter or given an opportunity to make submissions about the matter. All Occurrence Reports
will be shared with CMTO, may be considered as part of your Application for Initial Registration,
and will also form part of your registration file with the College.
10 Inappropriate Touch of a Client by a Candidate during the Objectively
Structured Clinical Evaluation (OSCE)
It is imperative that the Objectively Structured Clinical Evaluation (OSCE) examination
environment is respectful and safe for all participants. Providing a standardized experience for
all candidates is extremely important and helps ensure the validity and reliability of this high-
stakes examination. However, standardization must never take precedence over an individual’s
safety and security. If a candidate inappropriately touches a standardized client, the
standardized client’s safety is of paramount concern.
Standardized clients and examiners share the responsibility of reporting inappropriate touch.
Inappropriate touch includes touch of the standardized client’s genitals or anus at any time for
any reason. It also includes touch of the breast or buttocks other than touch that is clinical in
nature appropriate to the OSCE.
Prometric has a detailed protocol, including scripted responses, to support standardized clients
and examiners with this responsibility. The protocol takes into consideration the possibility
that the standardized client may not be able to articulate what has happened and ensures that
the standardized client is being supported in the immediate aftermath of a reported incident.
If a standardized client or examiner believes they have observed a candidate touching a
standardized client inappropriately, the candidate’s examination may be stopped. Alternatively,
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anyone witnessing or experiencing inappropriate touch may bring it to the attention of
Prometric immediately after the examination using an Occurrence Report.
A review of the incident will take place, and everyone present when, or immediately after, the
incident took place will be asked to provide a written record of their observations.
Once the written documentation is received, it will be reviewed by Prometric. Prometric may
seek additional information. A copy of the documentation collected will be provided to the
candidate who will be entitled to make submissions about it to Prometric. After considering all
relevant documentation, Prometric may:
- Determine that no inappropriate touch occurred. In this case, Prometric will do one of
the following:
o If the incident resulted in the candidate’s OSCE being stopped before
completion, the OSCE will not be counted as one of their three permitted
attempts, their result on that examination will be disregarded and the fee for
their next attempt to complete the OSCE will be waived.
o If the candidate’s examination was not stopped before completion (i.e., the
incident was reported in Occurrence Reports submitted after the examination),
the OSCE will count as one of the candidate’s three permitted attempts and the
candidate will receive an official examination result notification.
- Determine that inappropriate touch occurred. In this case, Prometric may do one or
more of the following as it deems appropriate:
o If the incident resulted in the candidate’s OSCE being stopped before completion
▪ The OSCE will not be counted as one of the candidate’s three permitted
attempts and their result on that examination will be disregarded; the fee
for their next attempt to complete the OSCE will not be waived, or
▪ The OSCE will be counted as one of the candidate’s three permitted
attempts and the candidate will receive an official examination result
notification, or
▪ The OSCE will be counted as one of the candidate’s three permitted
attempts and the candidate is also deemed to have failed the
examination.
o If the candidate’s examination was not stopped before completion (i.e., the
incident was reported in Occurrence Reports submitted after the examination)
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▪ The OSCE will be counted as one of the candidate’s three permitted
attempts and the candidate will receive an official examination result
notification, or
▪ The OSCE will be counted as one of the candidate’s three permitted
attempts and the candidate is deemed to have failed the examination.
o Recommend to the College of Massage Therapists of Ontario (CMTO) that the
candidate be required to successfully complete remedial education approved by
the Registrar prior to being eligible to attempt another Certification Examination,
either OSCE or MCQ. The candidate will be unable to take the OSCE or MCQ
pending a decision from CMTO.
All documentation related to the matter will be shared with CMTO for consideration if/when
the candidate applies for registration and will be kept on file with CMTO as part of the
candidate’s record.
11 Prohibited Items / Articles
Possession and/or access to the following items are strictly prohibited and will NOT be
permitted past the security checkpoint:
• Wrist watches or any other type of time keeping device;
• Electronic devices of any kind including but not limited to cell phones, Blackberries,
Smartphones, iPhones, PDAs, wireless e-mail devices, iPods, MP3 players, pagers,
calculators, clocks, cameras, scanners, radios, recording devices, hand-held computers,
programmable watches, transmitters or receiving devices, microphones, etc.;
• Headphones, headsets, ear-phones, ear buds, or Blue Tooth capable devices;
• Notes, papers, books, exam review, or other study materials in any format or media
(including CDs);
• CDs, USB keys, DVDs or other electronic media;
• Newspapers, magazines, dictionaries, prayer books, or any other written material;
• Luggage, handbags, purses, backpacks, briefcases, tote bags, or bags of any kind;
• Pens, pencils, markers, or highlighters of any kind;
• Hats (religious apparel that does not contain a brim or obscure the applicant’s facial
features is permitted).
1
1
Please let Prometrics know immediately if your religious beliefs require face coverings in public so that arrangements can be made for
alternative means of maintaining examination security.
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12 Examination Content and Item Development
The Certification Examinations are based upon internationally recognized testing standards,
designed to ensure fairness, openness, and defensibility. The cornerstone of these standards is
the requirement that the Certification Examinations be job-related. The education and
experience requirements and the content of the examinations must reflect what competent
Massage Therapists in Ontario do on the job.
In addition, the internationally recognized testing standards employed at the examinations
ensure that each candidate is afforded an optimal, standardized testing experience. The
Certification Examinations undergo rigorous psychometric review that is supported by the input
of Subject Matter Experts (SME’s), a highly trained group of Massage Therapists practicing in
Ontario. Prometric ensures the development, administration, and review of the Certification
Examinations. CMTO's Exam 2023 Approved Reference List are used by SME’s for all
examination questions. A detailed review of exam Content Development Document is available
on Prometric’s website.
12.1 Objectively Structured Clinical Evaluation (OSCE)
The Objectively Structured Clinical Evaluation (OSCE) is the clinical component of the College’s
Certification Examinations. This exam is designed to evaluate the candidate’s knowledge and
application of skill. The OSCE tests candidates’ ability to safely and effectively apply the
principles and processes of Massage Therapy practice within the context of multiple clinical
scenarios in each of seven test stations. For information on what is assessed at the OSCE, please
refer to the 2023 OSCE Content Outline as well as CMTO’s Standards of Practice. The OSCE
consists of 7 test stations (detailed in Table 2: OSCE Stations & Descriptions).
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Table 2: OSCE Stations & Descriptions
Station
Title
Station Descriptions
Station 1
Therapeutic
Exercise
In this station, the candidate must demonstrate knowledge of five therapeutic exercises.
The list of exercises provided includes a combination of stretching, strengthening, and
range of motion techniques. The candidate will be instructed to use specific forms of
resistance such as an adjustable ankle weight, a dumbbell, a resistance band, or body
weight. There is also an exercise mat, a chair, and a massage table available in the room.
The client has already given informed consent, including written consent when
appropriate, so that the candidate can proceed with the required tasks.
Station 2
Client Health
History Interview
An accurate and up-to-date health history form that includes the client’s primary complaint
is provided to the candidate. The candidate is expected to interview the client to obtain
additional information regarding that complaint for the purpose of informing further
assessment and treatment planning. Other than the health history form, there is no
equipment provided or required for this station. Consent is not applicable so the candidate
can proceed with the interview. Please refer to Appendix A for a sample Health History
form.
Note: treatment tables are approximately 27-30 inches high (from floor
to treatment surface).
Station 3
Assessment 1
The candidate is expected to demonstrate their ability to perform specific assessment
techniques. A list of assessments is provided to the candidate that includes a combination
of required palpations, range of motion assessment, muscle strength/length tests, and
neurological and orthopedic tests. The candidate may perform these tasks in any order as
the tasks are not intended to form a cohesive massage therapy assessment. The candidate
will have access to equipment including a reflex hammer, cotton balls, and a pinwheel. The
client has already given informed consent, including written consent when appropriate, so
that the candidate can proceed with the required tasks.
Station 4
Assessment 2
In this station, the candidate is expected to conduct a thorough assessment of the client by
choosing and performing assessment techniques relevant to the health history and
assessment findings provided. The assessment should include a variety of special tests,
range of motion, and palpations to determine the cause of the client’s symptoms and
exclude other possible causes. The candidate should communicate their suspected clinical
impression to the client. The candidate will have access to equipment such as a reflex
hammer, cotton balls, and a pinwheel. The client has already given informed consent,
including written consent when appropriate, so that the candidate can proceed with the
required tasks.
Station 5
Initial treatment
and Consent
Selected findings from the client’s health history interview and assessment are provided to
the candidate. The candidate is expected to design an initial treatment considering those
findings, communicate that plan to the client, and obtain informed consent to proceed
with the treatment. When necessary, candidates are also expected to obtain written
consent for the inclusion of any relevant sensitive areas (a written consent form is available
for use). Other than the written consent form, there is no other equipment provided or
required. Please refer to Appendix B for a sample written consent form (modified for exam
purposes).
Station 6
Treatment
Selected findings from the client’s health history interview and assessment are provided to
the candidate. The candidate is expected to use this information to design and perform a
focused massage therapy treatment that addresses each of the presenting symptoms with
suitable techniques within the scope of practice for massage therapy. The candidate will
have access to equipment such as oil, lotion, and towels. The client will be ideally
positioned for the treatment, but the candidate may reposition the client if they choose.
The client has already given informed consent, including written consent when
appropriate, so that the candidate can proceed with the required tasks.
Station 7
Techniques
In this station, the candidate is expected to demonstrate their ability to perform a variety
of massage therapy techniques on specific anatomical structures/areas. A list of six
techniques is provided to the candidate. The candidate may perform these techniques in
any order as the techniques are not intended to form a cohesive massage therapy
treatment. The candidate will have access to equipment such as oil, lotion, and towels. The
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There are two examiners and one standardized client in each OSCE station. When the exam
candidate walks into the station, the standardized client is already in the best position to begin
the required tasks.
Why are there seven stations in the OSCE?
Seven stations are necessary to assess the candidate’s ability to safely and effectively obtain a
case history, conduct an assessment, outline a treatment plan, obtain informed consent,
perform a treatment, and assign therapeutic exercise and home care. The stations assess
candidates on required entry-level competencies. All these skills are required for safe and
effective practice as a Massage Therapist.
What is expected of a candidate at their OSCE?
At each OSCE station, the candidate will be provided with case scenario information in a
document called the ‘stem’. Every case scenario has a list of tasks to be completed. This
information is designed to help candidates with time management so that they can finish all
tasks within each particular station within the allotted time.
The instructions and relevant information on the OSCE stems are presented in a clear, concise,
and straightforward manner. It is important to note that even if a stem is asking for five tasks,
for example, this does not necessarily imply that there are only five criteria points (marks)
associated with that station. There may be multiple components/actions associated with one
specific task. This means that if a candidate does not fully perform all components of a required
task, they will not obtain all the possible criteria points.
To perform effectively in the OSCE stations and associated content areas, candidates are
expected to:
• Focus their approach and tailor their interaction to specifically address the presenting
clinical problem and/or required tasks indicated on each stem;
• Follow the Standards of Practice in their interactions with the client as they would in a
real clinical setting;
• Complete the required tasks within the time allotted;
• Carefully read the stem including the ‘IMPORTANT DETAILS’ in the last section of the
stem;
• Perform tasks in their entirety, such as performing all components of a special test or a
technique;
• Performing all tasks in compliance with all relevant Standards of Practice;
• Approach each station’s tasks in a step-by-step manner;
Station
Title
Station Descriptions
client has already given informed consent, including written consent when appropriate, so
that the candidate can proceed with the required tasks.
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• Accurately follow the instructions on each OSCE stem;
• Complete the tasks on the relevant structures;
• Complete the tasks correctly and accurately;
• Refer to the stem frequently in order to review or clarify the information that is
necessary to perform the tasks correctly and accurately.
In some OSCE stations, candidates are required to:
• Demonstrate a high level of critical thinking;
• Actively engage with the Standardized Client, inquiring about pain or other symptoms
that are/may be elicited;
• Think quickly on their feet to determine how to proceed based on the scenario and the
various responses they receive from the client (both solicited and unsolicited)
avoid simply memorizing the elements of the assessment or treatment process.
Treatment of sensitive areas at the OSCE
Treatment of sensitive areas is permitted in a Massage Therapist’s practice when in compliance
with CMTO’s Standard for Maintaining Professional Boundaries and Preventing Sexual Abuse.
Accordingly, CMTO may include the treatment of sensitive areas as a competency to be tested
during the OSCE. However, for the safety and comfort of OSCE Standardized Clients, candidates
will never be required to treat or undrape a Standardized Client’s breast tissue during the OSCE,
regardless of the gender of the Standardized Client.
CMTO’s Standard for Maintaining Professional Boundaries and Preventing Sexual Abuse
includes the breasts as a sensitive area, non-specific to gender. This means that, regardless of
the gender of the client, breasts should not be treated or undraped unless clinically indicated.
Also, a candidate seeking better access to a structure on the anterior chest wall is not
considered a clinical indication for undraping a client’s breasts, nipples or areolae.
12.2 Multiple Choice Question (MCQ) Examination
The MCQ is the multiple-choice question portion of the Certification Examinations. It is a
computer-based examination, which consists of 150 multiple-choice questions (MCQ)
administered over a three-hour period.
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The MCQ is designed to evaluate the candidate’s theoretical knowledge in various competency
areas. Competency area subtopics and the percentage of questions allocated to each
competency area are provided in the MCQ content outline. Test questions provide four options
where one option is correct, and three others are incorrect. For information on what is
assessed on the MCQ, please refer to CMTO’s 2023 MCQ Content Outline, as well as CMTO’s
Standards of Practice.
12.2.1 Conflicts of Interest
Candidates have an opportunity to declare a potential conflict of interest during the
examination registration period before the OSCE commences. Candidates are given an
opportunity to view a list and photograph of examination staff, which includes Examiners and
Standardized Clients. If a candidate believes that he/she will not receive a fair evaluation due to
a perceived conflict of interest, he/she can request that the examination staff replace the
affected individual(s) during the candidate’s examination.
Examination staff members are given a list of candidate names at the beginning of the
examination day and can request that they be replaced if they perceive a potential conflict of
interest with either evaluating a candidate or performing as a Standardized Client.
Candidates will have the ability to declare if they have been previously assessed by an examiner
and can request another examiner if they believe they will not receive an objective
assessment. Prometric will endeavour to replace the examiner; however, the accommodation
is subject to the availability of staff present on the exam day. If Prometric cannot replace the
examiner, the candidate has the option to postpone the examination and reschedule the
examination to the next available examination date at no cost. While Prometric will attempt to
accommodate candidates as much as possible to ensure that a rescheduled examination does
not include the same examiner, there is no guarantee that future OSCE dates will not include
the examiner.
Candidates must also be aware that postponing and rescheduling an examination may result in
education becoming out-of-date thus requiring completion of the CMTO Refresher Course, as
outlined in Ontario Registration Regulation 864/93 of the Massage Therapy Act, 1991. Should a
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candidate decide to postpone an OSCE examination, Prometric cannot guarantee availability of
exam dates within the same year.
12.2.2 In the Stations
At any time, the following individuals may be present in a station:
• The candidate;
• The standardized client;
• Two examiners;
• An observer monitoring the consistency of the scoring by the examiners and consistency
of performance by clients. Observers do not evaluate candidates.
12.2.3 Timing of the OSCE
Candidates have two minutes to read the OSCE stem and 10 minutes to perform the tasks
within each station. There will be three minutes of travel time between stations to
accommodate extra disinfecting within the OSCE stations.
Candidates will be notified through the entirety of their exam as to when the following
activities happen:
• Lift the cover page and read the Stem on the exterior station door.
• Enter the station.
• There are three minutes remaining in the station.
• Exit the station
12.2.4 Standardized Clients
The examination stations are staffed by standardized clients who will be in an appropriate state
of dress or undress depending on the station type. If you wish to introduce yourself to the
client, feel free to do so.
Standardized Clients are trained to communicate with candidates based on standardized
scripts. Scripts are activated in very specific circumstances based on the candidate’s approach
in the OSCE station.
During the OSCE, the candidate may elicit symptoms in the client, such as pain.
As in real-life Massage Therapy practice, candidates may choose to inquire further regarding
the symptoms to determine the origin of the client’s complaints.
12.2.5 Examiners
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Examiners are experienced Registered Massage Therapists who are trained to provide impartial
and fair evaluations. They are rigorously trained for specific stations and the associated item
checklists and objective marking criteria. Examiners assess each candidate according to the
predetermined checklist of criteria based on the Standards of Practice and other approved
references. Examiners do not know the identity of the candidates they evaluate and do not
know which Massage Therapy programs the candidates attended.
If the candidate’s activity will place or is placing the client at risk, the examiners will intervene
to protect the standardized client. Examiners will not respond to questions about the scenario
or provide performance feedback. Examiners will not stop candidates during a station who are
doing something other than what was instructed unless the client is at risk.
12.2.6 OSCE Stems
The stem is the instruction sheet that describes the case-specific information, required tasks
and other important details for each station. There are two identical copies of the stem posted
at each station: one is attached to the outside of the station door; the other is attached to the
inside of the door for easy reference while inside the station.
Candidates should carefully read the stem to ensure that they are doing exactly what is
expected of them in each station. The stem has important information about the scenario and
details that will help guide candidates through the required tasks. The stem will clearly state
whether or not informed consent has been obtained. The last section of the stem, “IMPORTANT
DETAILS,” provides information that will help candidates to make the most of their limited time
in each station. There are no tricks in the exam and all necessary information is provided to
candidates both inside and outside the room.
12.2.7 Props
All items necessary in each station will be accessible to candidates.
There will be massage tables in all stations where a table is needed. Massage tables are set to
one height and cannot be adjusted. Candidates are expected to make the modifications
necessary to permit them to adapt to that height. In general, the height of the massage tables
in the OSCE stations can range from approximately 24 to 28 inches. This height is not
guaranteed, variances may occur.
There is hand sanitizer in every station. You are expected to use the hand sanitizer before and
after interacting with each standardized client. There is no access to running water and soap
(i.e., sink) between stations.
Prometric supports a scent-free environment, so candidates should not wear any scented
products.
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13 Certification Examination Scheduling
13.1 Table 1: Certification Examination Fees
Activity
Fee
Objectively Structured Clinical Evaluation (OSCE)
(per attempt)
$865.00
Multiple-Choice Examination (MCQ)
(per attempt)
$615.00
First OSCE Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules one day after the OSCE application deadline and up until and including 14 days
before the examination date.
$200.00
Second OSCE Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules less than 14 days before the examination date.
$865.00 (entire exam fee)
First MCQ Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules one day after the MCQ application deadline and up until and including 7 days
before the examination date.
$150.00
Second MCQ Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules less than 7 days before the examination date.
$615.00 (entire exam fee)
IMPORTANT NOTES
• Prometric understands the commitment candidates make to achieve this Certification
and the stress added fees can cause. Prometric is committed to freezing all fees
through December 2024. If a fee increase is required after 2024, candidates will be
notified no less than six months prior to any fee increase.
• The First or Second Examination Late Withdrawal/Rescheduling Fees (shown in Table 1)
may apply in the following instances:
• A withdrawal request received by Prometric after one of the
withdrawal/rescheduling deadlines;
• A rescheduling request received by Prometric after one of the
withdrawal/rescheduling deadlines;
• Not possessing valid, government-issued photo identification showing the
candidate’s name identically to how the candidate’s name appears on the
examination roster;
• Late arrival after the examination session commences;
• Failure to attend a scheduled examination.
• Withdrawal fee may be waived in extenuating circumstances such as a medical
emergency. Supporting documentation must be provided. Please submit all supporting
documentation to SMT-OperationsTeam@prometric.com. Email must include your user ID,
exam date, and supporting documentation.
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13.1 OSCE Dates and Scheduling
The following sections detail OSCE dates, application deadlines and policies. For information on
OSCE fees, please see Table 1 above.
13.1.1 Official Graduation List
To begin the process to apply to take the Certification Examinations, your Massage Therapy
education program must upload the graduation list with your name to the Prometric website.
Once your education has been uploaded to the Prometric website, you will receive an email
with instructions on how to log in and complete the Certification Examination application.
Once you successfully complete and submit your application, you will receive an email with
instructions to schedule your MCQ and OCSE exams.
13.1.2 OSCE Examination Schedule
The OSCE schedule commences in the spring of each calendar year. In 2023, the first OSCE
exam date will be May 2
nd
and the last available OSCE date will be early December.
OSCE dates will be added in six-week increments starting in spring of each year. As the open
dates fill, additional dates will be added.
OSCE sessions in French are available in each half of the year. Accommodation examination
sessions will be scheduled individually.
The OSCE dates for each year will be added to the site calendar in January of that year. The
OSCE sessions will typically start in May and continue through December. It is critical that you
do not wait to schedule your exam as the sessions are available on a first come, first served
basis. If you wait until late in the year to schedule your OSCE exam, dates may be limited or not
available.
Please note:
• Please note that only candidates approved for accommodations are eligible to apply for
accommodation sessions and must request the accommodation when completing the
on-line application. Please allow up to eight weeks for the approval process prior to the
desired OSCE date (subject to approval).
13.1.3 OSCE and MCQ Scheduling Policies
Candidates may apply to take the OSCE or MCQ in any order. All applicants are permitted three
(3) attempts at each examination. If, for any reason, you do not feel prepared to participate in
your examination, or you have experienced an issue that may impact your examination
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performance, you are encouraged to contact Prometric and arrange to postpone your exam. If
you realize you should withdraw from the exam only after arriving for your examination
session, you may withdraw from the session any time up until the exam begins. Once you begin
the examination, even if you do not complete it, it will be counted as one (1) of your three (3)
attempts.
If you withdraw from your examination after the withdrawal/reschedule deadlines, the
relevant withdrawal fee applies.
The Certification Examinations are offered in both English and French. Candidates who wish to
take the examination in French must select this option when completing the online application.
For candidates who select a French MCQ, the computer system is structured to toggle between
French and English. Candidates who select a French OSCE cannot switch to English during the
exam.
IMPORTANT: Prometric reserves the right to:
• Cancel an OSCE or MCQ examination day or examination session at any time;
• Reschedule a session time on an OSCE or MCQ examination day;
• Reschedule an OSCE or MCQ to an alternate examination day.
If any of the above instances occur, you will be notified by e-mail.
Candidates who are unsuccessful at the Certification Examinations may schedule a subsequent
attempt, subject to availability. Candidates must wait until receipt of official examination
results before scheduling their subsequent attempt online. Candidates scheduling a subsequent
examination attempt are considered returning candidates and must use their existing candidate
profile on the Prometric website to complete the process. The fee for each subsequent attempt
is the same as the fee for the initial attempt (see Table 1 of this document).
13.2 OSCE Scheduling Considerations
• All OSCE dates in the current schedule are subject to availability and there is no
guarantee that dates will be available at the time you choose to apply;
• It is possible that if you are unsuccessful in your examination attempt, you may not have
an opportunity to secure a subsequent attempt in the same calendar year;
• If you opt to schedule either a first or subsequent OSCE attempt later in the OSCE
season, it may not be possible to secure a date due to lack of availability during this
time. Although OSCE dates can become available due to candidate withdrawals,
Prometric cannot predict if or when this will occur.
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13.3 OSCE Examination Scheduling Availability
Available OSCE dates will be displayed when you log in to schedule your exam in Prometric’s
scheduling portal. OSCE dates that are unavailable will not be displayed. However, if candidates
withdraw from scheduled OSCE sessions, dates that were full can become available.
Open OSCE dates are monitored regularly, and additional sessions will be added as the open
dates fill. The OSCE session will start in early May and continue through the beginning of
December. OSCE sessions are added in two-week intervals, as the other sessions fill. Sessions
cannot be added until all sessions in the prior period are full. This is to ensure all candidates
have an opportunity to test during the year.
If you want to test later in the year, you will need to log in regularly to find sessions during the
period you wish to test. If you wait until the end of the year, and all the sessions are full, you
will not be able to test. Please schedule your OSCE as soon as you are ready to take the exam.
If no available OSCE dates are displayed when you access the online scheduling tool, then you
would be unable to schedule an examination.
Please note Prometric cannot advise you as to when or if a potential OSCE opening will occur.
Prometric does not maintain a cancellation or wait list.
13.4 MCQ Examination Scheduling
The MCQ exam will be available in four windows each year. The open seats in each window will
be available on a first come, first served basis. If all seats in an exam window have been taken,
no available seats in that window will display when scheduling an exam. The four testing
windows in 2023 are:
• March 6-19, 2023
• June 5-18, 2023
• September 5-18, 2023
• December 4-17, 2023
These dates are available on a first come first serve basis. Please do not put off scheduling your
MCQ exam session. If you wait until the end of the year, there may not be any seats available
for you to schedule your exam.
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14 Certification Examination Application Process
14.1 How to Create an Examination Application
1. Your education program will upload your graduation and contact information to the
Prometric scheduling portal
2. You will receive an email with instructions to complete the on-line application
3. You must log in to Prometric’s CMTO Examinations application portal;
4. You will be asked if you have a valid login and password, select No;
5. You will complete the online application confirming your eligibility to write the exams,
including:
▪ Confirmation of contact information
▪ Confirmation of meeting CMTO’s language proficiency requirements
▪ Confirmation if accommodations are needed
NOTE: Candidates must have a unique email address that is not shared with any other exam
candidate or registrant.
For a smooth application process, please ensure the name entered at the time you create your
Prometric profile matches the name on your government issued photo ID and the information
submitted by your Massage Therapy program.
Your Prometric profile, photo ID, and graduation list submitted by your education program
must all contain the same name. If there are any name discrepancies in relation to your photo
identification, the information uploaded by your Massage Therapy program and/or your online
profile that have not been resolved by the required timeline, you may be denied entrance to
the exam and will incur the full examination fee. Please review the Identification and Name
Requirement and Name Changes sections of this document for more information.
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14.2 How to Schedule the MCQ and OSCE Exams
1. You are approved for the MCQ and OSCE exams when you receive the email below
2. To schedule your exam, you will get to the following link:
https://www.iqttesting.com/
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3. You will click on the Exam Registration option.
4. Exam confirmation page.
Click Exam
Registration.
Confirm the exam(s)
listed are correct, and
then click Next.
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5. Profile Screen.
6. Exam Scheduling Page.
Confirm your
information is
correct, and then
click Next.
You can change
the time and date
parameters here.
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7. Select the date and time.
8. Scheduling confirmation page.
Select the
date and time
you wish to sit
for your exam,
then click
Next.
Check the
Agreement Terms
box.
Confirm the time and
date are presenting as
selected.
Click Submit.
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9. The Admission Letter will provide you with all pertinent information you will need to take
your exam. Save the letter on your desktop for easy access.
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15 Withdrawing and Rescheduling from Scheduled Exam Sessions
15.1 Withdrawal/Rescheduling
IMPORTANT: Candidates have the option to withdraw from a scheduled examination session at
any time, up until the commencement of the exam, without the exam counting as an attempt.
Ultimately, it is the candidate’s decision and at their discretion to proceed with a scheduled
examination (applicable withdrawal fee applies- see Table 1).
• Prometric is not able to advise a candidate as to whether or not they should proceed with
or withdraw from a scheduled examination session. Once a candidate commences an
examination, it will count as a valid examination attempt [except in certain extraordinary
circumstances, as explained in Section 21] (Please refer to the Certification Examination
Review Request Policy);
• Once you complete the withdrawal or cancellation of your MCQ or OSCE exam, you will
receive a new MCQ or OSCE confirmation letter via e-mail;
• It is the candidate’s responsibility to ensure that they attend their rescheduled MCQ or
OSCE date.
15.2 MCQ and OSCE Withdrawal and Rescheduling Process
15.2.1 MCQ and OSCE Withdrawal and Rescheduling Process
Prometric is not able to advise a candidate as to whether or not they should proceed with or
withdraw from a scheduled examination session. However, once a candidate commences an
examination, it will count towards a valid examination attempt (except in certain extraordinary
circumstances, as explained in Section 21: Certification Examination Review Request Policy).
Rescheduling an OSCE Date before the First Late Withdrawal/Rescheduling Deadline
If a candidate has scheduled an OSCE exam on the IQT Quality Testing website and wishes to
reschedule to an alternate date before the first late withdrawal/rescheduling deadline, they will
need to log into the scheduling portal to change the exam date. (see Table 1)
Rescheduling an OSCE Date after the First Late Withdrawal/Rescheduling Deadline
If a candidate has scheduled an OSCE exam on the IQT Quality Testing website and wishes to
reschedule to an alternate date after the first late withdrawal/rescheduling deadline has
passed, they will need to log into the scheduling portal to change the exam date. Please note
that the First late withdrawal/rescheduling deadline fee will be applied (see Table 1).
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Rescheduling an OSCE Date after the Second Late Withdrawal/Rescheduling Deadline
Candidates are permitted to cancel or reschedule a scheduled exam less than 14 days prior to
their scheduled exam date, but they will forfeit their entire exam fee. If a candidate chooses
not to attend a scheduled exam session, and does not withdraw from the exam session, it will
not count as one of their three attempts. Please note, if a candidate chooses not to attend a
scheduled exam session, the Second late withdrawal/rescheduling deadline fee will be applied
(see Table 1).
Rescheduling an MCQ Date before the First Late Withdrawal/Rescheduling Deadline
If a candidate has scheduled an MCQ exam on the IQT Quality Testing website and wishes to
reschedule to an alternate date before the first late withdrawal/rescheduling deadline, they will
need to log into the scheduling portal to change the exam date ( see table 1).
Rescheduling an MCQ Date after the First Late Withdrawal/Rescheduling Deadline
If a candidate has scheduled an MCQ exam on the IQT Quality Testing website and wishes to
reschedule to an alternate date after the first late withdrawal/rescheduling deadline has
passed, they will need to log into the scheduling portal to change the exam date. Please note
that the First late withdrawal/rescheduling deadline fee will be applied (see Table 1).
Rescheduling an MCQ Date after the Second Late Withdrawal/Rescheduling Deadline
Candidates are permitted to cancel or reschedule a scheduled exam less than 14 days prior to
their scheduled exam date, but they will forfeit their entire exam fee. If a candidate chooses
not to attend a scheduled exam session, and does not withdraw from the exam session, it will
count as one of their three attempts. Please note, if a candidate chooses not to attend a
scheduled exam session, the Second late withdrawal/rescheduling deadline fee will be applied
(see Table 1).
MCQ and OSCE No-Shows
If a candidate fails to attend a scheduled MCQ or OSCE examination session and has not
provided a written request to SMT[email protected], the full MCQ or OSCE
examination fee will be forfeited (see Table 1).
If you are unsuccessful at the OSCE or MCQ exams and wish to make another attempt
If you are unsuccessful on your examination, you will receive another scheduling email with
instructions on how to schedule your subsequent attempt. You are only permitted three
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attempts prior to being required to complete a new Massage Therapy diploma. If this was your
third attempt, you will need to contact CMTO at r[email protected] to determine
your next steps. In addition, your Massage Therapy education must have been completed no
more than three years prior to your examination date or you will be required to complete the
CMTO Refresher Course.
16 Examination Sites
16.1 OSCE Site:
The OSCE examinations are administered at the following location:
Prometric CMTO OSCE Facility
180 Dundas St W St 301
Toronto, Ontario M5G 1C7
(Please click here for a map)
16.2 MCQ Sites:
The MCQ examinations are administered at the following test centre locations:
17 Identification and Name Requirements
The primary form of identification must be a currently valid government-issued photo ID from
the province/territory/state, or federal government. Examples of acceptable government-
issued ID include a driver’s license, passport, or other government issued photo identification.
Further, any identification presented must:
Test Centre Name
Address 1
Address 2
City
Toronto, ON -
Bloor Street East
425 Bloor St. East
Suite 202
Toronto
Cestar College of
Business, Health &
Technology
265 Yorkland Blvd.
Toronto
Mississauga, ON
1290 Central Parkway West
Suite 104
Mississauga
Ottawa, ON
450 March Rd.
Suite 101
Ottawa
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• Bear the name you used and indicated at the time of exam registration, specifically your
given name (first name) and surname (last name) which MUST match the given name
and surname which appears on the identification you will present at the test center.
• If the names do not match, you will not be permitted to take the examination and, in
that case, will forfeit the full examination fee (see Table 1);
• Include your photograph;
• Include your signature;
• Be valid and not expired;
• Not exhibit any characteristics of being changed, altered, defaced, obliterated, modified,
or changed in any way.
For identification verification purposes at the time of exam registration, your first name and
surname must match exactly what appears on all the following:
• The information submitted by your Massage Therapy program;
• Your currently valid, government-issued, photo identification.
Please note the following common name discrepancy occurrences, which would not meet the
photo identification examination entrance requirement and would result in not being admitted
to the exam:
• Misspelled names;
• Derivatives or variations (i.e. “Beth” versus “Elizabeth”);
• Partial names or incomplete names (“Smith” versus “Smith-Jones” or "Mary" versus
"Mary-Ellen");
• Nicknames;
• Aliases;
• Names appearing in an incorrect field (i.e. a middle name entered as a first name in the
candidate’s Prometric profile, but the photo identification presented does not reflect
the middle name as the first name).
It is the candidate's responsibility to ensure that any name discrepancies are resolved no later
than the application deadline for their scheduled examination date. Any name discrepancies
occurring between your name on your photo identification and your Prometric profile will not
be resolved on your examination day. If a name discrepancy is identified on your examination
day, you will not be permitted to participate in your exam and the full examination fee will be
forfeited (see Table 1).
17.1 Name Changes
If you are requesting to change your name in your profile on Prometric’s website, please note
that the following is required:
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• Written request (email is sufficient);
• A photocopy of an official document (e.g. marriage certificate, divorce decree) which
shows both your previous name and your current name;
If your Massage Therapy program has made a mistake in your name on a graduation list, you
will need to contact them directly to provide a revised graduation list to Prometric with your
name as it appears on your photo identification. Note that a candidate’s Massage Therapy
program should be submitting the candidate’s first and surname on the official graduation list
identically to their name as it appears on their government-issued photo identification. Middle
names are not required on the graduation list as long as a candidate’s first and surname match
the first and surname fields on their identification.
Candidates may send their documents (scanned official document and written request) to SMT-
OperationsTeam@prometric.com. Once your documents have been reviewed, your name will
be updated in Prometric’s database.
Address and e-mail updates can be made at any time by accessing your Prometric profile.
18 Certification Examination Scoring
The College Certification Examinations, i.e. the OSCE and MCQ, are standards-based
examinations. Passing candidates must demonstrate proficiency at or above the established
standard to pass the examination. A Candidate’s total scaled score will determine whether they
pass. This scaled score is statistically derived from the raw score and can range from one
through 99. The passing scaled score is 70 for the examination. The passing score reflects the
amount of knowledge that the Subject Matter Experts (Massage Therapists) have determined
to be appropriate for certification. A criterion-referenced standard-setting procedure and
expert judgment were used to evaluate each item on the examination in order to identify the
passing score.
The reason for calculating scaled scores is that different tasks or questions of the exam may
vary in difficulty. As new tasks/questions are introduced, these changes may cause one version
of the exam to be slightly easier or slightly more difficult than another. To adjust for these
differences in difficulty, a procedure called “equating” is used.
The goal of equating is to ensure fairness to all candidates. In the equating process, the
minimum raw score (the number of correctly answered questions) required to equal the
passing scaled score of 70 is statistically adjusted (or equated). For instance, if the test is
determined to be more difficult than the base form of the test, then the minimum raw score
required to pass will be slightly lower than the original passing raw score. If the test is easier,
the passing raw score will be higher. Equating helps to assure that the passing scaled score of
70 represents the same level of knowledge, regardless of which set of tasks/questions the
candidate is being tested on.
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This scoring model ensures that if all candidates are competent, then all will pass. They will not
be marked on a “curve”, which is dependent on the abilities of the candidate group. For a
detailed review of exam scoring, please click Content Development Document.
IMPORTANT: Please note that a candidate’s success in their Massage Therapy program does
not guarantee success in the Certification Examinations. Grades received during a candidate’s
Massage Therapy program are not relevant for the purposes of the Certification Examinations
and are not considered by the College.
Unsuccessful candidates will receive a diagnostic evaluation of their performance on the
examination. This information is designed to be useful for studying when retaking the
examination.
19 Examination Results
19.1 OSCE
The score a candidate receives is based on the candidate’s performance in each station as
evaluated by Massage Therapist examiners who are trained to apply established standard and
objective marking criteria. The overall score for the exam is the sum of the station scores.
Competency area subtopics and the percentage of marks allocated to each competency area
are provided in the OSCE content outline.
Generally, official OSCE results will be e-mailed to candidates within six (6) to eight (8) weeks
after the date of their OSCE examination. However, for candidates who take the OSCE during
the first couple of months it is offered each year, result notifications may take several weeks to
be finalized and issued after the examination date. This additional time is required in order to
obtain enough statistical information to ensure the validity and fairness of the OSCE scoring and
reporting process.
The data obtained in the first weeks of the OSCE administration are compiled and analyzed by
Prometric. Once this analysis is complete, official scores can then be released.
For more information on the Standard Setting/Score Scoring and Reporting, please the Content
Development document on the Prometric website.
Please ensure the College has your current e-mail address. Candidates can change their e-mail
address by selecting that option after logging into their online CMTO profile.
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19.2 MCQ
Official MCQ results will be e-mailed to candidates within six (6) to eight (8) weeks following the
exam date.
Follow-up emails and calls for OSCE or MCQ results prior to the anticipated release date are
unnecessary.
20 Accommodation Policy and Process
20.1 Requests for Accommodation
Applicants with documented/diagnosed disabilities or other needs may apply to Prometric for
accommodation. Accommodation forms should be downloaded from the Prometric website
and uploaded with your submitted application. Requests will be considered on a case-by-case
basis. Please allow several weeks for applications to be reviewed and either approved or
denied. Depending on the nature of the request and the type of accommodations requested,
some applications may take longer to process. Applicants will be notified as to the status of
their application once a decision has been made.
The Accommodations Application Form (includes the following sections):
• Accommodation Request Form;
• Accommodation Request Verification Form, where appropriate* (include specific
diagnostic data such as test results where applicable in support of the diagnosed
disability);
• Documentation of Testing Accommodation Form;
• Application Form
Any professional providing documentation relating to a candidate’s disability must:
• Be registered/licensed and/or have credentials appropriate to diagnose the
candidate’s disability;
• And have diagnosed and/or evaluated the candidate or have provided testing
accommodations for the candidate within the last five (5) years.
The professional is required to provide:
• An explanation as to the specific aspect of the disability which requires testing
accommodation;
• The effect of the disability on the candidate’s ability to perform under the customary
testing conditions;
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If there has been no history of testing accommodation, the professional verifying the disability
should include an explanation as to why testing accommodations are currently needed.
The candidate and the professional recommending the testing accommodation should consult
and come to an agreement as to the appropriate testing accommodation being requested. That
is, the accommodation requested by the candidate on the Accommodation Request Form
should agree/match with those recommended by the professional on the Accommodation
Request Verification Form. Without such agreement the candidate’s request for
accommodation will be delayed and may not be granted.
The candidate is responsible for ensuring that the professional(s) completing the requested
forms:
• Provides all of the required information;
• Completes the relevant portions of the documentation;
• Provides all of the required supporting documentation and materials.
If additional information is required about the candidate’s disability, either the candidate will
be requested to obtain it, or Prometric will contact the professional directly. The candidate’s
signature on the application form acknowledges this and authorizes Prometric, where
necessary, to contact such persons for any additional information about the candidate’s
disability as it relates to the candidate’s testing needs. Prometric will only communicate with
the candidate, professionals knowledgeable about the candidate’s disability, and the
candidate’s authorized representative (verification required). All information related to
accommodation is kept confidential and is used or disclosed only to the extent necessary to
administer the College’s regulatory responsibilities.
The candidate is responsible for ensuring a complete accommodation request is submitted.
Candidates who qualify for accommodations will be scheduled for their OSCE examinations on
the specified OSCE examination dates and notified accordingly.
Where Prometric has approved an accommodation for an eligible candidate, an Examination
Accommodation Agreement will be prepared by Prometric specifying the elements and exact
nature of the accommodation(s), signed by the candidate and the accommodations
representative at Prometric.
Please note that accommodation OSCE and MCQ examinations are conducted at the approved
Prometric test centers. Candidates who have been approved for MCQ accommodations will not
receive accommodations if they schedule their exams on their own. Candidates who have been
approved for accommodations must upload their signed accommodation agreement to their
application record in the CMTO Exam Portal. Upon receipt of these documents, the
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Certification Services Department will email you with a list of available dates to schedule an
accommodation for MCQ and/or OSCE.
Should an accommodation need arise after the candidate has applied for or been accepted for
an exam date, the candidate should advise SMT-OperationsTeam@prometric.com immediately
and in writing with as much information as possible.
Where a candidate is unable to complete an exam on one of the specified accommodation
dates for reasons related to the candidate’s need, the candidate should SMT-
OperationsTeam@prometric.com immediately and in writing with as much information as
possible.
20.2 Exceptions
Persons with observable disabilities that require accommodation need not complete the
Accommodation Request Verification Form. The candidate may indicate the request for elevator
or wheelchair accessibility on the Accommodation Request Form. Supplementary
documentation may not always be required for all (non-disability related) needs.
21 Certification Examination Review Request Policy
Examination candidates may request a review of their examination results within the specific
criteria established below.
Criteria for a Certification Examination Review
A review of a candidate’s examination results may only be based on a process issue, and not on
the content of the examination. That is, a candidate may only request a review of his/her
certification examination results in situations where s/he is of the opinion that extraordinary
circumstances arose coincidental to the holding of the examination. “Coincidental” is defined as
immediately prior to the examination or during the delivery of the examination. “Extraordinary
circumstances outside the control of the candidate” are defined as something (not of the
candidate’s doing) that was severe enough to have disrupted a candidate’s examination
experience to the extent that it could reasonably be seen to have altered their test score.
Examples of “extraordinary circumstances” include situations such as: a death in the family
immediately before the examination, a fire alarm during the examination that necessitated the
building being evacuated, a power failure that had an impact on the exam administration, etc.
A written request for a review must be submitted to Prometric at SMT-
OperationsTeam@prometric.com within 72 hours of completing the examination. Requests
outside of that time period will be considered on a case-by-case basis with careful
consideration of the reason for the delay in submitting the request.
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The request should include an explanation of the extraordinary circumstances upon which the
request is based along with any supporting documentation.
The request should also include the outcome that the candidate is seeking from the review.
In no circumstances will a request for review of an examination attempt be accepted if the
candidate fails to request a review (of an earlier attempt) until after he or she has made (and
failed) a subsequent attempt at the examination. For example, if a candidate fails an exam
twice, they cannot request a review of their first attempt after failing their second attempt.
Certification Examination Review Procedure
An internal review of the available information, including the candidate’s submissions, will be
conducted by Prometric and a decision, along with reasons for the decision, will be issued to
the candidate within 30 days (or as soon thereafter as possible) of receipt of the request for
review and all supporting documentation required.
In general, Prometric will consider the following when reviewing a Certification Examination
review request:
• The nature of the request;
• Whether or not the applicant raised the issue immediately following the examination;
• Whether or not the issue is long-standing, or if it occurred immediately prior to the
exam;
• Whether or not the candidate could have submitted a request to postpone their
examination, if the candidate is experiencing a long-term issue;
• If accommodation for the examination could have been requested in advance but was
not requested, an explanation as to why accommodation was not requested; and
• Any formal documentation that has been submitted in support of the request (this
documentation will depend on the nature of the request and might include, for
example, a physician’s note, government-issued documents, etc.).
Supporting Documentation
Depending on the nature of the extraordinary circumstances, it is often necessary for an
applicant to provide supporting documentation to verify the statements made in the request.
For instance, if an applicant’s examination review request is based on an unexpected health
emergency that he or she experienced just prior to the examination, then appropriate medical
documentation should be provided to verify this event. The documentation should also explain
how the medical condition impacted the applicant’s ability to perform on their examination.
After the completion of the review, the Prometric may do one of the following:
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• Determine that no extraordinary circumstances arose coincidental to the holding of the
examination which were severe enough to have had an impact on the candidate’s
performance to the extent that it could reasonably be seen to have had an adverse
impact on their examination performance; or
• Grant the candidate another attempt at the examination without counting the current
attempt as one of the three attempts permitted to take the examination.
Under no circumstances can Prometric change an examination score.
Please note that the requirement to successfully complete the College’s Certification
Examinations is a non-exemptible registration requirement. This means that neither Prometric
nor CMTO may exempt an applicant from the requirement for successful completion of the
certification examination.
22 CMTO’s Certification Examination Content Outlines
The 2021 Objectively Structured Clinical Evaluation (OSCE) and Multiple-Choice Question (MCQ)
Content Outlines are available on CMTO’s website:
• CMTO’s Objectively Structured Clinical Evaluation (OSCE) 2023 Content Outline
• French Version - CMTO’s Objectively Structured Clinical Evaluation (OSCE) 2023 Content
Outline
• CMTO’s Multiple Choice Question 2023 (MCQ) Examination Content Outline
• French Version - CMTO’s Multiple Choice Question 2023 (MCQ) Examination Content
Outline
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23 Appendix A: Health History Form
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24 Appendix B: Written Consent Form
Written Consent Form
I consent for the following checked areas to be included in
my treatment:
Buttocks (gluteal muscles)
Chest Wall Muscles
Upper Inner Thigh(s)
Breast (s)
Client Signature:
_________________________________________
*Abbreviated written consent form for use in CMTO Certification Exams
