Massage Today
Massage Today dotted line
dotted line

dotted line
Share |
  Forward PDF Version  

My View From Here

By Ralph Stephens, BS, LMT, NCTMB

About the Columnist
Other Articles

FSMTB: Falling Down on the Job

In 2008, the Federation of State Massage Therapy Boards (FSMTB) launched the Massage & Bodywork Licensing Examination (MBLEx), which has become the most-used exam for state licensure purposes. From humble beginnings, FSMTB has overcome significant obstacles to supplant NCBTMB as the primary provider of entry-level testing for the massage therapy profession.

By 2014, more than 22,000 tests were administered annually by FSMTB, while NCBTMB's use of their National Certification Examinations for state licensure purposes declined to negligible levels. Late last year, NCBTMB finally "threw in the towel" and signed an agreement with FSMTB declaring that they would no longer remain in the entry-level testing business (in exchange for an unspecified amount of cash). This move helped to separate the functions of licensure and certification, which have been confused and misunderstood for two decades.

While FSMTB has moved from underdog to top-dog status in the massage testing world, it has fallen down in its responsibility to massage therapy schools and their graduates who must pass the MBLEx to qualify for state licensure. On July 1, 2014, FSMTB rolled out major changes to the structure of the MBLEx, and failed to properly inform the profession about it.

Here's what happened. The exam delivery system was changed to what is called Computer Adaptive Testing (CAT). This is a common model in the field of psychometrics – no problem there. In adaptive testing, the difficulty of test questions changes according to whether the candidate answers correctly or incorrectly. A candidate must answer enough questions correctly at an average level of difficulty in order to achieve a passing score.

In addition, FSMTB changed the testing rules to prevent candidates from being able to go back and review their answers, or to skip questions and answer them later. Combined, these two changes threw test-takers for a loop, as they were unprepared for the radically different exam experience. Schools could not have helped out their students and graduates, because FSMTB had kept them in the dark as well.

No big deal, claimed FSMTB. The change was listed in the new version of the MBLEx Candidate Handbook (in a single paragraph on page 30), and they thought it was all that was needed. Actually, when you're controlling the gateway for professional licensure for an entire field, you have to do a much better job of informing and educating your stakeholders about changes to the exam program. Especially when going to an exam format this profession is totally unfamiliar with.

As it turned out, it was a big deal and the proof is in the numbers. Comparing the national pass rates on the MBLEx from the second half of 2014 (July 1 - December 31) after the changes were made to pass rates in the first half of 2014 (January 1 - June 30) shows significant declines. In particular, the first-time pass rate fell 9.1% from 77.4% to 68.3%. Pass rates for re-testing fell by an even-greater 16.3% from 44.4%, to just 28.1%.

The damage here is potentially huge. As a result of the changes made by FSMTB, more people will have to pay that agency to re-take the exam, and more people are unable to get licensed and pursue new careers in massage therapy. People who received Title IV federal student loans are far more likely to default if they are blocked from entry into their chosen career.

It gets worse. An increase in default rates in Title IV loans (as well as school-based private loans) could put massage schools on costly probation status with the Department of Education or could cause them to lose Title IV eligibility altogether – a death sentence in the current education landscape. A school's accreditation status could also be placed in jeopardy if licensure and placement numbers fall below those set by accreditation agencies. We are already losing lots of schools due to tighter student loan regs by the U.S. Department of Education. (Good riddance to the bad actors who were gaming the system for years.) However, FSMTB's sudden modification to the MBLEx without adequate notice or critical information about the changes is putting some of our best schools and their graduates at high risk.

An entire year has now passed since CAT was implemented, and FSMTB has still not put forth the needed educational materials to allow schools to properly prepare their students for the MBLEx. As well, we're all still waiting for FSMTB to provide an authoritative study guide for the MBLEx along with online practice examinations. Those support resources are standard-issue in every other profession with a board federation that conducts its licensing exam program. What's the problem here? We know it's not lack of money, since FSMTB is sitting on more than $5 million in cash reserves bankrolled from exam fees.

By the way, the business-savvy folks at Associated Massage & Bodywork Professionals have recently jumped into fill this void with a new subscription service called ABMP Exam Coach. While this looks to be a well-constructed test preparation website, it is no replacement for official resources developed by the exam administrator itself.

FSMTB seems to be operating from the old play book made infamous by NCBTMB. Poor customer service, lack of respect, no transparency in its decision making, and an inability to give stakeholders what they need. So, now we're stuck with even more unresponsive arrogance than before. It has become an out of the frying pan into the fire situation.

FSMTB has gotten what they wanted – to be the single-source test provider for entry-level state licensure. Now they must fulfill their obligations to the profession (students and schools alike) to guarantee that all aspects of the testing process are well understood, and that official test prep resources are provided. They need to hear from the profession – that's you if you care – at each state massage board and at the FSMTB national office: or via e-mail at

dotted line