Certification Examination Fees




Objectively Structured Clinical Evaluation (OSCE)
(per attempt)


Multiple-Choice Examination (MCQ)
(per attempt)


First OSCE Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules on day after the OSCE application
deadline and up until and including 14 days before the examination date.


Second OSCE Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules less than 14 days before the
examination date.

$805.00 (entire exam fee)

First MCQ Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules on day after the MCQ application
deadline and up until and including 7 days before the examination date.


Second MCQ Late Withdrawal/Rescheduling Deadline
Candidate withdraws or reschedules less than 7 days before the
examination date.

$575.00 (entire exam fee)

IMPORTANT: Candidates who do not complete program requirements to graduate from their Massage Therapy program and do not notify the College within four weeks of their scheduled OSCE are required to pay the $150.00 withdrawal fee.


Updated By-Law No. 7 approved by Council:
Amendments to Examination Fees and Withdrawal Fees for 2019


At its meeting of May 15, 2018, the Council of the College of Massage Therapists of Ontario (CMTO) approved an update to By-Law No. 7: Fees that will increase Certification Examination fees in 2019 to $575.00 for the Multiple-Choice Question (MCQ) examination, and $805.00 for the Objectively Structured Clinical Evaluation (OSCE) examination. This is a 15 percent increase for each examination. The by-law also gives Council the option to increase Certification Examination fees in 2020 and 2021, if needed.

In addition, the examination withdrawal fees in Schedule A to By-Law No. 7 have been amended such that Examination Candidates who do not attend their scheduled examination without formally withdrawing within the timeframe specified in the Schedule will forfeit their examination fee.

Prior to making these changes, draft amendments were circulated proposing a 35 percent increase in the examination fee, and the forfeit of the full examination fee for those who withdraw from their examination after the withdrawal deadline. The College would like to thank those who took the time to respond to the survey and share their views.

Approximately 45 percent of respondents were in favour of the proposed examination fee increase, and approximately 62 percent of respondents were in favour of the proposed change to the examination withdrawal fees.

Of those who were opposed to the exam fee increase, most expressed concern about the ability of Massage Therapy students to pay the increased fee. Many respondents understood the need for a fee increase but suggested that it be phased in over time.

After careful consideration, Council approved a 15 percent increase to the examination fees in 2019, with optional additional increases in 2020 and 2021. Subsequent increases are not mandatory, and there is a maximum fee cap set for each year. This ensures that the total fee increase from 2019 to 2021 will not exceed the original 35 percent proposed.

With regard to the examination withdrawal fees, the College will create a policy to address those situations where candidates believe that there were circumstances beyond their control that caused them to fail to appear for the examination. In addition, the new Schedule A clearly articulates the withdrawal timelines to help Examination Candidates better understand how the withdrawal fees may apply to them.

CMTO believes that these changes are an important recognition of the fixed costs related to the development and delivery of valid, objective and reliable Certification Examinations. They also reflect the opportunity lost when a Candidate blocks a spot during an examination administration that could otherwise be used by another Candidate if it were released in a timely manner.

Three questions that came up several times in the survey comments are as follows:

Q: Didn’t CMTO raise the examination fees just a couple of years ago?

A: CMTO’s Examination Fees history is as follows:








$   400.00




$   925.00









The MCQ fee was not raised for ten years from 2003 to 2013, and the increase to the fee for the OSCE in 2019 is the first fee increase for that examination in 16 years.

The average total fee for MCQ and OSCE examinations for other regulated health professions in Ontario is more than $2,500. Even with the fee increase in 2019, CMTO’s examination fees remain well below that average.

Q: Why does it cost so much to run the exams?

A: CMTO’s Certification Examinations are what is referred to as ‘high stakes’ examinations. They are designed to differentiate between a practitioner who is competent and one who is not, and they are a requirement for registration with CMTO. In order for them to meet their purpose, they must be valid, objective, reliable and fair, and they must be psychometrically sound.

The Certification Examination fees cover not only the administration but also the development of the examinations. It takes a full year to develop the examination content for the following year. In general, there are six steps to examination content development:

  1. Content Outline Development
  2. Item (Question) Writing
  3. Item Review and Translation
  4. Test Development
  5. Standard Setting/Score Scaling/Scoring and Reporting
  6. Examination and Test Question Statistical Analysis, Review and Candidate Feedback

These six steps are described in detail on CMTO’s website. In addition to creating new examination items and incorporating updates to CMTO’s Standards of Practice, CMTO’s examination item bank must be reviewed and updated in full whenever there is an update to the Inter-jurisdictional Practice Competencies and Performance Indicators for Massage Therapists at Entry-to-Practice, as happened in 2016.

Examinations of this quality are expensive to develop and administer. CMTO’s Council has determined that, as much as possible, the cost of developing and administering the examinations should be borne by the Examination Candidates, not CMTO registrants.

Q: Where can I get more information about CMTO’s finances?

A: CMTO publishes audited financial statements in the Annual Report each year. These reports are available on the CMTO website going back to 2001 and include information about the direct revenue and expenses related to the Certification Examinations. Indirect costs, such as CMTO staff costs for developing and running the examinations, are not included as an examination expense. Similarly, the OSCE examinations are held in CMTO’s Toronto office (providing a significant cost saving for the administration of that exam) but the related overhead expenses do not appear as an examination expense in the audited statements.