How Hard is the MBLEx Really?

(Updated 2024) One of the most frequently asked questions I get from massage therapy students is, “How hard is the MBLEx?” I was wondering the same thing as I was preparing for the massage exam.

How hard is the MBLEx, really? The good news is that the content on the MBLEx is not objectively hard. There are no complicated mathematical calculations, minimal critical thinking skills, and no essays to write. However, many massage therapists still struggle to pass. One of the main reasons that the MBLEx is difficult for so many test candidates is the large total volume of content covered on the massage exam. The body of knowledge and possible questions in the anatomy & physiology section alone is enormous, yet it only represents only 11% of the MBLEx.

What is the MBLEx pass rate? According to the Federation of State Massage Therapy Boards (FSMTB), 73% of MBLEx candidates passed the massage exam on their first attempt. This is according to the FSMTB’s most recent Annual Report, which analyzed the MBLEx pass rate in 2022.

The previous FSMTB report stated that of those candidates who initially failed the massage exam and made a repeated attempt, only 40% passed the MBLEx on their second try. Let’s look into how hard is the MBLEx, and what you can do to increase your chance of passing.

Why is the MBLEx so hard?

There’s a reason that the MBLEx is so challenging to pass.

The Massage and Bodywork Licensing exam (MBLEx) must ensure that anyone who passes the test meets a certain standard of competency in order to protect the public. Potential massage therapists must be able to demonstrate that they have a solid knowledge of how to offer therapeutic massage safely to their clients.

This means that future licensed massage therapists must have a thorough understanding of each of the content areas on the massage exam.

So the MBLEx is not designed to be an easy exam. That’s for sure! It is designed to permit only test candidates who demonstrate a level of competency that meets or exceeds the standards set by the FSMTB. Massage therapists can increase their chance of passing the massage exam with our proven MBLEx Prep Course and practice exams that are designed to simulate the actual MBLEx.

Why is the MBLEx pass rate so low on repeated attempts?

It is fairly common in massage therapy as well as other professions to have a dramatically lower pass rate for repeated attempts on a licensing exam. For example, the licensing exam pass rate for registered nurses (NCLEx) drops from 86.6% on initial attempts, to 42.9% for repeated attempts. Since the MBLEx is no harder the second time, why are the pass rates lower for repeated attempts?

There are a few possible reasons for this that I can think of.

For starters, the factors that held the candidate back the first time could still exist during their second attempt. These problems could include:

Attending an inadequate massage training program
Having weak test taking skills
Chronic test anxiety
Failing to create and stick to a MBLEx study plan
Not putting in enough MBLEx review time
Reading difficulties

There are probably a lot of other possible explanations as to why repeated test attempts have a pass rate that is so much lower.

The FSMTB does provide testing accommodations for people with disabilities. The most commonly reported testing disabilities as indicated in their annual report are: learning disabilities and dyslexia (31%), visual deficits (23%), and ADHD (19%). The most common types of accommodations include providing extra time or a reader, or providing a private room to take the massage exam.

What is the hardest part of the MBLEx?

The FSMTB currently does not provide any statistical data about test candidate performance in specific content areas of the MBLEx. In other words, there’s no way of knowing if test takers find the pathology or client assessment sections the hardest, for example.

Having this information really wouldn’t be all that useful anyway. Because what is “hard” is subjective. What makes the MBLEx hard for someone else may be easy to you. And what may be tedious for someone else to study, may be super interesting to you.

*Every content area on the MBLEx requires sufficient dedication and studying. To find out which sections of the massage licensing exam might be the most difficult for you, try taking a few practice tests or quizzes.

Success is no accident. It is hard work, perseverance, learning, studying, sacrifice and most of all, love of what you are doing or learning to do.
Pele

Beyond anatomy and physiology

Most of us chose to go to massage therapy school because we have an interest in human anatomy and physiology, kinesiology and the application of therapeutic techniques. But that’s only a part of the MBLEx.

People in general like to study what they’re good at, and most interested in. I know I would much rather spend an hour studying massage techniques or reviewing the structures in the suboccipital region, than reading about ethics, documentation or rules about maintaining tax records.

The problem is that a big part of the MBLEx covers the “less fun and interesting”, but still essential, content that every practicing massage therapist needs to know. The MBLEx will seem hard if the exam candidate doesn’t prepare for these content areas too.

According to the FSMTB, the content covered on the MBLEx is based on a Job Task Analysis Survey, and reflects the knowledge and skills relevant to entry-level competence for a massage therapist. This includes everything from client assessment, ethical practice, understanding contraindications for massage, professional licensure and insurance, and dozens of other topics.

Here’s the current MBLEx content outline (2024):

Anatomy and Physiology	11%
Kinesiology	12%
Pathology, Contraindications, Areas of Caution, Special Populations	14%
Benefits and Effects of Massage	15%
Client Assessment, Reassessment and Treatment Planning	17%
Ethics, Boundaries, Laws, Regulations	16%
Guidelines for Professional Practice	15%

Let’s say a student was preparing for the massage exam but only focused their studying on only the first 4 content areas. And they barely reviewed the client assessment, ethics and laws, and professional practice sections. That means that for 48% of the MBLEx, they will have to rely on educated guesses and what they can recall from class! So be sure to include in your massage exam study plan a thorough review of every content area covered on the MBLEx.

Tip: There is a much smaller pool of likely questions in the last two content areas (Ethics, and Guidelines). For example, there are only so many ways the FSMTB can ask questions about Scope of Practice. Compare this to about a thousand questions they could ask about the circulation system. So my advice would be to take the time to thoroughly study the last two content areas well, even if they aren’t as interesting to you. These two content areas also account for a larger percentage of the test (16% and 15%) than A&P, Kinesiology, or Pathology and Contraindications. Then you will likely ace these two content areas of the MBLEx. Plus this information will help you throughout your career.

Factors that make the MBLEx seem hard

How hard the MBLEx seems is really subjective. Not every test candidate will find it to be a hard exam. The massage exam may be relatively easy for one test candidate, but feel like an impossible roadblock to another. Some factors that can influence how hard the MBLEx is for you may include:

How good was your instruction during massage school?
Was your massage program long and through, or did it just cover the minimum content?
Do you have a background in a related field like healthcare or fitness? Or have you taken previous college anatomy and physiology classes?
Did you graduate recently, or has it been a few years?
Do you have a good understanding of key massage terminology and concepts?
Did you keep up with all your class assignments and homework?
Did you study thoroughly for each test and quiz? Or did you usually have to cram the night before the test?
Do you tend to have test anxiety or difficulty focusing during exams?
How much time will you commit to preparing for the MBLEx?
Did you use test prep resources specifically for the MBLEx?

So as you can see, there are many individual factors that can effect how hard the MBLEx feels to a test candidate. Now the important question to ask is…

What can I do to prepare for the MBLEx?

There are a few ways to go about this, but they all involve having a study strategy and a plan.

You should start by first identifying your strengths and weaknesses regarding the content on the MBLEx. Determine which content areas are your strongest, and which you will need to devote the most time to.

Then determine your time frame. How long do you have before you need to take the massage exam? Are you still in school with months until graduation? Or do you need to pass the MBLEx soon so you can get licensed and start working as a massage therapist ASAP? Using the best time management strategies can also help you prepare for the massage licensing exam.

Remember that the MBLEx is a comprehensive exam that covers a large volume of content. It isn’t something that you can cram for! Also, is your schedule wide open? Or are you already trying to balance school, a job, and family, with little time left over? If this is the case for you, then you will have to prioritize what’s most important to you, considering all these aspects of your current situation.

The key is not to prioritize what’s on your schedule, but to schedule your priorities.
Stephen Covey

Once you figure out what you need to study, and how much time you have to prepare, it’s time to develop your MBLEx study strategy. This includes deciding on what MBLEx test prep methods or tactics you will be using. Your study strategy could include things like:

Using practice tests and flashcards
Taking an online MBLEx Review Course
Attending a weekly study group with your classmates
Reviewing your notes from massage school
Studying first thing in the morning vs. in the evenings

After you have determined a study strategy that fits your preferred learning style and needs, then it’s time to create your study plan and schedule.

This doesn’t have to be anything elaborate. But it should be realistic and complete. Consider what has worked best for you in the past. Have you been able to endure several long study sessions every day, to prepare for big exams in a relatively short time? Or does a short, daily study schedule over several weeks or months work better for you?

To summarize the steps to prepare for the Massage & Bodywork Licensing Exam: