The epilepsy surgery patient management conference (PMC) is a fundamental part of the pre-surgical evaluation and represents the final stage of the process [1–3]. Previous work has demonstrated high inter-rater reliability of surgical decision making among epilepsy centers utilizing multidisciplinary PMC . Less is known about the accuracy of predicting outcomes using this approach. Studies are identifying ways to improve predictions of post-operative outcomes [5,6]. During this meeting attended by staff in epilepsy, neurosurgery, neuroradiology, nuclear medicine, neuropsychology, psychiatry, social work, and bioethics, all of the evaluations leading to the consideration of epilepsy surgery for an individual patient are comprehensively reviewed, one modality at a time.