Background: For over 40 years, the objective structured clinical examination (OSCE) has been a part of medical education, eventually finding its way into most aspects of clinical training and evaluation. However, the EEG/epilepsy fellowship training has not classically involved OSCE evaluations. Methods: We designed and implemented a formative OSCE for pediatric and adult EEG/epilepsy fellows in Montreal, Quebec, Canada. The examination was offered in French and English. Stations included: technical issues, short cases, a long case, and communication. We solicited post-examination feedback from all participants via anonymous electronic survey after they had completed the Canadian Society for Clinical Neurophysiology (CSCN) EEG examination. We asked questions surrounding utility of the examination, areas for improvement, and whether the participant had been successful in passing the CSCN examination. Results: Six fellows took the initial formative OSCE. All six reported passing the subsequent CSCN examination. All participants reported the OSCE as useful in examination preparation. The communication station was consistently ranked as the least useful station, an unsurprising finding given that the CSCN examination does not involve a communication component. Conclusions: OSCE is an effective tool in assessment of the level of competence of EEG/epilepsy fellows, and as preparation for the CSCN EEG examination.