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What miscPrompt is for

miscPrompt is the fall-back lever in the instructions block. Reach for it after contentPrompt and outputSchema are pulling their weight — only to tighten repeated misbehaviour the other two can’t cleanly prevent.
Most sections don’t need one. Only a small subset of Corti Standards populate miscPrompt. If you can express the rule via contentPrompt Include/Exclude or as a (typed) constraint on outputSchema, do that first.
Categories where miscPrompt can be useful:
  1. Edge-case fallbacks — what to write when the natural case isn’t in the source.
  2. Vocabulary — locking the model to fixed abbreviations, units, phrasings, or relevant vocabulary.
  3. Defensive grounding — “do not include suspected” / “do not infer” / “only when explicitly mentioned in the source material” rules for sections where this extra critical to constrain the model from applying its intelligence.

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Examples from Corti Standards

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Edge-case fallback — Allergies

miscPrompt: For a documented allergen with no described reaction, set the reaction to : not specified. If the patient has no known allergies, output NKDA with an empty reaction. Do not add allergies, intolerances, or reactions not explicitly stated in the source.
Three rules, all “fallback when the natural case is absent”. Adds extra robustness in combination with the prompting in outputSchema paired with the Allergies section’s array-of-objects schema { allergen, reaction }. 
"outputSchema": {
      "type": "array",
      "description": "Open-ended set of allergy or intolerance entries, one per substance documented in the source material.",
      "itemFormat": "{item}\n",
      "items": {
        "type": "object",
        "description": "One allergy or intolerance entry.",
        "fieldFormat": "{allergen}{reaction}",
        "fields": [
          {
            "key": "allergen",
            "description": "Name of the allergen or substance the patient does not tolerate.",
            "value": {
              "type": "string"
            }
          },
          {
            "key": "reaction",
            "description": "Reaction detail with a leading ': ', e.g. ': rash' or ': anaphylaxis'. For a documented allergen with no described reaction, use ': not specified'. Leave empty for no known allergies (NKDA).",
            "value": {
              "type": "string"
            }
          }
        ]
      }
Why not use defaults here? The default is output when the model does not generate anything. In the {reaction} field case, we would need 2 different defaults: one that is an empty string when allergies are explicitly negated (NKA) vs one where an allergy was mentioned but the reaction is not specified. miscPrompt handles these in the absence of conditional defaults.

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Vocabulary normalization — Medications & Actions-and-Plan

miscPrompt: Always use the following route abbreviations when the route is explicitly stated: PO for per os (by mouth), IV for intravenous, IM for intramuscular, SC for subcutaneous, SL for sublingual, PR for per rectum, ID for intradermal, NG for nasogastric, INH for inhalation, and TOP for topical use. Always use the following frequency phrasings when the frequency is explicitly stated: once daily, twice daily, three times daily, four times daily, every morning, every evening, at bedtime, every other day, every N hours, as needed (PRN), … Normalize route and frequency to these standardized terms instead of copying the source wording verbatim.
The two-list pattern. You could split each list as enum on a per-field schema, but enumerating in miscPrompt is more readable, easier to extend, and handles composite cases (route + frequency together) easily.

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Defensive grounding — Past Surgical History

miscPrompt: Omit suspected, uncertain, planned, or merely considered procedures. Do not include the indication or outcome unless the source includes it as part of the procedure name itself.
Tight prohibition list. The model has a prior to medicalize and infer — miscPrompt is where you push back when that prior fires too often. Past Medical History uses the analogous “Omit suspected or uncertain diagnoses. Do not include treatments or negative findings.” The same pattern shows up in Prescription (“Do not include a medication here if the clinician has merely mentioned or considered it without issuing a prescription”).

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When not to use miscPrompt

  • contentPrompt Include/Exclude already covers it — don’t restate.
  • outputSchema can express it more strictly — prefer the schema. Typed enum is enforced; prose “use one of: …” is only steered.
  • Tone or sentence-shape (in general) — that’s writingStyle (Recipe 3). The Referral example above is borderline — sentence-count budgets are layout, not voice.
  • As a dumping ground — long multi-paragraph miscPrompts compete with contentPrompt for attention. Keep each rule to one or two sentences. The Medications vocabulary lists are at the upper bound of acceptable length.