Good Evening . Due to technical issues today’s email got delayed. Apologies. We will make up for it 🙂
Could you produce last month’s case sheets if a consumer court asked for them? Do you know what your patients’ chatbots told them about their tablets last night? Today’s first two stories are why I’m asking. If you or someone at home is chasing a Dermatology seat, read the third before deciding anything. We end at 2 AM with Atul Gawande and a consultant every resident deserves.
— DR. ADITYA SETH, EDITOR-IN-CHIEF
01 · THE LEAD
MEDICOLEGAL
The case sheet sat in the doctor’s own hospital. The commission held its absence against her.
The patient was 32, working, and in what her gynaecologist called a “precious pregnancy”, with every antenatal note written into a booklet given to her. At about 17 weeks she was admitted with spotting and a clot on the scan. By the gynaecologist’s account, a repeat scan the next day showed it had stabilised, and the patient then grew unhappy with the ward and left against medical advice on day three, refusing to sign the LAMA form. A week later she was back with threatened abortion. The doctor says she was catheterised and told to lie on her left side, and kept sitting up. The patient denies refusing any advice and says a junior doctor managed her. About a week into that admission she bled heavily and miscarried.
Before the commission, the patient’s side filed seven documents, among them the hospital’s own bills and test reports. The gynaecologist’s side filed none. With no case sheet in front of it, the commission had nothing to show the walk-out or the sitting up, and for the night of the miscarriage it wrote that the doctor had left her patient “mercilessly in the hands of the hospital staff”. It awarded just under half of the Rs 21.8 lakh claimed. One document the patient filed is dated to her first visit, and the order never says whether it is the booklet the gynaecologist wrote in.
WHY IT MATTERS
A record defends you only once it is filed, so have your lawyer mark the case sheet, nursing notes, consent forms and drug charts as exhibits with your affidavit.
If the antenatal booklet goes home with the patient, photocopy the pages you write in or keep a parallel OPD note.
When a high-risk inpatient deteriorates, write down who was called, at what time, when they arrived and what was done.
02 · CLINICAL
She took 400 mg of lamotrigine down to zero on ChatGPT’s schedule, then died of SUDEP
Bowen Wan, a 31-year-old engineer in Seattle, still had a few seizures a month when she began to fear the drug was slowing her speech before job interviews. ChatGPT drafted the taper, told her not to mention it at a primary care visit, and praised her for refusing the blood test that would have shown her drug level. Within days she described confusion, lost time and an otherworldly feeling, and the chatbot called each episode her brain readjusting. She raised her worry at least 158 times. Her parents sued OpenAI on 27 October. About 100 million Indians use ChatGPT every week, and some of them are your patients.
What a neurologist would have heard in each of those episodes, and what to ask at your next review.
03 · EXAMS AND ADMISSIONS
Rank 5,628 got the last government Open seat in Dermatology, against 2,725 last year. The colleges toppers want got harder to get.
That number was set by a single seat in Dadra and Nagar Haveli. At 14 of the 20 colleges toppers picked most, you needed a better rank than in 2025, and VMMC’s last Open seat went to rank 12. Six of the top 100 ranks took Dermatology, up from three. Round 1 joining closes on 2 November and Round 2 runs from 6 to 14 November. Last year, Round 2 pushed the Open cut-off out to 6,251 after 202 Round 1 allottees gave up their seats.
Where your rank stands for Round 2, category by category, and every college’s last Open rank
05 · DOCTORS
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Doctors
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At 2 AM, surgical resident Atul Gawande waited too long to call his consultant, and a patient nearly died
From his first book, Complications: a woman from a car crash could not be intubated, his attempt at a surgical airway failed, and an anaesthetist got a tube in at the last moment. At the M&M a week later, his consultant said four words that every senior should hear. We told it slide by slide on Instagram.
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