The Lawletter Vol 36 No 10
John Stone, Senior Attorney, National Legal Research Group
The Fourth Circuit Court of Appeals has upheld summary judgment granted in favor of a university medical school that had been sued by a dismissed medical student with attention deficit hyperactivity disorder ("ADHD"). Halpern v. Wake Forest Univ. Health Sci., 669 F.3d 454 (4th Cir. 2012). The claims of disability discrimination were brought under the federal Rehabilitation Act of 1973, which prohibits discrimination against the disabled in programs or activities receiving federal financial assistance, and that part of the Americans with Disabilities Act ("ADA") that prohibits disability discrimination in places of "public accommodation," 42 U.S.C. §§ 12181–12189.
To the extent possible, the ADA and the Rehabilitation Act are construed to impose similar requirements. Accordingly, despite the different language these statutes use, they require a plaintiff to demonstrate the same elements to establish liability. In the relevant context of a student excluded from an educational program, to prove a violation of either the ADA or the Rehabilitation Act, a plaintiff must establish that he or she (1) has a disability; (2) is otherwise qualified to participate in the defendant's program; and (3) was excluded from the program on the basis of his or her disability. If a person, due to his or her disability, requires a modification to meet the essential requirements to participate in an educational program and if the necessary modification is unreasonable, then that person is not "qualified" under the ADA and the Rehabilitation Act to participate in the program. In Halpern, the dismissed student had a disability, but his claims fell because he was not otherwise qualified to participate in the medical school's program and the modification or accommodations he sought were found to be unreasonable.
From the defendant medical school's viewpoint, the problem was not the student's disability, per se, but his objectionable behavior that may well have stemmed from the disability. To determine whether a plaintiff has satisfied the burden of establishing that he or she is qualified for an educational program, a court must decide whether the plaintiff has presented sufficient evidence to show (1) that he or she could satisfy the essential eligibility requirements of the program, that is, those requirements that bear more than a marginal relationship to the program at issue; and, if not, (2) whether any reasonable accommodation by the defendant would enable the plaintiff to meet these requirements. For purposes of this analysis, the court in Halpern began with the premise that the University's professional judgment as to the medical student's ability to continue in the medical program with his ADHD and anxiety disorder and as to whether his proposed accommodations would effect substantial modifications to the program was entitled to deference.
The court concluded that the unprofessional behavior of the student and the real potential for such behavior to undermine patient care rendered the student, absent accommodation, not "otherwise qualified" for the University's medical school program, for purposes of determining whether his dismissal had violated the ADA and the Rehabilitation Act. Professionalism was a fundamental goal of the program and was required of all students, and the University reasonably pointed to evidence that inappropriate and disruptive behavior by physicians increased adverse patient outcomes. In addition, the student treated nonphysician staff unprofessionally, including being rude and abusive, he was resistant to constructive criticism, and he failed to appear for a family medicine exam.
The plaintiff's argument that there were reasonable accommodations of his disability that had not been implemented by the medical school fared no better before the Fourth Circuit. His request for accommodation for his ADHD and anxiety disorder, by means of a special remediation plan, which included ongoing psychiatric treatment, participation in a program for distressed physicians, and continuing in the University on strict probation, was not reasonable. The student had not informed the University of his disability for several years and had initially requested only testing accommodations; by the time he requested the remediation plan, he had already engaged in numerous unprofessional acts, including acting abusively towards staff and taking multiple unexcused absences. In addition, the proposed accommodation was of indefinite duration and had an uncertain likelihood of success, and the student had reverted to unprofessional conduct even after university officials attempted to intervene or to rectify his conduct, including permitting him medical leave.
