Table 5.
Medical Student Dismissal Cases That Raised Lack of Due Process in Addition to Other Causes of Action.
| Case and Year Decided | Type of Dismissal | Case Scenario | Outcome |
|---|---|---|---|
| Failure of courses/modules in preclerkship curriculum | |||
| Giles v Howard University 5 (1977) | Academic | Student passed all first semester courses except biochemistry. School allowed him to continue and he passed all second semester courses but failed biochemistry retake, a curriculum requirement. Student was put on academic probation and required to repeat first-year courses including biochemistry. During his repeat first year, he passed biochemistry and failed anatomy and was dismissed. Student requested readmission. The school said they would consider the request provided he passed the NBME subject exams in anatomy, biochemistry, microbiology, and physiology. He failed all 4 exams and his request for readmission was denied. He filed a lawsuit raising due process issues. The court found under the school’s promotion policy it had the right to dismiss failing students and it had provided the student an opportunity to remediate. | Dismissal upheld |
| Leacock v Temple University School of Medicine 10 (1998) | Academic | See text Case 3. | Dismissal upheld |
| Naglak v Berlin 11 (1989) | Academic | Student failed 2 second year courses, pathology and pharmacology at Penn State and was dismissed for academic reasons. She filed a lawsuit for due process violation. Penn State settled with her in which she agreed to withdraw from the school and not seek reenrollment. Penn State had agreed to accept her remedial courses in pathology and pharmacology from another school and state she had completed 2 years of medical school and was a student in good standing. The student subsequently applied to other schools but was informed she could not be considered a transfer student without passing the NBME Part 1 exam. Not having student status, she was ineligible for the NBME exam or admission as a transfer student. She filed a lawsuit alleging she was fraudulently induced to settle with Penn State and that Penn State’s failure to provide her means to transfer to a different accredited medical school deprived her of her educational property rights without due process. | Dismissal upheld |
| Nichols v McDonald 13 (1990) | Academic | Student was admitted to the University of Iowa’s College of Medicine Educational Opportunities Program designed to give disadvantaged students access to a medical education. In this program, basic sciences courses are taken during the first 3 semesters. Student had academic difficulties failing biochemistry during the first semester that he remediated, failing physiology during the spring semester that was remediated at a different school after having been put on probation. He was taken off probation and passed all second-year fall courses. During his fourth semester, he failed the school’s Introduction to Clinical Medicine (ICM) course and was put on probation with the requirement to pass the course during the spring semester. Student appealed the decision requesting he take a make-up exam. The school’s Promotions Committee denied the request. He took a leave of absence and failed the ICM course upon his return for the spring semester. The Promotions Committee reviewed his entire academic record and recommended dismissal. On appeal, the school’s Executive Committee upheld the dismissal. The student filed a lawsuit claiming the Promotions Committee’s decision deprived him of his procedural due process rights. | Dismissal upheld |
| Watson v University of South Alabama College of Medicine 14 (1979) | Academic | Student was admitted to University of South Alabama. During his first year, he was enrolled in 10 different courses. He received 4 failing grades, 1 below average but passing grade, 1 average grade, and 4 passing grades. The school’s promotions committee reviewed the student’s entire academic record and recommended dismissal. The student appeared in front of the committee stating financial difficulties and family problems interfered with his studies and requested that he be allowed to repeat the first year. The committee reaffirmed their dismissal decision which was upheld by the Dean on appeal. The student filed a lawsuit alleging racial discrimination, breach of contract for failing to comply with the student bulletin, and lack of due process. | Dismissal upheld |
| Failure of USMLE Step examinations | |||
| Regents of the University of Michigan v Ewing 2 (1985) | Academic | See text Case 2. | Dismissal upheld |
| University of Mississippi Medical Center v Hughes 15 (2000) | Academic | Student at time of enrollment in 1992, based on the school’s academic guidelines, was required to maintain a grade point average (GPA) of 75. There was no requirement to pass the USMLE, although it was a state requirement for licensure. In 1993, the school’s faculty recommended passage of the USMLE as a requirement to enter the junior year, a requirement set by most medical schools. Students were notified of the requirement in 1993. Student passed all his courses, but failed the USMLE twice in 1994. The school provided him the option to enroll in a self-study program with leave of absence until the 1995 exam. In 1995, the school required passing Step 1 and students failing the exam would be dismissed. In 1995, student failed the exam, his third attempt and was dismissed. Student appealed the dismissal but it was upheld. Student filed a lawsuit alleging breach of contract by the school for changing its graduation requirements and lack of due process. A lower court stated that the school’s decision was arbitrary and for the school to allow the student to sit for the 1997 exam and readmit the student so he could sit for the exam. The school challenged this decision at an appellate court. The appellate court reversed the lower court’s decision and stated due process had been provided and the school had the right to modify its education requirements given that passage of the USMLE was a state requirement for licensure. | Dismissal upheld |
| Ward v Rush-Presbyterian- St. Lukes Medical Center 16 (1986) | Academic | Rush Medical College adopted a rule requiring students pass the NBME Part 1 exam prior to starting their third year. Students failing the exam by November of their third year were put on probation with their entire academic record reviewed by the Promotions Committee. Students who failed it 3 times were subject to dismissal and removed from clinical duties to prepare for the exam. Several students filed a lawsuit alleging the school’s NBME requirement was arbitrary and capricious and they were victims of racial discrimination. The court held the faculty’s professional judgment on standards was not reviewable and there had been adequate due process and no evidence of discrimination. | Dismissal upheld |
| Failure of clerkships | |||
| Bain v Howard 12 (2013) | Academic | Student enrolled at Howard University. He passed his first-year courses. During his second year, he failed a neuroscience course which he successfully remediated. He subsequently failed USMLE Step 1 but passed it on his second attempt. During his third year, he failed the NBME subject exams in psychiatry and surgery. He failed retake exams which led him failing the clerkships. He also failed the subject exam in obstetrics but did not take a retake. Per Howard’s policy, he could have been dismissed for failing 2 clerkships; however, Howard let him repeat the third year. During his second attempt at the third-year curriculum, he failed the NBME subject exams in pediatrics, psychiatry, and obstetrics leading to his dismissal per school policy. He subsequently filed a lawsuit alleging breach of contract and failure to comply with LCME standards. The court agreed there was a contractual obligation; however, stated that his repeated NBME subject exam failures, exams graded external to Howard, did not indicate arbitrariness on Howard’s part and his dismissal was for academic reasons. | Dismissal upheld |
| Board of Curators of University of Missouri v Horowitz 1 (1978) | Academic | See text Case 1. | Dismissal upheld |
| Eiland v Wolf 17 (1989) | Academic | Student had completed all the school’s academic requirements except for a fourth-year elective course in community health that led to his dismissal. He filed a lawsuit alleging lack of due process and violation of his equal protection rights. A lower court agreed with the student and directed reinstatement and awarding of the MD degree. The school appealed the decision. The appellate court reviewed the student’s entire academic record and commented that the student had failed 4 clinical rotations that included internal medicine, pediatrics, and dermatology that were remediated. The school’s Promotions Committee that reviewed the entire student record prior to graduation recommended dismissal. The student had requested the committee to reverse their recommendation which was to no avail. The student then appealed to the Dean who reversed the committee’s dismissal decision and put the student on probation. The student subsequently remediated the clerkships he failed, but failed the community health requirement, a graduation requirement. The Promotions Committee reviewed the student’s entire record again and recommended dismissal, which was upheld by the Dean the second time leading to the student to seek legal redress. | Dismissal upheld |
| Greenhill v Bailey 18 (1974) | Academic | Student was accepted with advanced standing after his application for admission through the traditional process had been rejected twice. His undergraduate GPA was 2.54 where the mean of the accepted class was 3.4. Prior to his acceptance, he completed 2 years at the College of Osteopathic Medicine where his grades were at the bottom of the class. He failed the NBME Part 1 exam but passed it on retake. During his clerkships, he failed obstetrics and internal medicine and received the lowest passing grade in pediatrics. The Promotions Committee reviewed the student’s entire academic record and recommended dismissal which was upheld by the school. The student filed a lawsuit alleging the school’s decision was arbitrary and capricious based in part on subjective evaluation during clerkships and that there was lack of procedural due process due to the student not being allowed to be present at a Junior Class Promotion Committee meeting. | Dismissal upheld |
| Hill v University of Kentucky 19 (1992) | Academic | See text Case 4. | Dismissal upheld |
| Lunde v Iowa Board of Regents 20 (1992) | Academic | Student entered medical school in 1985. During her preclerkship courses that she passed, she was noted to have issues relating to others, inappropriate behavior, falling asleep in class, and the inability to prioritize information, separating relevant from irrelevant data. During her clerkships, her behavior toward faculty, residents, and her peers was inappropriate and she was unable to synthesize relevant information leading to her failing several clerkships, neurology, urology, and obstetrics. She was placed on probation and allowed to retake the clerkships she failed. She failed them a second time and the school dismissed her. She filed a lawsuit alleging sexual discrimination, equal protection violation, and violation of free speech and due process concerns. | Dismissal upheld |
| Moire v Temple University School of Medicine 21 (1985) | Academic | Student was enrolled in Temple. During her third year, she failed her psychiatry clerkship. The Student Promotions Committee, after reviewing her entire record, recommended she repeat the entire third year on probation. The Committee’s decision was upheld after appeal to the Dean. She subsequently graduated from Temple and obtained an internal medicine residency. She then filed a lawsuit alleging sexual harassment (Title IX) leading to her failure of psychiatry clerkship and lack of due process. | Claim dismissed. No due process violation. No sexual discrimination. |
| Mustell v Rose 22 (1968) | Academic | Student passed his preclerkship courses and failed medicine and surgery during his third-year clerkships. The school’s policy was that a student could repeat a failure of one course but failure of 2 courses in the same academic year led to dismissal. The student Promotions Committee reviewed the entire student record and recommended dismissal. The student was notified by mail of the Committee's decision. The Dean approved the recommendation and notified student. The student filed a lawsuit alleging he did not have the opportunity to appear before the Promotions Committee and his failing grades were arbitrarily decided. | Dismissal upheld |
| Sofair v State University of New York 23 (1976) | Academic | Student had academic difficulty during his medical school curriculum. He failed pathology during his second year that was remediated. He failed medicine and surgery during his third year that were successfully remediated. He failed nephrology during his fourth year. At the time his peers graduated, he still lacked 2 courses required for graduation. The school’s Promotions Committee, based on review of his academic record including grades and narratives, recommended he repeat the entire fourth year following a structured program designed by the Promotions Committee. During his repeat fourth year he took 4 courses, passing 3 and failing a 6 week surgery internship. He had secured an internship in medicine. The Fourth Year Medical Grades Committee notified student in writing they were recommending dismissal because he failed to demonstrate adequate clinical aptitude. He was notified that he had the right to appeal. The school’s Committee on Academic Promotions had reserved time for him later that day, the day he was notified. He received a second letter from the Committee that day stating they were following the Grade Committee’s recommendation. Student filed a lawsuit alleging the school’s decision was arbitrary and capricious. Student stated that there was lack of procedural due process given that he received notice of dismissal without notifying him of the factual basis for the deficiencies noted in his clinical aptitude and not providing him time to appear in front of the Academic Promotions Committee to present his side of the case. The court reversed the student’s dismissal and notified the school to provide the student a detailed written statement regarding findings used to conclude student lacked clinical aptitude and provide student the opportunity to be heard after he had time to review the written statement. After the hearing, the school could make a more informed decision regarding dismissal the court stated. | Dismissal reversed pending adequate notice to student and hearing |
| Stoller v College of Medicine 24 (1983) | Academic | Student entered school in 1976. During the fall term, he failed microbiology and was placed on probation. In the winter term, he failed biochemistry. His record was reviewed and he was informed he would be subject to dismissal without improvement. He was allowed to enter the second year on probation. During his second year, he passed behavioral science but the course director commented his responses to questions reflected poorly on his discretion and judgment. His record was reviewed and based on comments from the behavioral science course was considered for dismissal. He was directed to discontinue research and focus on academics. Subsequently, he was taken off academic probation. During his third year, he failed surgery and was notified by the Promotions Committee that he was subject to dismissal and placed on probation. He passed his psychiatry, neurology, and obstetrics clinical rotations. Halfway through his pediatrics clerkship, he was perceived as being weak and told by the clerkship director to improve his academic performance. The pediatrics’ faculty met and awarded grades to all students except for this student. The department decided to give him an oral exam due to weakness in his clerkship performance. Although his fund of knowledge was passable, the examiners felt he should repeat the clerkship. The clerkship director, based on all evaluations and the exam results, gave student a failing grade. The Promotions Committee met and reviewed his entire record and recommended dismissal after the student had appeared. The student’s record was reviewed by the Dean after meeting with the student and the student was dismissed. His appeal to the university President was denied. The student filed lawsuit alleging the dismissal decision was arbitrary and capricious and lacked procedural due process. | Dismissal upheld |
| Lack of professionalism | |||
| Abbas v Woleben 6 (2013) | Academic | Student was admitted to medical school in 2006. After completion of the first 2 years of school, the school granted student 5 leaves of absence for health and personal reasons from June 2008 until January 2011. Student had been recommended for dismissal in 2009 for not taking the USMLE by Promotions Committee. The recommendation was not upheld by the Dean. In January 2011, he was given notice of an upcoming Promotions Committee meeting. The Promotions Committee met in January 2011 and recommended dismissal for lack of academic progress. The letter did not inform the student of his right to appeal. Further, the school administrators informed him that he could not protest decision. Student was dismissed and filed a lawsuit alleging breach of contract and lack of due process. | Dismissal upheld |
| Corso v Creighton 25 (1984) | Academic | Student during his first year of medical school was accused of cheating on his first year final examinations. The student was notified of the allegation in writing. The Acting Dean established a committee to investigate the allegation. The committee stated that the student had collaborated with another student. The school’s Advancement Committee recommended to the Executive Committee and Dean expulsion. The student was notified in writing and by phone. He was informed he could respond to the charge and respond to the Associate Dean for Student Affairs. Student met with the Associate Dean to discuss the issue denying the cheating. He requested to appear in front of the Executive Committee but that request was denied. The Acting Dean conducted his own investigation interviewing 20-25 students. The Acting Dean met with student and he denied cheating. Several of the other 25 students admitted cheating and implicated student in the cheating and student was expelled. Student filed a lawsuit alleging breach of contract. The lower court stated that student was dismissed for lying, a nonacademic offense, which required certain due process requirements. The appellate court disagreed and stated the offense was cheating, even though student lied about it and it was academic in nature. The appellate court also stated the student handbook is contractual. Based on procedures elaborated in the handbook, they found the school was not in compliance with their own policy that required a university committee, not school committee, to adjudicate serious offenses, expulsion meeting that criterion. The court concluded that the student must be afforded the procedural safeguards to appear before a university committee before the school rendered a decision. | Dismissal reversed pending committee hearing specified in student handbook |
| Doherty v Nellis 26 (2016) | Nonacademic | Student was a second-year medical student who was alleged to have assaulted a staff member in the student recreational center in June of 2014. Review of the student’s record documented going back to November 2012, there had been complaints of inappropriate behavior by female students at school functions against student. During 2013, female student members of the first-year class expressed concern about their safety and inappropriate behavior. The incident was addressed by the university through several meetings and dialogues with student and his attorney. In September 2014, the Student Conduct Board recommended dismissal. Student appealed decision to the university Provost who concurred with decision. Student filed a lawsuit alleging lack of due process, unlawful taking, violation of American with Disabilities Act, and conspiracy claim. | Dismissal upheld |
| Fernandez v Medical College of Wisconsin 27 (1996) | Academic | Student was admitted in 1987 and entered school’s 5 year program. During her second year, she took a semester leave of absence for scheduling issues and a subsequent semester leave of absence for health reasons. Student was warned by school’s Academic Standing Committee of her lack of academic progress that could lead to dismissal. Student was informed by school that she needed to complete her biochemistry course, take a full load of second-year courses, and take the NBME exam in June. Due to issues at the school, the June exam was not offered. The school notified all students in a memo they were encouraged to take the exam in September. Student did not take the exam. The school’s Academic Standing Committee reviewed student’s entire academic record and recommended dismissal based on failure to meet previous mandates and unprofessional behavior. Unprofessional conduct identified was not taking the NBME exam, not taking other examinations, and repeated leaves of absence for personal and academic reasons. The Committee provided her notice and said they would consider other grounds they discovered. Student also received notice that it would consider evidence of unethical conduct (dishonesty) that included misrepresentation regarding loans, reasons for not taking NBME exam, lack of congruency in health insurance application, and false pledges during an alumni phonathon. At student’s request, an ad hoc committee was convened to evaluate dishonesty claims. Student appeared with her attorney and was allowed to call witnesses and the session was tape-recorded. The Ad Hoc Hearing Committee found the dishonesty claims credible. The Academic Standing Committee subsequently convened and considered the dishonesty claims as being relevant to student’s credibility. The Committee found she failed to demonstrate the required level of professional responsibility in not taking exams in a timely manner, not accepting responsibility for her actions, and disregarding mandates about the NBME exam. After review of her entire record, the Committee recommended dismissal. An Appeals Committee upheld the dismissal. Student filed a lawsuit alleging defamation, infliction of emotional distress, breach of contract, lack of substantive due process, conversion of student loan money, breach of fiduciary duty, and fraud. | Dismissal upheld |
| Flaim v Medical College of Ohio 28 (2005) | Nonacademic | Student was a third-year medical student arrested and convicted of a felony drug crime. Two days after his arrest, school notified him in writing that he was suspended until an external investigation/hearings were completed. He was also informed of his right for an internal investigation. He declined to appear until criminal charges were adjudicated. After pleading guilty to one charge, he contacted the school and received written notice that he would appear in front of Student Conduct and Ethics Committee. The Committee heard testimony from the arresting officer and was able to review portions of his criminal record. The Committee informed him after the hearing that it would provide the Dean with a written recommendation. The recommendation was never generated. The Dean expelled the student 2 days after the hearing for violation of the institution’s code of conduct. Student filed lawsuit alleging lack of due process. | Dismissal upheld |
| Jenkins v Hutton 29 (1997) | Academic | Student passed the first 2 years of medical school without difficulty. Student failed the NBME Part 1 exam in June 1990. He also failed to show up for his third-year rotations. A month into the third year he requested a leave of absence to study for NBME exam. His request was granted. Student however did not take the next scheduled NBME exam in June 1991. He was called to a Promotions Board meeting in November 1991 to discuss why he didn’t take the NBME exam. He failed to attend. In March 1992, he was requested to meet the Board again. He was informed he must take the exam in June 1992. He again did not take it. The Board sent him notice that he could not start his fourth year until he took the exam. He was also required to complete his final 2 years of coursework in 3 years requiring him to complete all course work by graduation day, June 1994. Student completed his third year during 1991-1992 academic year. He took only one course in order to study for NBME exam during the 1992-1993 academic year. He passed the NBME exam in June 1993. He passed all his fourth-year rotations with high pass or honors. He registered and completed his final rotation after graduation in June 1994. The Board met in June. Student was present and addressed the Board. The Board voted to adhere to its original guidelines of completion of all requirements by graduation day, June 1994 and voted for dismissal. Student appealed the decision. The decision was upheld by the Appeals Board and Dean. Student was dismissed for failure to complete the program in specified time period. Student filed lawsuit-alleging lack of due process. | Dismissal upheld |
| Lee v University of Michigan-Dearborn 7 (2007) | Nonacademic | Student was alleged to have interfered and harassed a university professor through obscene gestures, filming her, stalking her, and sending her slanderous e-mails. Inappropriate comments were present in some assignments. The faculty member filed a complaint against the student. A hearing was conducted by a Non-Academic Conduct Board where the student, university professor, and other witnesses appeared. Evidence indicated that the university professor had obtained a personal protection order against the student. The University’s Hearing Board found the student guilty of the following university code violations: “B.3 Interfering with Liana McMillan’s University business, ie, studying, teaching, administration; B.5. Harassment, ie, stalking that involved deliberate interference or a deliberate threat to Liana McMillan; B.7. Failing to comply with the directions of University officials and campus safety; B.14. Violating published University policies, including those regarding affirmative action.” The Hearing Board recommended expulsion. The student appealed the decision to a university Code Appeals Board. The Board found that the student had adequate due process but the sanction of expulsion was too excessive and reduced the penalty to “expulsion in abeyance” with the condition of no further contact (verbal, written, electronic, or other contact) with the professor and the student pursue counseling. Violation of this condition would lead to expulsion and the student was allowed to continue classes. While the student was appealing the Code Appeals Board’s decision in the Michigan Court of Claims, she was expelled for violating the no-contact provision for sending an e-mail where the professor along with others were contacted. |
Due process claim dismissed |
| Stathis v University of Kentucky 30 (2005) | Nonacademic | See text Case 5. | Dismissal upheld |
Abbreviation: LCME, The Liaison Committee on Medical Education.