Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca8-03-03469/USCOURTS-ca8-03-03469-0/pdf.json

Parties Involved:
Christopher L. Falcone
Appellant
University of Minnesota
Appellee

Document Text:

1

The HONORABLE JOHN R. TUNHEIM, United States District Judge for the

District of Minnesota.

United States Court of Appeals

FOR THE EIGHTH CIRCUIT

___________

No. 03-3469

___________

Christopher L. Falcone, *

*

Plaintiff - Appellant, *

* Appeal from the United States

v. * District Court for the

* District of Minnesota.

University of Minnesota, *

*

Defendant - Appellee. *

___________

Submitted: June 16, 2004

Filed: November 15, 2004

___________

Before LOKEN, Chief Judge, JOHN R. GIBSON and BYE, Circuit Judges.

___________

LOKEN, Chief Judge.

When Christopher Falcone was admitted to the University of Minnesota

Medical School, he advised the University’s Disability Services Office that he suffers

from learning disabilities. Falcone received accommodations but was dismissed from

the medical school after failing three clinical courses. He then commenced this

action, claiming the dismissal violated Section 504 of the Rehabilitation Act of 1973,

29 U.S.C. § 794(a). The district court1

 granted summary judgment in favor of the

University, and Falcone appeals. Reviewing the grant of summary judgment de novo,

Appellate Case: 03-3469 Page: 1 Date Filed: 11/15/2004 Entry ID: 1833733 
-2-

and viewing the facts in the light most favorable to Falcone, we affirm. See Amir v.

St. Louis Univ., 184 F.3d 1017, 1024 (8th Cir. 1999) (standard of review). 

I. Background.

The University divides its four-year medical school curriculum into two parts.

After two years of courses in a classroom setting, students undertake clinical rotations

during the third and fourth years. When Falcone began taking classroom courses in

September 1995, he was allowed extra test time, flexible deadlines, and tutoring,

accommodations similar to those afforded when he obtained undergraduate and

master’s degrees from Berkeley and the University of Illinois. By November 1995,

he was nevertheless failing two first year courses and had missed an exam in a third

course. The University’s Committee on Student Scholastic Standing (“COSSS”)

recommended that he switch to a part-time schedule, and Falcone agreed. 

In the 1995-96 academic year, Falcone successfully completed five of fourteen

Year One courses, but he failed Human Genetics and was therefore required to appear

before COSSS. After an August 1996 meeting, COSSS advised Falcone that he must

complete the nine remaining Year One classes, including Human Genetics, during the

1996-97 academic year. Failure to do so, COSSS warned, “may result in a hearing

for dismissal.” Falcone also consulted with a Disability Services Specialist and

agreed to the following accommodations: double time and a private room for

examinations, a microscope and slides for home use, student notes, and regular

meetings with his faculty mentor. Falcone nonetheless failed Pathophysiology II in

March 1998 and Pathophysiology IV in May 1998. COSSS permitted him to take

make-up exams in these courses, despite a medical school policy that students below

the eighty percent passing rate may not retake examinations. With this additional

accommodation, Falcone completed his two years of classroom courses and began

clinical rotations in the summer of 1998.

Appellate Case: 03-3469 Page: 2 Date Filed: 11/15/2004 Entry ID: 1833733 
2

The accommodations included double time and a private environment for

exams, flexible breaks during the day, permission to use checklists for clinical

procedures and to take notes during meetings, and “access to at least weekly,

regularly scheduled feedback meetings” with the instructors. 

-3-

Falcone failed the Pediatric Neurology clinical rotation in the following winter

quarter. The Associate Dean for Student Affairs wrote him advising that he must

appear before COSSS to request permission to repeat the course. If permission was

denied, the Dean explained, or if permission was granted and he again failed, or failed

any other clinical course, “a hearing for dismissal will be held.” Falcone appeared

before COSSS in February 1999. He explained that he failed Pediatric Neurology

because he was petrified by the fragile babies, intimidated by the faculty, and

unprepared for the rotation. After a Disability Specialist developed a new list of

accommodations for his clinical rotations,2

 COSSS allowed Falcone to repeat the

pediatric neurology rotation but warned that “if you fail another clinical rotation, you

will be subject to a hearing for dismissal.” A letter defining the new accommodations

was sent to Falcone’s clinical rotation instructors. At least two may not have received

the letter, and another told Falcone it made him look incompetent. 

Falcone failed the Clinical Medicine IV rotation in October 1999 and appeared

before COSSS in December. COSSS allowed Falcone to remain in school and retake

the course because he was not provided reasonable accommodations but expressed

“substantial concerns about your overall readiness to obtain an M.D. degree.”

Falcone then failed Emergency Medicine in February 2000, his third failure in a

clinical course. After a lengthy hearing, COSSS unanimously voted to dismiss him

from the medical school. In an April 3, 2000, letter notifying Falcone of the decision,

the Chair of COSSS wrote:

The Committee based its decision to dismiss you primarily on two

factors: (1) the Committee felt that you had received appropriate

accommodations on the Emergency Medicine rotation as requested by

Appellate Case: 03-3469 Page: 3 Date Filed: 11/15/2004 Entry ID: 1833733 
-4-

Disability Services; and (2) you have been unable to demonstrate, with

or without accommodations, that you can synthesize data obtained in a

clinical setting to perform clinical reasoning, which is an essential

element of functioning as a medical student and ultimately as a

physician.

Falcone appealed this decision and again appeared before COSSS, expressing the

view that he “could become a physician scientist and have a bright future in basic

research.” COSSS voted unanimously not to reinstate him. The Chair’s letter to

Falcone explained that COSSS “continues to believe that you cannot adequately

synthesize data obtained in a clinical setting to perform clinical reasoning . . . .

Without these skills, the Committee believes you could compromise patient safety as

a physician.” 

II. Discussion.

Section 504 provides, “No otherwise qualified individual with a disability . . .

shall, solely by reason of her or his disability . . . be denied the benefits of . . . any

program or activity receiving Federal financial assistance . . . .” Section 504 applies

to postgraduate education programs that receive or benefit from Federal financial

assistance. See 45 C.F.R. § 84.41. However, the statute does not require an

educational institution to lower its standards for a professional degree, for example,

by eliminating or substantially modifying its clinical training requirements. “An

otherwise qualified person is one who is able to meet all of a program’s requirements

in spite of his handicap.” Southeastern Cmty. Coll. v. Davis, 442 U.S. 397, 406

(1979); see 45 C.F.R. § 84.44(a) & App. A ¶ 31. 

To avoid summary judgment on his wrongful dismissal claim, Falcone must

present sufficient evidence that he was disabled, otherwise qualified, and dismissed

solely because of his disability. See Jeseritz v. Potter, 282 F.3d 542, 546 (8th Cir.

2002); Amir, 184 F.3d at 1029 n.5. The University concedes for purposes of

Appellate Case: 03-3469 Page: 4 Date Filed: 11/15/2004 Entry ID: 1833733 
-5-

summary judgment that Falcone is disabled. The issues, then, are whether Falcone

presented sufficient evidence that he was “otherwise qualified” to remain in medical

school but was nonetheless dismissed solely because of his disability. 

A. Taking up the easier issue first, we agree with the district court that no

rational factfinder could conclude that Falcone was dismissed solely because of his

learning disabilities. The University explained that Falcone was dismissed because

“you have been unable to demonstrate, with or without accommodations, that you can

synthesize data obtained in a clinical setting to perform clinical reasoning, which is

an essential element of functioning as a medical student and ultimately as a

physician.” Falcone presented no evidence that this explanation was pretextual, or

that the University’s decision was a bad faith exercise of its virtually unrestricted

discretion to evaluate academic performance. See Bd. of Curators of the Univ. of Mo.

v. Horowitz, 435 U.S. 78, 95 (1978) (Powell, J., concurring) (evaluating performance

in clinical courses “is no less an ‘academic’ judgment . . . than assigning a grade to

. . . written answers on an essay question”). “We will not invade a university’s

province concerning academic matters in the absence of compelling evidence that the

academic policy is a pretext for [disability] discrimination.” Amir, 184 F.3d at 1029.

Falcone argues that he presented sufficient evidence of bad faith because he

was not provided all the accommodations listed in the Disability Specialist’s letter in

every clinical rotation. However, it is uncontroverted that the University made

numerous accommodations throughout Falcone’s medical school career, bending its

policies and giving him additional chances when his performances raised serious

concern about his ability to function as a physician. Despite these accommodations,

Falcone failed three clinical courses, after he failed numerous classroom courses

before finally completing that part of the curriculum. “Nothing in the record suggests

that the University’s decision was based on stereotypes about [Falcone’s disability]

as opposed to honest judgments about how [he] had performed in fact and could be

expected to perform.” Anderson v. Univ. of Wis., 841 F.2d 737, 741 (7th Cir. 1988);

Appellate Case: 03-3469 Page: 5 Date Filed: 11/15/2004 Entry ID: 1833733 
-6-

see Hines v. Rinker, 667 F.2d 699, 703 (8th Cir. 1981) (“no genuine issue of material

fact is presented . . . where the record provides ample evidence of the dismissed

student’s scholastic ineptitude”) (quotation omitted). 

The University was not required to tailor a program in which Falcone could

graduate with a medical degree without establishing the ability to care for patients.

Based on the uncontroverted evidence of Falcone’s academic deficiencies, the only

reasonable inference from this record is that he was dismissed because of the

University’s genuine concern about his inability to synthesize clinical data.

B. In addition, we agree with the district court’s alternative ground, that

Falcone failed to present sufficient evidence that he was otherwise qualified to remain

in the University’s medical school program. It is undisputed that Falcone was not

qualified to remain in medical school without accommodations. He then bears the

burden “to establish that reasonable accommodations for his disability would render

him qualified for the medical school program.” Stern v. Univ. of Osteopathic Med.

& Health Scis., 220 F.3d 906, 909 (8th Cir. 2000). 

Falcone argues that genuine issues of material fact preclude summary judgment

on this issue because he did not receive one of the agreed accommodations in all his

clinical courses -- access to at least weekly, regularly scheduled feedback meetings

with each instructor -- and because his performance improved in clinical rotations

when he received that level of feedback. In prior medical school cases, the issue has

been whether the students requested reasonable accommodations that the universities

refused to provide. See Stern, 220 F.3d at 908-09; Zukle v. Regents of the Univ. of

Cal., 166 F.3d 1041, 1048-51 (9th Cir. 1999). Here, on the other hand, the parties

agreed on the accommodations to be provided, but Falcone argues they were

imperfectly delivered. The University’s COSSS disagreed and also concluded that

he was, in any event, academically unfit. The latter point is critical -- even if there

is a genuine fact dispute over whether the feedback accommodation was perfectly

Appellate Case: 03-3469 Page: 6 Date Filed: 11/15/2004 Entry ID: 1833733 
-7-

implemented, Falcone must still show that, if it had been perfectly implemented, he

would have passed the clinical courses that he failed. We agree with the district court

that Falcone did not meet this burden. 

The University presented abundant evidence supporting its conclusion that no

amount of additional feedback would have made Falcone “otherwise qualified” to

remain in school and receive a medical degree. In Emergency Medicine, Falcone

acknowledged that he received feedback at the end of each shift from the residents

with whom he worked and never approached the course instructors for additional

feedback, yet he failed that course, his third failure in a clinical rotation. In Renal

Medicine, a clinical course in which Falcone praised the level of feedback provided,

the instructor did not issue a grade because Falcone’s “fundamental abilities for

clinical medicine were not sufficient,” and he was “not able to handle the load and

working pace of an intern in an internal medicine program.” In addition, Falcone’s

Pediatric Neurology instructor had “great reservations about [his] ability to practice

medicine.” His Otolaryngology instructor noted his inability “to synthesize the

information at hand into a practical, workable plan.” And his Surgery instructor

noted that all faculty and residents who worked with Falcone “expressed concern with

his ineptitude to relate with patients.” 

Falcone did not controvert this evidence, nor did he present evidence other than

his own opinion that he would have become “otherwise qualified” had he been

provided more or better instructor feedback. Falcone failed an unacceptable number

of clinical courses because he could not “synthesize data obtained in a clinical setting

to perform clinical reasoning.” He failed to present evidence showing that more

feedback or better delivery of any other agreed accommodation would have cured this

deficiency. Accordingly, the grant of summary judgment on this issue was proper.

The judgment of the district court is affirmed.

______________________________

Appellate Case: 03-3469 Page: 7 Date Filed: 11/15/2004 Entry ID: 1833733