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Dean v. University at Buffalo School of Medicine and Biomedical Sciences

United States District Court, W.D. New York

March 31, 2014

MAXIAM DEAN, Plaintiff,
THE UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES, THE STATE UNIVERSITY OF NEW YORK, MICHAEL E. CAIN, M.D., Individually and in his official capacity as Dean of the University at Buffalo School of Medicine and Biomedical Sciences, and NANCY NIELSEN, M.D., Ph.d., Individually and in her official capacity as Senior Associate Dean of the University at Buffalo School of Medicine and Biomedical Sciences, Defendants.


WILLIAM M. SKRETNY, District Judge.


Plaintiff commenced this action on March 12, 2010, alleging that Defendants violated his rights under the Fourteenth Amendment to the United States Constitution; Title II of the Americans With Disabilities Act of 1990 (the ADA), 42 U.S.C. §§ 12131 et seq.; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794; and 42 U.S.C. §§ 1981 and 1983, when they dismissed him from the University at Buffalo School of Medicine and Biomedical Sciences' ("UBMED") M.D. program. Discovery is complete and Defendants have moved for summary judgment dismissal of Plaintiff's complaint under Rule 56 of the Federal Rules of Civil Procedure. The motion is fully briefed and the Court finds there is no need for oral argument. For the reasons discussed below, Defendants' motion is granted.


The University at Buffalo School of Medicine and Biomedical Sciences is an accredited medical school within the State University of New York system. At all relevant times, Defendant Cain was UBMED's Dean, and Defendant Nielsen was its Senior Associate Dean for Medical Education. Cain Decl. ¶ 1; Nielsen Decl. ¶ 1.

UBMED's M.D. program is a full-time, four-year course of study that is divided into two phases. The Year 1 and Year 2 modules/courses comprise the Phase I curriculum, and those in Years 3 and 4 comprise the Phase II curriculum. Plaintiff was admitted to the M.D. program in 2004. Nielsen Decl. ¶ 5; Dean Decl. ¶¶ 1, 3-4. He was dismissed from the program after completing his Phase 1 curriculum.

At all relevant times, UBMED had a written "Academic Status Policies" ("ASP") which sets forth, inter alia, its grading system of: Honors (H), High Satisfactory (S), Satisfactory (S), Unsatisfactory (U), and Incomplete (I). Nielsen Decl. ¶ 5 Bates 000224-246. Although not included in the ASP, UBMED also uses the designation "Z, " which is equivalent to a Satisfactory (S). Def's Stmt. ¶¶ 9-10. To progress from Year 2 to Year 3, a student "must pass all Phase I modules and elective courses." Bates 000234. A student fails to meet academic standards, and may be dismissed from the program, if he or she does not complete the Phase I curriculum within thirty-six months. Id . 000235, 238. A student may also be dismissed if he or she fails any required course/module/clerkship for a second time. Id . 000238.

Plaintiff completed his Phase I curriculum within the requisite thirty-six month period. He initially received a grade of Unsatisfactory in two courses during his Phase I studies. He retook those courses and received a grade of Satisfactory in each. Dean Decl. ¶¶ 5-7, Exh. B.

In addition to the Phase I curriculum requirements, a student cannot progress from Year 2 to Year 3 until he or she passes Step 1 of the USMLE[1] and the Year 2 Clinical Competency Examination. Bates 000233-234. Plaintiff took and passed his Year 2 Clinical Competency Examination in Spring 2006. Dean Decl. ¶ 82, Exh. V.

Students may not sit for Step 1 of the USMLE until they have passed all their Phase I modules and courses. Bates 000233. Students are allowed only three attempts to pass Step 1, and all attempts must be completed in one academic year exclusive of official (non study) leaves of absence. Id. at 000236. UBMED may dismiss any student who fails Step 1 of the USMLE three times. Id. at 000238. Plaintiff's deadline for successful completion of the Step 1 exam, exclusive of any non-study leaves of absence, was May 31, 2007. Dean Decl. ¶ 12.

On June 21, 2006, Plaintiff made a written request to Dr. Nielsen for a six-week leave of absence to study for the Step 1 exam, stating: "I will sit for the Step 1 on August 18, 2006." Nielsen Decl. ¶ 6, Bates 000086; Dean Decl. ¶ 87.[2] Dr. Nielsen granted the leave request and confirmed that Plaintiff was to attend his Third Year Orientation on July 10, 2006, and begin a Pediatric clerkship on August 21, 2006. after his leave. Id . ¶ 7, Bates 000086. On or about August 16, 2006, Plaintiff took, but failed, the Step 1 exam. Complaint ¶ 40; Docket No. 25-2 ("Dean Depo.") at 52.

By letter dated September 13, 2006, Dr. Nielsen advised Plaintiff that he would be permitted to complete his then-current Pediatrics clerkship, after which he would be placed on a six-week administrative leave of absence. She further advised that he must sit for the Step 1 exam by November 11, 2006 in order to begin the next scheduled clerkship on November 13. Dr. Nielsen requested that Plaintiff notify her in writing if he required more than six weeks to prepare to retake the exam, and reminded him of the one-year time period for his three attempts. Nielsen Decl. ¶ 8, Bates 000084.

On October 31, 2008, Dr. Nielsen received a note from Plaintiff stating that he would like to retake the Step 1 exam on December 23, 2006, rather than November 11, 2006. In a written response, she granted him an additional six-week leave of absence to study, and advised that he was to return to his third year curriculum on January 8, 2007 in a Psychiatry clerkship. Id . ¶ 10, Bates 000082-83. Plaintiff thereafter sought a further extension in order to attend the "Pass Program, " a private examination preparation course consisting of lectures and tutoring. Defs' Stmt. ¶ 30. Dr. Nielsen placed Plaintiff on an additional six-week study leave, and his return to the third year curriculum was postponed until February 19, 2007. Nielsen Decl. ¶ 11 Bates 000081.

By certified letter dated January 4, 2007, Dr. Nielsen reminded Plaintiff of the need to retake Step 1 no later than Saturday, February 17, 2007, so he could begin his scheduled clerkship the following Monday. The letter was later returned as unclaimed. Id . ¶ 12 Bates 000332-333. The University eventually was able to contact Plaintiff and, on or about January 24, 2007, he was read Dr. Nielsen's letter over the phone. Id . Bates 000330. Plaintiff again requested additional leave time, but Dr. Nielsen advised him that he had been afforded many months to prepare, there would be no more extensions, and he must sit for the Step 1 by February 17th or "be dismissed from medical school automatically." Id . ¶13, Bates 001055. Plaintiff characterized this response as unfair, stating his belief that he could delay his second attempt at the Step 1 exam until the end of May by waiving his third opportunity to take it. He then stated that he had experienced depression, stress and anxiety prior to attending the Pass Program, was convinced he could pass the Step 1 with the support and guidance he was receiving, but felt he needed an extra month in the program. Id . Bates XXXXXX-XX. Dr. Nielsen suggested that he retake the Step 1 by February 17th, but delay his return to the third year curriculum so as to remain in the Pass Program and continue his studies, at least until he received his test results and knew whether he would need to take the exam a third time. Id . Bates 001054.

Plaintiff took the Step 1 exam on or about February 16, 2007, but failed on this second attempt. Defs' Stmt. ¶ 35. On or about March 20, 2007, Dr. Nielsen advised Plaintiff that he would go on a leave of absence at the end of his then-current clerkship "in order to provide more study time for your third and final Step 1 examination." He was to sit for his final attempt by May 31, 2007, and was reminded that a third failure would result in his dismissal from medical school. Nielsen Decl. ¶ 15, Bates 000078.

In his Complaint, Plaintiff alleges that he became disabled sometime after his second attempt at the Step 1 exam. Compl. ¶¶ 40-42. On May 4, 2007, Plaintiff presented at the University's Counseling Services for a crisis evaluation session where he reported various depression-related symptoms, such as disrupted sleep, fatigue, and difficulty concentrating and maintaining focus. Dean Decl. ¶¶ 19-20, Ex. J. The psychologist he met with, Andrea Greenwood, Ph.D., recommended he seek assessment for medication to treat the symptoms of depression, and schedule a further appointment with her for a more comprehensive psychological assessment. Id . That same day, Plaintiff saw Dwight Lewis, M.D., who offered to prescribe medication. Plaintiff declined, indicating he wanted to first try counseling only. Dr. Lewis provided Plaintiff an excuse slip recommending that he take a three-month leave of absence from medical school due to situational depression. Plaintiff delivered the document to UBMED the same day. Id . ¶¶ 21-23, Exhs. D, K; Defs' Stmt. ¶ 39. Dr. Nielsen informed Plaintiff, by letter and email, that Dr. Lewis's excuse slip did not contain sufficient information to extend him leave. Nielsen Decl. Bates 000070; Dean Decl., Exh. F-H.

On May 17, 2007, when Plaintiff again met with Dr. Greenwood, she prepared a letter at his request advising Dr. Nielsen and the University Leave of Absence Committee about his reported symptoms and her recommendations. Dean Decl. Exh. J. On May 18, 2007, Plaintiff saw Dr. Lewis, indicated he was receptive to medication, and was prescribed Lexapro, an anti-depressant. On May 21, 2007, Dr. Lewis wrote to the Leave of Absence Committee and provided additional information as a follow up to his excuse slip, noting that Plaintiff's symptoms "were acutely exacerbated by a recent relationship discord." Defs' Stmt. ¶ 43; Dean Decl. Exhs. I, K. Both Drs. Greenwood and Lewis recommended a leave of absence to allow Plaintiff time to return to healthy/proper functioning. Neither provided a recommendation as to the leave duration. Dean Decl. Exhs. J, K. In Plaintiff's own letter to the Leave of Absence Committee, also dated May 21, 2007, he described the symptoms he had experienced in the past two months and requested three months' leave. Dean Decl. Exh. I. The following day, the Committee recommended that Plaintiff be granted a leave of absence until June 30, 2007, approximately six weeks after he started on Lexapro, to permit his mental health therapy to begin working. The Committee was of the view that Plaintiff should not be granted leave for additional "study time, " and that no further leaves be granted after June 30. Id . Exh. L. One day later, Dr. Cain, UBMED's Dean, accepted the Committee's recommendation, extended Plaintiff's deadline to retake the Step 1 exam to June 30, 2007, and reiterated that "[n]o further delays whatsoever will be granted." Id . Exh. N.

In Dr. Greenwood's May 17 letter to the Committee, she indicated that Plaintiff would be followed up by Dr. Warren, the Counseling Services' consulting psychiatrist, on May 31, 2007. Id . Exh. J. Following that appointment, Dr. Warren wrote a letter confirming that Plaintiff had started on Lexapro on May 18. He went on to note that Plaintiff had experienced some mild improvement, but continued to have signs and symptoms of major depression, and expressed his support for a leave of absence that would allow the prescribed treatment to become effective; a period of six to eight weeks. Id . Exh. O. By letter dated June 1, 2007, Plaintiff provided Dr. Cain a copy of Dr. Warren's letter and requested a three month leave of absence so he could "focus on preparing for the retake." Id . Exh. P. In short, he sought the full medical leave recommended by Dr. Warren, plus additional study time. Dr. Cain extended the deadline for Plaintiff to take the Step 1 exam to July 28, 2007-i.e., a period of just over ten weeks after Plaintiff began taking Lexapro. Id . Exh. Q.

Plaintiff alleges that he regained normal functioning in mid-July. Compl. ¶ 90. On or about July 23, 2007, an individual from the Pass Program, Dr. Francis, left a voicemail at Dr. Cain's office on Plaintiff's behalf. The following day, Dr. Nielsen sent Plaintiff an email advising that due to privacy regulations, "the school will not speak to anyone but a student about that student, " and would not be returning Dr. Francis's call. Defs' Stmt. ¶¶ 58-59, Bates 000277. The record contains no indication that Plaintiff responded to the email or ...

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