Powell v. National Bd. of Medical Examiners,
| Citation | 364 F.3d 79 |
| Decision Date | 07 April 2004 |
| Docket Number | Docket No. 02-9385. |
| Parties | Marie POWELL, Plaintiff-Appellant, v. NATIONAL BOARD OF MEDICAL EXAMINERS, University of Connecticut School of Medicine, Bruce M. Koeppen, Defendants-Appellees. |
| Court | United States Courts of Appeals. United States Court of Appeals (2nd Circuit) |
Aaron David Frishberg, New York, New York, for Plaintiff-Appellant.
Albert Zakarian, Hartford, Connecticut (Jennifer L. Sachs, Day, Berry & Howard, LLP, Hartford, Connecticut, of counsel), for Defendant-Appellee National Board of Medical Examiners.
Jane D. Comerford, Assistant Attorney General, University of Connecticut Health Center, Farmington, Connecticut (Richard Blumenthal, Attorney General, Hartford, Connecticut, of counsel), for Defendants-Appellees University of Connecticut School of Medicine, and Bruce M. Koeppen.
Before: WALKER, Chief Judge, NEWMAN, and CARDAMONE, Circuit Judges.
Plaintiff Marie Powell (plaintiff or appellant) appeals from a judgment of the United States District Court for the District of Connecticut (Thompson, J.) entered October 7, 2002, granting motions for summary judgment made by defendants the National Board of Medical Examiners (National Board), the University of Connecticut School of Medicine, and Bruce M. Koeppen, M.D., its academic dean (collectively, UConn or school). In two complaints, plaintiff alleges that defendants discriminated against her based on her alleged disability in contravention of the Americans with Disabilities Act of 1990, as amended, 42 U.S.C. § 12101 et seq. (ADA), and the Rehabilitation Act of 1973, as amended, 29 U.S.C. § 701 et seq. (Rehabilitation Act). Plaintiff contends UConn discriminated against her when it required that she pass the United States Medical Licensing Examination (licensing examination) administered by the National Board in order to continue into the third year of the school's medical program. She asserts further that the National Board discriminated against her when it refused her application for an accommodation on the examination. Several state law claims were also alleged in plaintiff's complaints, but the grant of summary judgment to defendants on these claims is not appealed.
Plaintiff is a young woman now in her 30's who 12 years ago matriculated at medical school where, after completing two years of course work, she experienced difficulties in passing the licensing examination required by the defendant medical school and administered nationally by the defendant testing service. After twice failing the licensing examination, plaintiff asked for an accommodation of more time to take it on the grounds that she had a learning disability. That request was denied and plaintiff took the test and failed it for the third time, and later was dismissed from medical school, prompting the litigation now before us on appeal.
To decide an appeal where what is involved is right versus wrong is not difficult; but where, as here, neither party has acted wrongfully, to make a just determination between the parties is difficult. A review of the record reveals plaintiff's perseverance and dedication to her studies and also reveals defendant school of medicine's truly extraordinary efforts to help plaintiff succeed. Applying the relevant legal standards, we affirm the grant of summary judgment in defendants' favor.
Powell enrolled in UConn's medical program in August 1992. She was discontinued as a student in 1997. At the time of her enrollment the school was unaware that plaintiff allegedly suffered from a disability. Of the 11 courses she took that made up the first-year curriculum, Powell was deficient in two of them. The first-year courses are referred to as Basic Medical Sciences I (BMS-I). After successfully completing remedial work with respect to one of the courses, plaintiff was promoted to the second-year curriculum, referred to as Basic Medical Sciences II (BMS-II). In her second year, Powell was deficient in four out of ten courses, resulting in the award of an unsatisfactory grade for BMS-II. In addition, in June 1994 Powell failed Step I of the United States Medical Licensing Examination.
Developed and administered by the defendant National Board, a private, non-profit corporation, the medical licensing examination is a comprehensive test. It is composed of three parts, or steps, and most medical schools in the United States require their students to pass Step I before advancing to the third-year medical school curriculum. Further, in all United States jurisdictions, passage of all three steps of the medical licensing examination is mandated in order to satisfy state licensing requirements to become a doctor. Step I, the part at issue in this case, is designed to assess a medical student's ability to apply the concepts, knowledge and principles that make up the fundamentals of patient care.
The 1992-93 UConn student handbook states that at the end of each of the first two years students are required to take a comprehensive examination, and that taking Step I fulfills the second-year requirement. The handbook further provides that the school may place conditions for promotion on a student who receives an unsatisfactory in BMS-II, including retaking and passing Step I. UConn stated that two to five students per year are asked to obtain a passing score on Step I as a condition for promotion to the third-year medical school curriculum.
In June 1994 plaintiff was informed by the Promotions Committee that in order to convert her BMS-II grade to satisfactory, and thus be eligible to begin the third year, she needed to pass Step I and remediate three of her course deficiencies. For two years — from June 1994 until June 1996 — plaintiff repeatedly attempted to fulfill these and other requirements for advancement to the third-year clinical curriculum. The school actively assisted her in these efforts by providing free tutoring services, overlooking an honor code violation she committed, expressing its concern with her level of stress and allowing her the opportunity to remediate certain subjects multiple times.
In June 1996 UConn conditionally promoted plaintiff to the third-year curriculum, again subject to her passing Step I of the medical licensing exam. The school wanted evidence that plaintiff had mastered the BMS-I and BMS-II subject matter since it had taken four years for her successfully to complete the first two years of the school's curriculum. UConn believed passage of Step I would provide them with that proof. In October 1996, after the school paid for plaintiff to take a preparatory course, she failed Step I again. In response, the school developed a six-month tutorial program for plaintiff to follow during the spring of 1997 in preparation for the June 1997 Step I exam, and did not charge plaintiff tuition for this period.
Powell failed the test again in June 1997 and the school initiated the process of dismissal. Final decision regarding the student's dismissal was deferred pending the outcome of her lawsuit against the National Board regarding its failure to grant her accommodation request, a matter which will be discussed below. If the National Board prevailed, plaintiff would be dismissed. If plaintiff prevailed, she would be given another chance to sit for Step I and, if she passed, would be allowed to continue to the third year of the medical program. As it turned out plaintiff did not prevail, and was later discontinued as a student.
In February 1997 plaintiff was referred to a neuropsychologist, Dr. A. Wallace Deckel. Dr. Deckel was employed by UConn's Department of Psychiatry and the medical school paid for his examination of plaintiff. Dr. Deckel's report concluded that, based on a battery of tests, Powell appeared to be suffering from dyslexia and attention deficit disorder (ADD), but the doctor also was of the opinion that anxiety and depression could not be ruled out as the causes of her academic problems. He recommended Powell be given extra time to take the Step I examination.
Plaintiff submitted a redacted version of Dr. Deckel's evaluation to the National Board as part of her application for an accommodation of extended or double time to take the June 1997 exam. The National Board rejected her request because it concluded Powell's documentation failed to establish that she was disabled and thus a covered individual under the ADA. It further noted that her documentation did not include objective evidence of difficulties she experienced before entering medical school, as would be expected were the disability a significant functional impairment. The National Board also faulted Dr. Deckel, stating that when making his diagnosis he did not provide full clinical data to support his conclusions, and that the role of plaintiff's anxiety and depression was not ruled out as the cause of her academic difficulties.
Powell later submitted an unredacted version of Dr. Deckel's evaluation, accompanied by an additional letter from him, addressing the National Board's concerns and stating his diagnosis. These materials were received too late for the June 1997 exam. Powell was told she could resubmit them for a later examination, although the National Board informed plaintiff that the additional information and documents she had submitted did not appear to support a test accommodation.
Having failed to obtain an accommodation and having been dismissed as a medical student in 1997, plaintiff filed two complaints against the National Board and UConn in 1999. The first complaint claimed violations of a number of state and federal statutes and sought all possible relief, including injunctive relief allowing plaintiff to sit for the medical licensing examination with an accommodation, and to be allowed to continue the third-year curriculum at the medical...
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