Halpern v. Wake Forest University Health Sciences

669 F.3d 454, 2012 WL 627788
CourtCourt of Appeals for the Fourth Circuit
DecidedFebruary 28, 2012
Docket10-2162
StatusPublished
Cited by245 cases

This text of 669 F.3d 454 (Halpern v. Wake Forest University Health Sciences) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Halpern v. Wake Forest University Health Sciences, 669 F.3d 454, 2012 WL 627788 (4th Cir. 2012).

Opinion

Mfirmed by published opinion. Judge FLOYD wrote the opinion, in which Judge NIEMEYER and Judge MOTZ joined.

OPINION

FLOYD, Circuit Judge:

Appellant Ronen Halpern brought an action alleging that his dismissal from medical school for unprofessional behavior violated the Rehabilitation Act of 1973, 29 U.S.C. § 794, and the Americans with Disabilities Act (ADA), 42 U.S.C. § 12182. The district court granted summary judgment in favor of Appellee Wake Forest University Health Sciences (Wake Forest or the Medical School). Halpern filed this timely appeal. Because we agree with the district court that, with or without a reasonable accommodation, Halpern was not “otherwise qualified” to participate in the Medical School’s program, we affirm.

I.

A.

Halpern was enrolled in Wake Forest’s Doctor of Medicine program from July 2004 to March 2009. As at most medical schools, Wake Forest’s curriculum is designed as a four-year program. During the first two years, students take classes *457 to acquire knowledge in core areas, and for the last two years, students participate in rotations in different clinical environments. Prior to beginning these rotations, students must pass Step One of the United States Medical Licensure Examination (the Step One Exam).

The Medical School’s Student Bulletin outlines the seven fundamental educational goals of its curriculum. One of these is that students establish “[p]rofessional [a]ttitudes and [bjehavior.” The Bulletin instructs that to satisfy this goal, students must demonstrate, prior to graduating, their respect for and ability to work with other health care professionals, adherence to the highest standards of integrity, ability to admit mistakes and lack of knowledge, and other identified aspects of professional behavior.

B.

Halpern has been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and anxiety disorder — not otherwise specified, 1 both of which he treats with prescription medications. He received his ADHD diagnosis while he was an undergraduate student at Emory University, and Emory provided accommodations for this disability. Upon matriculating at Wake Forest in July 2004, Halpern failed to disclose his ADHD diagnosis, and he did not request any disability-related accommodations.

Halpern’s difficulties with professionalism began almost immediately after his arrival at the Medical School and continued throughout the first two years of his enrollment. In August 2004, Academic Computing staff reported that Halpern had acted in a “very abusive” manner that was “far and beyond worse” than anything they had experienced with other students. Dr. Joseph Ernest, then-Associate Dean of Student Services, met with Halpern and convinced him to apologize for his behavior so as to “set[J a more professional standard for his interactions” with Academic Computing.

During the fall of his second year of medical school, Halpern was absent from a small group session without notice. He falsely represented to faculty members inquiring into his absence that he had given advance notice to the group facilitators that he would not be present. When confronted, he retorted that he “got more out of’ a different small group session that he had opted to attend without permission “than any ... lecture, small group, or ... class assignment to date.” Subsequently, he was late to a lecture but signed the attendance sheet as though he had arrived on time. Faculty members contacted him regarding the discrepancy, and he replied that he was already “well aware of’ the issues discussed. Halpern now attributes his conduct during this period to side effects of his ADHD medication.

Halpern experienced a severe reaction to this medication during the spring of his second year of school. He first informed the Medical School of a potential problem in March 2006, when he asked to postpone his Step One Exam. After Halpern presented a doctor’s note explaining that he was suffering an adverse reaction to medication, the Medical School approved Halpern’s request to delay the exam until May *458 2006. In May, Halpern asked to delay the exam further, initially because of car problems. After the school informed him that this was an insufficient reason and that the school was unable to provide him with an alternate vehicle as he had requested, he sought and received an additional medical postponement. He successfully took the Step One Exam in June 2006.

From June 2006 to August 2006, Halpern participated in an internal medicine clinical rotation. It is undisputed his performance in this rotation was deficient. His evaluation indicates he had numerous problems, including a below-average fund of medical knowledge and difficulty forming differential diagnoses. His “largest obstacle,” however, “was his frequent lapses in professionalism”: He was resistant to feedback, lacked interpersonal skills, and was absent without permission for more than one week. Additionally, Halpern failed to use an electronic log system, and he resisted efforts to help correct what he insisted was a technical problem, claiming that he had “more important things to do, like see patients.” Academic Computing staff ultimately concluded that he was refusing to enter the necessary data, thereby preventing staff and faculty from recording feedback on his performance. After failing this rotation, Halpern met with Dr. Ernest and revealed that he had not slept in twelve days. Shortly thereafter, Halpern went on medical leave to address the severe side effects of his medications.

Halpern returned to the Medical School in February 2007. During conversations with Dr. Ernest discussing his return to rotations, Halpern indicated that he might seek accommodations for his medication-related insomnia, but he did not reveal his ADHD diagnosis. Dr. Ernest suggested that Halpern meet with each clerkship director prior to beginning a rotation to discuss their policy regarding absences, but he noted that some of the accommodations Halpern wanted — including the ability to call out of work without prior notice if he had been unable to sleep — likely would be infeasible. Dr. Ernest explained that, like practicing physicians, medical students were expected to provide advance notice of absences whenever possible and to coordinate coverage for patient care. Halpern reports that he felt discouraged from seeking an accommodation, and he failed to submit a formal request for any accommodation. In this meeting with Dr. Ernest, Halpern signed an acknowledgement that he was on “Academic or Professional Probation” as a result of failing a rotation.

Halpern resumed clinical rotations in April 2007. From April 2007 to October 2008, he successfully completed ten clinical rotations. The evaluations for these rotations show he received either passing or honors marks in the “Patient RapporiyProfessionalism” category, and many of the comments regarding his performance were positive. But, these records also reveal several incidents of unprofessional behavior in connection with his rotations. His neurology evaluation noted he missed a required lecture with the clerkship director.

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Bluebook (online)
669 F.3d 454, 2012 WL 627788, Counsel Stack Legal Research, https://law.counselstack.com/opinion/halpern-v-wake-forest-university-health-sciences-ca4-2012.