Shin v. University of Maryland Medical System Corp.

369 F. App'x 472
CourtCourt of Appeals for the Fourth Circuit
DecidedMarch 11, 2010
Docket09-1126
StatusUnpublished
Cited by38 cases

This text of 369 F. App'x 472 (Shin v. University of Maryland Medical System Corp.) 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
Shin v. University of Maryland Medical System Corp., 369 F. App'x 472 (4th Cir. 2010).

Opinion

Affirmed by unpublished opinion. Judge DUNCAN wrote the opinion, in which Judge MICHAEL and Judge HARWELL joined.

Unpublished opinions are not binding precedent in this circuit.

DUNCAN, Circuit Judge:

Frank Shin, M.D., appeals a decision of the district court granting summary judgment to the University of Maryland Medical System Corporation (“UMMSC”) and its Residency Program director Dr. Susan D. Wolfsthal (collectively, “Appellees”). The district court granted summary judgment to Appellees on Dr. Shin’s discriminatory discharge and failure to provide reasonable accommodation claims, reasoning that Dr. Shin was not “a qualified individual with a disability” under the Americans with Disabilities Act (the “ADA”). 42 U.S.C. § 12111(8) (2006). Because we agree that Dr. Shin could not perform the essential functions of his job with or without reasonable accommodation, we affirm.

I. 1

Dr. Shin began his medical internship with UMMSC on June 24, 2006. 2 Initially, he performed his medical intern duties satisfactorily. Medical interns are rated on a 9-point scale at UMMSC. Generally, the score of 1-3 is deemed a failure; 4-6 is satisfactory; and 7-9 is superior. In his first rotation through Emergency Care Services from June 24, 2006, through July 27, 2006 (“Block 1”), Dr. Shin scored eight out of nine for overall competence. His evaluator stated that “Dr. Shin [was] ready to be an excellent clinician, [having] had a strong start to his first year of residency.” J.A. 297.

After the first month, however, Dr. Shin’s evaluation scores began to drop. For his rotation through Critical Care Services from July 21, 2006, through August 23, 2006 (“Block 2”), both Dr. Stephen Gottlieb and Dr. Mandeep Mehra gave Dr. Shin an overall competence score of three. Dr. Mehra explained that Dr. Shin had to be “shadowed heavily by the residents to prevent medical errors,” which placed “a greater burden of responsibility on the other interns and resulted in residents needing to act as interns.” S.J.A. 85. 3 During this rotation, Dr. Mehra limited Dr. Shin’s workload to three patients and once had to have other residents help complete his work.

Dr. Shin’s deteriorating performance prompted Dr. Wolfsthal to meet with him about the problem. At that meeting, Dr. *474 Shin explained that he found “it difficult to balance new admissions in the setting of taking care of patients already on the service.” S.J.A. 86. He also explained that, to keep up with his workload, he often arrived at 6 a.m. and stayed until 8-9 p.m. Dr. Shin added that on night call he would take one to two extra Provigil pills to stay awake. 4 To address the problem, Dr. Wolfsthal and Dr. Shin developed the following action plan:

1. [Dr. Shin] would thoroughly work up 2 patients while on call.
2. He would meet with [Dr.] Rebecca Manno on a weekly basis to discuss efficiency and organizational skills as well as key topics in cardiology.
3. He [would] check with [Dr.] Alan Krumholz [in the Department of Neurology] ... to see how he might best manage his medications in this setting.
4. In addition to working on organizational skills, he [would] also improve his skills in retrieving old records, dealing with cross-cover issues 5 and writing notes.
5. Whenever called on a cross-over issue, he [would] review the event and his plans with [a resident].

S.J.A. 87 (footnote call number added).

Two weeks later, Dr. Wolfsthal and Dr. Shin met again to discuss his progress. Despite the action plan, Dr. Wolfsthal discovered that Dr. Shin had written orders for patients that were inappropriate, such as “ordering IV Prednisone, ordering [Fresh Frozen Plasma] on the wrong patient and placing a patient on a standing order of narcotics that cause somnolence.” 5.J.A. 88. Thus, Dr. Wolfsthal asked Dr. Shin to continue meeting with both Dr. Manno and Dr. Krumholz. In addition, she gave him the phone number for the Employee Assistance Program so that he could seek confidential counseling.

On September 1, 2006, UMMSC placed Dr. Shin on probation. The Clinical Competency Committee noted that Dr. Shin had “extremely poor organizational skills and major knowledge deficits.” S.J.A. 91. Although the Committee recognized that Dr. Shin had performed better during his Block 3 rotation, 6 that success was attributed to the fact that Dr. Shin was generally limited to three or four patients and that those patients were “the less complicated ones.” S.J.A. 91. Thus, UMMSC informed Dr. Shin that he would need to meet the following criteria before December 1, 2006, to remain in the internship program:

1. Achieve scores of 5 in all areas of competency in all rotations. 7
*475 2. Demonstrate the ability to manage a census of 4-7 patients and admit 5 patients per call night. He may on occasion admit less than 5 patients depending on the flow of admissions, but he must demonstrate the ability to admit 5 when the need arises.
3. Demonstrate improvement in both his written and oral presentations.
4. Continue meeting weekly with Dr. Rebecca Manno to work on organizational skills and efficiency as well as enhancing his knowledge base.
5. Meet every 2-3 weeks with Dr. Wolfsthal.
6. Be evaluated and have a drug screen at the Employee Assessment Program (EAP)____
7. At the end of 3 months, Frank will do a full H & P ([Clinical Evaluation Exercise]) under direct observation by Dr. Graeme Forrest.

S.J.A. 92 (footnote call number added).

Dr. Shin’s overall competence scores, however, never improved. For his rotation through Critical Care Unit/Telemetry (“Block 4”), Dr. Gary Plotnick gave Dr. Shin a four, and Dr. John Kastor gave him a three. Dr. Kastor characterized Dr. Shin’s rotation as a “troubled performance,” and recommended that Dr. Shin not be allowed to “[a]dmit more than one patient on call until [h]is ability to d[e]al with more information improves.” S.J.A. 94. Dr. Kastor also noted confidentially that Dr. Shin displayed “[t]he poorest performance by an intern that [he had] experienced at [UMMSC].” S.J.A. 248. Similarly, Dr. Plotnick explained that Dr. Shin had “difficulty putting it all together” and “[n]eed[ed] help synthesizing and seeing the big picture.” S.J.A. 93. Dr. Plotnick communicated to Dr. Wolfsthal that Dr. Shin “need[ed] complete supervision.” S.J.A. 95. These reviews prompted Dr. David Tasker to recommend that Dr. Shin no longer be allowed to attend the outpatient clinic, a requirement of the internship program.

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