Legal Cases Involving Residency Terminations
(Place the cursor over the Case name to get more information. Not all cases have links associated with them)
Stretten v Wadsworth Veterans Hospital (1976)
Resident physician in pathology at veterans hospital brought suit to enjoin dismissal from residency program. The United States District Court for the Central District of California, Harry Pregerson, J., enjoined dismissal and defendants appealed. The Court of Appeals, Sneed, Circuit Judge, held that residents are not "physicians" within statute providing for notice and full adversary hearing in front of a disciplinary board; that termination on basis of charges of inability to perform satisfactorily as a pathology resident did not infringe on the claimant's liberty interest, that plaintiff had property interest in his residency; that due process did not require a full adversary hearing either before or after termination; and that as lower court's temporary restraining order and preliminary injunction had the practical effect of making staff meeting which preceeded termination date a pretermination hearing, plaintiff's property interest was adequately protected.
Reversed. Resident loses.
Ezekial v. Winkley (1977)
Surgical resident in a private teaching hospital sought damages and injunctive relief, alleging that he was not accorded "fair procedure" in his dismissal from residency program. The Superior Court, Los Angeles County, Norman R. Dowds J., sustained demurrer without leave to amend, and plaintiff appealed. The Supreme Court, Richardson, J., held that surgical resident in a private teaching hospital had to be accorded notice of charges and an opportunity to respond pursuant to the common law right of "fair procedure," prior to his dismissal from the residency program, where the plaintiff had already been accepted and substantially engaged in such program where dismissal from program would effectively prevent his acceptance in any other program, necessary to his certification as a surgeon.
Termination Upheld. Resident loses.
Jimmy K.V. Chin, M.D. v. Kauikeolani Children's Hospital (1978)
This is the case of a terminated pediatrics resident in Hawaii who filed a lawsuit against his residency program for wrongful termination. He alleged violations of 42 U.S.C. §§ 1981, 1983, 1985, and 1986. His wife was a plaintiff in the case as well due to the suffering that she also endured. The case was filed in 1974 and came to trial in 1978. This case was dismissed because the plaintiff had no evidence of discrimination. He was also forced to pay the attorney fees for the defendants because the lawsuit was considered frivolous and/or unreasonable.
Pushkin v Regents of University of Colorado (1981)
Action was instituted on claim that defendant university and others wrongfully denied plaintiff admittance to psychiatric residency program because he suffered from multiple sclerosis. The United States District Court for the District of Colorado, John L. Kane, Jr., 504 F.Supp. 1292, entered judgement awarding the plaintiff injunctive relief, and defendants appealed. The Court of Appeals, William E. Doyle, Circuit Judge, held that: (1) a private cause of action existed under the Rehabilitation Act on ground that plaintiff was excluded from participation in or denied benefits of or subjected to discrimination under a program receiving federal financial assistance; (2) it was not necessary to exhaust other remedies by taking such remedial action as the Department of Health and Human Services deemed necessary to overcome the effects of unlawful discrimination; (3) the proper standard of review under the Act was not equal protection or disparate treatment analysis, but an analysis of whether plaintiff was an otherwise qualified handicapped individual who was excluded from the program on the basis of his handicap; and (4) record supported findings that plaintiff was qualified for program apart from his handicap and that reasons articulated by defendant university and others for rejecting plaintiff were based on incorrect assumptions or inadequate factual grounds.
Marimon v. Mercy Hosptial and Medical Center (1983)
Resident, who was terminated by hospital from residency training program, appealed a judgment of the Superior Court, San Diego County, Jack R. Levitt, J., denying his petition for writ of mandate and request for temporary relief, and appealed an order of the same court denying his motion to vacate the judgment and enter a different judgment. The Court of Appeal, Cologne, Acting P.J., held that: (1) it was unnecessary for court to find that resident's inability to function within structure of residency training program had adverse effect on quality of medical care provided by hospital; (2) resident was not denied common-law right of fair procedure in termination proceedings; (3) it was not error for hospital, in post termination judicial review committee hearing, to specify in greater detail instances supporting basic charges or to discuss and present evidence on all patient cases or incidents supporting charges; and (4) although substantial-evidence test, rather than independent-judgment standard, should have been applied on judicial review, substantial evidence supported termination and error was not prejudicial.
Moire v Temple University School of Medicine (1985)
* This involves a medical student instead of a resident, but the circumstances are similar enough
Female Physician Brought Civil Rights action against medical school and supervisor of her psychiatric clerkship program at a private clinic alleging that defendants illegally conspired against her and gave her a failing grade on her psychiatric clerkship because of her sex, necessitating that she repeat her third year at medical school. The District Court, Shapiro, J., held that: (1) medical student failed to establish supervisor of medical student's clerkship program at private clinic sexually harassed student or sanctioned a harassing environment at the clinic and therefore student failed to establish her claims against both supervisor and medical school under Fourteenth Amendment, 1983, 1985 and Title IX, and (2) failing grade for student's clerkship was not arbitrary or capricious and therefore medical school's ratification of that grade was not in violation of any right of medical student to substantive due process.
Judgement in favor of defendants. Medical Student loses.
John P. Swidryk, M.D. v. Saint Michael's Medical Center (1985)
This case is less about residency termination and more about malpractice and supervision. John P. Swidryk M.D. filed a lawsuit in 1985 against his OB/GYN residency program and residency director for education malpractice. Dr. Swidryk himself was being sued for malpractice due to a delivery in 1973 that lead to brain damage. At the time of the incident, Dr. Swidryk was in the first month of his OB/GYN residency. It is alleged that Dr. Smith was negligent in failing to supervise adequately the intern and resident program and as a proximate result of Dr. Smith's negligence, Dr. Swidryk has been sued for malpractice. Further, Dr. Swidryk claims Dr. Smith breached a contractual duty to him by failing to provide a suitable environment for a medical educational experience in that Dr. Smith failed to supervise adequately the intern and resident program. The case was dismissed because the judge did not believe that the court should be investigating educational matters when there is a board that does that specifically. They also cited the potential to create excessive litigation time if they set a precedent by allowing this case to be heard. It could result in educational malpractice lawsuits being filed each time that a clinical malpractice lawsuit was filed.
Hankins v. Temple University Health Sciences Center (1987)
This is an African American Female physician enrolled in the Rheumatology Fellowship at Temple University who was terminated from her fellowship around October of 1985. She filed a lawsuit alleging racial and gender discrimination. She was terminated on the basis of poor performance first documented in May 1985. The noted deficiencies were (1) attendance and punctuality (2) peer relationships (3) histories, physical examinations, special techniques, management plans (4) consultations and progress notes (5) physician patient relationships, on call availability (6) fund of medical and rheumatological knowledge. Dr. Hankins failed to produce any substantial evidence of discrimination. The court found that the University's proffered evidence in support of its motion for summary judgment demonstrates a fund of legitimate, nondiscriminatory reasons for her termination.
Samper v Rochester University (1987)
Female medical resident sued hospital and various doctors alleging sex discrimination and violation of procedural due process in connection with negative clinical evaluations of her performance. Defendants moved for summary judgement. The Supreme Court, Monroe County, Wesley, J. held that: (1) statute providing immunity from suit to physicians or review committees for evaluations done without malicious intent did not immunize hospital and physicians for alleged sex discrimination against medical resident resulting in poor evaluations, and (2) resident was not entitled to due process protections in connection with evaluation meeting.
Lipsett v University of Puerto Rico (1988)
Female surgical resident brought action against university, various administrators, and director of program at Veterans Administration hospital. The United States District of Puerto Rico, Carmen C. Cerezo, J., denied motion by director to dismiss based on sovereign immunity, granted summary judgement for university and administrators, and granted summary judgement for director. Appeal was taken. The Court of Appeals, Bownes, Circuit Judge, held that: (1) female participant made out prima facie case of hostile work environment and quid pro quo sexual harassment and of discriminatory discharge; (2) fact issues existed as to whether university and its administrators knew or should have known of sexual harassment but nonetheless failed to take appropriate action; and (3) prima facie case of quid pro quo sexual harassment was made out against director.
This judge decided in favor of the Resident, but the case carried on until 1991.
Esmat ZAKLAMA, M.D. v. MT. SINAI MEDICAL CENTER (1988)
This resident began residency in 1981 at Jackson Memorial Hospital in Miami, Florida. He made it through his first three months without incident before he was was sent to an away rotation at the defendent institution, Mt Sinai Medical Center in Miami. Dr. Zaklma was evaluated unfavorably and determined to lack technical competence by the Director of Training at Mt Sinai. Two and a half months into this rotation, the Chief of Anesthesiology determined that Dr. Zaklama could no longer stay at Mt. Sinai because of the unfavorable things that had been said or occurred. Dr. Zaklama was no longer allowed to treat patients at Mt Sinai, and when he returned to Jackson Memorial (His home hospital), his residency was terminated. Dr. Zaklama filed his lawsuit almost one year later, in October 1982. In 1987 he won his lawsuit and was awarded $85,000 in compensatory damages, and $50,000 in punitive damages. Mt Sinai appealed and the result was reversed in district court. Dr. Zaklama filed his counter appeal in the eleventh district court of appeals, and won again.
RESIDENT WINS! Twice! What's more, is that his case is VERY similar to my own.
His formula for victory:
The resident won based on the introduction of ample evidence from which a reasonable jury might conclude that Mt. Sinai unlawfully discriminated against him. Two anesthesiologists under whom Zaklama worked while at Mt. Sinai both testified that Zaklama's work had been satisfactory. Zaklama introduced evidence to rebut some of the charges made by Dr. Marshall in his evaluations. He also introduced evidence that other residents with low test scores and unfavorable evaluations had been allowed to continue in the program. Finally, Zaklama established that he had successfully completed the residency requirements for an anesthesiologist since leaving Mt. Sinai. While Zaklama did not introduce any direct evidence of discrimination, direct evidence is not required. A plaintiff is entitled to rely on circumstantial evidence to convince the trier of fact that an employer's explanation for his discharge is pretextual and that his discharge was more likely than not motivated by discriminatory intent.
Please note that although this doctor won, it took about 6 years. He had graduated from residency and moved on before the whole thing would end. Also, the rules for proving discrimination may have changed. I would need to consult a lawyer type to be sure. I'm not so sure that a plaintiff is still entitled to rely on circumstantial evidence to 'prove' discrimination.
It is an exciting victory, but does not change my overall opinion that most of us would be better off not suing.
Ross v University of Minnesota (1989)
Resident who was dismissed from university's psychiatry residency program sued university, seeking injunctive and declaratory relief, and damages for university's alleged breach of an employment contract, for denial of his substantive and procedural due process rights, for infliction of emotional distress, and for defamation. The District Court, Hennepin County, John W. Borg, J., granted summary judgement for the university, and dismissed the complaint. Resident appealed. The Court of Appeals, Parker, J., held that: (1) the resident was a "student" rather than an "employee"; (2) termination from the psychiatry residency program did not constitute a breach of contract; and (3) resident was not defamed by University.
Lipsett v. University of Puerto Rico (1991)
In the end, the defendants motioned for a new trial, and were denied. The resident's request for equitable relief was denied, and the university's request for attorney fees was denied because Lipsett's lawsuit was not "frivolous, unreasonable, or without foundation."
So in the end she wasn't re-instated and did not receive any monetary damages.
Dr. Ifeoma Ezekwo v. NYC HEALTH & HOSPITALS CORPORATION; Harlem Hospital Center; Columbia Univ (1991)
This is a Black Nigerian Woman who spent much of her residency in conflict with her attending physicians. She had relatively good evaluations but was passed over for the position of chief resident in her final year. A position that she felt that she deserved. This resident actually graduated, and at the time that the case was heard, she had not yet passed her board certification and was having trouble getting credentialed because her attendings from residency would not provide her with letters of recommendation. She filed her lawsuit in April 1988 alleging sex and race discrimination, as well as retaliation for the numerous complaints that she filed against the residency program. She graduated from residency in June 1988. I'm thinking those last two months of residency must have been pretty awkward.
In the end she lost the lawsuit, but is currently practicing Opthalmology in The Bronx.
Hernandez v Overlook Hospital (1995)
Medical resident who was terminated from private hospital's residency program, sought preliminary injunction to have counsel present and participate at hospital hearing, to obtain relevant patient files, and have reporter present to transcribe hearing. The Superior Court, Chancery Division, General Equity Part, Union County, Kentz, J.S.C., held that: (1) resident did not have to exhaust administrative remedies; (2) as a matter of first impression, fundamental fairness required right to have counsel attend and participate in the hearing; (3) termination from the residency was substantially the same as physician termination from hospital staff; (4) fundamental fairness required resident examine and copy relevant patient records; and (5) reported should be permitted to record hearing.
Resident wins the right to have his attorney present and have the hearing recorded.
Roth v Lutheran General Hospital (1995)
Doctor who suffered from strabismus moved for preliminary injunction, seeking admission to the hospital's pediatric residency program. The United States District Court for the Northern District of Illinois, James F. Holderman, J., denied motion, and doctor appealed. The Court of Appeals, Coffey, Circuit Judge, held that doctor was not entitled to preliminary injunction because he failed to show some likelihood of success on his Rehabilitation Act, Americans with Disabilities Act (ADA), and retaliation claims.
John Doe v. University of Maryland Medical System Corporation (1995)
Very sad case. A 3rd year Neurosurgery resident gets stuck with a needle during surgery in 1992 and tests positive for HIV shortly afterwards. The residency staff eventually terminates his residency out of concern for patient safety. He is offered non-surgical residencies but declines them. He files this lawsuit shortly after termination alleging that UMMSC had discriminated against him in violation of the Rehabilitation Act, Title II of the ADA, and the Equal Protection Clause of the Fourteenth Amendment. Dr. Doe also alleged retaliation in violation of the Rehabilitation Act and the ADA, breach of contract, and invasion of privacy. He requested injunctive relief, a declaratory judgment that UMMSC had violated the Rehabilitation Act and the ADA, and compensatory and punitive damages. The court decided that hospital does not violate § 504 of the Rehabilitation Act or Title II of the ADA when it terminated an HIV-positive neurosurgical resident based upon the risk of transmission of the disease during performance of exposure-prone procedures. Such individuals pose a significant risk to the health or safety of their patients that cannot be eliminated by reasonable accommodation, and therefore are not otherwise qualified within the meaning of the Rehabilitation Act and the ADA.
Smita Arun Patel v. Howard University (1995)
This is an Anesthesia resident from India who completed Medicine and Anesthesia residencies their before enrolling as a PGY-2 at the Howard University Anesthesiology program in 1987. Her residency was terminated in 1990 for a failure to progress. She appealed the termination but lost. Her lawsuit alleges infrequent evaluations, negligence in the operation of the evaluation system, and breach of contract. The court decided in favor of the residency and based much of this on the thorough documentation of her clinical and academic deficiencies over a long period of time. They did, however, award her $1 dollar in damages. Seems like a slap in the face.
The lawsuit carried on for 5 years, and she lost in the end. An internet search revealed that this doctor is working in Ellicot City, Maryland as an internist. I cannot find any information to suggest that she attended or completed any residency after she left Howard Anesthesia.
Baldwin v. University of Texas (1996)
Black Female OB/GYN resident sues the University of Texas Medical Branch and various faculty members, alleging intentional racial discrimination, conspiracy to discriminate, and state law defamation. The district court held that: (1) The resident's claims against UTMB were barred by doctrine of sovereign immunity; (2) resident's claims for monetary damages against individual defendants in their official capacities were barred by doctrine of sovereign immunity; (3) resident's allegations were insufficient to establish that defendants' actions in refusing to renew her contract and in recommending that she be remediated were more likely motivated by impermissible racial discrimination than by their evaluation of resident's surgical skills or reasons given by the defendants for their actions were unworthy of credence; (4) UTMB and its employees constituted a single legal entity incapable of conspiring with itself; (5) evaluations and performance reviews were protected expressions of opinion under Texas law; and (6) statements made by faculty members in performance evaluations were protected by qualified privilege. Case dismissed.
Fagan v. The Stamford Hospital (1996)
Resident appeals a termination based on the fact that it appeared to be nothing more than retaliation for her complaint against the department heads. The court agreed that they had conspired against the resident, and fired her in her fourth year of residency. This document says that she was re-instated. Another document that I have says she was awarded $2,500,000 in damages. Either way..
Shailesh Gupta v. New Britain General Hospital (1996)
This is the case of a 5th year General Surgery resident who started his PGY-2 year in 1985 getting terminated in his final year, September 1988. The resident was identified as having deficient skill in the beginning of his third year of his residency. He went on probation at the start of the 4th year, and was unable to demonstrate adequate improvement over the following year. His 5th year contract was renewed by the graduate medical education committee by a single vote. The conditions of his final year were(1) he had to spend the entire year at the hospital, rather than rotating out to other facilities; (2) he could supervise a junior resident in the operating room only if an attending surgeon was also present; (3) he was required to obtain professional counseling; and (4) the general surgical section would evaluate his performance on a quarterly, rather than an annual, basis. At his first quarterly evaluation in September, 1988, the general surgical section unanimously determined that he did "not show any potential for being a safe and independent surgeon" and so decided to dismiss him. This determination was based on a number of factors, including the plaintiffs inability to make decisions in the operating room, his unwillingness to accept responsibility for errors, and gaps in the plaintiffs "knowledge base." The plaintiff was informed of his immediate dismissal from the residency program. After various unsuccessful efforts to challenge his dismissal as a violation of his civil rights and as a result of discriminatory practices, Dr. Gupta filed a lawsuit seeking damages because of alleged breaches of the residency agreement by the hospital. His complaint alleged that his dismissal violated the residency agreement because the hospital had: (1) failed to honor the obligations inherent in the residency agreement as a contract of employment; (2) failed to provide proper training facilities as required by the residency agreement; (3) acted arbitrarily, capriciously or in bad faith; and (4) violated an implied covenant of good faith and fair dealing. The resident lost based on failing to present adequate evidence to prove the 4 points listed above.
Please note the amount of time that this individual lost before this matter was concluded. 8 years. However, this is another Doctor who wins in the long run. You can find him after a brief search in google. He is a radiation oncologist working in Texas. He started his Rad Onc residency less than a year after leaving the General surgery residency according to his record. Just a reminder that you may not be able to continue in your specialty, but that doesn't mean you've been ruined.
Momah v. Albert Einstein Medical Center (1997)
This is a Black Nigerian OB/GYN resident brings suit against Albert Einstein Medical Center alleging racial discrimination. He stated that he was subjected to discriminatory treatment, and a hostile environment at the defendant medical center. He claimed that he was harassed and unnecessarily criticized by the medical center staff. He said that he was treated differently than other residents who were outside the protected race and of a different national origin. The case was dismissed based on the resident's inability to establish that the proffered, legitimate, nondiscriminatory reason for terminating him was pretext for race and national origin discrimination. His strongest evidence appeared to be the fact that he consistently received favorable evaluations on his medical fund of knowledge. However, he did receive poor ratings in the areas of patient care, sensitivity, maturity, reliability, and his ability to develop cooperative relationships with other residents, attending physicians, and nurse. There are also records showing that the residency director received numerous complaints from attending physicians, nurses, patients, and other residents about the quality of care, attentiveness and sensitivity which Dr. Momah was showing towards patients, his responsiveness to calls and pages, and his lateness to morning rounds. Ultimately, the court ruled in favor of the defendants.
Saad v Sacred Heart Hospital (1997)
Resident was terminated by the Family Medicine residency program, and sought judicial review. The Court of Common Pleas, Lehigh County, denied his motion for posttrial relief from its order denying a continuing temporary injunction, and Saad appealed. The Commonwealth Court, held that the trial court's review of the decision was limited to ensuring that proper due process procedures were followed and not whether or not he deserved to be terminated. The resident did not sue for damages, and since his focus was due process, that is all the court looked at.
Kevin Lee v. Trustees of Darthmouth College (1997)
Another rather unfortunate, health related case involving a neurosurgery resident. During his third year of his Neurosurgery residency (1992), Dr. Lee experienced numbness in his body below the waist. At the time, Dr. Lee thought he was suffering from a solvent-induced paresthesia because he recently had been exposed to an industrial solvent. He was told by his neurologist colleagues that his symptoms could last between six weeks and six months. However, when he returned to Hitchcock for the second half of his third year, his problems worsened, and he experienced a burning pain in his legs, buttocks, and waist. An MRI eventually identified a lesion in his lower thoracic spine. He was diagnosed with transverse myelitis. Dr. Lee did his best to deal with the condition, but his residency was eventually terminated because the chairman because of limitations resulting from the transverse myelitis. As a result, Dr. Lee filed suit alleging that the chairman terminated his participation in the neurosurgery residency program at Mary Hitchcock Memorial Hospital in violation of the Americans with Disabilities Act of 1990(ADA), 42 U.S.C. §§ 12101-12117 (1995), and the Rehabilitation Act of 1973, 29 U.S.C. § 794 (1985). The only case file that I can find ends with some legal discussion of who can and cannot receive summary judgement. But nothing is said of the overall outcome. It is possible that they settled out of court, or that Dr. Lee dropped the case. After poking around a bit, I found out that he finished his neurosurgery residency at Wayne State University in 1998. So as far as I'm concerned, this resident won.
Banna R. Jabbour v.Albany Medical Center et al., Appellants (1997)
This gentleman was initially a neurology resident at Albany from 1991-1992. He was told by his program director in January of his intern year (1992) that his contract was not going to be renewed and he was not going to get credit for his intern year. He then applied to and was accepted to a family medicine residency at St Clare's Hospital in Schenectady, New York. In April, of that same year an incident occurred, and the plaintiff was accused of conducting an inappropriate physical examination of a 15-year-old female patient. The program then suspended Jabbour, and, a few days after the incident, called St. Clare's Family Practice Residency Program and relayed that "plaintiff had been terminated" from the Neurology Department at AMC. On April 28, 1992, plaintiff was formally notified that he was being terminated and was entitled to a hearing. By letter dated May 1, 1992, Duke Dufresne, Director of the Family Practice Residency Program at St. Clare's, informed plaintiff that he was aware of his termination under circumstances which, if accurate, would render him ineligible for employment at St. Clare's. Dufresne requested that plaintiff contact him to explain the situation. A hearing on the charge was held on May 20, 1992 and June 1, 1992, after which the Hearing Committee sustained the charge and recommended to the Medical Board that plaintiff be terminated. The Medical Board adopted the recommendation of the Hearing Committee and the AMC Board of Governors subsequently approved the recommendation to terminate plaintiff effective April 22, 1992.
Plaintiff was apparently not accepted into another residency program for the period between July 1, 1992 and June 30, 1993, and he thereafter commenced this action for damages alleging four causes of action: (1) breach of employment contract with AMC against both defendants, (2) prima facie tort against both defendants, (3) intentional interference with the contractual relationship between plaintiff and AMC by Lava, and (4) intentional interference with contractual relationship against both defendants with respect to plaintiff's prospective employment with St. Clare's. Following joinder of issue, defendants moved for summary judgment and Supreme Court dismissed the second and third causes of action but denied the motion with respect to the first and fourth causes of action. The case was dismissed.
This appears on the surface to be a case of a poorly performing resident who was terminated for good reason. By January of his intern year, his program director had decided that not only would he deny this resident advancement to the next level, essentially terminating his neurology residency, but he was also going to deny him credit for the intern year that he was in the midst of completing. Then on top of all of this, the resident is accused of doing something inappropriate to a 15 year old female patient. The guy is either very unlucky and got railroaded, or has some very poor judgement. Impossible to say.
Resident Loses. A quick check of the internet revealed that Dr. Jabbour eventually completed a psychiatry residency and is gainfully employed. So despite what seems like an publicity nightmare (accused of inappropriate behavior with a female minor while at work), he recovered, and moved on.
Carter v. St. Louis University (1998)
African American resident physician in the University of St. Louis General Surgery Residency Training Program was terminated in March of 1994 for poor performance. The resident alleges that he was subjected to racial discrimination. He cited subjective evaluations, procedural irregularities, and statistical evidence concerning the university's historical record for training and employment of African-American surgeons. Ultimately, the judges did not rule in his favor due to the fact that the resident's ABSITE scores for his 1st, 2nd, and 3rd years of residency were 9th, 25th, and 9th percentile respectively. The residency program had a known standard of 25th percentile as the minimum standard for this annual test. The fact that evaluations were subjective and the available statistical evidence did not support the resident's case.
Sreeram v Louisiana State University Medical Center (1999)
Female Surgical resident of Indian descent files a lawsuit after she is terminated from the Louisiana State Medical Center Residency program. She asserted that she was terminated on the basis of gender and national origin. Her strongest evidence for this was the retention of a white male resident with lower in-training exam scores and program ranking than her, and statistical analysis that demonstrated that only 6 of the 99 residents who trained in that program over the past 10 years were women, and of those six, only 2 graduated. She also offered alleged statements by medical center staff about her gender and ethnicity as evidence of discrimination: including a statement that Indian women were not as assertive as American women, and concerns about why women would put themselves through residency when they wouldn't have time to "do a lot of things girls need to do." The University countered her statistical data by pointing out that a female completed the program the same year that the resident was terminated, and another female resident was ranked first
Guo v. Maricopa County Medical Center (1999)
This is a female resident who started her Anesthesia residency at MCMC in July of 1992. 3 months into her residency problems were noted and she was placed on probation. Her academic issues were documented throughout her residency. Most notably, her inability to pass Step 3 of the USMLE and scoring beneath the 25th percentile on her in-training exam in every year were used as evidence of her inability to attain the appropriate level of medical knowledge. She was also sent back from an away rotation because of her 'shallow knowledge base.' In October of 1995, she was hospitalized for a drug overdose. She was placed on 5 weeks of paid leave, and then terminated for failure to progress in the residency. Dr. Guo then sued MCMC for alleged breach of contract and violations of the Americans With Disabilities Act and the Family and Medical Leave Act. The trial court granted summary judgment in favor of MCMC, ruling that the evidence indisputably showed that MCMC was entitled to terminate the contract, that Dr. Guo was unable to meet her burden of proving that she was qualified to perform the functions of the job with or without accommodation, and that MCMC did not violate her rights under the Family and Medical Leave Act.
I assume that she filed the lawsuit in 1996, and if so, the case carried on for 3 years before the judge ruled in favor of the residency. According to U.S. Doctor Finder, she graduated from an Internal Medicine Residency at New York Medical College in 2003, and is practicing in Staten Island. It appears that this doctor had a very difficult journey. But in the end, she completed training and is practicing medicine.
Bali v. Christiana Care Health Services (2000)
A resident was reduced from the a third year categorical resident to a second year preliminary resident. The court found that this was a breach of contract, and the resident was re-instated at his rightful year in training.
Grudzinski v Medical College of Ohio (2000)
This resident lost big. Multiple times. I don't think I could summarize this physician's professional experience any better than the link above.
Swanson v University of Cincinnati (2001)
Resident brings suit claiming that he was terminated on the basis of his disability and refused his requests for reasonable accommodations. The United States District Court for the Southern District of Ohio granted summary judgement for the defendants, and the resident appealed. The Court of Appeals held that: (1) Eleventh Amendment barred surgical resident's action under Title I of the ADA for monetary damages against state university; (2) resident's major depression was not disability within meaning of the ADA, the Rehabilitation Act or Ohio's anti-discrimination statute; (3) defendant's did not regard resident as disabled under the ADA, the Rehabilitation Act or Ohio's anti-discrimination statute; and (4) successor did not have employer-employee relationship with resident.
Jane v The Bowman Gray School of Medicine (2002)
Hispanic Psychiatry resident filed a lawsuit against The Bowman Gray School of Medicine - North Carolina Baptist Hospital challenging his termination from the residency program. The District Court ruled against him for the following reasons: (1) USCA 1983 cannot be applied against private medical schools and private hospitals since they are not state actors, and he could not provide any evidence that they received public funding. (2) When seeking compensatory relief, a plaintiff has to demonstrate intentional discrimination - he failed to do so. If you only want an injunction then demonstration of discriminatory intent is not required. (3) The resident failed to demonstrate that he was performing the job successfully. He could not refute the hospital's claim that he failed to comply with the requirements of his probation, failed to provide adequate continuity of care, misrepresented the facts surrounding refill information, and failed to recognize the ethical problems with "dual relationships."
Maynard v Board of Regents of Universities of Florida (2003)
A Black Male Surgical Resident who was born in the Netherlands Antilles, brought suit against state university's board of regents after he was dismissed from residency program, alleging race discrimination under Title VII and breach of contract. The United States District Court for the Middle District of Florida, Elizabeth A. Kovachevich, J., granted summary judgement for board and resident appealed. The Court of Appeals, Restani, J., sitting by designation, held that: (1)resident, by failing to timely file objections to magistrate judge's non dispositive discovery rulings with district court, waived his right to appeal those matters before Court of Appeals; (2) district court properly proceeded to decide board's motion for summary judgement, despite resident's request for additional discovery; (3) district court did not abuse discretion when it denied resident's last minute motion to amend complaint to assert Title VII retaliation claims, as well as claim against chairman of university's surgery department; (4) resident's breach of contract claim was barred in federal court by Eleventh amendment; (5) Florida waived its sovereign immunity for breach of contract suits in its own courts; and (6) resident did not establish a prima facie case of race discrimination under Title VII.
Dixon v. Regents of the University of California et. al. (2003)
Settlement News Release (2004)
A Black Male physician enrolled in the UCLA School of Medicine Family Medicine Residency program in 1993 and was essentially terminated at the end of his first year for allegedly poor performance. Dixon felt that he was the victim of racial discrimination, initially obtained a right to sue letter from the Department of Fair Employment and Housing (DFEH) and elected to pursue the internal administrative hearing process provided UCLA. After more than two years hearings, Dixon notified UCLA that he was abandoning the administrative hearing process, because there did not appear to be any end in sight, and would instead file his lawsuit in a court of law. This case eventually dragged on for years until it was finally settled out of court in 2004. The resident entered a settlement agreement on July 15, 2004 for $1.3 million
Resident Wins. This is the only victory that I could find record of involving allegations of racial discrimination in a residency training program.
Ghosh v Southern Illinois University (2004)
An OB/GYN resident from India files a discrimination lawsuit after she is terminated from her residency. She alleged that the termination was retaliatory and discriminatory. The Residency program's reasons for dismissal were because 'she lacked accountability for her own education, did not adequately fulfill some patient care duties, did not recognize her own limitations, and had poor relationships with faculty, other residents, and nursing staff.' One of the residents strongest defenses was that the residency director made a statement that third parties might be prejudiced against resident because of her skin color and her accent. The court did not believe that this constituted direct evidence of discrimination and determined that her dismissal was not discriminatory.
GOURDINE v. CABRINI MEDICAL CENTER (2004)
Fenje v. Feld (2004)
Dr. Paul Fenje was accepted into the anesthesiology residency program at the University of Illinois at Chicago (UIC). Shortly thereafter, but before the residency began, the program's director learned that Dr. Fenje had been terminated from a previous residency because of questions about his competency. Based on his lack of candor in the application process (he had not disclosed his dismissal from the prior residency), Dr. Fenje was dismissed from the UIC program. Fenje responded with this lawsuit against the program's director, Dr. James Feld, alleging that the termination of his residency violated his due process and equal protection rights under the Fourteenth Amendment to the United States Constitution. The district court granted summary judgment to the defendant. The resident appealed and lost again.
** This case highlights a very important lesson. Not mentioning a residency termination while applying to a new residency will come back to bite you later. This is the third time I've seen this. The best thing to do is identify the factors or issues that you believe contributed the most to your termination and show the new program that although you may have been terminated once, you have overcome those limitations or circumstances that led to that termination. Omitting the termination is never a good idea.
St. Croix v. UNIV of Colorado Health Sciences Center (2007)
Dr. St. Croix is a woman of Asian descent who was employed in a general surgery residency at UCHSC from June 2001 until January 2003. A residency is a four-year educational program following medical school that emphasizes fundamental technical skills and allows residents to learn pre-operative and post-operative care. To show residents the various surgical procedures, UCHSC requires them to rotate through a number of surgical specialties. Dr. St. Croix received training at four Denver hospitals, and was evaluated by an attending physician at the conclusion of each rotation. Dr. St. Croix's evaluations were consistently poor. She also scored at the bottom of her class on written examinations.
The promotions committee did not believe Dr. St. Croix adequately completed her first year of residency, but did not have a program in place to allow her to repeat the year. Thus, in April 2002, the committee promoted Dr. St. Croix to the second year of residency, but placed her on probation. Under the conditions of her probation, Dr. St. Croix was to perform at the "A" and "B" level to remain in the residency program. However, through the end of 2002, she continued to receive many "C" and "D" marks and poor evaluations from attending physicians.
Dr. St. Croix filed suit after she was terminated claiming that she had been subjected to disparate treatment on account of her race and gender, because other residents who were not members of a protected class were treated more leniently than she had been treated, despite having engaged in equally serious or more serious misconduct. Dr. St. Croix also contended she had endured a hostile work environment, created by rumors and innuendo arising from broad knowledge of the photographs, and UCHSC and Dr. Nehler had not taken any action to abate it or discipline those who had sexually harassed Dr. St. Croix by circulating pornographic photographs of the doctor that were found on the internet.
** This is a a reminder that even if you are treated poorly, and racism and or sexism are elements of this treatment, it doesn't really matter. The only thing that matters is that you can prove your competence in the field that you are training. She consistently received poor evaluations, and no amount of racism or sexism can excuse poor performance.
Halverson v University of Utah School of Medicine (2007)
Diana Halverson, M.D. an intern in the University of Utah Emergency Medicine Residency was terminated at the end of her first year. She filed a lawsuit alleging that she performed her duties in a satisfactory manner, she received evaluations that met or exceeded expectations. She also alleges that at no time prior to her termination notice did she receive any feedback suggesting that any negative evaluation would adversely affect her residency, nor was she placed on corrective action or placed on probation for remediation before the termination was attempted. The court sided against her finding that her accusations were baseless, and she was required to play the legal fees of the defendants.
*UPDATE (18 January 2015): I am very pleased to bring you an update to this case. The physician in this case contacted me personally and asked that I amend the record to reflect her outcome. The residency program ended up settling out of court for an undisclosed amount. She also did not have to pay any legal fees either. She re-applied to residency the next year, was accepted, and graduated from a different program with little difficulty. She is now practicing Emergency Medicine as an attending and a partner at her practice group. Great story.
*Her account reinforces the fact that cases on this page do not reflect the complete story for everyone. There are many cases that will never come to our attention because they are settled out of court, with no record being left for the public to discover. This means that the public record may very well be skewed in favor of residency programs since there are records of lost court cases, but no records of successful settlements for residents.
Abdullah v. University of North Dakota, and Dr. David J. Theige (2009)
** ** Note to Sarmed Abdullah who has contacted me twice with a request that I amend my webpage entry. You will notice that the link above this message goes directly to a google scholar article containing the information that I summarize below. This is public information and I am simply making it available. If you want to speak with me instead of dropping threats through the comment section, how about leaving an email address that I can contact you through. Also, just so you know, almost nothing that you have sent to me makes much sense to me. I have no idea what it is that you are trying to communicate to me.
Physician, Sarmed Abdullah, brought action against state university and dean of residency program for breach of contract, intentional interference with prospective business opportunity, and wrongful dismissal from residency program in violation of substantive due process rights, Americans with Disabilities Act (ADA), and the state Human Rights Act. The District Court, Burleigh County, South Central Judicial District, Gail H. Hagerty, J., granted summary judgment dismissing physician's claims. Physician appealed.
The Supreme Court, Maring, J., held that:
1 physician's dismissal from residency program was not arbitrary, capricious, or in bad faith;
2 dean was immune from liability in his individual capacity in physician's action for interference with a business opportunity;
3 physician did not have a substantive due process right to graduate from residency program; and
4 university's dismissal of physician from residency program for professional concerns did not violate the ADA.
His failure to disclose a previous residency that he resigned from became a major issue in this case, and called his ethics and honesty into question. Something to keep in mind for those who are terminated or resign and are tempted to omit it from your CV.
Botvinick v. Rush University Medical Center (2009)
After Bradley Botvinick completed his residency in anesthesiology at Rush University Medical Center ("Rush"), he obtained employment with Anesthesiology Associates of Dunedin ("AAD"), a Florida doctors' association. Botvinick lost that job, however, when the hospital where AAD doctors practice denied Botvinick's application for clinical privileges. Believing that Rush sabotaged his application by feeding the hospital false, petty information about his reputation, Botvinick sued Rush and several of its doctors for tortious interference with his expectation of employment. The district court granted the defendants' motion for summary judgment, concluding that Botvinick lacked evidence that the defendants interfered with his application for privileges.
** I have seen this situation with doctors who have contacted me through the website. You have actually completed residency, but can't get a license and/or privileges because someone says something unfavorable about you during the credentialing process. This is a reminder that you are not out of the woods just because you graduate from residency.
You need to be practicing medicine and have new references and performance evals before you are safe to call up your old residency director and tell him how much his breath stinks, and that you plan on vandalizing his grave decades in the future. Another interesting thing to mention is that as a part of his application for privileges, Botvinick signed a "release and immunity" statement which protected all third parties (such as members of his residency program staff) who made statements about his performance or character for the purposes of the application. In signing that release, he most likely lost all rights to sue any person who spoke of him unfavorably.
Bascom v. The Brookdale Hospital (2010)
This former resident training in Internal Medicine with The Brookdale Hospital and filed his first lawsuit in 2002. The link above is a summary of his 4th filing. The resident alleged racial and religious discrimination, but had no evidence to support these claims, and was said to present 'mere conjecture.' This claim was dismissed just as the three before it were. He was also given a warning that continuous filings alleging something that has already been litigated constitutes harassment. He was threatened with a monetary penalty if he continues down this road.
Shin v. University of Maryland Medical System Corporation (2010)
This is an Emergency Medicine Intern who began his first year in 2006. He had a strong performance during his first month, but started to struggle during his second month. His preceptors were quoted as stating 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." During this rotation, his attending 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. 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. 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 issue and writing notes 5. Whenever called on a cross-over issue, he [would] review the event and his plans with [a resident].
Despite this action plan, he continued to have performance issues. 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." 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 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.
The Residency program and hospital continued to very thoroughly document continued performance issues. Noting that the resident was argumentative and lacking insight into his limitations. He was evaluated by behavioral health and was found to have below average working memory, difficulty switching back and forth between ideas, and significant impairment in visuospatial reasoning and visual memory. He was diagnosed with attention deficit disorder and placed on stimulant medication. He as also placed on a leave of absence for 2 months of more intensive therapy and rehabilitation.
Upon his return, he was found to show no improvement even with the medication. He was terminated and the termination was upheld by the internal grievance proceeding. He filed a lawsuit alleging discrimination based on his medical condition and their failure to make accommodations for him. The case was dismissed in favor of the University of Maryland based on the fact that Dr. Shin's condition did not grant him American with Disabilities Act Protection.
This resident shared several experiences that me and a handful of others have experienced. He did well in medical school, but did not discover that he had a mental health issue until residency. He was diagnosed with attention deficit, but I suspect he might have really had depression. In his case, the optimal treatment was not discovered before the leadership ran out of patience. It seems that his termination was warranted due to the overwhelming support that he was given in attempts to get him through the internship with fewer duties.
A brief search of the internet reveals that he started Psychiatry residency in South Dakota in 2012, 5 years after he was terminated from the University of Maryland ER program.
Craig v. Yale Medical School (2011)
This is an African American Male, M.D. Ph.D. who began the Yale OB/GYN residency in July 2008. He was terminated after his first 6 month formal evaluation in December 2008 that indicated he was not doing well. He took the issue to a grievance counsel who found that he was not treated fairly due to the residency's failure to move along a progressive pathway towards dismissal (verbal warning, written warning, probation, termination). They just jumped right to termination. After he was re-instated by the grievance counsel, he was placed on probation. It is hard for me to acertain when, but I assume that he was terminated after he was re-instated. This case is far from over, and will be followed by this website as more details emerge. One of the details that came out is that 67% of the black males who have come through the program have been terminated. Seems significant if there have been more than 10, but less than that, and this statistic may imply more than it actually proves.
Nigro v. Virginia Commonwealth University/Medical College of Virginia (2012)
This is a former family medicine resident who started resident in 2008, and was terminated in 2009. Poor performance was documented throughout her first year of residency, and she was informed of non-renewal of contract in March 2009. She filed a complaint with the EEOC in June 2009, received a right to sue letter in November 2009, and filed her lawsuit in August 2010. The lawsuit allegations include: Breach of Contract against VHS and VCU; Denial of Due Process in violation of 42 U.S.C. § 1983 against VHS, VCU and the Hospital; Defamation against the residency director, VHS, VCU and the Hospital; Intentional Infliction of Emotional Distress against the residency director, VHS, and VCU; Intentional Interference with Contract against the residency director; Gender Discrimination in violation of Title VII against VCU and the Hospital; and Retaliation in violation of Title VII against VCU and the Hospital. The case was dismissed at the district court, and the link above states that the court of appeals also dismissed the resident's lawsuit.
Nam v. Regents of University of California (2016)
This female resident started her Anesthesia residency at UC Davis Medical Center in 2009. A lot happens, and there are interpersonal conflicts with two different program directors. But there is no issue of medical or clinical competence. This story follows the familiar pattern of offending a program director, a program director striking back, and in the course of defending herself over several years, her 'professionalism' became the focus of their attacks with a termination. If you follow the link and read the narrative, you can see that she was placed on investigative leave once after an attending complained about her, and again after fellow residents complained. They claimed that she was verbally abusive and threatened physical attacks against colleagues. A quote from the narrative:
"When she returned to the work in September 2011, despite this fact that none of the complaints were substantiated the environment she returned to was very difficult. I have never seen the volume of minutiae documented in the multiple letters that were attached to the Letter of Intent to Dismiss."
I'm not sure who that quote if from exactly, but it tells the story of this lonely road that we walk as the system is in the process of regurgitating you on the street with your career being defecated out beside you. Dr. Nam is a
General Practitioner in California who appears to run a fee for service practice. I believe that her case is ongoing. The only court records that I can find are the court striking down her Resideny's attempt to use the SLAPP legislation to claim that she does not have a basis for her lawsuit (google it). It is also possible that the resident won a settlement and there will be no public record of the outcome.
Resident wins first round in the courtroom
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