Court: FIU’s medical school didn’t violate ADA when it dismissed student

Florida International University did not violate a federal law meant to protect people with disabilities when it tossed a student from its medical school for academic underperformance, an Atlanta federal appeals court ruled Monday in a years-long legal battle.

In a 10-page ruling, the U.S. Court of Appeals for the Eleventh Circuit opined that Elie Nehme, who had failed numerous courses and was forced to repeat a year of medical school, didn’t qualify for protection under the Americans with Disabilities Act.

“Why? He could not meet the university’s minimum academic standards, even with reasonable accommodations for his disability,” the court wrote in the ruling.

Nehme “did not get off to a good start” in medical school, the opinion notes.  During his first year he failed an introductory biology course (though passed it during a remediation exam) and showed “marginal competency” in three other first-year medical school courses. His second year of medical school was worse, when he failed a course (and the remedial exam) in cardiac and pulmonary medicine.

One of Nehme’s professors directed him to the medical school’s wellness center to see whether he qualified for accommodations. He did. Diagnoses for attention deficit hyperactivity disorder and an unspecified anxiety disorder qualified Nehme for two accommodations: 50% extra time on exams and a minimally distracting testing room.

Poor performance continues

But Nehme’s poor performance continued. The medical school’s student evaluation and promotion committee scheduled a hearing with Nehme for March. Before that, though, Nehme requested and received voluntary medical leave from January through April 2018.

While on leave, Nehme appeared before the medical school’s student evaluation and promotion committee, testifying that he had medical problems that made it hard for him to attend class.  Despite their concerns, the committee allowed Nehme to repeat his second year of medical school. 

He passed his classes and was allowed to remain for a third year, which is when clinical experience begins.

Although he performed well in his practical experiences and got good evaluations from the physicians in the field he worked with, his academic performance continued to be subpar; Nehme scored below the 10th percentile on seven exams in his third year.

He was again called before the school of medicine’s promotion committee. At the hearing, Nehme blamed his failure of a year-end psychiatry exam on a fire in his neighbor’s apartment on the morning of the test. He said he failed his year-end surgery exam because he was distracted by his father’s medical problems.

However, he never claimed that he lacked proper disability accommodations for any of the exams. The medical school’s evaluation and promotion committee recommended that Nehme be allowed to voluntarily withdraw or be dismissed.

He appealed the committee’s decision to the medical school’s appeal committee. There, he reiterated his struggles but never mentioned lack of accommodations. The dean affirmed the promotion committee’s recommendation that he be dismissed. He appealed to FIU’s interim provost.

During that appeal, Nehme claimed he received improper accommodations for one of his exams but not all of them. The interim provost referred Nehme’s new lack-of-accommodations claim to the school’s Office of Inclusion, Diversity, Equity, and Access.

While that office found sufficient evidence to support Nehme’s claim the finding was further reviewed by the university. The interim provost found “no indication that the allegations regarding a lack of accommodations made by Mr. Nehme had an adverse impact on his academic performance.”

He was dismissed from medical school Oct. 16, 2020.

One month later, Nehme filed suit in U.S. District Court for the Southern District of Florida, where he alleged failure by the school to provide reasonable accommodations for his disability and also illegal discrimination.

FIU successfully moved for summary judgment on both claims, arguing (among other things) that Nehme could not show a violation of the ADA because he did not qualify for the protections under the federal law. Nehme appealed that decision.

Decision affirmed

In affirming the decision, the appeals court noted that “decision makers the promotion committee, appeals committee, dean, and interim provost all agreed that Nehme did not have the academic skills necessary to succeed, and thus could not be promoted to the fourth year of medical school. They based their decision on Nehme’s exceedingly poor academic record, which reflected his inability to meet the medical school’s ‘essential eligibility requirements,’ even when he received full accommodations.”

The court continued: “The record thoroughly supports the university’s conclusion.  Setting aside the disputed Psychiatry retake, Nehme still failed a total of eight courses. And five of those failures came after he was already on academic probation — a designation marking ‘unsatisfactory progress toward the medical degree,’ and one that often serves as a ‘precursor to dismissal from medical school.’ The medical school’s handbook is plain: a student on probation ‘may be recommended for dismissal’ if her ‘academic performance does not improve.’ That is exactly what happened here.”