4th Circuit Rejected the ADA Claim for a Medical Student with ADHD

In Halpern v. Wake Forest University Health Sciences, Ronen Halpern was enrolled in Wake Forest's Doctor of Medicine program from July 2004 to March 2009. Halpern has been diagnosed with ADHD and anxiety disorder, both of which he treats with prescription medications. 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. There were incidents of abusive behavior toward staff and unexplained absences. Halpern failed his first rotation in 2006 due to “frequent lapses in professionalism,” with poor interpersonal skills and more absences. Shortly thereafter, Halpern went on medical leave to address the severe side effects of his medications. Halpern returned in April 2007 and thereafter successfully completed ten clinical rotations. However, there were several incidents of unprofessional behavior along the way, including poor interactions with staff and faculty.

Finally, in November 2008, Halpern failed to send letters of appreciation to scholarship donors, despite numerous reminders. Although typically this would not have resulted in expulsion, because Halpern was on probation due to his failure of his first rotation, the Medical School referred his file to the Student Progress and Promotions Committee, which recommended dismissal. In internal appeals, Halpern proposed a strict probation plan as an alternate remedy. Concluding that the professionalism concerns would not be addressed by this plan, the Dean of the School decided to dismiss Halpern.

Halpern filed suit under the Rehabilitation Act and ADA. The district court granted summary judgment for the defendant because Halpern was not “otherwise qualified” and his proposed accommodation was unreasonable. The Fourth Circuit unanimously affirmed. In the context of a student excluded from an educational program, to prove a violation of either Act, the plaintiff must establish that (1) he has a disability, (2) he is otherwise qualified to participate in the defendant's program, and (3) he was excluded from the program on the basis of his disability. There was no dispute that Halpern had a disability. As to the second prong, the Court, like other circuits, gave “great deference” to the school’s professional judgments regarding necessary qualifications and the reasonableness of accommodations. It found that professionalism was an essential requirement of the Medical School’s program and that, without an accommodation, Halpern could not satisfy this requirement. Despite Halpern’s passing of ten rotations, the Court found there to “extensive evidence of Halpern’s unprofessional behavior.”

The Court also rejected Halpern’s proposed accommodation – psychiatric treatment, participation in a program for distressed physicians, and continuing on strict probation – because it was untimely, had an indefinite duration, and had an uncertain likelihood of success. Halpern’s expert conceded the last two points. Finally, the Court rejected the claim that Wake Forest failed to engage in an interactive process.