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Hajjar-Nejad v. George Washington University

United States District Court, D. Columbia.

March 31, 2014


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MOHAMMAD JAVAD HAJJAR-NEJAD, Plaintiff, Pro se, Gaithersburg, MD.

For GEORGE WASHINGTON UNIVERSITY, Defendant: Henry Morris , Jr., Savalle C. Sims, LEAD ATTORNEYS, Jackson David Toof, ARENT FOX, LLP, Washington, DC.

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COLLEEN KOLLAR-KOTELLY, United States District Judge.

Plaintiff Mohammad Javad Hajjar-Nejad brings this action pro se against the George Washington University, principally challenging his dismissal as a medical student from GW's School of Medicine and Health Sciences in July 2007. Presently before the Court is Defendant's [154] Motion for Summary Judgment.[1] Upon consideration of the pleadings [2], the relevant legal authorities, and the record as a whole, the Court GRANTS Defendant's [154] Motion for Summary Judgment. Accordingly, this action is DISMISSED WITH PREJUDICE in its entirety.


A. Factual Background

Defendant the George Washington University (" GW" or " Defendant" ) is a private, not-for-profit, university located in Washington, D.C. Def.'s Ex. 1 (Goldberg Decl.) ¶ 3. It offers an M.D. degree through its School of Medicine and Health Sciences (" Medical School" ). Id. ¶ 4. Plaintiff Mohammed Javad Hajjar-Nejad (" Hajjar-Nejad" or " Plaintiff" ) was an M.D student in Defendant's Medical School from August 18, 2004 until July 26, 2007. Pl.'s Facts ¶ 5. On November 7, 2003, Plaintiff signed an Offer of Acceptance form provided by Defendant confirming his decision to attend GW's Medical School. Def.'s Ex. 3 (Hajjar-Nejad Dep. Exhibits), Ex. 36 (Offer of Acceptance). Plaintiff's Third Amended Complaint presents his race as " Arabic or Middle Eastern," his religion as " Muslim," and his national origin as " Iranian" (the nationality of his parents). TAC ¶ 7.

The standard curriculum for M.D. students at GW's Medical School spans four years, with the first two years focused on classroom instruction in the basic sciences and the final two focused on clinical clerkships and electives. Def.'s Ex. 4 (Schroth Decl.) ¶ ¶ 3-5. When Plaintiff was an M.D. student, GW also ran an alternative curriculum for third-year students -- referred to as the " third year honors curriculum." Id. ¶ 6. This Honors curriculum varied from the standard curriculum in the distribution of time spent in the inpatient and outpatient clinical settings. Id. ¶ 7. Honors curriculum students also had to perform a

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special project, which could include such things as basic science research, clinical research, community service, medical humanities research, health policy research, and international health research. Id. ¶ ¶ 8-9. During the 2006-2007 academic year, W. Scott Schroth, M.D., M.P.H., Senior Associate Dean for Academic Affairs, (" Dean Schroth" ) ran the Honors curriculum. Id. ¶ 1, 13. Plaintiff applied to the Honors curriculum for his third year, and on April 22, 2006, Dean Schroth notified Plaintiff that he had been selected for the program after a review of applications by a committee of nine faculty members. Pl.'s Ex. 12 (Honors Curriculum Acceptance E-mail). Plaintiff's special project as part of the Honors curriculum involved research into cardiovascular disease. Pl.'s Ex. 8 (Plaintiff's MSEC Statement) at 147-52.

Plaintiff's first rotation, or " clerkship," in the Honors curriculum was internal medicine, which was headed by Dr. Robert Jablonover and ran from July 7, 2006 to August 11, 2006. Def.'s Ex. 3, Ex. 14 (Subcommittee Minutes of May 30, 2007) at 1. On July 25, 2006, during this clerkship, Plaintiff sent an e-mail to Dr. Jablonover, reporting an alleged " recent difficulty" Plaintiff was experiencing with a resident who supervised his work. Def.'s Ex. 3, Ex. 4 (July 25, 2006 E-mail) at 1. Plaintiff complained the " tone, manner, and actions" of this resident were " very unprofessional and coercive." Id. at 1. Plaintiff also detailed several disagreements with this resident, whom he felt was interfering with his education. Id. at 1-2 (" [A] learning environment should be positive and conducive to student learning. This resident has become an obstacle to this." ). Dr. Jablonover replied to Plaintiff's e-mail the same day stating " thank you for your message and for bringing this to my attention. It would be difficult for me to meet today at 1:30; would 4:30 be okay today?" Def.'s Ex. 3, Ex. 8 (Jablonover-Schroth E-mail Exchange) at 2. Based on e-mails in the record, Dr. Jablonover apparently met with Plaintiff regarding his concerns with this resident and e-mailed other doctors asking them to " meet with [this resident] to anonymously discuss [Plaintiff's concerns] . . . and to help provide her with some feedback and guidance re: her interactions with students and her role as a teacher." Id.

On August 23, 2006, Dr. Jablonover sent an e-mail to Dean Schroth which set out the details of Plaintiff's evaluation for the internal medicine clerkship. Id. at 1-2. This e-mail states that Plaintiff's " overall performance grade was 2 (low pass)" and identifies the following issues with Plaintiff's performance: " [d]id not always seem to complete reading assignments; average knowledge base; sometimes focuses on basic sciences without necessarily applying the information clinically to the patient" ; " [s]ometimes had difficulty generating differential diagnosis; did not always focus on/prioritize clinical duties" ; " [s]ometimes not prepared with his patients' information; now [sic] always present on rounds (intermittent); did not seem to appreciate opportunities inherent in hands-on learning; resistant to feedback sometimes; sometimes defensive when given constructive feedback" ; " [s]ometimes seemed uncomfortable talking with patients, which sometimes made therapeutic relationships difficult; sometimes gowned and gloved when not appropriate clinically." Id. This evaluation did also note positive aspects of Plaintiff's performance in the rotation, with Dr. Jablonover stating " he did present in student conference with me an excellent resident-level Powerpoint presentation." Dr. Jablonover also specifies in this e-mail that he met with Plaintiff about his grade and " explained to [Plaintiff] that [he] was presenting information given to [him] second-hand [by other doctors supervising

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Plaintiff] and that there are always two or more sides or perspectives to an issue." Id. In response, Dr. Jablonover notes that during this discussion " he seemed to counter each point and was defensive throughout." Dr. Jablonover concluded his e-mail to Dean Schroth by noting, " I don't think the problem is one of academics but more one of attitude. I'm concerned that [Plaintiff], while being very motivated, is often seems [sic] quite resistant and closed to constructive feedback. I encouraged him to be more open to suggestions given to him by others who are farther along in their training and to discuss with them in a constructive manner any disagreements that might arise." Id. Dr. Jablonover also noted that Plaintiff would likely be interested in challenging his grade. Id. Dean Schroth replied to this e-mail stating that he was scheduled to meet with Plaintiff that Friday. Id. at 1. He also provided background on the process for student complaints regarding grading. Id. Neither party cites evidence in the record of any e-mail communication between Dean Schroth and Dr. Jablonover regarding Plaintiff that occurred prior to this exchange.

On August 25, 2006, Dean Schroth sent an e-mail to Dr. Jablonover and another physician, Dr. Samantha McIntosh, summarizing his August 25, 2006 meeting with Plaintiff:

[H]ad a very interesting discussion with [Plaintiff] today. [A]lthough I think his agenda all along related to his concerns about his evaluation, he spent the first 10 minutes explaining how he wanted to work with me on the medical center strategic plan to improve teaching at the medical school. [H]e has some good points and I appreciate his interest in quality improvement.
[H]owever, all of this obviously came out of his experience in medicine. I'll reflect back to you what he was concerned about. [F]irst, he sees his weak evaluation as a 'grudge' by the department because he did not get along with the resident and leveled criticisms at the department and the clerkship director. [H]e felt like rounds were too long, not focused much on education per se (more on just getting clinical tasks done) and had little bedside teaching. [H]e was concerned that he was rarely observed taking a history or physical exam (he's probably right on this one, to which [I] agreed). [H]e denied being difficult at times, ascribing this to one misunderstanding with his resident who paged him to come perform a rectal exam and then was not there when he showed up. [H]e went off to do something else and then got 'yelled' at for not being there. [H]e implied that he'd had little feedback about his performance during the 6 weeks. [H]e was fairly dismissive of his meetings with [R]obert, implying that you were contradictory in your advice and poorly informed about his fund of knowledge and work habits.
[I] think I can see how he got himself into this situation. [H]e is very rigid, and his interaction style, although polite on the surface, is not collaborative but rather confrontational and critical. [I] reflected this back to him in those exact terms because he was making me feel defensive and uncomfortable, but [I]'m not sure he's hearing me either.
[I]n the end, [I]'m not sure we got very far. [H]e will challenge his evaluation and follow our regs. [I] told him that if he didn't like your decisions he could go to [W]asserman, and then to the [D]ean's office if he wants. [I]t will be interesting to see how he does on other rotations. [I] told him point blank that [I] thought he needed to be more introspective about his interpersonal style

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and think about how he interacts with others.

Def.'s Ex. 3, Ex. 12 (Written Statement to MSEC), Ex. 2.

Plaintiff next proceeded to his surgery clerkship, which ran from August 14, 2006 to September 22, 2006. Def.'s Ex. 3, Ex. 24 (Askari Surgery Evaluation). Dr. Juliet Lee was the clerkship director for the surgery clerkship and Dr. Reza Askari was a senior resident in this rotation. Def.'s Ex. 6 (Askari Decl.) ¶ 4; Def.'s Ex. 7 (Lee Decl.) ¶ 1. On September 21, 2006, Dr. Lee sent an e-mail to Dean Schroth expressing concerns regarding Plaintiff's performance in the surgery clerkship. This e-mail reads:

I have to let you know about one of the students in the new curriculum, [Plaintiff]. He has really struggled throughout the six weeks and my major concern is that he lacks insight into his own deficiencies and has progressed minimally throughout the rotation in his clinical judgment and understanding. I have been following his progress over the last several weeks with the residents and they are at their wit's end with him. [REDACTED] They give him almost daily feedback about his performance and the Chief resident has been giving him weekly formal feedback. Despite all efforts, he has not made any strides. . . .
He also has been noted to wander off from the rotation for a few hours at a time, saying he has medical appointments to one person and then giving another story to another member of the team. As far as I know, he was only excused by me for one medical appointment. He also mentioned that he had to go do some lab work. If he has some work that he is performing for his project and using surgery clerkship time to do it, I am not going to tolerate it. He also told the residents that he has a medical condition which requires him to eat frequently. While this is OK to get something to eat, it shouldn't take three hours. . . .
In terms of his book knowledge, he is doing fine. But none of this information has been translated to patient care or clinical medicine. I am seriously concerned about him and his ability to function. From the residents['] standpoint, they would not want [Plaintiff] taking care of them. My understanding from them and the attendings is that he will likely get a low pass for his clinical rotation in Surgery. With the changes in the grade points for the new curriculum students, he would be at a -4 for his total points. Failing the clerkship is -7 points. While I think he might pass overall based on exams, I think his clinical skills are far behind what we expect of third years.

Def.'s Ex. 3, Ex. 19 (Lee-Schroth E-mail Exchange). Dean Schroth replied to Dr. Lee's e-mail with the following:

[T]his is 100% consistent with the information that we received from his first rotation, the medicine clerkship, who also gave him a low pass (and lots of feedback that he resists). [I] have met with [Plaintiff] repeatedly. [H]e lacks insight into his deficiencies I'm afraid. [I] would urge you and the residents to strongly consider whether his performance is indeed 'passing' or not. [T]echnically, a low pass is still a pass, and he will move on through the curriculum. [I]f you really think that he has serious clinical performance deficiencies, a below passing grade (eg. [sic] conditional or fair) will bring this to a clear 'head' and allow us to work with him on remediation efforts. [H]e is very bright and very 'book' smart, but he has trouble functioning in the clinical environment, difficulty working as part of a team, and

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lacks insight into these problems. [I] see that he is scheduled to meet with me again next week. [P]robably about this issue [I] suspect.

Id. There is no evidence in the record of any e-mail communication between Dean Schroth and Dr. Lee regarding Plaintiff that occurred prior to this exchange. In addition, Dean Schroth states that he did not intend his e-mail as a directive to give Plaintiff a below passing grade, Def.'s Ex. 4 ¶ 17, and Dr. Lee states that she did not perceive it as such, Def.'s Ex. 7 ¶ 5.

Plaintiff also received a negative evaluation for the surgery clerkship from Chief Resident Reza Askari. In this evaluation, Askari states " [t]here were several instances in which there appeared to be inconsistencies in the information [Plaintiff] provided to the members of the team. He often told members of the team varying stories as to his whereabouts and the need to be elsewhere." Def.'s Ex. 3, Ex. 24 at 3. Dr. Askari noted that these " several instances of untruthfulness, raise[] doubts as to adherence to ethical principles" and " [Plaintiff's] lack of ethical integrity toward the members of the team and his colleagues makes his overall performance unacceptable." Id. at 4, 6. Askari did note that Plaintiff was " educationally motivated, did ask for repeated feedback and wanted to improve, however while he made a small amount of progress, the lack of adherence to ethical principles hurt his overall performance." Id. at 5.

Plaintiff alleges that at one point during his surgery clerkship, he asked Dr. Askari to eat breakfast with him. Def.'s Ex. 2 at 272:4-19. According to Plaintiff, Dr. Askari replied " I don't eat with your kind." Id. Defendant disputes that this statement was ever made. Def.'s Facts ¶ 37. Plaintiff concedes that both he and Dr. Askari are of Iranian descent. Pl.'s Facts ¶ 33. He alleges that Dr. Askari is a member of the Baha'i faith, and argues that this statement shows Dr. Askari's discriminatory purpose in negatively evaluating Plaintiff. Def.'s Ex. 2 at 272:15-19. However, there is no evidence in the record that Askari is a member of the Baha'i faith, and in his deposition, Plaintiff recognized that his belief that Askari is Baha'i is speculation. Id. at 263:22-264:9.

Dean Schroth met with Plaintiff on September 25, 2006, as he said he planned to in his email to Dr. Lee. Def.'s Ex. 4 ¶ 18. Prior to this meeting, on September 22, 2006, Plaintiff submitted to Dean Schroth a document entitled " Motion for Injunctive Relief of Incorrect/Wrong Evaluation and for Development of an Active Task Force Committee." Def.'s Ex. 2 at 85:17-86:18; Def.'s Ex. 3, Ex. 5 (Plaintiff's Motion) at 1. This fifteen page document is styled as a legal brief, and includes a case caption which states " MJ HAJJAR-NEJAD, MSIII, Complainant, Vs. Department of Medicine, Respondent." Def.'s Ex. 3, Ex. 5 at 1. In its introduction, the document " requests the overturning of the evaluation by the Department of Medicine and, more importantly and essentially, for the creation of an active task force committee composed of students, administrators, deans, and hospital officials for the coordination and implementation of our goals and objectives as spelled out so explicitly in the University strategic plan." Id. In this document, Plaintiff appears to take issue with the setup of the clinical curriculum as well as his grade in the internal medicine clerkship. Id. at 14-15.

According to Dean Schroth's private memo regarding the September 25, 2006 meeting, he discussed Plaintiff's appeal of his medicine grade as well as the concerns raised by Dr. Lee regarding Plaintiff's surgery clerkship. Def.'s Ex. 4, Ex. A (Schroth Memo of Sept. 25, 2006 Meeting) at 1. In this memo, Dean Schroth states:

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[Plaintiff] continues to be defensive and shows no insight into the fact that he is having these problems. [H]e blames everything on residents who don't teach well, are 'unethical' and uninterested in patient care or student learning. I told him point blank that he needs to stop doing his research on the side, and focus on what is causing these problems in his performance. [I] plan to remove him from the honors curriculum and [I] told him this. [I] will gather some more information about his performance from the medicine and surgery teams. [H]e is staring [sic] OB at [Holy Cross Hospital] today.

Id. Plaintiff disputes that Dean Schroth told him to discontinue his research at the September 25, 2006 meeting. Pl.'s Facts ¶ 50.

Plaintiff next proceeded to his obstetrics and gynecology clerkship, which ran from September 25, 2006 to October 20, 2006. Def.'s Ex. 3, Ex. 27 (Gaskins Evaluation) at 1. Plaintiff also received negative evaluations in this rotation. Dr. Sherita Gaskins, a clinician in the obstetrics and gynecology clerkship, raised concerns regarding Plaintiff's conduct during the clerkship. Id. " [P]laintiff consistently left morning sign outs before they were over. His fellow students complained that he refused to assist them in the morning rounds (which is a requirement for all students)." Id. at 3. As one of several examples of her concerns regarding Plaintiff's truthfulness, she stated that " [Plaintiff] misrepresented Dr. Mufarrij, the site director, by telling me that he had Dr. Mufarrij's permission to take the afternoons off to study during the last week of the rotation. When Dr. Mufarrij and I compared notes, he informed me that this was not the case. [Plaintiff] had not spoken to him about taking time off." Id. at 2. Dr. Gaskins concluded her evaluation by stating:

[Plaintiff] is undoubtedly a very intelligent, ambitious student, but we as a group had very serious concerns regarding his very unprofessional behavior. He openly lied to us on more than one occasion and he refused to pull his weight with regard to patient care. Integrity is one of the cornerstones of our profession and the strong lack of it demonstrated at this early stage of [Plaintiff's] career is very disturbing.

Id. at 5. Obstetrics and gynecology attending physician Dr. Joel Palmer also gave Plaintiff a negative evaluation, stating that he " appears to find the easy way out of doing work" and " has on several occasions left before the recommended time for students to be here in the hospital." Def.'s Ex. 3, Ex. 28 (Palmer Evaluation) at 2. Dr. Palmer stated that Plaintiff " [n]eeds to be informed that there is a requirement for physicians or physicians in training to be truthful and cooperative with the other physicians he works with." Id. at 4.

Subsequently on October 18, 2006, Dr. Lee e-mailed Dean Schroth a letter prepared by Dr. Askari discussing concerns with Plaintiff's " professionalism and integrity." Pl.'s Ex. 22 (Plaintiff's Appeal to Vice President for Academic Affairs) at 97. In her e-mail, Dr. Lee stated, " [a]s we discussed before, [Plaintiff] had much difficulty on the surgical rotation on a number of issues. I think the residents and attendings tried very hard to work with him." Id. The letter from Dr. Askari states that Plaintiff " lacked the ability to synthesize . . . information into useful assessments and clinical plans." Def.'s Ex. 6, Ex. B (Askari Memorandum) at 1. " With relation to his behavior towards other members of the team, there were problems as well. I had several complaints by the other student of the team as to the

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unfair distribution of cases, which eventually led me to assign the daily cases myself and no longer left it up to the students to pick." Id. Dr. Askari closed his letter with the following:

However, my biggest problem with [Plaintiff] relates to his adherence to honesty and ethical principles. As the rotation continued it started to become apparent that [Plaintiff] was often telling different members of the team, including myself and our attending staff different stories as to his whereabouts during parts of the day (examples of his need for a dental appointment for which he never went to, or the need to get a loan to pay for his dental visit). . . .
It appears that while on the surface [Plaintiff] was motivated, on repeated attempts he failed to show improvement in his clinical assessments and most importantly he lacked honesty and integrity and failed to show adherence to basic ethical principles. I am thereby unable to pass him for his surgical clinical rotation.

Id. at 1-2. Dean Schroth responded to Dr. Lee's e-mail containing Dr. Askari's letter by stating " this is very concerning. [S]o I assume this means he will receive at least a conditional (if not a fail) grade for the surgery clerkship? [I]f so, [I] need to know ASAP because it will mean that we must pull him out of the honors curriculum (!) and integrate him back into the standard curriculum." Pl.'s Ex. 22 at 97. With regard to Dr. Askari's e-mail, Dean Schroth asked " will reza's evaluation be submitted as part of his formal surgery evaluation? [I] think it should be, and it may trigger a professional comportment committee review. [I] will go over it with the other deans." Id.

Later that same day, October 18, 2006, Dean Schroth e-mailed Plaintiff requesting that the two meet. Def.'s Ex. 3, Ex. 29 (Schroth October 18, 2006 E-mail). This e-mail read:

[W]e need to talk this week. I am waiting on the final word from surgery, but it looks like you will not pass the surgery clerkship. [T]his means that we will have to mainstream you back into the regular curriculum. [W]e have a few options which we can discuss. [T]he immediate question is to decide what you will do next week: stay for another month of OB, or move to another clerkship (primary care and psychiatry both have room to accommodate you). [P]lease call the office. I have time to meet on Friday both in the morning or the afternoon. I know you are at HC now, so we can also do this by phone.

Id. Plaintiff failed to respond, despite apparently being in the building where Dean Schroth's office is located on October 20, 2006. Def.'s Ex. 4, Ex. B (Gebara Memorandum) at 3. On October 20, 2006, Dean Schroth sent Plaintiff another e-mail, with the subject line of " hello?" , again requesting that the two speak:

[Plaintiff], you need to call me. [Y]ou will not be starting pediatrics on Monday. [Y]ou need to transition to the regular curriculum and pediatrics does not have room for you for two months. [Y]ou can start on psychiatry or primary care, but we need to talk about this right away. [H]arolyn [Johnson, an administrative assistant in the Dean's office] has been trying to reach you all afternoon at home, cell phone, and at HC hospital. [W]e've paged you and called all the units at HC. I sent you a message two days ago, but you have not responded.
CALL ME on my cell phone: .... I'll have it on the rest of the day and most of the time over the weekend.

Def.'s Ex. 3, Ex. 30 (Schroth October 20, 2006 E-mail). Plaintiff did not respond to this e-mail. Instead, on October 23, 2006,

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according to Defendant, Plaintiff reported for his pediatrics rotation. Def.'s Ex. 4 ¶ ¶ 23. Upon learning from the coordinator of this rotation that Plaintiff had done so, Dean Schroth had him sent to GW. Id. ¶ 24. Plaintiff states that he contacted Dean Schroth to set up an appointment on the morning of October 23, 2006. Pl.'s Facts ¶ 59. However, there is other evidence in the record that Plaintiff admitted receiving Dean Schroth's emails and failed to respond to them. Def.'s Ex. 3, Ex. 14 at 2-3.

In any case, Plaintiff met with Dean Schroth on October 23, 2006. Def.'s Ex. 4 ¶ 25. Also present for parts of this meeting were Dr. Jim Scott, Dean of the Medical School (" Dean Scott" ), Dr. Yolanda Haygood, Associate Dean for Student and Curricular Affairs, and Plaintiff's parents. Id. During these discussions, Plaintiff was told that he would be receiving a below passing grade in the surgery clerkship, that he was being returned to the standard curriculum, and that he needed to focus on improving his clinical performance instead of doing research. Id. ¶ 26. Plaintiff asserts that at this meeting Dean Schroth also threatened that Plaintiff would be forced to take a leave of absence. Pl.'s Facts ¶ 67. Plaintiff also alleges that Dean Scott promised that the Medical School would take no further action against Plaintiff after removing him from the Honors curriculum. Id. At the same time, Plaintiff also contends that Dean Scott told Plaintiff that he would not allow Plaintiff to go into surgery as a profession and would place false performance appraisals on Plaintiff's permanent file and transcript, so as to prohibit his transfer to any other medical school or graduate program. Id. The Court notes that in a document prepared by Leigh Anne Gebara, Executive Assistant to the Dean, memorializing the portion of the October 23, 2006 discussions that she attended, none of these allegations are supported.[3] Def.'s Ex. 4, Ex. B. Further, in a letter Dean Schroth states that he sent to Plaintiff summarizing the October 23, 2006 discussion and the preceding events, there is no mention of a request that Plaintiff take a leave of absence, Dean Scott's alleged vow not to pursue further action against Plaintiff, or Dean Scott's alleged threats to keep Plaintiff from becoming a surgeon and bar his transfer. Id., Ex. C (Schroth Letter Summarizing October 23, 2006 Meeting).

Ultimately, Plaintiff received the below passing grade of " conditional" in his surgery rotation based on the fact that he failed the clerkship's clinical portion. Def.'s Ex. 3, Ex. 20 (Plaintiff's Surgery Evaluation).

On December 27, 2006, Dean Schroth sent Plaintiff a letter informing him of plans to " form a Professional Comportment Subcommittee of the Medical School Evaluation Committee (MSEC) to investigate

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the numerous instances of unprofessional behavior reported in your clinical evaluations from the medicine, surgery, and obstetrics and gynecology clerkships completed earlier this semester." Id., Ex. D (Schroth letter of December 27, 2006). This letter also provided Plaintiff with a copy of the Regulations for M.D. Candidates (" Regulations" ) which governed the Professional Comportment review process. These Regulations set out procedures for evaluation of a student's professional comportment, stating " [o]ccasionally, a student's behavior, or pattern of behavior, may raise concerns as to the student's suitability to continue in the study of medicine. The process described below is intended to deal with behavior that may be unacceptable to the School of Medicine and Health Sciences or raise questions about the student's fitness for the practice of medicine." Def.'s Ex. 3, Ex. 16 (SMSHS Bulletin) at 32.

On February 20, 2007, Associate Dean Rhonda Goldberg sent Plaintiff an e-mail stating that she would be " facilitating [the] process" of forming the Professional Comportment Subcommittee. Def.'s Ex. 12 (Third Amended Complaint Exhibit) at 76.[4] She further stated " I am to notify you about the composition of the Subcommittee and you are allowed ten days to object to any person's appointment to the Subcommittee." Id. Dean Goldberg then stated " [t]he Subcommittee I am proposing is" and listed four names. Id. Plaintiff responded to this e-mail on March 2, 2007. Id. at 77. In this e-mail, Plaintiff did not object to any specific member named in Dean Goldberg's e-mail, but rather objected to the process by which he was removed from the Honors curriculum and the fact of the Subcommittee's formation. Id. Dean Goldberg responded to this e-mail on March 8, 2007 stating:

My e-mail to you on February 20, 2007 was to request that you confirm that you have no objections to any of the proposed Subcommittee members. Since you did not object in your email, I will assume that all are approved and therefore I will set up a meeting to review your situation.
Please understand that the purpose of the meeting is to discuss your behavior reported in your clinical evaluations from the medicine, surgery and obgyn clerkships. I am not clear about your reference to the Honors curriculum or the MSEC in your email. You will, of course, have an opportunity to talk with the Subcommittee and share your views.

Id. at 78. On March 20 and 22, 2007, Dean Goldberg sent Plaintiff two additional e-mails advising him of two changes to the membership of the Subcommittee. Id. at 79, 80. She again requested that he e-mail her if he objected to either of these individuals. Id. Plaintiff replied on March 30, 2007 again objecting to the process by which he was removed from the Honors curriculum as well as the fact of the Subcommittee's formation. Id. at 81. However, he did not specifically object to either individual mentioned by Dean Goldberg. On April 27, 2007, Plaintiff sent Dean Goldberg an e-mail raising various procedural objections in the formation of the Subcommittee and naming four alternative individuals Plaintiff proposed for the Subcommittee. Id. at 93-94. These objections to the individuals on the Subcommittee were untimely under the Regulations.

In addition, on April 21, 2007, Plaintiff submitted to GW Dean of Students Linda Donnels a document entitled " Brief of Case Findings." Def.'s Ex. 3, Ex. 6

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(Brief of Case Findings). This document sets out, in outline form, various procedural errors that Plaintiff contends were committed in his dismissal from the Honors curriculum and in the initiation of the Professional Comportment Subcommittee. Id.

On May 3, 2007, the Professional Comportment Subcommittee, consisting of two Medical School faculty members and two Medical School students, met to consider the issues raised with respect to Plaintiff's professional comportment. Def.'s Ex. 3, Ex. 13 (Minutes of Professional Comportment Subcommittee May 3, 2007 Meeting). Plaintiff was present and accompanied by counsel. Id. According to minutes of the May 3, 2007 meeting, the Chair of the Subcommittee, Dr. Bernard Weidermann " explained that [the] meeting pertained to issues of comportment and was not a forum to address disagreements with grades per se." Id. The Subcommittee then interviewed several individuals, including Plaintiff. Id. At this meeting, Plaintiff presented documents to the Subcommittee, which the Subcommittee " agreed to review." The Subcommittee also agreed to " consider any questions [Plaintiff] may wish to submit . . . ." Id. On May 4, 2007, Plaintiff e-mailed Dean Goldberg twenty-one proposed questions for the Subcommittee to consider in investigating his professional comportment. Def.'s Ex. 12 at 98-99.

On May 30, 2007, the Professional Comportment Subcommittee met again. Def.'s Ex. 3, Ex. 14 (Minutes of Professional Comportment Subcommittee May 30, 2007 Meeting). According to minutes of this meeting, the members discussed the twenty-one questions proposed by Plaintiff and " agreed that all were focused on various procedural questions related to the comportment review process, rather than questions that would add further insight into the events in question." Id. at 1. By way of example, the Subcommittee noted the following questions proposed by Plaintiff: " If Dr. Lee thought it was necessary to give me any instructions on performance, why did she not inform me in writing before she submitted her letter to the Deans at the very end of the clerkship?" Id. The Subcommittee then discussed " the key elements of concern for professional comportment." Id. First, reviewing the evidence regarding Plaintiff's internal medicine clerkship, the Subcommittee found that although the concerns with Plaintiff's performance did " not directly speak to comportment issues . . . [they] could reflect an interpersonal skills problem that also manifested itself in comportment concerns." Id. Second, Plaintiff's surgery rotation was " a source of significant problematic reports" regarding Plaintiff's professional comportment. Id. at 1-2. The Subcommittee also found " significant concerns about [Plaintiff's] comportment on the next clerkship in obstetrics and gynecology . . . ." Id. at 2. The Committee also was concerned by Plaintiff's failure to respond to Dean Schroth's request for a meeting in October 2006:

During questioning in the Subcommittee meeting on May 3, [Plaintiff] admitted that he had received Dean Schroth's messages, but preferred to study for his obstetrics exam scheduled for October 20 rather than focus on the message. However, [Plaintiff] could not offer a credible answer as to why he did not contact Dean Schroth after the exam was completed, well before starting the pediatrics rotation. Rather than answer direct questions to explain his thought process over these days, he kept returning to the fact that he needed to complete his exam. This type of response to direct questioning astonished some Subcommittee members and seemed to support the idea that [Plaintiff] was either directly manipulative or

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simply unable to process information and respond in a direct fashion, perhaps due to some basic deficit in interpersonal skills.

Id. at 2-3. The Subcommittee found that, taken as a whole, " the documents and discussions point to some central themes extending over these clerkships." Id. at 3. First, " [t]here were numerous instances of misunderstandings regarding [Plaintiff's] absence from clinical duties, all associated with his working on research projects, studying for exams, or attending to personal issues. To this end, he at least worked to manipulate the system to his advantage." Id. Second, " he appears to have difficulty functioning as a team member with a purpose other than making the best possible grade, and this harms his relations with team members." Id. Third, " rather than seeking to improve his performance by examining his own behavior, he instead seems inclined to externalize this information to blame others, rather than himself, for all issues. He focuses on grading system process rather than on working to understand how he can improve." Id. Finally, the Subcommittee found that Plaintiff's " behavior during the comportment review process itself seems to confirm the concerns of his clerkships. Most concerning was his reaction to direct pleas from Dean Schroth in late October to meet with him and develop a new plan for third year. . . ." Id. Furthermore, " [t]hroughout numerous emails to plan the comportment hearing, he continued to avoid answering direct questions about the composition and scheduling of the comportment hearing, choosing instead to argue about process. This mode of response was vividly apparent during his attendance at the May 3 meeting as well as his list of follow-up questions which did not address the specific issue of clarifying his actions as requested." Id. Based on these findings, the Subcommittee issued the following conclusion and recommendations:

The Subcommittee members have serious concerns regarding [Plaintiff's] comportment and his ability to function as a physician. We are concerned that he may do well in classroom, standardized tests, and one-on-one interactions, but he appears to need work in synthesizing information into valid differential diagnoses and treatment plans, and he has displayed serious difficulties in working as a team member focused on patient care rather than on individual performance. We believe he should expend a great deal of effort in trying to understand his own interpersonal interaction modes and how that relates to becoming an effective physician. We therefore recommend the following:
1. He must repeat any clerkship for which he receives a grade of low pass or below.
2. Even if he receives passing grades subsequently, the Subcommittee Chair must review his clerkship evaluations when he has completed all clerkships to look for comportment-related issues, and if less than satisfactory will refer to the Medical Student Evaluation Committee for investigation.
3. Following successful completion of all his third-year clerkships, he must complete an acting internship in internal medicine at George Washington University hospital, as soon as possible in his fourth year. This rotation was recommended because of the likelihood that he will have reliable supervision and observation in a complex medical setting.
4. The Subcommittee minutes shall become part of his permanent record.
5. He is encouraged to spend time reflecting on his evaluations and difficulties

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in these rotations and consider a leave of absence to attend to these details optimally. He may wish to seek further resources and assistance through the dean's office to help him improve in these areas.

Id. at 3-4. Pursuant to the Regulations, the Subcommittee referred Plaintiff's professional comportment review to the Medical Student Evaluation Committee (MSEC), consisting of faculty members and medical school students. See Def.'s Ex. 3, Ex. 16 at 33. The MSEC met to consider Plaintiff's case on June 18, 2007. Def.'s Ex. 3, Ex. 33 (Letter from Akman to Scott). Plaintiff was present and accompanied by counsel. Id. Based on a letter summarizing this meeting, Bernard Weidermann, the Chair of the Subcommittee, presented the Subcommittee's findings and recommendations and answered questions from the MSEC members. Id. Plaintiff answered questions from the MSEC, and was provided the opportunity to make an oral statement to the MSEC and to submit a written statement after the meeting. Id.

Next, according to the summary of its proceedings, the MSEC met in executive session on July 9, 2007 to consider Plaintiff's written statement and to conclude its deliberations on the matter. Id. As ...

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