On The Docket
David B. Brushwood, BSPharm, JD
Student pharmacists can be dismissed from their pharmacy program for a variety of reasons, including poor academic performance and academic dishonesty. Most dismissals are relatively easy to support based on objective evidence. The dismissal of a student pharmacist for lack of clinical skills and for unprofessional conduct during APPE courses is more subjective and is more difficult to justify. A former student pharmacist recently sued her university, challenging her dismissal for failed APPEs.
Background
According to the judge, the student pharmacist suffered from physical and emotional disabilities. The student pharmacist was granted an accommodation that allowed her additional time to complete assignments and exams. Prior to starting her APPEs, she had received “B” and “C” grades with an occasional “A” during her didactic coursework.
There is disagreement about what happened during the student pharmacist’s first rotation. She alleged that the preceptor told her she was “not good enough, you’re not capable of being a pharmacist.” The preceptor also allegedly said that the student pharmacist was “too sick to work as a pharmacy student,” and that she “should be a pharmacy technician.”
The student pharmacist failed the rotation. She was placed on academic probation and was assigned to a remedial rotation, which she also failed. She was then dismissed from the program.
The student pharmacist sued the university, contending that her dismissal was based on disability discrimination. The university requested that the court dispose of the case on summary judgment, contending that the student pharmacist was dismissed for her “deficits in clinical knowledge, inability to
counsel patients independently,” and failure “to identify/solve drug therapy related problems.”
Rationale
The judge first noted that student discipline is generally “left to the broad discretion of the academic institution,” and that to prevail in a wrongful dismissal lawsuit a former student must show that the academic institution’s decision was “such a substantial departure from academic norms” that the institution “did not actually exercise professional judgment.”
The judge concluded that in this case the university had “ample basis to legitimately find that [the student] was not suitable to continue in the program.” Faculty and administrators had documented “strong critiques of [the student’s] substantive knowledge and professionalism.”
The court acknowledged the difficulty of the student pharmacist’s position. The judge said, “having advanced so far in pursuit of her degree—incurring considerable expense in the process—only to fall short of matriculation is an immense hardship.”
Nevertheless, the court granted the university’s motion for summary judgment.
Takeaways
APPEs are a rigorous educational activity that allow student pharmacists to experience the pharmacy profession in real time and in real places. They also allow the pharmacy profession to experience student pharmacists. The match between a student pharmacist and the profession is usually successful. But that is not always the case, as this lawsuit suggests.
Sometimes an APPE student pharmacist is not able to embrace the clinical and professional responsibilities the pharmacy profession requires, even after a relatively successful period of study. The student pharmacist may conclude that the pharmacy profession is not a good fit for them. Conversely, the pharmacy profession may conclude that the student pharmacist is not a good fit for the profession.
The result of any such mismatch between a student pharmacist and the pharmacy profession at such a late time in the student pharmacist’s course of study is tragic. The judge in this case clearly recognized the misfortune of the student pharmacist’s useless investment of significant time and money.
On the other hand, academic institutions cannot grant degrees to unqualified students. Boards of pharmacy will eventually discover a licensee who lacks clinical skills and/or engages in unprofessional conduct. The public expects to be protected.
The key lesson of this disheartening lawsuit is that early warning systems must be utilized, through IPPEs and other meaningful practice experiences early in the curriculum to identify potential mismatches between student pharmacists and the pharmacy profession. ■