## Facts

- Dr. Joshua R. Pushkin, a physician with multiple sclerosis who used a wheelchair and had limited walking and writing ability, applied to a university psychiatric residency program.
- Completion of an accredited psychiatric residency was necessary for board certification; Pushkin had already completed one year of psychiatric residency and was practicing medicine with an emphasis on psychiatry.
- During the admissions process, multiple faculty members interviewed Pushkin; evaluators raised concerns tied to his disability, including speculation about effects on judgment and memory, emotional stability, and anticipated absences for treatment.
- Pushkin provided evidence countering those assumptions, including favorable prior evaluations and medical information indicating treatment could be scheduled to limit disruption.
- The program rejected his application; the trial court found that the program director stated the decision was based on Pushkin’s multiple sclerosis.
- Pushkin sued alleging disability discrimination under § 504 of the Rehabilitation Act and under 42 U.S.C. § 1983; the residency program received federal financial assistance.
- The district court found a § 504 violation, enjoined the program to admit Pushkin to the next class, and awarded attorney’s fees and costs, but denied monetary damages.

## Issues

1. Whether Pushkin was an “otherwise qualified” individual with a disability for admission to the residency program under § 504.
2. Whether he was excluded from a federally funded program “solely by reason of” his disability.
3. What burden-shifting framework governs a § 504 claim challenging denial of admission to an academic/medical training program.
4. Whether the program’s stated reasons were legitimate academic judgments or pretexts for disability discrimination.

## Decision

- The court of appeals affirmed the judgment finding a violation of § 504.
- It held that Pushkin was an “otherwise qualified” applicant and that the program excluded him solely because of his disability.
- It upheld the injunction requiring admission to the next residency class and the award of attorney’s fees and costs.
- Because damages were denied below and not appealed, the appellate review focused on liability and equitable relief.

## Legal Principles

- Section 504 prohibits excluding an otherwise qualified person with a disability, solely because of the disability, from participation in a program receiving federal financial assistance.
- “Otherwise qualified” asks whether the applicant can meet the program’s essential requirements despite the disability, without changes that would fundamentally alter the program.
- A § 504 admission-discrimination claim may proceed under a burden-shifting approach: (1) plaintiff establishes a prima facie case (disability, otherwise qualified, federally funded program, exclusion solely by reason of disability); (2) defendant articulates legitimate, non-discriminatory reasons; (3) plaintiff may show those reasons are pretext.
- Academic discretion does not permit exclusion based on speculative fears, stereotypes, or unsupported assumptions about disability-related limitations.
- Injunctive relief is appropriate to place the plaintiff in the position he would have occupied absent unlawful exclusion.

## Conclusion

The court held that a federally funded psychiatric residency violated § 504 by rejecting an otherwise qualified physician based on unsupported assumptions about multiple sclerosis, and it affirmed an injunction requiring his admission and an award of attorney’s fees and costs.


Pushkin v. Regents of the Univ. of Colo., 658 F.2d 1372 (10th Cir. 1981)