## Facts

- Sherrie Lynn Zukle enrolled in the University of California, Davis School of Medicine and experienced significant academic difficulty in the pre-clinical curriculum, accumulating multiple provisional failing grades.
- The school referred her to its academic review committee, placed her on probation, required learning-disability testing, and permitted a decelerated (“split”) curriculum extending the pre-clinical period.
- Testing identified a reading disability affecting reading comprehension and speed under time constraints.
- The medical school provided accommodations including extended exam time, note-taking assistance, audio textbooks, and an adjusted schedule.
- In the clinical curriculum, Zukle continued to receive failing or provisional failing performance evaluations in clerkships and failed the national licensing examination (USMLE).
- The school granted additional flexibility (including time to study and retake the USMLE) but denied requests to restructure clinical training by starting clerkships out of sequence and reducing clinical hours before final exams.
- After continued academic and clinical deficiencies, the school initiated dismissal proceedings and dismissed her for failure to meet academic and clinical standards.
- Zukle sued under Title II of the ADA and § 504 of the Rehabilitation Act (among other claims). The district court entered summary judgment for the Regents, and Zukle appealed.

## Issues

1. Whether a public medical school violates Title II of the ADA or § 504 of the Rehabilitation Act by dismissing a student with a learning disability who cannot meet essential academic and clinical standards despite accommodations.
2. Whether the student’s requested changes to clinical clerkships (including substantial rescheduling and reduced clinical hours) were required reasonable accommodations or impermissible fundamental modifications of the program.

## Decision

- The Ninth Circuit affirmed summary judgment for the Regents.
- The court held Zukle was disabled but not “otherwise qualified” because she could not satisfy essential academic and clinical requirements even with reasonable accommodations.
- The court held the additional accommodations requested would have fundamentally altered or substantially modified the medical school program and were not required by the ADA or Rehabilitation Act.
- The court concluded the dismissal was based on legitimate academic judgment and performance failures, not discrimination because of disability.

## Legal Principles

- Title II of the ADA and § 504 of the Rehabilitation Act use a substantially similar “qualified individual” framework in the public education context.
- A student is “otherwise qualified” only if she can meet a program’s essential requirements with or without reasonable accommodation.
- Educational institutions are not required to lower standards or make substantial or fundamental program modifications to accommodate a disability.
- Courts give substantial deference to an academic institution’s professional judgment on essential requirements and student fitness, particularly where the school engaged in individualized review and considered accommodations.
- An accommodation that materially restructures core components of professional training (such as immersive clinical clerkships) may be deemed a fundamental alteration and thus not required.

## Conclusion

The Ninth Circuit upheld the medical school’s academic dismissal of a learning-disabled student, ruling that extensive accommodations did not make her otherwise qualified and that the ADA and Rehabilitation Act do not compel fundamental alterations to essential medical education and clinical training standards.


Zukle v. Regents of the Univ. of Cal., 166 F.3d 1041 (9th Cir. 1999)