In 2011, KC*, a medical student at McGill, entered the university’s General Surgery residency program. At the time, he did not know that he had Attention Deficit Hyperactivity Disorder (ADHD). By November 2013, he had withdrawn from the program due to physical and mental exhaustion.
In the time between, KC was diagnosed, put on academic probation for his academic performance prior to diagnosis, appealed the decision to no avail, and faced discrimination from members of the Faculty and other barriers that prevented him from being appropriately accommodated.
Citing “discrimination and violation of his right to dignity and honor,” the Center for Research-Action on Race Relations (CRARR) filed a complaint on KC’s behalf against McGill in November 2015. The case was brought to the Quebec Human Rights and Youth Rights Commission. Currently, KC and CRARR are waiting to see if McGill will accept mediation. If it does not, the case will be referred to investigation.
Initial concerns
During his first year at McGill, KC started experiencing insurmountable academic difficulties. In an interview with The Daily, he said, “I was studying twice as hard as others,” yet he was not getting good results. “Also that year I did fail […] two exams that were important, despite working hard,” KC added.
In October 2012, KC began to wonder if he had ADHD. He informed his program director, Paola Fata, of his speculations and told her that he would be undergoing testing for ADHD.
“She just decided on her own that I have an inability. […] Medically, legally, you can never say that.”
According to KC, Fata verbally told him that she was not comfortable with the situation. However, KC said Fata made a written note at the time, which he obtained a copy of a few years later. According to KC, she had written that his ability to carry out his clinical or senior responsibilities was affected, presumably by his disability.
“She just decided on her own that I have an inability. […] Medically, legally, you can never say that.” From that point on, according to KC, Fata decided that he could no longer fulfill the task of taking surgical calls.
Diagnosis, academic probation and appeals
When KC was officially diagnosed with ADHD, the Royal College of Physicians and Surgeons of Canada accommodated him for exams. He re-took the two exams he had previously failed, and in June 2013, he was informed that he had passed. However, in May 2013, he was put on academic probation.
“I was not given the chance to appeal that decision in front of [the General Surgery] [promotions] committee.”
KC said that the decision to place him on probation was based solely on his performance until the end of December 2012, which was before his diagnosis, the start of his treatment, and his having learned to manage his ADHD. “I was not given the chance to appeal that decision in front of [the General Surgery] [promotions] committee,” KC added. “Usually you can appeal [such a decision] in front of your own program’s promotion committee […] before it is final.”
In the summer of 2013, he appealed to the Faculty Postgraduate Promotions Committee, requesting accommodations for his disability, but his appeal was rejected. According to KC, the committee claimed that he had been treated for ADHD, but that his condition did not improve. “You cannot treat ADHD,” he said. Instead, he was forced to start the probation period.
“You cannot treat ADHD.”
KC was pressured to abandon his residency and re-apply a year later. “My learning opportunities were cut off and, besides that, I was expected to perform [academically] in a very good manner, although I was kind of stuck against the wall,” because he had stopped taking surgical calls months before, KC said.
That Fall, three and a half years into his residency program, KC chose to go on medical leave. As a result of these series of events, he had developed symptoms of depression and anxiety.
KC also met with the director of the Office for Students with Disabilities (OSD) at the time, Frédéric Fovet, who informed KC that he was the third medical resident to contact him regarding disability-related discrimination and lack of accommodation. KC contacted the Ombudsman at McGill to report his case, who said the Dean of Students, André Costopoulos, would handle it. Costopoulos agreed that he should have received accommodations to prevent his situation from deteriorating, but nothing came of this.
“My learning opportunities were cut off and, besides that, I was expected to perform [academically] in a very good manner, although I was kind of stuck against the wall.”
KC alleges instead that when Armand Aalamian, the Associate Dean of Postgraduate Medical Education and Professional Affairs, started at McGill, he did not recognize KC’s disability. KC had to submit to more testing, which again confirmed his diagnosis.
A year before resigning, KC met with the Human Rights Commission and informed the Faculty of Medicine of this meeting. He told the Faculty that “it would be a case that [the Commission] would accept,” but his situation, again, remained unchanged.
A systemic problem
In June 2015, the Committee on Accreditation of Canadian Medical Schools (CACMS) put McGill’s Undergraduate Medical Education (UGME) program on probation for failing to meet 24 accreditation standards and requiring monitoring on an additional eight.
“Issues of accommodation were not in the accreditation survey.”
Dean of Medicine and Vice Principal (Health Affairs) David Eidelman told The Daily in an interview that there were four categories of problems that CACMS identified, including curricular monitoring, issues related to clinical learning environments, failure of the school’s program at a teaching site in Gatineau to meet certain criteria, and changes to the curriculum that had not been implemented.
Eidelman highlighted that “issues of accommodation were not in the accreditation survey.” He also noted that the Faculty of Medicine is not on probation, only the UGME.
But in an interview with The Daily, Fo Niemi, executive director of CRARR, said “We wonder to what extent there’s a correlation [between KC’s case and the school’s probation] because I don’t think we can solve this case without addressing what we call the more systemic problem.”
“We wonder to what extent there’s a correlation [between KC’s case and the school’s probation] because I don’t think we can solve this case without addressing what we call the more systemic problem.”
Niemi said that “one of the conditions of probation is that you have to improve the issue of mistreatment of students when they complain or when they need help.”
According to Eidelman, since being put on probation, the school has upgraded the quality and functioning of the curriculum committee, revised the administration of education services, and revisited the consultation and governance models in place for the faculty, among other changes.
“One of the conditions of probation is that you have to improve the issue of mistreatment of students when they complain or when they need help.”
KC informed The Daily of at least six other residents who he says have not been accommodated or faced roadblocks to accommodations. “Even if [students are] informed and supported, the faculty seems to be requiring one proof after another, to the point where [people’s cases] just get drawn out,” Niemi said.
While Niemi and KC question if these complaints signify a systemic issue, in an interview with The Daily, Costopoulos noted that he does not believe there are more student complaints or issues filed in the Faculty of Medicine than in other faculties.
When students bring a complaint to him, Costopoulos said his office works to understand both the student’s situation and any constraints of the faculty, and also reaches out to appropriate services, such as the OSD. His office proposes solutions and, according to him, “usually it works.”
However, “In a very few cases [consensus isn’t reached], and that may lead to escalating to a decision by a dean in a faculty or, ultimately, in very, very few cases, a grievance,” he admitted. KC’s situation appears to be one such case, as his meeting with Costopoulos did not yield a solution with the Faculty.
When asked about her experience with medical students, Teri Phillips, the director of the OSD, told The Daily in an email, “In my five months as the director of the OSD, I have not personally met with any medical students […] nor have I had any specific concerns brought to my attention.”
“In a very few cases [consensus isn’t reached], and that may lead to escalating to a decision by a dean in a faculty or, ultimately, in very, very few cases, a grievance.”
“Generally, the Faculty [of Medicine] is very accommodating to students in terms of things related to health and well-being,” Eidelman told The Daily.
“Whether that meets the expectations of all students, I can’t say,” he added. Eidelman admitted that “sometimes students and the administration disagree on what is a valid reason for accommodation,” but he believes that this does not apply to health problems.
“This case will hopefully be a wake up call, because the moment the Dean of Students is informed, that’s part of management, [so] the entire university management, like it or not, must be informed.”
Niemi maintains that “the facts speak for themselves. This case will hopefully be a wake up call, because the moment the Dean of Students is informed, that’s part of management, [so] the entire university management, like it or not, must be informed.”
*Name has been changed