Labor & Employment Law Daily Wrap Up, DISCRIMINATION—DISABILITY—N.D.N.Y.: Autistic medical resident twice discharged from residency program takes ADA, Rehab Act claims to trial, (Sep 23, 2026)

By Kathleen Kapusta, J.D.

The resident, who was diagnosed with autism spectrum disorder at the age of three, also advanced to trial on her retaliation claim.

A former medical resident with autism spectrum disorder (ASD) who was twice dismissed from the medical residency program can proceed to trial with her Rehab Act, ADA, and New York State Human Rights Law disability discrimination and failure-to-accommodate claims, a federal court in New York ruled, finding fact issues as to whether she could perform the essential functions of the residency program with accommodations and whether the disputed accommodations were effectively or meaningfully implemented. The court also denied summary judgment on the resident’s retaliation claim (Pak v. Albany Med Health System, No. 1:23-CV-378 (DNH/DJS) (N.D.N.Y. Sept. 22, 2026)).

When the plaintiff joined the health system’s residency program as a second-year resident in neurology in September 2021, it was her fifth residency program. While there were concerns with her judgment, knowledge, communication, and professionalism, she also received positive assessments from several faculty members who described her as hardworking, diligent, and committed to patient care.

Remediation plan. In January 2022, the resident was placed on a remediation plan based on perceived performance deficiencies. She requested accommodations for her ASD the following month. As part of the remediation process, a psychiatrist evaluated her, concluding in April that her difficulties were “restricted to communication with members of the staff” and that the resident did “not experience a level of impairment from her [ASD] that is such to prevent her from practicing medicine.” Nevertheless, she was dismissed from the program days after her remediation period ended.

Reinstated. The resident challenged her dismissal and in May, she was reinstated to the program under the previous remediation plan. She claimed that the program director and associate director subjected her to heightened scrutiny. On her first day back, the associate director wrote in an email that he was “concerned[] that [plaintiff] will fail again, and fail soon” and that [w]e’re planning on intensively thorough and comprehensive documentation moving forward.” He also expressed concern that, “short of a major patient complication,” the program “would lack sufficient proof for Human Resources to accept another termination.”

The resident also claimed she experienced hostility from certain faculty members, including a physician who referred to her as “insane” and said it would be masochistic to volunteer to be her mentor.

Accommodation requests. Although the resident requested as accommodations for her ASD time off for medical appointments, written supervisory directives, a faculty mentor, a quiet workspace, and autism-awareness training, she claimed that several approved accommodations were delayed, inconsistently implemented, or ineffective in practice.

Second termination. In August 2022, the resident complained to program leadership and HR that the physician who called her insane was mistreating her. In October, she complained that the physician told her that “individuals with autism are not capable of learning” and excluded her from workplace teams. Shortly after that, she was again dismissed from the program purportedly for mismanaging a patient under the physician’s care.

Disability discrimination. Moving for summary judgment on the resident’s disability discrimination claim, the health system argued she could not perform the essential functions of a second-year neurology resident, even with reasonable accommodation. In support, it pointed to evidence of deficiencies in her “medical knowledge, communication skills, professionalism, and patient care.” The resident, however, pointed to evidence of positive evaluations and improvement as well as the psychiatrist’s opinion that her ASD did not prevent her from practicing medicine and that her communication-related difficulties were potentially manageable with appropriate support and accommodations.

Noting that the parties also disputed whether several of her requested accommodations were even meaningfully implemented, the court found a material fact issue as to whether she could perform the essential functions of the residency with reasonable accommodations.

Evidence of pretext. As to the health system’s assertion it terminated her residency because of her longstanding deficiencies, the court found a genuine dispute as to whether these performance-based explanation, although well-documented, actually accounted for the resident’s termination. Here, it again noted that the psychiatrist determined in April 2022 that the resident’s workplace difficulties were limited to communication with staff, were attributable to her ASD, and could potentially be addressed with the appropriate accommodations.

The resident also pointed to the associate director’s email after her reinstatement expressing concern that she would “fail again, and fail soon” and stating that, absent a “major patient complication,” the program would lack sufficient proof to terminate her. There was also evidence of disability-related hostility by certain faculty and staff, including comments about her ASD. On this record, said the court, a reasonable jury could find the health system’s stated performance-based reasons for its actions were pretextual and that her disability was a but-for cause of the challenged treatment. Accordingly, the court denied summary judgment on this claim.

Failure to accommodate. Turning to the resident’s failure-to-accommodate claim, the court noted evidence she disclosed her ASD and requested accommodations while her remediation was ongoing. She claimed that after she was reinstated to the program, she continued to experience difficulty attending medical appointments, her faculty mentor was unable to meet with her regularly, she was not provided a permanent quiet workspace, and the health system declined to implement proposed autism-awareness training. For its part, the health system disputed whether each requested accommodation was reasonable or necessary and claimed she did receive reasonable accommodations.

Because the resident’s ASD allegedly causes her to interpret language literally and makes clear, direct communication particularly important, she requested concrete written supervisory directives and a faculty mentor, said the court, noting that the psychiatrist’s assessment established that communication-related accommodations could have helped her in performing her job. Thus, a jury could conclude that at least some of her requested accommodations were connected to ASD-related limitations and could have assisted her in performing the essential functions of the residency.

Meaningfully provided? The court also found a fact dispute as to whether the health system meaningfully provided the accommodations it eventually approved. For example, although it approved intermittent time away from work for medical and coaching appointments, the resident claimed that other residents and attending physicians continued to complicate her efforts to attend those appointments and that she repeatedly informed program leadership of the problem without improvement. She also claimed that although she was offered access to a quiet space when available, she was never provided with a permanent and consistent quiet space.

As to her request for concrete written supervisory directives, shortly after the plan was implemented, the associate director observed that “many of the items on the [remediation] plan are difficult to measure and therefore up to interpretation.” A reasonable jury, the court observed, could conclude that such directives did not satisfy her request for concrete and explicit performance guidance tailored to limitations associated with her ASD.

And while the health system argued that she could not perform the essential functions of the residency despite the accommodations she received, the court again noted evidence of positive evaluations and improvement following her reinstatement and the psychiatrist’s opinion that her ASD did not prevent her from practicing medicine and her communication-related difficulties could potentially be addressed with appropriate accommodations. “Thus,” said the court, “whether plaintiff could have performed the essential functions of the position had the disputed accommodations been effectively or meaningfully implemented cannot be resolved as a matter of law on the present record.”

Undue hardship. The court also found the health system failed to establish undue hardship as a matter of law as competing evidence concerning her performance, the effectiveness of the accommodations actually provided, and the extent to which additional or different accommodations could have addressed her limitations presented questions for a factfinder. Thus, the court also denied summary judgment as to her failure-to-accommodate claim.

Retaliation. Regarding the resident’s retaliation claim, the court found the timing of the challenged actions presented a fact issue. The resident relied on the associate director’s June 1 email written immediately following her reinstatement stating that he was “very concerned that she will fail again, and fail soon,” as well as evidence that program leadership knew of her complaints concerning disability discrimination and the benefits director was “concerned that certain people at [the health system] may have engaged in disability discrimination.”

Though the health system argued that performance concerns underlying both terminations predated her protected activity and continued throughout her residency, her retaliation theory, said the court, was not limited to her initial accommodation request. She continued to complain of disability discrimination following her reinstatement and, in August and October 2022, specifically complained about the physician’s alleged treatment of her. Shortly after the October complaint, the physician reported the disputed patient incident that precipitated the resident’s final termination.

Viewing this evidence together, the court found the record sufficient to permit a reasonable jury to find her protected activity was a but-for cause of the challenged adverse action and this claim also survived summary judgment.

The case is No. 1:23-CV-378 (DNH/DJS).

Judge: Hurd, D.

Attorneys: Amy Robinson (Giskan Solotaroff & Anderson) for Stella Pak. Robert F. Manfredo (Bond, Schoeneck & King) for Albany Med Health System.

Companies: Albany Med Health System

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