The principal issue in this case is the proper characterization of a residency agreement pursuant to which a surgical resident was dismissed during the final year of his residency training program. The plaintiff physician, Shailesh Gupta, alleging that he had entered into an employment contract with the defendant, New Britain General Hospital (hospital), brought an action challenging the propriety of his dismissal from the hospital's residency training program. The trial court granted a motion for summary judgment filed by the hospital. The plaintiff appealed from the judgment of the trial court to the Appellate Court. We transferred
Because this appeal arises from the granting of summary judgment in favor of the hospital, our review proceeds from a view of the facts in the light most favorable to the plaintiff. See, e.g., Strada v. Connecticut Newspapers, Inc., 193 Conn. 313, 317, 477 A.2d 1005 (1984). In July, 1985, the hospital appointed the plaintiff to serve as a resident physician in the second year of its five year
Shortly after the renewal of the plaintiffs residency agreement for a second year, supervising faculty at the hospital and elsewhere
In February, 1988, during the plaintiffs third year at the hospital and while he was still on probation, the hospital's resident evaluation committee (residency committee) preliminarily determined that there had been insufficient improvement in the plaintiffs clinical performance to justify renewal of his residency
Despite continued doubts as to the plaintiffs performance during this ninety day period, the residency committee nonetheless decided, in July, 1988, by one vote, to renew the plaintiffs residency agreement for a fourth and final year.
At the plaintiffs first quarterly evaluation in September, 1988, the general surgical section unanimously determined that the plaintiff did "not show any potential for being a safe and independent surgeon" and so decided to dismiss him. This determination was based on a number of factors, including the plaintiffs inability to make decisions in the operating room, his unwillingness to accept responsibility for errors, and gaps in the plaintiffs "knowledge base." The plaintiff was informed of his immediate dismissal from the residency program.
The plaintiff, with the assistance of counsel, exercised all the procedural rights of review afforded to him under the hospital's bylaws. His dismissal was affirmed, first by an ad hoc committee of the medical staff and,
After various unsuccessful efforts to challenge his dismissal as a violation of his civil rights
The hospital moved for summary judgment, which the trial court granted.
On appeal, the plaintiff renews the claims that he made at trial, adding only that the trial court overlooked genuine issues of material fact in granting summary judgment. "The standards governing our review of a trial court's decision to grant a motion for summary judgment are well established. Practice Book § 384 provides that summary judgment shall be rendered forthwith if the pleadings, affidavits and any other proof submitted show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." (Internal quotation marks omitted.) Doty v. Mucci, 238 Conn. 800, 805, 679 A.2d 945 (1996). Applying these standards, we reject the plaintiffs claims and affirm the judgment of the trial court.
In the plaintiffs principal challenge to the trial court's decision upholding his dismissal, he takes issue with the court's characterization of the nature of the residency agreement. He contends that the court improperly determined that, as a matter of law, the residency agreement gave rise to an educational, rather than
A proper assessment of the nature of the plaintiffs employment status must take into account the language of the residency agreement as well as any circumstances that might illuminate our interpretation of this language. On the present record, despite the plaintiffs argument to the contrary, this assessment is purely a question of law.
The plaintiff contends that the parties, by emphasizing different portions of the residency agreement that favor their respective interpretations of that agreement, implicitly demonstrated that material facts were in dispute. These "facts," he contends, were not properly considered by the trial court in its decision to grant summary judgment. We disagree.
It is well settled that, for purposes of summary judgment, the moving party "has the burden of showing the absence of any genuine issue [of] material facts which, under applicable principles of substantive law, entitle him to a judgment as a matter of law ... and the party opposing such a motion must provide an evidentiary foundation to demonstrate the existence of a genuine issue of material fact." (Citations omitted; emphasis added; internal quotation marks omitted.) Doty v. Mucci, supra, 238 Conn. 805-806. Merely alluding to disputed material facts, however, without providing substantiation, does not sufficiently establish those facts to preclude summary judgment. See, e.g., Strada v. Connecticut Newspapers, Inc., supra, 193 Conn. 317.
The plaintiff has failed to identify any disputed issues of material fact relevant to the characterization of his
In the absence of any question of fact, the proper characterization of the residency agreement, as a matter of law, implicates a number of factors, including the language of the agreement, the purpose of the parties in entering into the agreement, and the institutional setting of the agreement. With respect to the dismissal of a resident based on his failure to attain the necessary level of clinical competence, we agree with the trial court that an analysis of these factors, in their entirety,
The language of the residency agreement bears many indicia of a contract for educational services. In its first sentence, the agreement provides that "[t]he general objectives of the Program are to provide to the Physician a proper educational experience in the professional field encompassed by the Program while simultaneously providing to the Hospital's patients a high quality of health care." (Emphasis added.) The agreement further provides that "[t]he Program covered by this Agreement is a part of an overall program of education provided at the Hospital." (Emphasis added.) To facilitate this learning experience, the hospital promises to "maintain its staffing and facilities so as ...to provide a proper educational setting for the Program." (Emphasis added.)
Other parts of the residency agreement contain provisions, however, that are indicative of an employer-employee relationship. Thus, the agreement provides that the plaintiff "will be paid a weekly salary at a rate of $22,800.00 per year" and that "[t]he Hospital will provide to the Physician ... insurance coverage and other benefits...." The agreement assures the plaintiff that he will receive "such holidays, vacation time and leaves of absence as may be set forth in the Hospital's general schedule of employee benefits." The agreement promises that the plaintiff, during his term at the hospital, "will be a member of the Hospital's Medical Staff, having all of the rights and responsibilities attendant upon such membership...."
The trial court concluded that, despite the employment aspects of the residency agreement, its "consistent purpose" was "to provide an educational opportunity." Implicitly drawing on cases in which
Although we agree with the trial court's ultimate conclusion, we are not persuaded that a singular search
In this case, the plaintiff was dismissed as a result of the hospital's decision that he was not then, and would not likely become, a safe and independent surgeon. Such a decision has little to do with the normal
A residency training program provides medical school graduates with the clinical training necessary for board certification in specialty or subspecialty areas. See footnote 2. A residency is, in many respects, part of an educational continuum begun in medical school. See S. Reuter, "Professional Liability in Postgraduate Medical Education," 15 J. Legal Med. 485 ("[r]esidents are physicians in transition"). The ultimate objective of the residency program is to educate the physician in the healing arts. Rather than relying on book study alone, a residency program achieves this result by involving the physician in day-to-day patient care and specialized clinical activities. Id., 487.
Residency program supervisors, like medical school professors, are responsible for evaluating a resident's progress and offering suggestions for improvement. See, e.g., D. Langsley, "Evaluation During Residency," in How to Evaluate Residents (J. Lloyd & D. Langsley, eds. 1986) pp. 11, 12. A residency committee's decision to dismiss a resident physician for poor performance in the clinic mirrors a professor's decision to fail a medical school student for poor performance in the classroom. See Ross v. University of Minnesota, supra, 439 N.W.2d 33 ("[t]he decision to terminate a resident from a hospital-based residency program is the same as any other decision to fail a graduate student for inability to meet academic requirements"). As Justice Powell observed in Board of Curators v. Horowitz, 435 U.S. 78, 95, 98 S.Ct. 948, 55 L. Ed. 2d 124 (1977) (Powell, J., concurring), "[evaluation of ... performance in
The plaintiff advances two reasons in support of his argument that his dismissal was nonetheless employment related. According to the plaintiff, the hospital is his employer, as a matter of law, because it controls his work and because it is not itself a part of a university, school or college. We disagree.
The plaintiffs first argument relies on "right to control" cases as evidence of his status as the hospital's employee. See Silverberg v. Great Southwest Fire Ins. Co., 214 Conn. 632, 639, 573 A.2d 724 (1990). We have used the "right to control" test to distinguish between an independent contractor and an employee. See, e.g., Hunte v. Blumenthal, 238 Conn. 146, 154, 680 A.2d 1231 (1996); Silverberg v. Great Southwest Fire Ins. Co., supra, 639. That test has no relevance, however, to the criteria for differentiation between a student and an employee. Indeed, it is a premise of the "right to control" test that what is at issue is the control of "the means and methods of work"; Silverberg v. Great Southwest Fire Ins. Co., supra, 639; thus assuming the very point that is presently at issue.
The plaintiffs second claim is that the term "hospital"
For all the reasons stated above, we hold that, in the circumstances of this case, the plaintiffs dismissal implicated the educational component of the residency agreement and was, therefore, an academic decision. In light of this conclusion, we must consider the merits of the plaintiff's other challenges to the validity of his dismissal.
Even if his dismissal was properly grounded in academic reasons, the plaintiff maintains that, for three other reasons, the hospital's decision did not comport with its contractual obligations to him. In his view, the hospital: (1) failed to provide him with appropriate training; (2) discharged him arbitrarily, capriciously, or in bad faith; and (3) violated its obligation of good faith and fair dealing. Like the trial court, we are persuaded by none of these contentions.
The plaintiff claims that the hospital, in breach of the residency agreement, failed to provide him a residency program that "would reasonably and adequately train him" and that was "in accordance with the standards established for teaching hospitals." The trial court recognized that this claim, as a matter of law, was consistent with the court's determination that the residency agreement manifested an educational undertaking, but concluded that, as a matter of fact, the plaintiff had not submitted evidence of disputed material facts sufficient to rebut the hospital's motion for summary judgment. We agree.
The plaintiff's claim that the hospital failed to provide him adequate training must be put into context. "Where the essence of the complaint is that [an educational institution] breached its agreement by failing to provide an effective education, the court is ... asked to evaluate the course of instruction [and] called upon to review the soundness of the method of teaching that has been adopted by [that] educational institution." (Internal quotation marks omitted.) Ross v. Creighton University, 957 F.2d 410, 416 (7th Cir. 1992). This is a project that the judiciary is ill equipped to undertake. See id.; Donohue v. Copiague Union Free School District, 47 N.Y.2d 440, 445, 391 N.E.2d 1352, 418 N.Y.S.2d 375 (1979); Cavaliere v. Duff's Business Institute, 413 Pa.Super. 357, 370, 605 A.2d 397 (1992).
In reality, a claim such as that advanced by the plaintiff "raise[s] questions concerning the reasonableness of conduct by educational institutions in providing particular educational services to students—questions that must be answered by reference to principles of duty, standards of care, and reasonable conduct associated with the law of torts." Cencor, Inc. v. Tolman, 868 P.2d 396, 399 (Colo. 1994) (en banc). Because these tort
The jurisprudential considerations that shed doubt on the viability of the tort of educational malpractice also inform our analysis of a contract claim based on inadequate educational services. See Ross v. Creighton University, 740 F. Sup. 1319, 1331 (N.D. 111. 1990), rev'd in part on other grounds, 957 F.2d 410 (7th Cir. 1992) ("the policies forbidding the tort of educational malpractice likewise forbid a breach of contract claim based upon allegedly inferior instruction"); Paladino v. Adelphi University, 89 App. Div. 2d 85, 89, 454 N.Y.S.2d 868 (1982) ("the soundness of [the] policy of noninterference is equally applicable when the action is ... formulated in contract"). It is as a result of
Judicial noninterference is especially appropriate in cases like the present one, in which the focus of a breach of contract claim is an allegedly inadequate residency program. See Swidryk v. St. Michael's Medical Center, 201 N.J.Super. 601, 606-607, 493 A.2d 641 (1985) (recognizing resident's claim for educational malpractice would infringe on administrative and legislative authority). Specialized bodies, such as the accreditation council for graduate medical education (accreditation council), currently have the responsibility of overseeing and regulating residency programs, including the one offered by this hospital. In this state, successful completion of a program accredited by the accreditation council is a prerequisite to obtaining a license to practice medicine and surgery. Public Acts 1995, No. 95-271; General Statutes § 20-13. In light of the highly specialized nature of patient care, these external regulators are better suited than are courts to evaluate the effectiveness of a residency program.
There are, however, at least two situations wherein courts will entertain a cause of action for institutional breach of a contract for educational services. The first would be exemplified by a showing that the educational program failed in some fundamental respect, as by not offering any of the courses necessary to obtain certification in a particular field. See Wickstrom v. North Idaho College, 111 Idaho 450, 452, 725 P.2d 155 (1986); Ross v.
In this case, the plaintiff has neither alleged nor presented factual evidence of a fundamental failure on the part of the hospital's residency program. Rather, his claims fall into two categories: (1) general allegations of inadequacy; and (2) more specific allegations that the hospital failed to attain "the standards established for teaching hospitals." With regard to the first category, the plaintiff has done no more "than simply allege that the education was not good enough." Ross v. Creighton University, supra, 957 F.2d 416-17. This, in turn, is insufficient to state a cause of action. See id.; Cencor v. Tolman, supra, 868 P.2d 398. With regard to the second category, the hospital's alleged failure to live up to the promise contained in the residency agreement that the hospital "is, and will continue to be, properly accredited by all necessary accrediting authorities," the plaintiff failed to adduce, in the trial court, any evidence either that the hospital had lost its accreditation or that its accreditation was in serious jeopardy.
We conclude, accordingly, that the trial court properly determined that the plaintiffs second claim was "without a factual basis" and, therefore, properly
The plaintiff further contends that his dismissal was improper, even as an academic decision, because the decision to terminate his residency resulted from arbitrary, capricious, and bad faith conduct by the hospital. The trial court rejected this claim, finding that the plaintiff had failed to allege or to offer evidence in its support. We agree.
As with the plaintiffs claim of deficiencies in his hospital training, we approach with caution, and with deference to academic decisionmaking, the plaintiffs challenge to the motivation of the hospital in terminating his residency. "Like the decision of an individual professor as to the proper grade for a student in his course, the determination whether to dismiss a student for academic reasons requires an expert evaluation of cumulative information and is not readily adapted to the procedural tools of judicial or administrative decisionmaking." Board of Curators v. Horowitz, supra, 435 U.S. 90; see also Regents of the University of Michigan v. Ewing, 474 U.S. 214, 225-26, 106 S.Ct. 507, 88 L. Ed. 2d 523 (1985); Doherty v. Southern College of Optometry, 862 F.2d 570, 576 (6th Cir. 1988), cert. denied, 493 U.S. 810, 110 S.Ct. 53, 107 L. Ed. 2d 22 (1989); Lekutis v. University of Osteopathic Medicine & Health Services, 524 N.W.2d 410, 413 (Iowa 1994); Abbariao v. Hamline University School of Law, 258 N.W.2d 108, 112 (Minn. 1977); Olsson v. Board of Higher Education, 49 N.Y.2d 408, 416, 402 N.E.2d 1150, 426 N.Y.S.2d 248 (1980); cf. Mahavongsanan v. Hall, 529 F.2d 448, 450 (5th Cir. 1976) (for dismissal grounded in disciplinary, rather than academic, reasons, courts appropriately may engage in more thorough due process analysis).
Educational discretion is, nonetheless, not limitless. The plaintiff properly observes that, in exercising its professional judgment, an educational institution does not have license to act arbitrarily, capriciously, or in bad faith. Such a substantial departure from academic norms may implicate substantive due process; see Regents of the University of Michigan v. Ewing, supra, 474 U.S. 224; or may constitute the breach of an educational contract by a private institution. See Doherty v. Southern College of Optometry, supra, 862 F.2d 577 (implicit in contract is promise not to act capriciously or arbitrarily); Paulsen v. Golden Gate University, 25 Cal.3d 803, 808-809, 602 P.2d 778, 159 Cal.Rptr. 858 (1979) (en banc) (applying arbitrary and capricious standard to private school).
In the present case, therefore, the issue is not the jurisprudential basis for the plaintiffs claim but its factual
The plaintiff contends that the affidavit he submitted in opposition to the hospital's motion for summary judgment was sufficient to meet his evidentiary burden.
We conclude that the plaintiff failed to adduce material facts to survive a motion for summary judgment on his claim of arbitrariness, capriciousness, or bad faith on the part of the hospital. The trial court's decision to this effect must, therefore, be upheld.
The plaintiff's final claim is that the hospital, even in the exercise of its academic judgment, dismissed him improperly because his dismissal violated the hospital's implied covenant of good faith and fair dealing. The trial court, without explicitly addressing this claim,
The two principles that govern the plaintiffs claim are undisputed. "Every contract carries an implied covenant of good faith and fair dealing requiring that neither party do anything that will injure the right of the other to receive the benefits of the agreement." Habetz v. Condon, 224 Conn. 231, 238, 618 A.2d 501 (1992). "Bad faith means more than mere negligence; it involves a dishonest purpose." Id., 237.
In this case, the plaintiff has failed to articulate how an implied covenant of good faith and fair dealing provides greater protections than that afforded him under the arbitrary, capricious, and bad faith standard described in part IIB of this opinion. Even if a different argument theoretically could be mounted, we would, nonetheless, have to conclude that the plaintiff has failed to offer any independent evidentiary foundation to substantiate this claim. See Doty v. Mucci, supra, 238 Conn. 805-806.
The affidavit submitted by the plaintiff to rebut the hospital's motion for summary judgment fails to identify any material facts in dispute and fails to provide an evidentiary foundation in support of his claim of breach of an implied covenant of good faith and fair dealing. The plaintiff suggests that, by occasionally offering the plaintiff positive feedback and by delaying his dismissal until he had already been promoted to his fourth year, the hospital acted pursuant to some sinister motive. We discern no such malevolence. It is more plausible, by far, that the hospital's actions demonstrate its patience
The judgment is affirmed.
In this opinion the other justices concurred.
"RESIDENT PHYSICIAN AGREEMENT
(Residents, Interns and Fellows)
THIS AGREEMENT has been entered into on July 1, 1985 between NEW BRITAIN GENERAL HOSPITAL, a Connecticut corporation having its principal office at 100 Grand Street, New Britain, Connecticut (the `Hospital), and Shailesh Gupta, M.D., residing at 1890 Surrey Place, Gates Mills, OH 44040 (the `Physician').
The Physician has been duly appointed to serve as a(n) PGY-II in the Hospital's General Surgical Residency program (the `Program') during the period from July 1, 1985 through June 30, 1986. The Program will be conducted under the general supervision of the Chief of Surgery (the `Program Director'). This Agreement will set forth the respective rights and duties of the parties as participants in the Program.
IN CONSIDERATION OF their mutual promises and undertakings, the parties to this Agreement hereby agree as follows:
The general objectives of the Program are to provide to the Physician a proper educational experience in the professional field encompassed by the Program while simultaneously providing to the Hospital's patients a high quality of health care. The Hospital represents that the Program is, and will continue to be, properly accredited by all necessary accrediting authorities. The Hospital will maintain its staffing and facilities so as to maintain such accreditation and to provide a proper educational setting for the Program. The Physician's duty time in the Program will be scheduled by the Program Director with due regard for the needs of Hospital patients and the educational interests of the Physician.
The Program covered by this Agreement is a part of an overall program of education provided at the Hospital. If the Program is not the concluding part of such an overall program and if the Physician successfully fulfills his or her obligations under this Agreement during the Program period and is recommended for advancement by the Program Director, the Hospital will renew this Agreement for the subsequent part of the overall program upon terms to be agreed upon at the time of renewal. If the Program is the concluding part of such an overall program and if the Physician successfully fulfills his or her obligations under this Agreement during the Program period, the Hospital will certify in proper fashion that the Physician has successfully completed the overall Program....
The Physician agrees to fulfill all educational requirements of the Program and further to provide safe, effective and compassionate health care to Hospital patients during the Program period. Furthermore, the Physician shall comply with all laws, bylaws, rules, regulations and policies to which the Hospital is subject or which the Hospital shall from time to time adopt and shall exhibit professional conduct at all times while on duty or engaged in any activity under the auspices of the Hospital. The Physician shall comply with all proper directives and instructions of the Program Director.
During the term of this Agreement, the Physician will be a member of the Hospital's Medical Staff, having all of the rights and responsibilities attendant upon such membership as set forth in the Hospital and Medical Staff Bylaws or as modified by this Agreement. Subject to prior approval by the Program Director, the Physician may engage in any outside activity which does not interfere with his or her obligations under this Agreement.
During the Program period, the Physician will be paid a weekly salary at a rate of $22,800.00 per year. Salary increments will be provided at the time of renewal of this Agreement or otherwise in accordance with general Hospital policy from time to time in effect. The Hospital will provide to the Physician such insurance coverage and other benefits as are set forth in the Hospital's general schedule of employee benefits from time to time in effect. The Physician acknowledges that professional liability insurance coverage provided by the Hospital will not extend to any of the Physician's activities outside of the Program.
Except as otherwise expressly stated in this Section 3, the Physician will be entitled to such holidays, vacation time and leaves of absence as may be set forth in the Hospital's general schedule of employee benefits. The scheduling of any holidays, vacation time or leaves of absence for the Physician shall be subject to the prior approval of the Program Director having due regard for patient coverage, rounds, on-call requirements and educational requirements of the Program. The Hospital shall reimburse the Physician for qualifying educational expenses in the aggregate amount of $0.00 incurred during the Program period....
IN WITNESS [WHEREOF], the Hospital and the Physician have duly executed this House Staff Physician Agreement as of the day and year first set forth above....
NEW BRITAIN GENERAL HOSPITAL s/ Gerald D. Strauch, M.D.
s/ Shailesh Gupta, M.D. (L.S.) 7/2/85"
These precedents are of limited relevance for two reasons. First, the mission of the courts in these cases was one of statutory construction and, accordingly, centered on ascertaining the intent of their respective legislatures. See, e.g., House Officers Assn. v. University of Nebraska Medical Center, 198 Neb. 697, 703-704, 255 N.W.2d 258 (1977) (state legislature intended residents to be included as employees). Second, because the statutes at issue required a definitive categorization of the status of residents, both the subjective and the objective tests were designed to yield a categorical answer to the question of whether residents serve as employees or as students. See Regents of the University of Michigan v. Michigan Employment Relations Commission, supra, 389 Mich. 112 (observing that employee and student categories are not "mutually exclusive" but nonetheless affirming residents' status as employees). Proper characterization of the residency agreement in this case does not require us to adopt a monochrome vision of the resident as either student or employee under any or all circumstances.