Ayla Royan v. CHICAGO STATE UNIVERSITY and ELMER GENTRY

In the
United States Court of Appeals
For the Seventh Circuit
____________________
No. 24-1734
A YLA R OYAN ,
Plaintiff-Appellant,
v.
C HICAGO S TATE U NIVERSITY and
ELMER GENTRY ,
Defendants-Appellees.
____________________
Appeal from the United States District Court for the
Northern District of Illinois, Eastern Division.
No. 1:20-cv-02014 — Lindsay C. Jenkins, Judge.
____________________
A RGUED J ANUARY 28, 2025 — DECIDED J ULY 22, 2025
____________________
Before HAMILTON , K IRSCH , and M ALDONADO, Circuit
Judges.
HAMILTON , Circuit Judge. Plaintiff-appellant Ayla Royan
appeals the district court’s grant of summary judgment for
defendant-appellee Chicago State University (CSU) on
Royan’s claim for violation of Section 504 of the Rehabilitation
Act of 1973, 29 U.S.C. § 794. Royan alleges that CSU dismissed
her from its College of Pharmacy’s Doctor of Pharmacy

-- 1 of 23 --

2 No. 24-1734
program because of a disability. The district court held that
Royan failed to present evidence from which a reasonable
jury could find that CSU dismissed her solely based on her
disability. We affirm.1
Even when the evidence is viewed in the light most favor-
able to Royan, it shows that CSU repeatedly accommodated
her disabilities and applied its academic standards without
discrimination. CSU placed Royan on probation and then ul-
timately dismissed her from the program after she failed two
clinical rotations that she was required to pass in order to
graduate. Royan has not presented sufficient evidence to sup-
port a reasonable inference that CSU’s stated reason for her
dismissal—her repeated academic failures—was pretextual.
The Rehabilitation Act protects individuals with disabili-
ties from discrimination based on those disabilities. It does
not, however, exempt students from meeting legitimate aca-
demic standards. Nor does it require institutions that reason-
ably accommodate a student’s disabilities to lower those
standards. Where, as here, undisputed evidence shows that a
university consistently accommodated a student’s disability
and applied its academic policies without discrimination,
summary judgment is appropriate.
I. Factual and Procedural History
A. CSU’s Program and Policies
CSU is a public university that operates a four-year Doctor
of Pharmacy program. The program’s first three years consist
1 Royan also named as a defendant and appellee Dean Elmer Gentry,
but she has not pursued on appeal any argument for holding Gentry per-
sonally liable under the Rehabilitation Act.

-- 2 of 23 --

No. 24-1734 3
of classroom-based instruction. In the final year, students
complete advanced pharmacy practice experiences referred to
as clinical rotations. Students must pass the clinical rotations
to graduate.
CSU’s College of Pharmacy maintains a student handbook
detailing academic policies, including conditions for proba-
tion, repeating courses, and dismissal. According to the hand-
book, a student who fails a course is placed on probation and
receives written notice that continued poor performance may
lead to dismissal. The Academic Standing Committee, con-
sisting of several assistant deans and department chairs, de-
termines the requirements for a student’s return to good aca-
demic standing and may decide to dismiss a student. Stu-
dents may appeal adverse decisions from the committee to the
Dean of the College of Pharmacy, whose decision is final.
B. Royan’s History with the Program
Plaintiff Royan enrolled in the doctoral program in 2014.
In 2016, she disclosed to CSU personnel that she had been di-
agnosed with clinical depression and an eating disorder. CSU
accommodated her medical conditions by granting exten-
sions for exams and assignments. CSU later approved a year-
long medical leave starting in August 2017. Following her
medical leave, Royan returned to the program in September
2018 and advanced to the clinical rotation phase in the spring
of 2019.
C. Royan’s First Clinical Rotation
Royan’s first clinical rotation, supervised by Dr. Shivani
Patel of the University of Chicago, began without incident.
During her first week, Royan disclosed to Dr. Patel that she
had a gynecological condition that could cause her to appear

-- 3 of 23 --

4 No. 24-1734
pale, sweat excessively, and move slowly. Approximately one
week later, a CSU administrator emailed Dr. Patel to confirm
whether Royan was meeting course expectations and to re-
mind her of the upcoming due date for Royan’s mid-rotation
evaluation. Dr. Patel did not report any concerns about
Royan’s performance in response. But, as Royan testified in
her deposition, Dr. Patel had criticized her performance in at
least three prior conversations with Royan herself. Specifi-
cally, Dr. Patel criticized Royan for failing to locate a clinical
guideline for a particular illness (which Royan contends did
not exist), for not adhering to privacy requirements, and for
performing poorly during a mock patient consultation.
The rotation took a decisive turn when Dr. Patel scheduled
a meeting with Royan for March 6 to review her performance.
Royan appeared visibly upset when she arrived at the meet-
ing. She told Dr. Patel about her diagnoses, her previous hos-
pitalizations, and a recent change in her psychiatric care. The
parties disagree about what happened next. According to
Royan, Dr. Patel reacted poorly after hearing about Royan’s
health struggles. She testified that Dr. Patel told her she was
“too sick” to complete the rotation successfully, said she
would feel responsible if Royan hurt herself, and said that
Royan was incapable of being a pharmacist. Royan further
claims Dr. Patel criticized her for being sweaty and slow, sug-
gested she should be a pharmacy technician rather than a
pharmacist, and recommended that she take a break from her
coursework to address her health. Royan described feeling
shocked and distraught by these statements.2
2 Dr. Patel provides a different account of that meeting, though we
must credit Royan’s for purposes of summary judgment. Dr. Patel testified

-- 4 of 23 --

No. 24-1734 5
Dr. Patel’s mid-rotation written evaluation for CSU—
which was formally submitted nearly two weeks late on
March 11—described Royan’s deficient performance. Dr. Pa-
tel noted that Royan “has deficits in her clinical knowledge
and patient care interactions,” that she “has a lot of work
ahead of her,” and that she “has not demonstrated readiness
and ability to fully conduct patient counseling inde-
pendently.” Dr. Patel also observed that Royan “was very
tearful and did not demonstrate the capacity to proceed with
[the] rotation and the ability to take on the rigor required to
successfully learn the foundations of ambulatory care.” None-
theless, Royan wished to continue with the rotation and to im-
prove.
Shortly after this emotional meeting, Dr. Patel emailed Ra-
chel Prusi, an administrator at the University of Chicago,
wishing to talk about Royan. The two met that day, and Prusi
contacted CSU’s Dr. Charisse Johnson (Assistant Dean) and
Dr. Elsa Bishop (Contract Pharmacist) to raise her concerns
about Royan. The group met the following day, March 7.
In a follow-up email summarizing the meeting, Dr. Patel
expressed concern for Royan’s well-being and again doubted
her capacity to continue in the rotation. Dr. Patel said she had
advised Royan to consider medical leave or other support op-
tions, but Royan had declined. In a separate message that day,
Dr. Patel elaborated on Royan’s performance, writing that she
was “not meeting the expectations of this rotation” and had
accidentally included a lethal dose on a mock drug chart.
that the conversation centered primarily on Royan’s deficient perfor-
mance in the rotation rather than her medical conditions.

-- 5 of 23 --

6 No. 24-1734
Dr. Johnson responded that CSU was working to ensure
Royan had access to appropriate support. She told Dr. Patel
that Royan would not return to the rotation the following day
and that she was coordinating with CSU police and the Be-
havioral Assessment and Intervention Team (BAIT) before
scheduling a meeting with Royan by March 8. When Royan
learned that she was to meet with Dr. Johnson instead of at-
tending her rotation, she called Dr. Patel. According to Royan,
Dr. Patel repeated her concern that Royan might harm herself
and said she (Patel) would be responsible if that occurred.
On March 8, Dr. Johnson and Dr. Bishop met with Royan.
According to a follow-up email, they discussed concerns with
Royan’s “clinical knowledge, inability to counsel patients in-
dependently, and need for improvement to identify/solve
drug therapy related problems.” Dr. Johnson warned that,
without significant improvement, Royan was at risk of failing
the rotation. She also reminded Royan of available support re-
sources. Royan does not dispute that these topics were raised,
but she maintains the primary focus was her disabilities. At
the end of the meeting, Royan agreed to return to Dr. Patel’s
rotation the following Monday, March 11.
Royan returned on March 11, but the parties again dispute
what happened next. Both agree that Royan presented her
“journal club presentation,” a capstone project for the rota-
tion. Royan claims Dr. Patel initially ignored her, then asked,
“[w]hy did you come back? I told you not to come back here,
I told you your grade was F,” before harshly criticizing her
presentation for over an hour, allegedly calling it “b***s***.”
Royan called Dr. Bishop immediately afterward. Accord-
ing to Dr. Bishop, Royan was “in hysterics, crying and audibly
upset” over Dr. Patel’s feedback on her presentation. Royan

-- 6 of 23 --

No. 24-1734 7
told Dr. Bishop that she would refuse to return to the site and
did not care if she received a failing grade. Royan testified that
Dr. Bishop then told her to leave the site. Later that afternoon,
Dr. Patel emailed Royan requesting she return. Royan did not
respond.
Later in the evening of March 11, Dr. Johnson emailed
Royan instructing her not to return to the site the next day and
promising to follow up later in the week. Dr. Johnson sepa-
rately contacted Dr. Patel, who said the day had been “rela-
tively normal” and that she had simply offered feedback on
the journal club assignment.
Dr. Johnson, Dr. Bishop, Dr. Patel, and Rachel Prusi met to
assess the situation. A summary email following the meeting
reiterated concerns about Royan’s ability to meet clinical ex-
pectations and to receive feedback. Because Royan had indi-
cated she would not return to the site, the group agreed to
identify an alternative placement. The email also referred to
“serious concerns about this student’s safety and well-being”
and requested that CSU conduct regular wellness checks on
Royan.
On March 12, Dr. Patel reported that an anonymous stu-
dent told her Royan had threatened to commit suicide if she
failed the rotation—a claim Royan denies. Dr. Johnson re-
layed the report to CSU legal counsel, who scheduled Royan
to meet with the BAIT team on March 14. Unaware of these
developments, Royan emailed Dr. Johnson and Dr. Bishop
that day, defending her performance. She admitted to some
mistakes but claimed Dr. Patel had predetermined that she
should not continue in the rotation. Royan added that her de-
cision not to return to the site was not emotional but based on
deteriorating mental and physical health since March 6.

-- 7 of 23 --

8 No. 24-1734
The scheduled March 14 meeting was delayed to March
21. At that meeting, Royan was informed she would receive a
failing grade for the rotation. The stated basis for the grade
was that Royan had voluntarily withdrawn and refused to re-
turn. Royan contends the real reason was CSU’s fear of liabil-
ity based on her disabilities, citing the presence of BAIT team
members at the meeting and their questions about her treat-
ment and medications.
D. Probation and Appeal
After CSU failed Royan in her rotation with Dr. Patel, the
Academic Standing Committee informed Royan that she
would have to attend a meeting to discuss the requirements
for continuing in the program. The committee—comprised of
faculty, department chairs, and the Associate Dean of Aca-
demic Affairs—met with Royan on March 26. There is no evi-
dence in the record that committee members other than Dr.
Johnson were aware of Royan’s disabilities at the time of the
meeting.
At the meeting, the committee placed Royan on academic
probation and outlined steps she would need to take to return
to good academic standing. These steps included successfully
repeating her clinical rotation with a different instructor.
Royan appealed her probation to then-Dean Elmer Gentry
on April 15. Two weeks later, having received no response,
she emailed Dean Gentry expressing distress over Dr. Patel’s
evaluation and frustration that her years of effort, while man-
aging treatment, had been overlooked. Gentry replied that no
decision had been made.
Gentry met with Royan as a part of the appeal. According
to Royan, Gentry told her she was not capable of working as

-- 8 of 23 --

No. 24-1734 9
a pharmacist “because of [her] health” and that the program
would be responsible if she harmed herself. Gentry denied
the appeal on May 10.
As part of her probation, Royan was assigned to a new
clinical rotation with Dr. Daniel Kerner beginning June 6,
2019. Royan had previously taken a course with Dr. Kerner,
which she passed with a “C,” but he had told her that she
would have failed if the class had been a clinical rotation.
Royan immediately objected to the assignment, citing prior
negative experiences, though she later acknowledged in her
deposition testimony that Dr. Kerner was unaware of her
mental health diagnoses.
Dr. Kerner provided Royan with weekly progress reports,
which were largely critical. They noted deficiencies in profes-
sionalism, difficulty receiving feedback, and persistent
knowledge gaps. After Royan responded defensively to one
report, Dr. McClain, a program administrator, warned her
that continued resistance to feedback could jeopardize her
standing in the program. Royan does not dispute that she
made mistakes, but she maintains that Dr. Kerner’s feedback
was colored by personal animus.
Royan ultimately failed the rotation. She was surprised,
believing she had performed well on her final presentation.
Dr. Johnson summarized several reasons for her failure, in-
cluding excessive absences, emotional outbursts, difficulty
communicating with providers, and lack of clinical improve-
ment. Following this second failure, the committee dismissed
Royan from the doctoral program.
On August 9, 2019, Royan appealed her dismissal to Dean
Gentry through counsel. Her appeal reiterated concerns

-- 9 of 23 --

10 No. 24-1734
about Dr. Patel’s treatment and claimed that Dr. Kerner was
“verbally abusive,” allegedly telling her she failed because of
an argument and a lack of professionalism.
Dean Gentry forwarded the appeal to CSU’s legal depart-
ment according to university protocol. On November 13,
2019, CSU’s counsel referred the matter to Dr. Matthew Fete,
who had replaced Gentry as dean of the College of Pharmacy.
Dean Fete denied the appeal, concluding the committee had
followed due process and complied with institutional policy.
Royan then filed this lawsuit, alleging that her dismissal
violated Section 504 of the Rehabilitation Act and the Ameri-
cans with Disabilities Act of 1990 (ADA), 42 U.S.C. § 12132,
and that Dean Gentry violated her Fourteenth Amendment
due process rights (actionable under 42 U.S.C. § 1983) by fail-
ing to resolve her appeal in a timely manner. Defendants
moved for summary judgment on all claims, which the dis-
trict court granted. Royan appeals only the court’s grant of
summary judgment on her Rehabilitation Act claim against
CSU.
II. Analysis
We review de novo the district court’s grant of summary
judgment, viewing conflicts in the evidence in the light most
favorable to Royan, as the non-moving party, and drawing all
reasonable inferences in her favor. E.g., Navratil v. City of Ra-
cine, 101 F.4th 511, 518–19 (7th Cir. 2024). Summary judgment
is appropriate when the moving party shows there is no gen-
uine dispute as to any material fact and it is entitled to judg-
ment as a matter of law. Fed. R. Civ. P. 56(a). “A dispute of
material fact is genuine ‘if the evidence is such that a reason-
able jury could return a verdict for the nonmoving party.’”

-- 10 of 23 --

No. 24-1734 11
Johnson v. Dominguez, 5 F.4th 818, 824 (7th Cir. 2021), quoting
Zaya v. Sood, 836 F.3d 800, 804 (7th Cir. 2016), quoting in turn
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986).
Section 504 of the Rehabilitation Act provides in relevant
part: “No otherwise qualified individual with a disability …
shall, solely by reason of her or his disability, be excluded
from the participation in, be denied the benefits of, or be sub-
jected to discrimination under any program or activity receiv-
ing Federal financial assistance ….” 29 U.S.C. § 794(a). To
show a violation of the Rehabilitation Act, the plaintiff must
satisfy four elements: “(1) the plaintiff must be a handicapped
individual as defined by the Act; (2) the plaintiff must be ‘oth-
erwise qualified’ for participation in the program; (3) the pro-
gram must receive federal financial assistance; and (4) the
plaintiff must have been ‘denied the benefits of the program
solely because of [her] handicap.’” Reed v. Columbia St. Mary’s
Hospital, 915 F.3d 473, 484 (7th Cir. 2019), quoting Mallett v.
Wisconsin Division of Vocational Rehabilitation, 130 F.3d 1245,
1257 (7th Cir. 1997).
With an important exception, “[t]he Rehabilitation Act ex-
pressly incorporates the standards and procedures applicable
to claims brought under the Americans with Disabilities Act.”
Swain v. Wormuth, 41 F.4th 892, 897 (7th Cir. 2022). The two
statutes differ in their causation requirements: “The Rehabili-
tation Act has a stricter causation requirement: the plaintiff’s
disability must be the sole reason for the alleged discrimina-
tory action; this contrasts with the ADA, which requires only
that the plaintiff’s disability be a reason for the challenged ac-
tion.” Conners v. Wilkie, 984 F.3d 1255, 1260 (7th Cir. 2021) (em-
phases in original). Apart from the issue of causation, prece-
dents applying either statute are instructive. See Garg v. Potter,

-- 11 of 23 --

12 No. 24-1734
521 F.3d 731, 736 (7th Cir. 2008) (“We examine our precedent
under the ADA to determine whether [plaintiff] has made out
a prima facie case under the Rehabilitation Act.”).
Royan failed to raise a genuine issue of material fact on
two of those four elements. First, the undisputed facts show
she was not “otherwise qualified” to continue in the doctoral
program, and she has offered insufficient evidence of pretext
to call into question the legitimacy of CSU’s stated reasons for
her dismissal. Second, no reasonable jury could conclude that
CSU dismissed her solely because of her disabilities. We ad-
dress each issue in turn.
A. Royan Was Not “Otherwise Qualified”
Royan was not “otherwise qualified” because she failed
two clinical rotations that she was required to pass in order to
continue in the program. “In the context of a university, a per-
son is ‘otherwise qualified’ if she is able to meet all of the pro-
gram’s requirements in spite of her disability, with or without
a reasonable accommodation.” Khan v. Midwestern University,
879 F.3d 838, 844 (7th Cir. 2018). As a general matter, we afford
substantial deference to academic institutions when it comes
to decisions involving a student’s qualifications or promotion
within an educational program. Regents of University of Michi-
gan v. Ewing, 474 U.S. 214, 225–26 & n.11 (1985).
Academic judgments are entitled to deference, particu-
larly where they concern the professional standards and aca-
demic requirements of an educational program. See Board of
Curators of University of Missouri v. Horowitz, 435 U.S. 78, 96 n.6
(1978) (Powell, J., concurring) (“University faculties must
have the widest range of discretion in making judgments as
to the academic performance of students and their

-- 12 of 23 --

No. 24-1734 13
entitlement to promotion or graduation.”). When reviewing
claims of discrimination in academic settings, we are mindful
that “academic judgments often rest on necessarily ‘subjective
judgments about academic potential.’” Novak v. Board of Trus-
tees of Southern Illinois University, 777 F.3d 966, 976 (7th Cir.
2015), quoting Vanasco v. National-Louis University, 137 F.3d
962, 968 (7th Cir. 1998). However, “[a]cademic institutions are
in no way exempt from our discrimination laws. Nor are there
separate and more lenient standards for them. But, when as-
sessing the evidence in such cases, courts must understand
the nature and mission of the institutions and evaluate the ev-
idence accordingly.” Id.
CSU argues that Royan was not “otherwise qualified” be-
cause undisputed evidence shows that she failed to meet the
program’s academic requirements. She did not complete Dr.
Patel’s rotation after refusing to return following her journal
club presentation, leading the committee to place her on aca-
demic probation. She then failed to satisfy the terms of that
probation by failing Dr. Kerner’s rotation, an instructor who,
by Royan’s own admission, was unaware of her disabilities.
Under CSU policy, Royan’s failure to satisfy her probationary
conditions by failing a second rotation permitted the commit-
tee to dismiss her from the program.
Both Dr. Patel and Dr. Kerner raised concerns about
Royan’s clinical knowledge, professionalism, and ability to
meet required performance standards. CSU maintains that
the committee’s decision to dismiss Royan was based solely
on these academic deficiencies and followed established pro-
cedures. Royan does not directly challenge this contention. In-
stead, she relies on her strong performance in other courses to
argue that she was “otherwise qualified” to continue. Good

-- 13 of 23 --

14 No. 24-1734
performance in some courses, however, does not mean that
Royan was “otherwise qualified” after failing to meet all the
academic standards necessary to advance in the program.
We rejected a similar argument in Khan v. Midwestern Uni-
versity, 879 F.3d 838 (7th Cir. 2018). There, the plaintiff failed
three first-year courses in medical school, making her eligible
for dismissal under the university’s academic policies. Id. at
840. Rather than dismissing her immediately, the university
allowed her to repeat those courses and to continue with her
course of study. Although she passed the repeated courses,
she failed other courses in her second year. Following those
failures (and while pregnant) she was dismissed from the pro-
gram. She sued under Section 504 of the Rehabilitation Act,
alleging discrimination based on her pregnancy-related disa-
bilities.
We affirmed summary judgment for the university, con-
cluding that Khan was not “otherwise qualified” to remain in
the program after failing to meet its academic standards. Id.
at 847. We emphasized that universities generally have broad,
though not unreviewable, discretion to set academic stand-
ards and to enforce them. Although Khan argued she was
“otherwise qualified” because she passed several courses, the
university required students to avoid accumulating a speci-
fied number of failures to continue in the program. Because
Khan did not meet that requirement, we held that undisputed
facts showed she was not “otherwise qualified” under the Re-
habilitation Act. Id. at 845.
The reasoning of Khan applies here. Like the student in
Khan, who failed multiple courses and was placed on aca-
demic probation, Royan failed her initial clinical rotation with
Dr. Patel and was similarly placed on probation. Also as in

-- 14 of 23 --

No. 24-1734 15
Khan, where the plaintiff was given a second chance to pass,
the committee allowed Royan to repeat her rotation with a
different preceptor. And even more like Khan, Royan was un-
able to remedy her academic deficiencies, failing her second
rotation with Dr. Kerner—who, according to Royan’s own
testimony, was unaware of her disabilities. This failure con-
stituted a breach of the terms of her probation and allowed
the committee to dismiss her from the program under CSU
policy. Royan’s strong performance in other courses does not
change these undisputed facts. No reasonable jury could find
that Royan was “otherwise qualified” within the meaning of
the Rehabilitation Act.
To show that she was “otherwise qualified” for the doc-
toral program, Royan argues that Dr. Patel, Dr. Kerner, and
other CSU administrators were lying about the reasons for
dismissing her from the program. In discrimination litigation,
such arguments are usually framed in terms of “pretext,”
which means “a lie, specifically a phony reason for some ac-
tion.’” Collins v. American Red Cross, 715 F.3d 994, 1000 (7th Cir.
2013), quoting Millbrook v. IBP, Inc., 280 F.3d 1169, 1175 (7th
Cir. 2002). But on this record, there is no genuine issue of fact
about the honesty of CSU’s stated reason for dismissing
Royan—her failure of two clinical rotations. We have said re-
peatedly in employment cases that the relevant question is not
whether the defendant’s decision was wise or even accurate,
but “whether the employer honestly believed the reasons it
has offered to explain the discharge.” Id., quoting Coleman v.
Donahoe, 667 F.3d 835, 852 (7th Cir. 2012). The same standard
applies in this educational setting.
To establish pretext, Royan must point to evidence that
would let a reasonable jury find that the committee’s

-- 15 of 23 --

16 No. 24-1734
explanation for her dismissal was dishonest. She has not done
so. She points to no evidence suggesting that her preceptors’
evaluations—or the committee’s decision to dismiss her after
two failed rotations—were dishonest or the result of discrim-
inatory animus. Nor has she cited any legal authority sup-
porting her position that CSU’s stated reason for dismissing
her from the program was pretextual. On that ground alone,
we could deem her pretext argument waived. See Rahn v.
Board of Trustees of Northern Illinois University, 803 F.3d 285,
295 (7th Cir. 2015) (finding waiver where plaintiffs “failed to
cite any legal authority in support of their argument” and col-
lecting cases); Yasinskyy v. Holder, 724 F.3d 983, 989 (7th Cir.
2013) (courts of appeals “will not entertain baseless and un-
supported factual contentions or undeveloped legal argu-
ments”); Fed. R. App. P. 28(a)(9)(A) (requiring that appellant’s
brief include “contentions and the reasons for them, with cita-
tions to the authorities and parts of the record on which the ap-
pellant relies”) (emphasis added). Regardless, the record does
not support a reasonable finding of pretext.
Our decision in Novak v. Board of Trustees of Southern Illinois
University, 777 F.3d 966 (7th Cir. 2015), guides the analysis. In
Novak, we affirmed summary judgment for a university that
dismissed a student from its program after he failed prelimi-
nary examinations required for advancement, despite having
been granted multiple disability-based accommodations. Id.
at 976–77. The student sued under the Rehabilitation Act, al-
leging that the university’s stated reason for his dismissal—
failure to meet its academic standards—was a pretext for dis-
crimination. Id. at 969. We disagreed. Although the plaintiff
had pointed to “perceived faults in the faculty’s evaluation
methodology,” none of those criticisms, even if taken as true,
supported an inference of pretext. Id. at 976–77. At most, the

-- 16 of 23 --

No. 24-1734 17
record reflected possible “error in the course of a faculty
member’s evaluation of the student’s work.” Id. at 976. As we
noted, “[t]here is no evidence that the faculty members’ grad-
ing of Mr. Novak’s Preliminary Examination was anything
other than an honest, professional evaluation of his potential
….” Id. at 977.
So too here. Like the plaintiff in Novak, Royan identifies no
evidence suggesting that her preceptors’ evaluations, or the
committee’s ultimate decision, were anything other than hon-
est academic judgments. Also as in Novak, the record reflects
that CSU repeatedly accommodated Royan “to ensure that
h[er] disability did not interfere with h[er] having a fair op-
portunity to meet the University’s standards” for the pro-
gram. Id.
Moreover, Royan does not meaningfully dispute the sub-
stance of her preceptors’ evaluations. For example, in one ex-
change with CSU administrators, she acknowledged that Dr.
Patel’s criticisms of her work were “absolutely correct.” Dkt.
127-22 at 2. She also expressly admitted that the decision to
leave Dr. Patel’s rotation—the action that directly led to her
failure—was her own. She wrote:
At this point I know Im [sic] not going to learn
anything from Dr. Patel anymore. I know she al-
ready made up her mind that I shouldn’t go to
any rotations. My decision to not go back to the
site is not emotionally [sic] because I know my-
self, I don’t quit easily. I made this decision be-
cause since Wednesday Ive [sic] been in a very
bad place mentally & physically even though, I
started fresh on Monday & thanked her for giv-
ing me another chance. But if a preceptor who

-- 17 of 23 --

18 No. 24-1734
barely has spent 30 minutes with me in a day
during these 4 weeks suddenly spend [sic] 2.5
hours criticizing me, questioning my intelli-
gence, and make [sic] me feel stupid in a very
unprofessional way, obviously is not willing to
teach me anything more.
Dkt. 127-22 at 2 (emphases added). This admission further
weakens Royan’s pretext argument. By acknowledging that
the decision to leave Dr. Patel’s rotation was her own, Royan
confirmed that her dismissal was tied to her voluntary actions
rather than a concealed discriminatory motive on the part of
CSU.
To the extent Royan contends that she left her rotation
with Dr. Patel at Dr. Johnson’s direction rather than voluntar-
ily, her own account of the events contradicts that claim.
Royan cannot create a genuine dispute of material fact when
the record plainly refutes her version of events. See Scott v.
Harris, 550 U.S. 372, 380 (2007) (“When opposing parties tell
two different stories, one of which is blatantly contradicted by
the record, so that no reasonable jury could believe it, a court
should not adopt that version of the facts for purposes of rul-
ing on a motion for summary judgment.”). Because Royan ad-
mits that she decided not to return to her rotation with Dr.
Patel, she cannot fault Dr. Johnson.
In sum: the undisputed facts show that Royan failed two
clinical rotations that she was required to pass in order to
graduate. She has not presented evidence that those failures
were the result of anything other than legitimate academic as-
sessments, and CSU consistently accommodated her disabili-
ties throughout her time in the program. On this record, no
reasonable jury could conclude that CSU’s stated reason for

-- 18 of 23 --

No. 24-1734 19
dismissing Royan was a pretext for discrimination. She was
not “otherwise qualified” for the doctoral program, as re-
quired to show a violation of the Rehabilitation Act.
B. Royan was not Dismissed Solely Because of her Disabilities
Royan’s claim also fails because she cannot show that CSU
dismissed her from the program solely by reason of her disa-
bility. 29 U.S.C. § 794(a). To survive summary judgment,
Royan’s disability “must be the sole reason for the alleged dis-
criminatory action….” Conners v. Wilkie, 984 F.3d 1255, 1260
(7th Cir. 2021) (emphasis in original). The parties devote sig-
nificant attention in their briefs to the proper standard of cau-
sation under the Rehabilitation Act. Although Royan’s posi-
tion on this point is not entirely clear, she appears to argue
that a “but-for” causation standard should apply. Her theory,
as best we can discern, is that but for her disclosure of her ill-
ness to Dr. Patel, she would not have failed that rotation,
would never have been placed on probation or assigned to Dr.
Kerner to repeat her rotation, and ultimately would not have
been dismissed from the program. For its part, CSU advocates
for a stricter causation standard, that “Royan’s burden under
Section 504 [of the Rehabilitation Act] requires her to prove
that her disability was the sole reason for her dismissal.” CSU
is correct.
Our precedent makes clear that the Rehabilitation Act’s
causation standard is more stringent than the ADA’s “but for”
inquiry. See Swain v. Wormuth, 41 F.4th 892, 899 (7th Cir. 2022)
(“The ‘solely by reason of’ causation standard is stricter than
the causation standard in Title I of the ADA, which the Reha-
bilitation Act otherwise incorporates for its liability stand-
ards.”); Conners, 984 F.3d at 1260.

-- 19 of 23 --

20 No. 24-1734
Royan has not produced evidence that would let a reason-
able jury find that CSU dismissed her solely because of her
disabilities. She failed her second and final clinical rotation
under Dr. Kerner, and she acknowledged in her deposition
and in her response to CSU’s statement of undisputed mate-
rial facts that Dr. Kerner was unaware of her depression and
eating disorder when he failed her. Absent evidence that
Royan’s disabilities influenced Dr. Kerner’s decision to fail
her, no reasonable jury could find that CSU dismissed her
“solely by reason of” her disabilities.
We reached a similar conclusion in Hedberg v. Indiana Bell
Telephone Co., 47 F.3d 928 (7th Cir. 1995). There, we affirmed
summary judgment for the employer in an ADA disability
discrimination case because there was no genuine dispute
that the decision-maker lacked knowledge of the plaintiff’s
disability at the time of his termination. Id. at 931–32.
The same is true here. Both Royan and Dr. Kerner con-
firmed that Dr. Kerner was unaware of her disabilities when
he failed her. This lack of knowledge forecloses any reasona-
ble likelihood that Dr. Kerner’s decision to fail Royan was mo-
tivated by animus toward her or her disabilities. As we ex-
plained in Hedberg: “[T]here are situations in alleged disabil-
ity discrimination cases where an employer clearly did not
know … of an employee’s disability. We think that an em-
ployer cannot be liable under the ADA for firing an employee
when it indisputably had no knowledge of the disability.” Id.
at 932; see also, e.g., Morisky v. Broward County, 80 F.3d 445,
448 (11th Cir. 1996) (citing Hedberg with approval and reject-
ing the “contention that a plaintiff can sustain a prima facie
case of handicap discrimination without proof that an em-
ployer had actual or constructive knowledge of an applicant’s

-- 20 of 23 --

No. 24-1734 21
disability”); Crandall v. Paralyzed Veterans of America, 146 F.3d
894, 896–97 (D.C. Cir. 1994) (“The courts of appeals have over-
whelmingly agreed” that to establish the necessary causal link
for Rehabilitation Act claims, the decision-maker “must have
acted with an awareness of the disability itself….”). If Dr.
Kerner had no knowledge of Royan’s disabilities, they could
not have been a reason—let alone the sole reason—for his de-
cision to fail her.
Conceding that Dr. Kerner was unaware of her disabilities,
Royan argues that his lack of knowledge does not preclude
liability. She invokes a variant of the “cat’s paw” theory of li-
ability under which a jury could impute the discriminatory
animus of other actors to Dr. Kerner’s decision to fail her. See
Johnson v. Koppers, Inc., 726 F.3d 910, 914 (7th Cir. 2013) (de-
scribing the cat’s paw theory of liability). To prevail under the
cat’s paw theory, Royan must show that Dr. Patel, motivated
by discriminatory intent, “concocted a false story about
[Royan], and that [Patel’s] story was the proximate cause of
[her] termination.” Id. at 915.
Royan argues that CSU deliberately assigned Dr. Kerner—
who had previously signaled a willingness to fail her—to su-
pervise her second rotation in order to set her up for failure.3
3 Royan asserted in her briefing and oral argument that Dr. Kerner
threatened to fail her if given the chance. The record simply does not sup-
port that claim. By Royan’s own account, Dr. Kerner observed that if her
earlier work with him had been part of a required six-week clinical rota-
tion, she would not have passed. See Dkt. 127-2 at 258:4–7. That comment,
while cautionary, cannot be reasonably construed as a threat. Rather, it
appears to have been an ordinary and frank evaluation of her performance
and a warning that improvement would be necessary to meet the

-- 21 of 23 --

22 No. 24-1734
We rejected a similar argument in Hedberg, where the plaintiff
asserted that an intermediate supervisor who knew of his dis-
ability must have informed the supervisor who made the ter-
mination decision. 47 F.3d at 931. We found that inference to
be “unsupported speculation” and therefore “not reasona-
ble,” especially given the lack of evidence that any such com-
munication had occurred. Id.
So too here. Royan’s proposed inference, that Dr. Kerner
must have known about her disabilities simply because Dr.
Patel did, is speculative and unsupported by the record. As in
Hedberg, Royan has identified no evidence of any
communication between Dr. Patel and Dr. Kerner, much less
any discussion of her disabilities, foreclosing any possibility
of discrimination by Dr. Kerner. As for her cat’s paw theory,
Royan has failed to point to any evidence that the committee
was even aware of her prior conflict with Dr. Kerner or that
the committee’s assignment was motivated by discriminatory
intent.
Without any evidence of communication between Dr. Pa-
tel and Dr. Kerner, there is no reasonable basis to infer that
Dr. Patel disclosed Royan’s disabilities to Dr. Kerner or en-
couraged him to discriminate against Royan on that basis.
Similarly, absent evidence that the committee was aware of
the prior friction between Royan and Dr. Kerner, no reasona-
ble jury could conclude that it assigned her to his supervision
in order to sabotage her repeat rotation.
In both of her rotations, Royan received evaluations that
consistently cited deficiencies in key areas such as attendance,
program’s academic standards. Such evaluations in an academic setting
are not the stuff of discrimination lawsuits.

-- 22 of 23 --

No. 24-1734 23
professionalism, clinical reasoning, and patient care. These
are not marginal issues; they are core competencies essential
to pharmacy practice. The university is entitled to enforce
those standards, particularly in fields such as this, where fail-
ure to meet training standards can endanger future patients.
At bottom, Royan’s theory rests on conjecture. But conjecture,
without supporting evidence, is not enough to defeat sum-
mary judgment. On this record, no reasonable jury could con-
clude that Royan was “otherwise qualified” to remain in the
program or that CSU dismissed her solely based on her disa-
bilities.
AFFIRMED.

-- 23 of 23 --