Osteopathic Medical School Dismissal Lawyer — DO Student Defense

Written by Zachary Gaynor, attorney · The Florida Bar, admitted 2016. Practice limited to student-side education law.

If you have been dismissed from a college of osteopathic medicine, the decision was almost certainly made by a student progress or promotions committee that recommended it, and by a dean who accepted the recommendation. Your appeal goes to a body inside the same school, on a deadline usually measured in five to fifteen business days from the letter, and at most programmes you may not bring a lawyer into the room. What you can do is make sure the written appeal is complete, accurate, and built on the school’s own published rules — because in almost every case those rules, and whether the school followed them, are the whole of the argument.

This page explains how dismissal works across osteopathic medical education generally: the accreditation rules every college of osteopathic medicine operates under, the COMLEX-USA attempt limits, the six-year clock, how progress committees are structured, and what the law actually gives a dismissed DO student. For the specific procedure at your school, use the list of programme pages further down.

Every DO programme runs on the same accreditation rules

Colleges of osteopathic medicine are accredited by the Commission on Osteopathic College Accreditation (COCA), which is recognised by the U.S. Department of Education as the accreditor of osteopathic medical schools. COCA currently accredits 47 colleges of osteopathic medicine operating at 74 sites.

That matters to a dismissed student for one reason above all others. COCA does not simply require a school to have rules; it requires the school to publish them and to follow them.

Element 1.4 (a CORE element) requires a COM to publish and abide by policies regarding due process for students.
Element 9.2 (CORE) requires a COM to publish and follow policies and procedures on academic standards including grading, class attendance, student promotion, retention, graduation, students’ rights and responsibilities, and the filing of grievances and appeals — and requires that all public information in catalogs, handbooks and other publicly available material be current and presented in an accurate, fair and complete manner.
Element 9.1 (CORE) requires the COM to establish and publish admission requirements, and to use admission policies and procedures that include demonstration of technical standards.
Element 2.4 (CORE) requires a confidential accreditation-standard complaint process, adjudicated without retaliation, and requires the school to publish a route for filing confidential complaints with COCA itself, together with COCA’s contact information.
Element 9.10 (CORE) requires that any health professional who provides health services to a student through a provider-patient relationship must recuse themselves from the academic assessment or promotion of that student — and that the recusal policy be provided to students and faculty annually.
Element 6.3 requires a policy that a single-degree DO student complete the degree within 150 percent of standard time — six years from matriculation.

Three practical consequences follow. First, a school that departed from its own published procedure has not merely made a bad decision; it has arguably failed a CORE accreditation element, and that is a point worth making inside the appeal, where it is heard by faculty who care about accreditation. Second, Element 9.10 is the most under-used provision in the set: if a faculty physician who treated you sat on your promotions committee or graded your assessment, the school’s own accreditor required that person to step aside. Third, COCA takes complaints directly, and the school is required to tell you how to make one.

The current continuing-accreditation standards were published in February 2026 and take effect 1 July 2026 for the 2026–2027 academic year, applying to reviews occurring after 1 February 2027; the 2023 standards govern reviews before then. If your school’s handbook is materially out of step with either version, that is worth flagging.

The four routes to dismissal, and which one you are on

Nearly every DO dismissal falls into one of four categories. Which one you are in changes what you should argue.

Preclinical course failure. Most programmes convert failed credit hours into a fixed outcome — remediate, repeat, or go before the committee — using numeric thresholds. The thresholds are arithmetic, so the argument is usually about the underlying grade rather than the dismissal, and grade challenges run on much shorter clocks than dismissal appeals.
COMLEX-USA failure. Board failures are treated as academic, which means less process is owed and more deference is given. The productive arguments here are usually about accommodations, about whether the school followed its own remediation and study-leave policy, and about attempt counting.
Clinical rotation failure. Rotation grades rest heavily on a single preceptor’s evaluation and on shelf-style examinations such as the COMAT. Both are more contestable than a preclinical grade, and the window to contest a rotation comment is usually very short.
Professionalism. This is the category that behaves least like the others. It is often the accumulation of small documented items — attendance, lateness, a missed deadline, a communication — and it is the category where the academic-versus-disciplinary line becomes the whole case, because a matter framed as professionalism gets academic deference while the same matter framed as misconduct would have required more process.

If your school has labelled a conduct problem as an academic one, say so early and in writing. Courts have long distinguished the two, and the label the school chose is not conclusive.

COMLEX-USA: the national rules, and why your school’s are stricter

Passing COMLEX-USA Level 1 and Level 2 is required before graduation from an osteopathic medical school; Level 3 is not. (The separate Level 2-PE clinical skills examination is no longer administered.) The NBOME publishes the national limits:

Four scored attempts at each COMLEX-USA examination level.
No more than four attempts at a level within any 12-month period, counting incomplete and voided attempts.
An exception beyond the four scored attempts — a single final attempt — is available only at the explicit request of a medical licensing agency, supported by a written petition from that agency and documentation from your dean or programme director confirming continued good standing.

Two things follow that catch students out. Your school’s internal cap is frequently stricter than the NBOME’s. A programme that dismisses after three failed attempts at one level, or six across the required levels, will end the degree while the NBOME would still let you sit. And the school controls eligibility regardless of the count: your dean must attest that you are in good academic and professional standing before you can register. A remaining national attempt is worth nothing if the school will not certify you — which is exactly why programmes make board eligibility one of the first things academic probation takes away.

If you are anywhere near an attempt limit, get the school’s own attempt-counting rule in writing before you sit again. Programmes differ on whether a voided attempt, a no-show, or a retake taken during a mandated study break counts against the internal cap, and that difference has ended degrees.

The six-year clock nobody mentions until it is a problem

COCA requires each single-degree DO student to finish within 150 percent of standard time — six years from matriculation. Almost every programme therefore counts leaves of absence, administrative breaks and suspensions toward that ceiling.

The effect is that the remedies which feel most protective are the ones that spend the clock. A student who takes a leave to recover, returns, repeats a year, then fails a board examination and is placed on a mandated study break may find that the time limit rather than any single failure is what makes further remediation impossible. Before agreeing to any leave, break, decelerated track or repeat year, ask in writing how much of the 150 percent it consumes and how much will be left. That question is rarely volunteered.

Progress committees: what they are, and how they actually run

The names differ — Student Progress Committee, Student Performance and Promotion Committee, Academic Progress Committee, Committee on Student Progress — but the shape is remarkably consistent across osteopathic programmes:

The committee recommends; the dean decides. The dean can usually accept, modify, overturn, or send the matter back. That means there are two decision points, and the second is often where a proportionality argument lands even when the underlying facts are not in dispute.
Notice is short — frequently two to five business days before the meeting.
Counsel is usually barred from the room. Most handbooks prohibit legal representation at the committee stage and at the appeal, and some go further and purport to bar an attorney from helping prepare the written appeal.
Students are often excluded while witnesses are questioned, and present only for their own statement. You may therefore never hear the evidence that decides your case.
No standard of proof is usually published for academic and professionalism matters, even where the same school publishes one for Title IX or conduct cases.
Appeals are usually narrow — commonly limited to new information, procedural error, or disproportionate sanction — and frequently final, with no further internal route.

Because so much turns on documents, the highest-value work in a DO dismissal is nearly always done before the hearing: getting the complete file, identifying every place the school departed from its own written procedure, obtaining the governing handbook edition (the one in force when you matriculated is not always the one being applied to you), and building a written submission a committee of faculty can act on. None of that requires an attorney in the room.

One caution drawn from the case law. In Nehme v. Florida International University Board of Trustees, 121 F.4th 1379 (11th Cir. 2024), the Eleventh Circuit leaned on the fact that the dismissal had passed through a promotion committee, an appeals committee, a dean and an interim provost — a documented, multi-layered deliberation. Schools that paper their process carefully are hard to challenge afterwards. Which is the argument for making your record inside that process, while it is still being built, rather than afterwards.

What the law gives a dismissed DO student

The first question is whether your school is public or private, because the answer changes the claim entirely.

Public colleges of osteopathic medicine

At a state institution, a student has constitutional due process rights — but the Supreme Court has drawn a sharp line between academic and disciplinary dismissals. In Board of Curators of the University of Missouri v. Horowitz, 435 U.S. 78 (1978), the Court held that an academic dismissal requires no formal hearing, only a careful and deliberate decision-making process, while a disciplinary dismissal requires notice of the charges and an opportunity to respond — the rule of Goss v. Lopez, 419 U.S. 565 (1975). The reasoning is that a disciplinary charge asks a factual question a hearing can help answer, while an academic judgment is evaluative and a hearing adds little. The Eleventh Circuit adopted Horowitz in Haberle v. University of Alabama in Birmingham, 803 F.2d 1536, 1539 (11th Cir. 1986).

On the substance, Regents of the University of Michigan v. Ewing, 474 U.S. 214 (1985) sets a demanding standard: a court may not override a genuinely academic judgment unless it is such a substantial departure from accepted academic norms as to demonstrate that the person or committee responsible did not actually exercise professional judgment. It is worth knowing that Ewing itself was a board-examination case — the student failed NBME Part I — and the dismissal was upheld even though he was the only student ever denied a retake, the Court noting that there was no evidence of concealed impermissible reasons and that the university had acted in good faith. The Eleventh Circuit reaffirmed the standard for a dental student in Rollins v. Board of Trustees of the University of Alabama, 647 F. App’x 924 (11th Cir. 2016).

The practical reading: at a public school the fight is usually over characterisation. A dismissal framed as academic gets Ewing deference. The same facts framed as misconduct trigger the notice-and-response requirements the Eleventh Circuit described in Nash v. Auburn University, 812 F.2d 655 (11th Cir. 1987). Florida draws the same line: in Militana v. University of Miami, 236 So. 2d 162 (Fla. 3d DCA 1970), a medical school did not have to give a senior student notice of the faculty committee meeting considering his academic dismissal or let him appear — expressly contrasted with disciplinary proceedings, where notice and a hearing are essential.

Private colleges of osteopathic medicine

At a private school there is no constitutional due process claim at all. The relationship is contractual, and Florida has said so since John B. Stetson University v. Hunt, 88 Fla. 510, 102 So. 637 (1924), which described it as solely contractual in character. The terms come from the school’s own publications at the time of enrolment — handbook, academic catalog, clinical training manual — and they form an implied-in-fact contract rather than an express one. Jarzynka v. St. Thomas University of Law, 310 F. Supp. 2d 1256, 1269 (S.D. Fla. 2004).

Five features of that body of law matter to a DO student:

The implicit promise. Florida authority recognises an implied promise that a student who complies with the terms the university prescribes will obtain the degree — Sharick v. Southeastern University of the Health Sciences, Inc., 780 So. 2d 136, 138 (Fla. 3d DCA 2000), itself an osteopathic case.
Specific promises only. Broad, aspirational handbook language — a right to be nurtured, a right to be treated equally — will not support a breach claim. Tercier v. University of Miami, Inc., 383 So. 3d 847, 851 (Fla. 3d DCA 2023) adopted that rule for Florida. So the productive move is to identify the exact provision the school broke: the graduation requirements, the permitted number of retakes, the remediation procedure, the stated grounds for dismissal, the appeal deadline, the composition of the committee.
Failing to follow its own procedure is the claim. In Sirpal v. University of Miami, 684 F. Supp. 2d 1349, 1359 (S.D. Fla. 2010), a student stated a breach of contract claim by alleging the university had not followed its own handbook procedures, including a failure to give the notice the handbook required. That is the shape of most viable cases against a private DO school.
Reservation-of-rights clauses are enforceable. In Jallali v. Nova Southeastern University, Inc., 992 So. 2d 338, 342 (Fla. 4th DCA 2008), a school’s reserved right to change requirements defeated a challenge to a newly imposed COMLEX Level 2 graduation requirement. Nearly every osteopathic handbook has such a clause, so “the rule changed after I enrolled” is rarely a winner standing alone.
The implied covenant of good faith and fair dealing applies where a term gives the university discretion, requiring it to observe reasonable limits in exercising that discretion. Ferretti v. Nova Southeastern University, Inc., 604 F. Supp. 3d 1330, 1336 (S.D. Fla. 2022). It attaches to an express term, though, and cannot override one.

The standard of review is narrow either way: a court asks whether the determination was arbitrary and capricious, irrational, made in bad faith, or in violation of the constitution or a statute. That bar is rarely cleared — but it has been. The jury in Sharick found a dismissal two months before graduation arbitrary, capricious, and without any discernible rational basis. And academic deference does not stop a court from enforcing a specific contractual obligation unrelated to educational judgment: Rhodes v. Embry-Riddle Aeronautical University, Inc., 513 F. Supp. 3d 1350, 1356–57 (M.D. Fla. 2021). A missed deadline, a committee constituted contrary to the handbook, or an appeal decided by the wrong body lives on that side of the line.

On damages, Sharick is the reason these cases are worth bringing at all: the court held it appropriate to consider lost future earnings in valuing the loss of a medical degree taken by an arbitrary, capricious or bad-faith deprivation, because the value of the degree substantially exceeds the tuition spent. On retrial the jury awarded lost earning capacity and the Third DCA affirmed the damages verdict. Nova Southeastern University of Health Sciences, Inc. v. Sharick, 21 So. 3d 41 (Fla. 3d DCA 2009). Where the degree can be obtained elsewhere, the measure is closer to the cost of reproducing it plus income lost in the delay.

Disability: Section 504, the ADA, and the Florida Civil Rights Act

Section 504 of the Rehabilitation Act, 29 U.S.C. § 794, reaches any programme receiving federal financial assistance — essentially every osteopathic school. The ADA reaches private schools through Title III and public ones through Title II. The Florida Civil Rights Act treats a private medical school as a place of public accommodation and is construed in conformity with the ADA.

The remedies differ in a way that decides how the case is brought. Title III of the ADA gives prospective injunctive relief only, not damages — Redding v. Nova Southeastern University, Inc., 165 F. Supp. 3d 1274 (S.D. Fla. 2016), citing Jairath v. Dyer, 154 F.3d 1280, 1283 (11th Cir. 1998). There is a trap inside that rule: a dismissed student who no longer seeks readmission may lack standing under Title III at all, because there is no prospective relief left to give. Section 504 permits monetary damages. The FCRA permits damages too but requires a complaint to the Florida Commission on Human Relations first (Fla. Stat. § 760.11). So a claim against a private DO programme is usually built on Section 504.

The threshold question is whether the student is otherwise qualified — able to meet the programme’s academic and technical standards with or without reasonable accommodation. The osteopathic cases show where students lose. In J.A.M. v. Nova Southeastern University, 646 F. App’x 921 (11th Cir. 2016), a student was not otherwise qualified where he could not complete a single full semester, and the accommodations sought — repeated leaves, rescheduled examinations — would have fundamentally altered the programme. In Redding, the student could not identify a reasonable accommodation that would have let him meet the standards. In Nehme, a medical student who failed eight or more courses was not a qualified individual despite accommodations — and the court confirmed that Ewing deference applies to the ADA analysis, not only to constitutional claims.

The pattern is consistent and worth stating plainly: accommodations do not backdate. A request made after a run of failures answers a different question than the same request made before them. The single most valuable thing a struggling DO student can do is disclose and request early, in writing, through the disability services office — not through a professor, and not after the committee letter arrives.

Technical standards get substantial deference. Wood v. President and Trustees of Spring Hill College, 978 F.2d 1214, 1222–23 (11th Cir. 1992), applying Southeastern Community College v. Davis, treats a school’s academic standards as entitled to deference. For a DO programme those standards typically include performing osteopathic manipulative medicine, conducting physical examinations, and functioning in clinical settings, and some are genuinely incompatible with some disabilities whatever the accommodation. That is the honest position. But technical standards are part of the admission policies COCA Element 9.1 requires, and under 34 C.F.R. § 104.44(a) a requirement is protected only if the school can demonstrate it is essential to the instruction or to a directly related licensing requirement. The bar is high; pretending otherwise helps nobody.

Osteopathic programme pages on this site

Every school writes its own progress, dismissal and appeal rules, and the deadlines are rarely the same from one programme to the next. These pages set out the procedure at each:

The first seventy-two hours after a dismissal letter

Almost every irreversible mistake in a DO dismissal is made in the first week, and almost always by doing nothing while deciding what to do. In order:

Find the deadline and write it down. It is in the letter or in the handbook, and it is usually counted in business days from the date of the letter rather than the date you read it. If the letter does not state one, ask in writing, that day, and keep the reply.
Send a short written acknowledgement stating that you intend to appeal and requesting the complete record relied on. You are not conceding anything by doing this, and it starts a paper trail that shows you were engaged from the outset.
Get the governing handbook edition. Not the current one on the website — the one in force for your cohort, and the one the school says it applied. Programmes revise handbooks annually, and applying the wrong edition is one of the more common procedural errors.
Ask who made the referral and on what documents. Many handbooks limit who may initiate a case. If the referral came from someone outside that group, that is a procedural point.
Do not resign, withdraw, or sign anything described as a voluntary separation, deceleration agreement or release without advice. A withdrawal can look kinder on a transcript and can also close the appeal route entirely.
Preserve everything — the learning-management system, examination score reports, emails with course directors and disability services, evaluation forms, and any accommodation letters. Access to school systems is often cut off within days of dismissal.
If disability is any part of the story, raise it now and in writing. Late disclosure is the single most common reason a good disability argument fails.

What a lawyer can do when a lawyer cannot attend

Most osteopathic programmes bar counsel from the committee meeting and the appeal hearing. That restriction is narrower than it looks, because it does not change what happens outside the room, where nearly all of the work is:

Reading the handbook against the record and identifying, sentence by sentence, where the school departed from its own procedure.
Building the written appeal — which, at a school whose appeal board decides finally and on the papers, is usually the case in its entirety.
Getting the file, the score reports, the evaluation forms and the committee’s stated reasons before the hearing rather than after.
Preparing the student for questions the committee will ask, and for the parts of the hearing they will not be present for.
Handling the accreditation, Section 504 and OCR routes that sit outside the internal process entirely — and preserving them, which a poorly worded internal submission can quietly damage.
Assessing honestly whether there is anything to be gained by litigating afterwards, and saying so if there is not.

Common questions

Can my osteopathic school really stop me bringing a lawyer to the hearing?

At a private school, generally yes. The relationship is contractual and the handbook is the contract; if it says representation is prohibited, that term is usually enforceable. Some handbooks go further and purport to bar an attorney from helping prepare the written appeal, which is a more aggressive position and a harder one for a school to police or to justify. Either way, the work that decides most appeals happens before the hearing.

Is failing COMLEX an academic dismissal or a disciplinary one?

Courts treat a board-examination failure as academic. That means less process is owed and courts give more deference. It also means the fruitful arguments are elsewhere: whether accommodations were properly provided, whether the school followed its own remediation, study-leave and attempt-counting rules, and whether the attempt count itself is right.

My school says I have used all my attempts, but the NBOME says I have one left. Who is right?

Both, usually. The NBOME sets a national ceiling of four scored attempts per level. Your school sets its own, often lower, limit and separately controls whether you may register at all, because your dean must attest to your good academic and professional standing. A remaining national attempt does not help without a school willing to certify it.

Does a leave of absence protect me?

It protects your enrolment, and it spends your clock. COCA requires completion within 150 percent of standard time — six years — and most programmes count leaves, administrative breaks and suspensions toward that ceiling. Ask in writing how much of the six years a proposed leave consumes before you agree to it.

I was treated by a school physician who then sat on my promotions committee. Does that matter?

It may matter a great deal. COCA Element 9.10 is a CORE element requiring that any health professional who provides health services to a student through a provider-patient relationship recuse themselves from that student’s academic assessment or promotion, and requiring the school to give the recusal policy to students and faculty annually. If that did not happen, it is both an appeal point and an accreditation point.

Should I withdraw instead of being dismissed?

Do not decide that without advice. A withdrawal can read better to a future programme, and it can also end your appeal rights, change what your transcript and MSPE say, alter your financial-aid position, and affect whether you can ever be readmitted. The transcript consequence and the procedural consequence rarely point the same way.

Can I go straight to court?

You can, but almost never should before finishing the internal process. Courts reviewing academic decisions ask only whether the school was arbitrary and capricious, irrational, acted in bad faith, or violated a statute or the constitution — a narrow standard — and a record showing the school ignored its own procedure while the student did everything the handbook asked is far more persuasive than one built after the fact.

Get in touch to talk through a specific situation, whether you are a student or a family.

General information about osteopathic medical education and student rights. It is not legal advice, it does not create an attorney-client relationship, and it cannot account for the facts of your situation or the law of your jurisdiction. Accreditation standards, examination policies and school handbooks change; verify the edition that applies to you. Zachary Gaynor is licensed in Florida and admitted in several federal courts; representation outside Florida is limited to matters that are internal to an institution or where local counsel is engaged.