The U.S. Court of Appeals for the Third Circuit recently revived a medical resident's harassment and retaliation claims against Mercy Catholic Medical Center, finding that the hospital is subject to Title IX. The Third Circuit's holding reversed, in part, the district court's determination that Mercy was not an "education program or activity" to which Title IX applies. This decision is precedential because most medical residency programs are hospital-based due to federal graduate education reimbursement requirements. As a result, this decision has the potential to subject to Title IX claims hospitals that are affiliated with but not controlled by educational institutions.

Mercy's residency program included faculty lectures, case presentations, meetings, and conferences in addition to clinical training. Mercy is affiliated with a university and residents take mandatory classes on the university's campus. The unnamed plaintiff alleged that while she was a member of the program, an unnamed supervisor created a hostile work environment, sabotaged her career when she rejected his advances, and otherwise retaliated against her in violation of Title IX.

The Third Circuit first analyzed whether Title IX applies to Mercy. The court looked to the plain text of Title IX, which prohibits discrimination on the basis of sex "under any education program or activity." In turn, "program or activity" is defined as "all of the operations of" certain organizations, including those "principally engaged in the business of providing health care."

In determining whether a program is an "education program or activity," the court noted four factors:

  • Whether a program is incrementally structured through a particular course of study or training
  • Whether the program allows participants to earn a degree or diploma, qualify for a certification, or pursue a specific occupation beyond on-the-job training
  • Whether the program provides instructors, examinations, an evaluation process or grades, or accepts tuition
  • Whether entities offering, accrediting, or otherwise regulating the program hold it out as educational in nature

The court determined that Mercy's program was plausibly an "education program or activity" because it is principally engaged in the business of providing health care, and its affiliation with the university makes its mission, at least in part, educational.

After determining that Mercy's program arguably falls within the ambit of Title IX, the court determined that the plaintiff's claims for Title IX retaliation and quid pro quo are viable. While Mercy argued that residents are employees required to bring discrimination complaints under Title VII, the court determined that Title VII and Title IX are concurrently applicable. Therefore, while the plaintiff failed to file a discrimination charge with the Equal Employment Opportunity Commission, that failure did not bar her ability to file her Title IX case directly with the courts.

The Third Circuit vacated the district court's decision to dismiss the case and remanded it for consideration of the plaintiff's quid pro quo and retaliation claims. Her hostile work environment claim, however, was barred by the applicable statute of limitations. While the question of Title IX's applicability to the resident program was a question of first impression in the Third Circuit, the decision is in step with holdings out of the First, Eighth, and Ninth Circuits.

Organizations receiving federal funding and that partner with higher education institutions or otherwise offer accreditation or licensing programs should take note of the broad applicability of Title IX. Not only does the court's holding suggest that such organizations may face lawsuits under Title IX, but it also indicates that those organizations should consider having Title IX policies and procedures in place to address complaints that arise.

Attorneys in Ballard Spahr's Health Care, Labor and Employment, and Higher Education Groups routinely advise organizations that receive federal funding on an array of labor, employment, and compliance issues. Our attorneys assist with Title IX compliance, harassment, and retaliation claims.


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