# Gilani v. UTSW Medical Center

> Court of Appeals for the Fifth Circuit · January 30, 2026

URL: https://www.frixlaw.com/law-library/cases/11248543

## Case

- **Court:** Court of Appeals for the Fifth Circuit
- **Decided:** January 30, 2026
- **Precedential status:** Unpublished
- **Opinion:** Opinion
- **Nature of suit:** Civil Rights
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/11248543

## How later opinions describe it (automated extraction)

- concluding that basis of dismissal of Ph.D. candidate in psychology was academic when premised on student’s grades, academic ethics, and approach to work

## Opinion text

Case: 25-10451 Document: 75-1 Page: 1 Date Filed: 01/30/2026

United States Court of Appeals
for the Fifth Circuit United States Court of Appeals
____________ Fifth Circuit

FILED
No. 25-10451 January 30, 2026
____________ Lyle W. Cayce
Clerk
Al Gilani,

Plaintiff—Appellant,

versus

University of Texas Southwestern Medical Center;
Angela Mihalic, Medical Doctor; Blake Barker, Medical Doctor;
WP Andrew Lee, Medical Doctor; Dwain Thiele, Medical Doctor,

Defendants—Appellees.
______________________________

Appeal from the United States District Court
for the Northern District of Texas
USDC No. 3:21-CV-1461
______________________________

Before Richman, Engelhardt, and Wilson, Circuit Judges.
Per Curiam: *
The University of Texas Southwestern Medical Center dismissed Al
Gilani from its medical school, citing his unsatisfactory academic
performance. Gilani sued under 42 U.S.C. § 1983, asserting that his
dismissal violated Title VI of the Civil Rights Act of 1964 and the Fourteenth
Amendment’s Due Process Clause. The district court dismissed some of his
_____________________
*
This opinion is not designated for publication. See 5th Cir. R. 47.5.
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No. 25-10451

claims and granted summary judgment to the defendants on others. We
affirm.
I
We first address Gilani’s Title VI claims. The district court granted
summary judgment to the University of Texas Southwestern Medical Center
(“UTSW”) on Gilani’s Title VI claims, and Gilani has not briefed those
claims in this court. “It is a well worn principle that the failure to raise an
issue on appeal constitutes waiver of that argument.” 1 Because Gilani has
forfeited his arguments, we will not disturb the district court’s grant of
summary judgment on those claims.
II
Gilani sued several UTSW employees in both their individual and
official capacities under § 1983. He also sued UTSW itself.
In the district court, Gilani conceded that his § 1983 claim against
UTSW could not go forward. That leaves his § 1983 claims against the
UTSW employees in their individual and official capacities. The district
court dismissed these claims against the individual defendants in their official
capacities, concluding that Gilani had failed to allege plausibly a Due Process
violation—either procedural or substantive. The district court also
concluded that the defendants were entitled to qualified immunity because
Gilani had failed to allege plausibly a constitutional violation in the first place.
A
“In determining whether a plaintiff’s claims survive a Rule 12(b)(6)
motion to dismiss, the factual information to which the court addresses its
inquiry is limited to (1) the facts set forth in the complaint, (2) documents
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1
United States v. Griffith, 522 F.3d 607, 610 (5th Cir. 2008).

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attached to the complaint, and (3) matters of which judicial notice may be
taken under Federal Rule of Evidence 201.” 2 “When a defendant attaches
documents to its motion that are referenced in the complaint and are central
to the plaintiff’s claims, however, the court can also properly consider those
documents.” 3 Here, the defendants’ motion to dismiss cited to an appendix
supporting their motion for judgment on the pleadings. 4 We consider the
documents therein to the extent they are referenced in Gilani’s complaint
and central to his claims.
“When considering a motion to dismiss, the court accepts as true the
well-pled factual allegations in the complaint, and construes them in the light
most favorable to the plaintiff.” 5 Gilani entered UTSW in the fall of 2016, at
which point he “had some difficulty with his first-year courses,” failing five
of them. He was granted an extended leave of absence. Upon his return, he
was placed on academic probation, and he successfully remediated his first-
year courses.
Over the summer before his second year of medical school, Gilani
enrolled in a summer research elective in Uganda. It is at this point that Dr.
Angela Mihalic enters the Complaint. Dr. Mihalic was Dean of Medical
Students at UTSW. Gilani alleges that he successfully completed the
requirements of the summer elective, but that he was nonetheless given a
failing grade—a failure engineered by Dr. Mihalic. The failing grade was
based on “accusations that [he] made misrepresentations regarding his

_____________________
2
Inclusive Cmtys. Project, Inc. v. Lincoln Prop. Co., 920 F.3d 890, 900 (5th Cir. 2019).
3
Id. (citing Causey v. Sewell Cadillac-Chevrolet, Inc., 394 F.3d 285, 288 (5th Cir.
2004)).
4
See id.
5
Taylor v. Books A Million, Inc., 296 F.3d 376, 378 (5th Cir. 2002).

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research timeline and travel during his time in Uganda.” UTSW’s Student
Promotions Committee (“SPC”) placed Gilani on “Academic Warning.”
At around the same time, Gilani failed his Gastrointestinal System
course (“GI Block”). His score was three quarters of a percentage point
below the pass cut-off. He was denied the benefit of a two-point curve that
every other student was afforded. Dr. Mihalic forbade Gilani from “ever
mentioning the abuse of the curve.”
UTSW decided “to dismiss him from the medical school based on his
academic performance, specifically, in the GI Block.” Gilani contends that
this decision was made by Dr. Mihalic and laundered—nominally—through
the SPC. Gilani appealed, and the SPC reversed his dismissal on the
condition that he remediate his performance in the GI Block. He would
continue, however, to be on academic probation, and “[a]ny further
academic or professionalism deficiencies w[ould] result in immediate referral
to the [SPC], with possible additional actions, up to and including dismissal.”
Gilani then failed his GI Block re-examination. He alleges that his
exam was hand-scored, and that he was denied the opportunity to review the
hand-scoring for accuracy. Again, Gilani asserts that Dr. Mihalic acted in the
shadows to ensure this outcome.
The SPC sent Gilani a letter informing him of his dismissal from
UTSW, “based on his purported failure of the duplicative, remedial exam
[that] he was denied any opportunity to review for accuracy.” Gilani
appealed, and he was permitted to make an oral presentation at an SPC
meeting. Gilani appealed again, this time to the Dean of UTSW. The Dean
delegated to Dr. Thiele, a Vice Provost, the task “to review ‘all materials
relevant to [his] appeal’ and to make a recommendation.” Gilani sought a
meeting with the Dean. The Dean declined and sent Gilani a letter indicating
that he had “‘decided to accept Dr. Thiele’s recommendation and uphold

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No. 25-10451

the [dismissal] decision’ because Mr. Gilani’s ‘academic performance does
not meet the standards required of [UTSW] medical students.’” This ended
Gilani’s studies at UTSW.

B
We review de novo both a district court’s dismissal for failure to state
a claim and a district court’s ruling on qualified immunity. 6 We begin with
Gilani’s procedural due process claim. Gilani alleges that his dismissal
proceedings violated UTSW’s policies. However, the Due Process Clause is
not coterminous with good institutional practice. The question before this
court is whether the procedure Gilani was afforded comported with the
constitutional requirements of procedural due process—not UTSW’s
institutional policies.
We assume without deciding that Gilani had a liberty or property
interest in his continuing education at UTSW. 7 The standard by which we
assess the process Gilani was afforded prior to his dismissal depends on
whether the dismissal was academic or disciplinary. Academic dismissals
arise from deficiencies in a student’s academic performance; disciplinary
dismissals arise from misconduct. 8 In the context of medical education,

_____________________
6
Inclusive Cmtys. Project, 920 F.3d at 899; Davila v. United States, 713 F.3d 248, 257
(5th Cir. 2013).
7
See Bd. of Curators of Univ. of Mo. v. Horowitz, 435 U.S. 78, 84-85 (1978)
(“Assuming the existence of a liberty or property interest, respondent has been awarded at
least as much due process as the Fourteenth Amendment requires.”).
8
See id. at 87 (“Misconduct is a very different matter from failure to attain a
standard of excellence in studies.”) (quoting Barnard v. Inhabitants of Shelburne, 102 N.E.
1095, 1097 (Mass. 1913)).

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academic performance extends beyond mere scholastic performance to the
personal qualities necessary to succeed as a physician. 9
If his dismissal was disciplinary, Gilani was entitled to “oral or written
notice of the charges against him and, if he denies them, an explanation of the
evidence the authorities have and an opportunity to present his side of the
story.” 10 The opportunity to present his side of the story may be informal. 11
If the dismissal was academic, the Due Process Clause imposes “far
less stringent procedural requirements,” 12 as “[c]ourts are particularly ill-
equipped to evaluate academic performance.” 13 The school need only “fully
inform[] respondent of the faculty’s dissatisfaction with h[is] clinical
progress and the danger that this pose[s] to timely graduation and continued
enrollment.” 14 The “ultimate decision to dismiss” a student must be
“careful and deliberate.” 15
On appeal, Gilani recharacterizes his dismissal as disciplinary. He
points out that dismissals for academic dishonesty may be disciplinary in
nature, then asserts that the University engaged in academic dishonesty,

_____________________
9
Id. at 91 n.6 (“Personal hygiene and timeliness may be as important factors in a
school’s determination of whether a student will make a good medical doctor as the
student’s ability to take a case history or diagnose an illness.”).
10
Goss v. Lopez, 419 U.S. 565, 581 (1975).
11
Horowitz, 435 U.S. at 85-86 (“All that Goss required was an ‘informal give-and-
take’ between the student and the administrative body dismissing him that would, at least,
give the student ‘the opportunity to characterize his conduct and put it in what he deems
the proper context.’” (quoting Goss, 419 U.S. at 584)).
12
Id. at 86.
13
Id. at 92.
14
Id. at 85.
15
Id.

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rendering the proceedings “disciplinary.” But we are not required to accept
as true Gilani’s conclusory allegation that UTSW engaged in academic
dishonesty, and the focus of our analysis is on the student’s shortcomings. 16
Gilani’s own pleadings establish that his dismissal was academic in nature.
He was dismissed once, then permitted to re-enroll on the condition that he
remediate his failure of the GI Block exam. Upon failing the re-examination,
he was dismissed again “based on his purported failure” of the GI Block
assessment. The Dean of UTSW later upheld the SPC’s dismissal because
Gilani’s “academic performance d[id] not meet the standards required of
UT Southwestern medical students.”
Because his dismissal was academic in nature, Gilani was entitled to
notice of the “faculty’s dissatisfaction with h[is] clinical progress and the
danger that this posed to timely graduation and continued enrollment.” 17
The school’s decision must be careful and deliberate. 18 Gilani was warned
about his academic progress. The care and deliberation of the school’s
decision is demonstrated by its reconsideration of Gilani’s first dismissal and
the fact that it granted him an audience before the SPC. His dismissal
comported with the requirements of procedural due process.
We proceed to the substance of Gilani’s dismissal. Substantive due
process review of academic dismissals is a “narrow avenue for judicial
review” requiring “such a substantial departure from accepted academic
norms as to demonstrate that the faculty did not exercise professional

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16
See Wheeler v. Miller, 168 F.3d 241, 248 (5th Cir. 1999) (concluding that basis of
dismissal of Ph.D. candidate in psychology was academic when premised on student’s
grades, academic ethics, and approach to work).
17
Horowitz, 435 U.S. at 85.
18
Id.

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judgment.” 19 The appropriate unit of analysis is the entirety of Gilani’s
career at UTSW. 20 Here, evidence of UTSW’s departure from its own
policies may be relevant to the extent they show that the dismissal was
arbitrary. 21
Gilani pleaded that he was excluded from a two-point curve afforded
every other student on the GI Block exam, and that this made the difference
between passing and failing. 22 It is a troubling allegation. However, the
Supreme Court confronted an analogous situation in Ewing. 23 There, a
student was denied the opportunity to retake a failed medical board exam—
an opportunity afforded some of his peers. The Supreme Court stated:
Admittedly, it may well have been unwise to deny Ewing a
second chance. Permission to retake the test might have saved
the University the expense of this litigation and conceivably
might have demonstrated that the members of the Promotion
and Review Board misjudged Ewing’s fitness for the medical
profession. But it nevertheless remains true that his dismissal
from the Inteflex program rested on an academic judgment that
is not beyond the pale of reasoned academic decision-making
when viewed against the background of his entire career at the

_____________________
19
Regents of Univ. of Mich. v. Ewing, 474 U.S. 214, 227 (1985).
20
See id. at 217-19.
21
See id. at 224-25 (“The University’s refusal to allow Ewing to retake the NBME
Part I is thus not actionable in itself. It is, however, an important element of Ewing’s claim
that his dismissal was the product of arbitrary state action, for under proper analysis the
refusal may constitute evidence of arbitrariness even if it is not the actual legal wrong
alleged.”).
22
ROA.202.
23
474 U.S. at 227.

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University of Michigan, including his singularly low score on
the NBME Part I examination. 24
The SPC considered Gilani’s entire academic record. This included
his course failures in the first year of medical school, his failure of the summer
research elective, and failure on the initial GI Block examination and the re-
examination. Both of Gilani’s GI Block examinations were reviewed by Dr.
Thiele, “a Professor of Internal Medicine, certified by the ABIM in the
subspeciality of Gastroenterology.” He concurred that the exams
“reflect[ed] insufficient mastery of the subject matter.” Even setting aside
Gilani’s failure of the initial GI Block examination, dismissal of a student with
such a record does not show an exercise of judgment “beyond the pale of
reasoned academic decision-making when viewed against the background of
his entire career at the University.” 25
Gilani asserts that several of his academic failures were engineered by
Dr. Mihalic. Gilani’s complaint establishes that the SPC, Dr. Thiele, and Dr.
Lee all reviewed Gilani’s academic record. It also establishes that the same
SPC that he alleges was in thrall to Dr. Mihalic once reversed his dismissal
on the condition that he remediate his GI Block exam. Dr. Thiele’s letter
reveals that he “personally verified each individual exam question marked as
‘incorrect’ on Mr. Gilani’s results.” In this context, Gilani’s allegations of a
campaign against him headed by Dr. Mihalic are insufficiently plausible to
survive a motion to dismiss.
Because the complaint does not plausibly allege a violation of Gilani’s
procedural or substantive due process rights, we do not reach the clearly

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24
Id. at 227-28.
25
Id.

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established law prong of qualified immunity for the individual-capacity
claims. 26
* * *
We AFFIRM.

_____________________
26
Doe v. Ferguson, 128 F.4th 727, 734 (5th Cir. 2025).

10

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/11248543. Public record. Not legal advice.
