Executive Summary: Key Legal and Evidentiary Issues

• Scope of procedural fairness owed to a medical resident facing termination from a family medicine residency program through an academic review process.
• Alleged reasonable apprehension of bias arising from the participation of Dr. Walker on the Academic Review Board, despite his cross-appointment to Family Medicine.
• Interpretation and application of the Academic Review Board policy excluding members of the residency program from sitting on an ARB panel, and whether Dr. Walker fell within that exclusion.
• Adequacy of disclosure by the university, including access to medical records and the significance of redacted patient information to the resident’s ability to respond.
• Weight given to evidence that the resident should not have been accessing medical records while suspended and that the redacted records related to patients unconnected to her.
• Overall assessment of whether any proven disclosure or bias concerns rose to the level of procedural unfairness sufficient to justify judicial review intervention.

Background and parties
The case involves Samantha Adams, a doctor enrolled in Queen’s University’s Family Medicine residency program. An Academic Review Board (ARB) investigated concerns about her performance and conduct and ultimately required that she withdraw from the residency. Dr. Adams appealed that decision internally to the university’s Postgraduate Tribunal, which dismissed her appeal in a written decision dated June 11, 2025. Having exhausted the internal academic processes, Dr. Adams then applied to the Ontario Superior Court of Justice, Divisional Court, for judicial review of the Postgraduate Tribunal’s decision in Adams v. Queen’s University, 2026 ONSC 1427. The judicial review was heard by a three-judge panel (Matheson, O’Brien and Mandhane JJ.), with the decision delivered orally on March 9, 2026 and released in written form on March 12, 2026.

Internal academic process and standard of fairness
Within Queen’s University’s postgraduate medical education structure, the ARB is responsible for reviewing serious academic or conduct concerns involving residents and can impose outcomes up to and including a requirement to withdraw. The Postgraduate Tribunal acts as an internal appellate body to review ARB decisions, including procedural fairness issues such as bias and disclosure. On judicial review, the Divisional Court noted the Tribunal’s own finding that Dr. Adams was owed a high degree of procedural fairness given the serious impact of being compelled to withdraw from a residency program on her professional trajectory. The Court expressly agreed with the Tribunal that a high level of procedural protection was appropriate in these circumstances.

The Academic Review Board policy and composition of the panel
A central issue in the case concerned the ARB Policy governing who may sit on an Academic Review Board panel. The policy precluded “members of the residency program” from serving on an ARB panel in a case involving that program. Dr. Adams argued that this clause was breached because Dr. Walker, who sat on her ARB panel, had a cross-appointment to the Family Medicine department. The Court summarized the Tribunal’s findings: Dr. Walker had been appointed to Emergency Medicine and held only a cross-appointment to Family Medicine. He was not part of the Family Medicine residency program itself and had minimal involvement with that program. On that basis, both the Tribunal and the Court concluded that his participation did not violate the ARB Policy’s restriction on members of the residency program serving on the panel.

Allegations of bias and reasonable apprehension of bias
Dr. Adams’ core procedural fairness argument on judicial review was that Dr. Walker’s role on the ARB panel gave rise to a reasonable apprehension of bias. She pointed to his cross-appointment and to an email he had sent to his assistant as evidence that an informed observer would view him as not impartial. The Tribunal had heard evidence on the bias issue, including evidence from Dr. Walker himself, and concluded there was no reasonable apprehension of bias. Importantly, actual bias was never alleged; the challenge was based solely on the perception of bias. On judicial review, the Divisional Court carefully considered the Tribunal’s assessment, including its treatment of the email. The Court held that a reasonable person, viewing all of the evidence, would not see a reasonable apprehension of bias and agreed with the Tribunal’s conclusion that Dr. Walker’s position and limited involvement with Family Medicine did not undermine the fairness of the process.

Disclosure and access to medical records
The second major procedural issue was the adequacy of disclosure by Queen’s and by the Tribunal, especially around patient medical records. Dr. Adams complained that redactions in certain medical records prevented her from having the information necessary to defend herself properly. The Tribunal had found that disclosure in relation to all issues was sufficient. With respect to patient records, the Tribunal made several key factual findings. First, Dr. Adams should not have been viewing medical records at all during the period when she was suspended from her residency responsibilities. Second, the disputed redacted records related to patients with no connection to Dr. Adams, meaning there was no demonstrated link between those particular patients and the concerns about her performance. On that basis, the Tribunal concluded that the redacted patient information could not reasonably have been used by Dr. Adams in advancing her case. Other disclosure complaints were viewed as resting on speculation that was not adequately supported by evidence. The Divisional Court adopted this reasoning and found that the disclosure provided met the required standard of procedural fairness in the context of an internal academic proceeding of this seriousness.

Judicial review outcome and costs
Having reviewed both the bias and disclosure issues, the Divisional Court concluded that Dr. Adams had not established a denial of procedural fairness in the Postgraduate Tribunal process. The Court stated that, substantially for the reasons given by the Tribunal, the alleged unfairness was not made out and the application for judicial review failed. As a result, the decision of the Postgraduate Tribunal dismissing Dr. Adams’ appeal and upholding the ARB requirement that she withdraw from the Family Medicine residency remained in place. Queen’s University, as the successful party on the judicial review, obtained a monetary order for its legal costs. The Court awarded costs to the respondent in the agreed amount of $7,500, and no other damages or monetary awards were granted in the proceeding.