Jordan Spatz graduated from the University of California, San Francisco (UCSF) medical school in 2021 at the age of 36. In 2017 and 2018, while in medical school, he reported two instances of alleged age-based harassment. His academic record was mixed, and he received some negative reviews during his sub-internships. Sub-internships are advanced clinical rotations in which senior medical students take on responsibilities similar to first-year residents and are evaluated for residency readiness.
Spatz applied to UCSF’s neurological surgery residency program during the 2020 cycle of the National Resident Matching Program (NRMP). The NRMP, also known as “the Match,” is the nationwide system that pairs medical graduates with residency programs through a computer algorithm. The algorithm matches applicants and programs based on the rankings submitted by both sides. Spatz applied to 18 neurological surgery programs in 2020 and listed UCSF as his first choice. He did not match anywhere that year because no residency program ranked him. He applied again in 2021. Once again, no program ranked him, and he again did not match anywhere. Spatz later argued that if UCSF had ranked him, he would have matched into its program. In 2022, Spatz applied a third time, but UCSF did not interview him, and he again failed to match anywhere.
After failing to match in 2022, Spatz filed suit against the Regents of the University of California. His complaint asserted seven causes of action, including age discrimination under the federal Age Discrimination Act of 1975 (Age Act), several claims under California’s Fair Employment and Housing Act (FEHA), and a whistleblower retaliation claim. Spatz argued that UCSF faculty considered his age in the selection process and that UCSF’s refusal to rank him resulted from age discrimination. Spatz also alleged retaliation for reporting age discrimination in 2017 and 2018, and for filing a 2020 formal complaint alleging age, disability, and national origin discrimination.
UCSF denied that age played any role in its decisions. UCSF argued that it did not rank Spatz because of his mediocre grades, poor sub-internship performance, and the highly competitive nature of its neurosurgery residency program, which admitted only three to four residents from more than 300 applicants each year. UCSF moved for summary judgment and asked the federal district court to dismiss all claims. Spatz only opposed summary judgment on his Age Act claim and did not oppose summary judgment on his state-law claims.
The trial court granted summary judgment in full. It held that the Age Act did not apply because UCSF’s refusal to rank Spatz constituted an “employment practice of an employer,” which the statute expressly exempts from coverage under 42 U.S.C. section 6103(c)(1). The trial court further held that, even if the Age Act applied, Spatz failed to raise a genuine dispute of material fact. Spatz appealed to the Ninth Circuit Court of Appeals.
The Ninth Circuit analyzed the Age Act’s language, which prohibits age discrimination in federally funded programs but exempts “any employment practice of any employer.” The Ninth Circuit applied the common-law meaning of “employer” and “employment practice.” It noted that medical residency has many characteristics of employment. Residents require substantial skill, work at hospital facilities, provide direct patient care under the hospital’s control, work long hours, receive salaries and benefits, and are taxed as employees. The Ninth Circuit examined the Supreme Court precedent that held that residents are employees for tax purposes. The Ninth Circuit also explained that the California Supreme Court and the National Labor Relations Board recognized residents as employees entitled to labor rights, and California appellate courts have emphasized the employee-employer nature of residency relationships. Based on these factors, the Ninth Circuit concluded that ranking residency applicants is the functional equivalent of hiring employees and thus qualifies as an employment practice excluded from the Age Act’s coverage.
Spatz argued that the legislative history of the Age Act showed Congress intended the statute to apply to medical schools. The Ninth Circuit rejected this argument because Spatz failed to provide proper citations, and the language he relied on referred only to medical schools, not residency programs. The Ninth Circuit also rejected his argument that the discrimination occurred while Spatz was a medical student, explaining that the relevant inquiry was whether UCSF’s refusal to rank him for residency constituted an employment practice. The Ninth Circuit held that it did, because residency ranking determines who will work as a resident physician, and residents function in practice as hospital employees rather than students.
The Ninth Circuit held that, even if the Age Act applied, Spatz failed to raise a genuine issue of material fact. UCSF presented evidence that his grades and sub-internship performance were weak, and faculty testified that age played no role in the selection process. Spatz did not produce admissible evidence to rebut this.
The Ninth Circuit affirmed the district court’s grant of summary judgment.
Spatz v. Regents of the Univ. of Cal. (9th Cir. Aug. 18, 2025, No. 24-2997).