In Board of Curators, Univ. of Mo. v. Horowitz (1978) 435 U.S. 78, several faculty members expressed dissatisfaction with Horowitz's clinical performance after her first year of study. (Horowitz, supra, 435 U.S. at pp. 80-81.) Upon the recommendation of the medical school's council on evaluation, Horowitz was advanced to her second and final year on probationary status. (Id. at p. 81.) Faculty dissatisfaction with Horowitz's performance continued during her second year of study, and, in the middle of the year, the council on evaluation concluded Horowitz should not be considered for graduation in June and recommended, "absent 'radical improvement,' " she be dismissed from the medical school. (Ibid.) As an " 'appeal' " of that decision, Horowitz was permitted to take a set of oral and practical examinations and to spend time with seven practicing physicians, who would offer their recommendations whether to permit Horowitz to graduate. (Ibid.) Based on those recommendations, the council on evaluation reaffirmed its prior decision to dismiss Horowitz. (Ibid.) Later, the council met again and, after receiving further negative reports on Horowitz's performance in rotations, unanimously reaffirmed its recommendation to dismiss Horowitz from the medical school. (Id. at pp. 81-82.) After the dean and coordinating committee approved the recommendation, Horowitz appealed to the health sciences provost, who sustained the medical school's decision. (Ibid.) In concluding due process did not require Horowitz be granted a formal hearing, the Supreme Court distinguished academic evaluations of a student from disciplinary determinations, to which the court traditionally attached a full-hearing requirement. (Horowitz, supra, 435 U.S. at pp. 86-87.) Unlike disciplinary actions, the decision to dismiss Horowitz "rested on the academic judgment of school officials that she did not have the necessary clinical ability to perform adequately as a medical doctor and was making insufficient progress toward that goal." (Id. at pp. 89-90.) The Supreme Court explained: "Such a judgment is by its nature more subjective and evaluative than the typical factual questions presented in the average disciplinary decision. Like the decision of an individual professor as to the proper grade for a student in his course, the determination whether to dismiss a student for academic reasons requires an expert evaluation of cumulative information and is not readily adapted to the procedural tools of judicial or administrative decisionmaking. Under such circumstances, we decline to ignore the historic judgment of educators and thereby formalize the academic dismissal process by requiring a hearing. The educational process is not by nature adversary; instead it centers around a continuing relationship between faculty and students, 'one in which the teacher must occupy many roles--educator, adviser, friend, and, at times, parent-substitute.' This is especially true as one advances through the varying regimes of the educational system, and the instruction becomes both more individualized and more specialized." (Horowitz, supra, 435 U.S. at p. 90.) Affirming the judiciary's limited role in reviewing academic decisions, the court "declined to further enlarge the judicial presence in the academic community and thereby risk deterioration of many beneficial aspects of the faculty-student relationship." (Ibid.) How much procedural due process is a university student entitled to before dismissal for academic reasons? The United States Supreme Court has established a student is not entitled to a formal hearing. The Supreme Court concluded Horowitz had been afforded "at least as much due process as the Fourteenth Amendment requires" because "the school fully informed Horowitz of the faculty's dissatisfaction with her clinical progress and the danger that this posed to timely graduation and continued enrollment" and "the ultimate decision to dismiss Horowitz was careful and deliberate." (Horowitz, supra, 435 U.S. at p. 85.)