Trump's former surgeon general calls for maintaining qualifications current nominee doesn't have

President Trump's former surgeon general, Jerome Adams, said this week that failure to maintain certain requirements for the role he once occupied would compromise the "mission and credibility" of the federal public health service.

Trump's current nominee for the role, Casey Means, graduated from medical school but did not complete her residency, meaning she is not a practicing physician, a distinction that historically has been a prerequisite for the role.

Means and her defenders, including Kennedy, say she left the formal health care system because it was not making people healthier, and she and her brother have carved out a popular lane as influencers and authors aligned with the "Make America Healthy Again" agenda.

Without naming any names, Adams stated in a lengthy post on the social platform X that his thoughts were in "no way a personal criticism of any candidate, but a clarification for the sake of the integrity of the [U.S. Public Health Service Commissioned Corps (PHSCC)] that I was blessed and honored to lead."

"Physician requirements include a medical degree (e.g., MD or DO), a residency, and a valid medical license," Adams wrote. "This is analogous to how an Army General must meet the minimum qualifications to serve in the military before being promoted to lead other troops who are held to those same standards."

When Trump announced he was replacing Janette Nesheiwat with Means to be his pick for surgeon general, critics from within MAGA and the Make America Healthy Again movement spoke out against her. Adams noted at the time that surgeon general nominees historically have been required to be licensed physicians.

Critics of Means, who graduated from Stanford University School of Medicine, have latched on to her decision not to complete her residency program.

According to former colleagues of Means, she left a five-year residency program at the Oregon Health and Science University after 4 1/2 years due to anxiety and feeling she wanted to do something different. Means is co-founder of Levels, a health technology company that focuses on tracking health information through medical devices.

Adams served as surgeon general during Trump's first term and is presidential fellow and the executive director of the Center for Community Health Enhancement and Learning at Purdue University.

He acknowledged that appointing nonphysicians is not explicitly prohibited by law but said the requirements of leading the PHSCC would make having a medical license "indispensable." Adams gave the example of the Air Force chief of staff not being legally required to have completed flight training or licensure, but noted those credentials are strongly implied by the responsibilities of the role.

"The Surgeon General’s position as a trusted public health authority and physician makes full training and licensure a critical expectation in addition to an implicit legal requirement," Adams wrote.