Trump's Next Pick for Surgeon General Faces Bars To Enter Office
Means' lack of an active medical license—and the significant hurdles she faces to reactivate it—may bar her from serving
President Donald Trump’s choice for surgeon general of the United States faces federal and state bars to entering the office, and it is not immediately clear that she can remedy them in the next six months, if at all.
When he pulled his first nominee the job, Janette Nesheiwat—following several stories I broke about how she had lied about and misrepresented her education, credentials, and military and disaster-relief experience, as well as questions about her supplement business and financial disclosures—Trump named wellness influencer Means as his next nominee.
Many outlets have reported that Means did not complete her surgical residency, is not board-certified, and holds an inactive license to practice medicine in the state of Oregon.
What apparently has not yet been reported is that Means not only does not meet the specific statutory requirements for the position—namely, “specialized training or significant experience in public health programs”—but that she would face another significant hurdle in order for the Senate to confirm her.
The Commissioned Corps
The surgeon general oversees the U.S. Public Health Service Commissioned Corps, in which dedicated professionals serve in a variety of public health categories: Medical, Dental, Nurse, Engineer, Scientist, Environmental Health, Veterinary, Pharmacy, Dietitian, Therapy, and Health Services. One must meet the specific requirements of one of these categories in order to be appointed into the corps.
For prior confirmed surgeons general, many of whom were not serving in the Commissioned Corps at the time of their nomination, the other statutory requirement—that the surgeon general “shall be appointed from individuals who (1) are members of the Regular Corps”—has been readily dealt with by nominating the individual to be both “Medical Director in the Regular Corps and Surgeon General of the Public Health Service.”
But in order to be appointed as a physician in the Commissioned Corps, one must have earned an accredited M.D. or D.O., have completed one year of accredited postgraduate medical education (an “internship”), and hold a “[c]urrent, unrestricted, and valid medical license from any U.S. state, Washington D.C., Puerto Rico, U.S. Virgin Islands, or Guam.”
According to public records, Means holds no such current, unrestricted, valid medical license.
And Means does not qualify for appointment into any other Commissioned Corps category, including the broadest, Health Services. She must obtain a new medical license, or reactivate the one from Oregon.
Reactivating a medical license in Oregon
Oregon, the state where she had been licensed until its status became inactive on January 1, 2024, does allow returning physicians to reactivate their licenses.
However, physicians who have not been recertified by a specialty board in the immediate prior 12 months (Means has never been certified) may be required to pass the Special Purpose Examination (SPEX). The Reentry to Clinical Practice packet lists six actions the physician may have taken in order for the state to waive this requirement; there is no publicly available information that Means has completed any of them; it is therefore likely she would be required to pass this exam.
And physicians who have been out of practice for specified periods of time prior to applying for recertification may have to fulfill additional requirements. Those who have not practiced for 24 or more consecutive months—which seems to apply to Means—must successfully complete a “re-entry plan”:
Some information from the state about reactivation appears to be inconsistent; one site shows that a graduate of a US-accredited medical school need not have completed a residency in order to be licensed to practice medicine.
However, one of the rules cited in the information for recertification states that physicians must have “current certification by a specialty board as defined in 847-020-0100”; or meet one of several extenuating circumstances—including “Suffered from a documented significant health condition which by its severity would necessarily cause a delay to the applicant’s medical study.”
The Los Angeles Times recently reported that Means dropped out of her residency due to stress and anxiety.
In a 2021 report, Oregon estimated it had about 15,000 actively practicing licensed physicians. However, the state separately reported that for the years 2020 through 2024, only 48 physicians in total whose licensed had lapsed successfully reactivated them.
The state estimates that it takes approximately 8 to 12 weeks for it to process applications for reactivation. However, that time period is subsequent to the applicant fulfilling all of the requirements to be eligible to apply for reactivation, including successfully passing the exam and completing the other parts of the re-entry plan.
Depending on which of those requirements the state applies to Means and the time it will take to meet, verify, and approve them, should she wish to reactivate her Oregon license—or seek a new one in another state or territory—it is possible that she will not be licensed to practice medicine this year, if at all, and therefore will not be eligible to be appointed into the Commissioned Corps, and would not meet the statutory requirements of the position.