Former Veterans Affairs Secretary David Shulkin; photo via Veterans Health

The Trump administration underwent yet another cabinet shake-up this week, as the president took to Twitter to announce the firing of Veterans Affairs (VA) Secretary David Shulkin, who previously served as VA chief under President Barack Obama.

Trump then quickly proclaimed that he would nominate current presidential physician and active duty Navy admiral Ronny Jackson to take over the VA, the government’s second largest federal agency.

Joining former Secretary of State Rex Tillerson and FBI Deputy Director Andrew McCabe in the long list of administrators and advisors either fired or resigned from Trump’s cabinet, Shulkin exited the VA under a storm of controversy, largely focused on the privatization of veteran health care. In an op-ed penned for the New York Times just one day after his firing, Shulkin bemoaned the agency’s move towards privatized medicine, blaming profit-seeking officials for his ousting.

“They saw me as an obstacle to privatization who had to be removed,” Shulkin wrote in Wednesday’s Times op-ed. “That is because I am convinced that privatization is a political issue aimed at rewarding select people and companies with profits, even if it undermines care for veterans.”

Piling onto the privatization battle, the VA has also come under fire over the past year for overprescribing opioid-based painkillers to returning soldiers, an issue that has only exacerbated the nation’s drug epidemic.

Jackson, a presidential physician who served George W. Bush, Barack Obama, and now Trump, has never lead an organization anywhere near as large as the VA, which is home to a staff of 360,000 people and $186 billion annual budget. Compounding his lack of administrative experience, Jackson has not clued the public in on his political standings, with little known about his opinions of health care privatization or opioids. As he awaits Congressional confirmation, a number of lawmakers and veterans specialists have already expressed concerns about the Admiral’s qualifications.

“I’ve seen him managing a staff of a couple dozen, which he did to perfection,” said Ned Price, a National Security Council spokesman under Obama, to the Washington Post. “But how that would translate to managing the second-largest department in federal government I have no idea. He has competence and integrity. I don’t think he’s going to fly around the world first-class or be buying thousands of dollars in furniture. But can he run VA? Anyone’s guess is as good as mine.”

Similarly, Illinois Senator Tammy Duckworth, a veteran of the Iraq War, released a statement expressing skepticism about Jackson’s nomination.

“I will carefully review Dr. Jackson’s qualifications to determine whether he has the best interests of our Veterans at heart or whether he, like many in the Trump administration, wants to push VA down the dangerous path of privatization,” Sen. Duckworth said.

A timeline for when Jackson will undergo confirmation hearings to take over the federal agency is currently unknown.