Casey Means, MD will NOT be the next US Surgeon General. Her nomination languished after a dismal performance before the Senate revealed a deep lack of training and experience.
The is the second Trump nominated candidate who failed to garner support in the Senate. The, first Dr. Jeanette Nesheiwat, was sidelined when the veracity of her educational credentials was called in to question.
Now, Trump turns once again to that bastion of high quality physicians, Fox News, for his next nominee, Dr. Nicole Saphier.
https://www.mskcc.org/cancer-care/doctors/nicole-saphier
At least Dr. Saphier did a residency! That is a step in the right direction and a big improvement over Dr. Means.
But what is it about Fox News? It seems Trump draws upon that bottom dwelling fake news organization for many of his nominations.
Where do most surgeon generals come from? What kind of background do they typically have?
The U.S. Surgeon General is not just a ceremonial role—it’s typically filled by a highly trained physician with deep public health and leadership experience. When you look across history, a fairly consistent profile emerges.
🩺 Typical Background of U.S. Surgeons General
1) Medical Degree (Almost Universal)
Nearly every Surgeon General has been a physician (MD).
Many trained in:
Internal medicine
Surgery
Family medicine
Pediatrics
Examples:
C. Everett Koop – pediatric surgeon
Vivek Murthy – internal medicine
David Satcher – physician-scientist
👉 A non-physician would be highly unusual in the modern era.
2) Strong Public Health Credentials (Very Common)
Most have formal training or leadership in public health, often:
MPH (Master of Public Health) or equivalent
Senior roles in:
CDC
State health departments
Academic public health institutions
Example:
Jerome Adams – MD, MPH; former Indiana State Health Commissioner
👉 This reflects the role’s mission: population-level health, not clinical practice alone.
3) Academic / Research Experience
A large proportion have held faculty appointments or conducted research.
University professors or lecturers
Published in peer-reviewed journals
Experience translating science into policy
Example:
Regina Benjamin – clinician + academic + public health leader
👉 The job requires credibility with both scientists and policymakers.
4) Government or Health System Leadership
Most have run large organizations or systems, such as:
State health departments
Federal agencies (CDC, NIH, HHS roles)
Large hospital systems or public clinics
Example:
David Satcher – former CDC Director
👉 Leadership experience is critical—the Surgeon General oversees the U.S. Public Health Service Commissioned Corps (~6,000 officers).
5) Communication & Public Trust Role
Modern Surgeons General are expected to be national communicators:
Public health campaigns (smoking, HIV/AIDS, opioids, COVID)
Media presence
Ability to explain complex science clearly
Example:
C. Everett Koop – widely credited with transforming public communication on AIDS
📊 What the “Typical Profile” Looks Like
If you had to summarize the historical norm:
MD (almost always)
Often MPH or equivalent public health training
Academic or research background
Senior leadership in public health or government
Strong science communication skills
⚠️ What Is Not Typical
Historically, it would be unusual for a nominee to:
Lack formal public health experience
Have minimal academic or research credentials
Be known primarily for media or commentary roles rather than health leadership
Bottom Line
The Surgeon General has traditionally been a physician–public health leader hybrid:
Not just a doctor, but a national health strategist, administrator, and communicator with deep grounding in population health.
It is clear, Dr. Saphier, who is a radiologist, doesn’t have the type of background needed to be a surgen general. It just proves Trump has no clue how to evaluate and select people for roles in his administration. He repeatedly selects physicians with incomplete or inappropriate training for the role such as Dr. Jay Battacharya who has absolutely no graduate medical education, Dr. Means who never finished a residency and Dr. Malone who never even did a residency.
