If the past is any indication, President-elect Donald Trump’s pick to head the Department of Veterans Affairs is anyone’s game.

In 2017, just 10 days before his inauguration, Trump chose Dr. David Shulkin, then the VA’s under secretary for health under President Barack Obama, for the top spot. When Trump dismissed Shulkin a little over a year later, he nominated his White House physician, then-Navy Adm. Ronny Jackson, for the post.

After Jackson withdrew from the process amid allegations of professional misconduct — some of which were later substantiated by the Pentagon’s Office of Inspector General — Trump surprised Acting Secretary Robert Wilkie with the assignment during a public address at the White House.

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“Wilkie, who, by the way, has done an incredible job at the VA, and I’ll be informing him in a little while — he doesn’t know this yet — that we’re going to be putting his name up for nomination to be secretary of the Veterans Administration [sic],” Trump said.

Former VA Secretary Shulkin said Tuesday that, given this history, Trump likely will “throw names out there” and ultimately decide on his own who should lead the executive branch’s second-largest department.

“It’s a fool’s errand to pick specific people. … I’m a case in point. Nobody really saw it coming,” Shulkin said during an interview with Military.com.

Nonetheless, some potential candidates may be eager to return to continue reforms started under the first Trump administration or perhaps a newcomer will lead the agency in a new direction.

The Trump campaign did not respond to a request for comment by publication, but several media outlets and think tanks, including the progressive Veterans Healthcare Policy Institute, have named several individuals as possible VA secretaries:

• Robert Wilkie: Wilkie served as VA secretary from July 2018 to January 2021, leading the department through the first year of the COVID-19 pandemic. An Air Force Reserve colonel who also served in the Navy Reserve, Wilkie worked as a congressional staffer and appointee in the Bush administration and later joined the Pentagon as the under secretary for personnel and readiness. As VA secretary, he largely was responsible for implementing the Mission Act and overseeing the VA’s support for the public health system during the pandemic. His tenure was marked, however, by an investigation into his mishandling of a congressional staffer’s complaint that she was sexually assaulted at the Washington, D.C., VA Medical Center. A VA Office of Inspector General investigation found that Wilkie disparaged the woman, a Navy veteran, and sought to undermine her credibility.
• Dan Gade: A retired Army lieutenant colonel, Gade is also a West Point graduate and former tank company commander who lost his right leg in a roadside bomb blast in Iraq in 2005. An advocate for disabled veterans, he is the author of a policy book, “Wounding Warriors: How Bad Policy Is Making Veterans Sicker and Poorer.” He served as head of Virginia’s Department of Veterans Services from 2022 to January 2024, appointed in 2022 by Gov. Glenn Youngkin.
• Peter O’Rourke: A Navy and Air Force veteran, O’Rourke has worked in the defense industry and served as an adviser to Trump’s first transition team on veterans issues before joining the VA in 2017 to serve as the head of its newly created Office of Accountability and Whistleblower Protection. He worked as acting secretary during Wilkie’s nomination process and resigned from the department in 2018. A 2019 VA Office of Inspector General investigation found that the OAWP had “misused its authority to fire low-level staffers, retaliate against whistleblowers, and hurt the very veterans the agency was created to help.”
• Darin Selnick: A senior adviser to the conservative Concerned Veterans for America advocacy group, Selnick was a member of a 2016 blue-ribbon panel, the Commission on Care, which studied ways to improve VA health care. Selnick, a retired Air Force officer, was co-author of a “strawman” report to the commission that proposed giving veterans access to private health services and closing VA health facilities — a model similar to a veterans-only Medicare program. He later served as a senior adviser to Wilkie when Wilkie was VA secretary. Selnick has said repeatedly in interviews that he is interested in ensuring that veterans get timely, quality care, either at a VA facility or in the community.
• Montana Rep. Matt Rosendale: The Washington, D.C., publication Politico has floated Rosendale, a hard-line Republican who did not seek reelection and has been highly critical of the VA, particularly its disability claims system and the rollout of its new Oracle Cerner electronic health records system, which remains at a standstill as the result of glitches and challenges that have affected patient care.

A number of people were considered following Shulkin’s departure, and any one of them could make the short list again.

Those included Ron Nicol, Naval Academy graduate and former submariner, who led the agency turnover team during the first Trump transition; Army veteran and congressional Rep. Brian Mast of Florida; and Samuel Spagnolo, president of the National Association of Veterans Affairs Physicians and Dentists, according to an Associated Press report in 2018.

Shulkin said that whoever is in charge will need to deal with several critical issues. In addition to the electronic health record, the VA must address its infrastructure challenges, which include aging buildings and underutilized facilities in locations where veterans no longer reside; problems with the community care system and access to care; a workforce that is expansive and not supported for maximum efficiency; and a benefits program that is expensive, “bureaucratic” and a burden for veterans, he said.

And overall, it needs to be mindful of its budget.

“Any new administration coming in is going to inherit a $15 billion deficit on top of a record budget, so this is a significant issue they are going to have to figure out,” he added.

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