David Shulkin is out as the head of the VA

Veterans Affairs Secretary, David Shulkin, is out as the head of that agency

Trump nominated Rear Admiral Ronny Jackson to the post — the president also recently nominated Jackson to receive a second star, promoting him to the rank of rear admiral.Jackson has served as the White House physician in the past three administrations.

In January, Jackson visited the White House briefing room and gave a glowing review of Trump's health.

"I told the president if he'd had a better diet over the last 20 years he could have lived to 200 years old," Jackson told reporters when asked about how to reconcile the president’s penchant for McDonald’s and Diet Cokes with what Jackson deemed his “excellent” health.

"The answer is he has incredibly good genes, it's just the way God made him," Jackson said.

A lone holdover from the Obama administration, Shulkin has butted heads with Trump over issues of veterans care, but it was an internal investigation alleging ethics violations and a misuse of taxpayer dollars that helped seal Shulkin's fate.

The trip itself cost taxpayers at least $122,334 and was comprised of mostly sightseeing, the report said.

That accusation of excessive spending drew tough criticism from some members of the House Committee on Veterans Affairs.

Rep. Mike Coffman called for Shulkin to resign, tweeting it is "exactly corruption and abuses like this that doesn't help our veterans."

This move allowed her expenses to be covered by the VA, according to the report.

Shulkin fired back calling the report "a direct assault on my spouse, my character and my unblemished record of service."

However, Shulkin ended up repaying $4,000 for his wife’s travel expenses.

Shulkin’s leadership abilities have also been a subject of criticism.

For years the VA agency has struggled with trying to improve its healthcare services for its patients, including streamlining various community care programs into a single system and improving accountability rules for employees who provide bad care.

The report detailed numerous areas of concern, including instances of unsterilized medical instruments.

This caused interruptions and cancellations of procedures, preventable hospitalizations and instances of prolonged or needless anesthesia, the report said.

Shulkin admitted that similar problems likely existed at other facilities across the country.

Donald Trump made it a campaign promise to reform the Department of Veterans Affairs, saying he would "make the VA great again."

Fulfilling one of those promises, last summer the president signed a bill that would make it easier for the department leaders to cut through the bureaucracy and quickly fire federal employees at the VA who are underperforming.

At the signing ceremony for that bill, President Trump spoke about the need to be able to quickly remove bad employees, mouthing his "you're fired" catchphrase.

“We’ll never have to use those words on our David," Trump said. "We will never use those on you, that’s for sure.”

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