Stanford Graduate With No Active Medical License Faces Senate Over Surgeon General Nomination
Casey Means, Trump's MAHA-aligned nominee, testifies amid scrutiny over incomplete residency training and alternative medicine advocacy.
Casey Means appeared before the Senate Health, Education, Labor and Pensions Committee Wednesday in a confirmation hearing for surgeon general, facing sharp questions from both parties about her credentials, vaccine views, and business conflicts.
President Trump nominated Means on May 7, 2025, following the withdrawal of his initial nominee Janette Nesheiwat. Trump said he did not know Means but nominated her based on Kennedy’s recommendation, calling her credentials ‘impeccable.’ The hearing, originally scheduled for October 2025, was postponed when Means went into labor hours before the session.
The License Question
Means earned her medical degree from Stanford in 2014 and began a five-year ENT surgical residency at Oregon Health and Science University but dropped out six months before completion. Her Oregon medical license transitioned to inactive status in July 2019, meaning she is no longer authorized to practice medicine or prescribe medication, though there is no indication of disciplinary action or revocation.
Means completed enough postgraduate work to qualify for a medical license in Oregon despite not finishing her residency. During Wednesday’s hearing, Means said her medical license is inactive because she is not seeing patients, and she does not plan to reactivate it. While holding an active medical license is not a statutory requirement for the surgeon general position, the role typically requires membership in the U.S. Public Health Service Commissioned Corps, which does mandate active licensure.
Dr. Jerome Adams, who served as surgeon general in Trump’s first administration, called Means’ likely confirmation ‘a disastrous precedent’ for someone who never completed medical training.
MAHA’s Medical Insurgent
Means is considered one of the leaders of the Make America Healthy Again movement through her social media impact and close association with Robert F. Kennedy Jr. Means and her brother Calley served as close advisers for Kennedy’s 2024 presidential campaign, helping to negotiate his eventual endorsement of Donald Trump.
Means left her surgical residency due to stress and disillusionment with healthcare in the United States. In her 2024 book ‘Good Energy,’ Means wrote that she felt ‘an overwhelming conviction that I couldn’t cut into another patient until I figured out why the patients and people around me were sick in the first place.’
After leaving her residency, Means founded Levels, a biotech company that uses continuous glucose monitors to help people track their metabolic health. Financial disclosures show she made hundreds of thousands of dollars promoting health and wellness products, and an Associated Press investigation found she at times failed to disclose that she could profit from the sales.
A 2022 study in the Journal of the American College of Cardiology found only 6.8% of Americans had optimal cardiometabolic health based on lab results from 55,000 people. Means has built her career arguing that metabolic dysfunction underlies most chronic disease — a position that has attracted both devoted followers and sharp criticism from mainstream medical experts.
Vaccine Skepticism on Display
In response to questions from both Republican Sen. Bill Cassidy and independent Sen. Bernie Sanders, Means declined to rule out vaccines as a contributor to autism, stating ‘we do not know as a medical community what causes autism’ and suggesting no stones should be left unturned. Means said vaccines save lives and that ‘anti-vaccine rhetoric has never been a part of my message,’ but declined to rule out vaccines as a contributor to autism despite decades of evidence showing no link.
On her website, Means has written that hormonal birth control has ‘horrifying health risks’ and that the ‘total burden’ of the vaccine schedule is ‘causing health declines in vulnerable children’ — neither claim substantiated by scientific evidence. Her medical license lapsed in 2024, and she has criticized parts of modern medicine like hormonal birth control and the childhood vaccine schedule.
Republican Sen. Bill Cassidy, who chairs the committee and is a physician, ultimately voted to confirm Kennedy after receiving promises he would not remove CDC information stating vaccines do not cause autism — but the site was updated in November to suggest possible links were ‘ignored by health authorities.’
An Unconventional Coalition
The nomination has drawn criticism from unexpected quarters. Far-right activist Laura Loomer sharply criticized Means’ nomination, calling her a ‘total crackpot,’ while RFK Jr.’s 2024 running mate Nicole Shanahan claimed there was an understanding that Means would not play a role in the Trump Administration. Opposition also emerged from some of Kennedy’s MAHA supporters, partly out of concern she wouldn’t be critical enough of vaccines or carry forward other priorities of their movement.
Kennedy defended Means during an interview on Fox News, saying ‘she walked away from traditional medicine because she was not curing patients’ and ‘couldn’t get anybody within her profession to look at the nutrition contributions to illness.’
Nothing is more urgent than restoring wholeness for Americans — physically, mentally, and societally. We are now the most chronically ill high-income nation in the world.
Casey Means, Opening Statement
In an ethics filing, Means pledged that if confirmed, she will resign from Levels and forfeit stock options in the company, and will stop working for Rupa, a specialty lab company for which she developed an online course.
What to Watch
The Senate’s response to Means’ confirmation will signal how far Trump’s MAHA agenda can penetrate traditional health institutions. The White House appears confident in her confirmation, as withdrawals of health official nominations have historically happened before hearings took place. Republican Sen. Cassidy now faces a difficult primary election due to his tensions with Kennedy and the MAHA movement, with Trump and the MAHA PAC endorsing his primary challenger Rep. Julia Letlow.
If confirmed, Means would oversee a 6,000-person public health service while lacking the clinical experience of any recent predecessor. Her appointment would mark the sharpest break yet between evidence-based medicine and the alternative health movement — with the nation’s top medical communicator having never completed the training required to treat a single patient independently. The metabolic revolution Kennedy promises depends on whether the Senate believes a Stanford degree and social media following outweigh a decade of missing clinical practice.