Exclusive: Here's how FDA employees learned their boss was really gone.

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A May 14, 2026 photograph of the lobby of a building at FDA headquarters in Silver Spring, MD. Source: an FDA employee. Note: metadata removed.

FDA Commissioner Dr. Marty Makary resigned on Tuesday. Agency employees learned of the news the same way we did: through the media. First, rumors of an impending ouster were leaked to the mainstream media via anonymous administration officials last week. During that trial balloon phase, President Trump said that Makary “was having some difficulty.” On Tuesday, Makary’s departure was finally reported as an outright scoop by Politico. A post by President Trump on Truth Social followed the news.

But according to multiple HHS sources who spoke with Inside Medicine, the thousands of FDA employees that Makary led since his confirmation in 2025 have yet to receive official word on his departure. No email from Makary. No formal statements from a deputy or any member of the Trump administration. No town hall. No all-hands meeting. Nothing.

On Thursday, however, FDA employees received their first real indication from the inside that their beleaguered boss was actually gone. Makary’s portrait had been unceremoniously removed from the lobby of an FDA headquarters building in Silver Spring, MD. Only an empty picture frame had been left behind. The above photograph, shared with Inside Medicine by the career FDA scientist who took it, was captured Thursday afternoon. (The original image was cropped and scrubbed of metadata to protect the source.)

A request for comment late last evening from former Commissioner Makary was not returned.

Shabby behavior matters.

This handling of the hasty departure of a Senate-confirmed commissioner, pushed out of his job not resulting from any scandal but instead due to mercurial forces and palace intrigue, struck me as shabby behavior by the administration. Even though many criticisms of Commissioner Makary’s policies are valid—I personally published research highlighting one of his worst moments in the job—I think it’s a bad look to treat a Senate-confirmed agency leader in this manner.

Nor is it simply impolite. It seems to me that an administration with a record of mistreating its own loyal-to-a-fault allies might soon encounter trouble recruiting top talent to fill the expanding list of vacancies at the highest levels of government, particularly at HHS. Others agree with this assessment.

Further reading on Commissioner Makary’s tenure:

• Marty Makary’s Turbulent Tenure at FDA Comes to an End. The Dispatch.

• After ‘most damaging period in FDA history,’ Makary will be hard to replace. Biospace.

• Makary Resigns as FDA Commissioner. MedPage Today.

The initial FDA source I spoke to was less surprised than rueful. “We are now used to backwards communication, a complete absence of transparency, and overall nonsense,” the scientist said. “We just find it funny.”

A second FDA employee said he was unsurprised both that Makary had to resign and that there had been no formal communication from the agency or administration.

But everyone agreed that in the past, dignity and decorum would have been the cultural norm for such a major personnel change, regardless of political affiliation. Any major public announcements like this would have been preceded by respectful internal communications.

No good deed goes unpunished —and no relief in sight.

It’s worth remembering that Makary was not forced out for reasons that any of us here would likely appreciate. For example, it has been reported that one of the reasons Makary reportedly fell out of favor was that some felt he had slow-walked the administration’s directive to “re-evaluate” mifepristone, a safe and effective abortion pill unfavored by the Trump administration. Makary had widely been expected to eventually do the administration’s bidding here, thereby rendering the medication much harder to get. (The Supreme Court ruled yesterday that access to these pills by telehealth could, for now, continue.)

Such dynamics, by the way, are why I don’t reflexively celebrate whenever some Trump administration appointee is felled. In many cases, otherwise objectionable people have gone down just when they were actually trying to do some good. It’s also important to remember that whoever comes next could be worse.

Indeed, the administration’s action underscored an ongoing sense among FDA employees that the Trump administration neither understands nor respects the agency. Makary’s departure was described as “temporary relief” that was quickly replaced “by the dread of the more heinous and less qualified clown they managed to replace him with.”

Diminished capacity.

Those are harsh words. But they’re worth printing, I think. That’s because what has happened at the FDA since President Trump took office is not merely a soap opera, but a genuine degradation in the agency’s capacity to carry out its duties.

All of the career FDA scientists I spoke to for this story expressed frustration at the events of the last year. One career scientist said that DOGE-driven reductions in force last year, followed by the exodus of other scientists who jumped from a perceived sinking ship, left the agency cutting corners at times. For example, while decisions on new products have, for the most part, not been delayed, staffers have in some cases not fully developed plans for post-marketing surveillance, like they normally would. Such activities are designed to discover unforeseen safety problems that only become detectable after a product goes to market once enough patients have received it that rare events can be unearthed.

So, it could be a while before the agency’s diminished capacity is felt by Americans. And in some instances, we might never know. If there’s no plan to uncover relatively rare (but real) safety problems that might become measurable only after a product has gone to market, we may simply never find out about them.

That’s the next FDA commissioner’s problem. Or, more likely, the one after that.

Thank you for reading. If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.