Dr. Tracy Beth Høeg, the acting director of the FDA's Center for Drug Evaluation and Research, says she was forced out of her position Friday, making her the second high-ranking Food and Drug Administration official to leave the agency this week, days after Commissioner Dr. Marty Makary publicly resigned Tuesday.
Høeg told MD Reports in an interview published Friday that she refused to go quietly. She did not submit a resignation letter. She did not pretend the move was voluntary. And she pointed the finger upward.
Fox News Digital reported that Høeg described being told the decision came from well above the officials who delivered the news:
"They made it clear that it wasn't their decision. They said it was from someone above them, from someone way above their pay grade."
The White House has yet to officially comment on Høeg's departure. Fox News Digital contacted the White House, the FDA, HHS, and Høeg for comment.
Høeg's ouster follows Makary's resignation earlier in the week. Makary had led the FDA for roughly 13 months before stepping down Tuesday amid swirling reports that the administration planned to remove him. Newsmax reported that HHS Secretary Robert F. Kennedy Jr. personally decided to move on from Makary, with the White House approving the change. An administration official told Politico, as cited by Newsmax: "It was really Secretary Kennedy himself who made this decision."
President Trump confirmed Makary's departure but declined to say whether he fired the commissioner or asked him to resign.
As we previously reported, clashes over vaping approvals and abortion-drug policy had put Makary on a collision course with multiple factions inside the GOP and with pharmaceutical companies.
The Washington Examiner reported that Makary faced pressure over flavored vape approvals, the FDA's handling of mifepristone, and disputes with drugmakers over approval processes. Trump said deputy commissioner Kyle Diamantas would take over the agency temporarily.
"Marty's a great guy, he's a friend of mine," Trump said.
Høeg had worked closely with Makary on drug regulation before being elevated to head the Center for Drug Evaluation and Research in December. Her tenure at the top of CDER was short. Her exit, by her account, was not her choice.
In her interview with MD Reports, Høeg drew a sharp line between resignation and termination. She told the outlet she explicitly refused to sign a resignation letter:
"I said I didn't want to resign. I said I'm not signing a letter of resignation if it's not my choice."
That distinction matters. A resignation implies the departing official made a voluntary decision. Høeg's account suggests she was given no option, and that whoever ordered her removal did so from a level of authority high enough that the officials delivering the message could not override it.
An FDA email to staff obtained by The Associated Press confirmed that Høeg's former deputy, Dr. Mike Davis, will replace her at CDER. The email did not, based on available reporting, explain the reason for the change.
The broader pattern of departures at the FDA extends beyond Makary and Høeg. STAT News reported that Katherine Szarama, former director of the FDA's Center for Biologics Evaluation and Research, and FDA Chief of Staff Jim Traficant are also leaving. The departures are part of what looks like a significant reshuffling of the agency's senior leadership.
Breitbart reported that Makary had faced criticism for not releasing a promised safety review of the abortion pill mifepristone and for struggling to manage the FDA amid layoffs and internal controversy. His 13-month run was marked by senior leadership turnover, pressure from lawmakers, and friction with anti-abortion conservatives who felt the agency was dragging its feet.
Trump, when asked directly whether he fired Makary or asked him to resign, sidestepped. "I don't want to say, but Marty's a great guy," the president said.
The FDA's recent approval of fruit-flavored vapes, a first for the agency, coming days after Trump pressed for faster action, illustrated the kind of policy tension that defined Makary's final months. The commissioner found himself caught between an administration that wanted speed and boldness, industry players who wanted predictability, and social conservatives who wanted accountability on life issues.
None of those groups appeared satisfied by the time Makary walked out.
The FDA shakeup does not exist in isolation. The broader Department of Health and Human Services has seen a wave of leadership changes under the Trump administration. The recent departure of CDC Deputy Director Ralph Abraham fits the same pattern, senior health officials cycling out as the administration recalibrates its approach to federal health policy.
Whether that recalibration produces better outcomes depends on who fills the vacancies and how quickly they can steer agencies that have been rocked by layoffs, internal dissent, and public scrutiny. The FDA regulates roughly a quarter of every dollar Americans spend. Its drug-approval pipeline affects everything from cancer treatments to the cost of insulin. Leadership instability at the top has real downstream consequences for patients and markets alike.
Høeg's claim that she was fired, not asked to resign, not given a graceful exit, but told to leave by someone "way above their pay grade", raises questions the White House has not yet answered. Who ordered the removal? Why? And if the administration is unhappy with how the FDA has been run, what specific policy direction does it intend to set with new leadership?
The departure of Acting ICE Director Todd Lyons earlier this year showed that even officials who delivered on the president's priorities can find themselves on the outside. The question for the FDA's next leaders is whether they can navigate the competing pressures that consumed their predecessors, or whether they, too, will be gone within the year.
Several key questions hang over the FDA's leadership crisis. The White House has not explained why Høeg was removed or who made the final call. The exact effective dates of both Makary's resignation and Høeg's departure remain unclear. And no official reason has been given for the exits of Szarama and Traficant.
Fox News Digital noted that Høeg's departure "may be part of a larger shakeup" following Makary's resignation. If so, the administration owes the public a clearer explanation of what it wants from the agency that approves the drugs Americans put in their bodies.
Accountability runs in every direction. If Makary and Høeg failed to deliver, say so plainly and explain what comes next. If this is a policy dispute dressed up as a personnel move, the American public deserves to know what's really being fought over, and who's winning.
