President Donald Trump’s dramatic reshuffling of his cabinet continued Wednesday with the ouster of Department of Veterans Affairs Secretary David Shulkin.

“I am pleased to announce that I intend to nominate highly respected Admiral Ronny L. Jackson, MD, as the new Secretary of Veterans Affairs,” the president tweeted. “In the interim, Hon. Robert Wilkie of DOD will serve as Acting Secretary. I am thankful for Dr. David Shulkin’s service to our country and to our GREAT VETERANS!”

As the president wrote, the now-former veterans affairs secretary will be replaced by Jackson, Trump’s current presidential physician who performed his most recent physical examination. Jackson was appointed to that position in 2013 by President Obama and was retained by Trump.

Shulkin’s removal may not be the last high-profile departure from the agency. Two sources familiar with the situation, one within and one outside of the administration, told The Daily Beast that his number two, Deputy Secretary Tom Bowman, is expected to follow Shulkin out the door in the near future.

Asked about those expectations, VA spokesman Curt Cashour would only say that Bowman “remains Deputy Secretary of Veterans Affairs.”

But Trump presaged Bowman’s likely departure by announcing an interim head of the agency—Undersecretary of Defense Robert Wilkie—instead of allowing Bowman to serve as acting director, as the VA’s line of succession would otherwise dictate. He’s “not out yet, but will be soon,” said an administration source familiar with the White House’s thinking.

Shulkin’s ouster has been expected for weeks, and sources close to the president were waiting all week for what they described as the inevitable tweet. Shulkin himself feared that he would suffer the same fate as outgoing Secretary of State Rex Tillerson, who learned of his own firing only after the president tweeted about it. But Shulkin’s departure appeared to have been carried out less abruptly.

Shulkin, a holdover from the Obama era, served as the head of the nation’s second-largest government agency for little more than a year, a tenure marked by his implication in a widening ethics scandal. Earlier this year, the VA’s Inspector General’s office found that he spent nearly half of a taxpayer-funded ten-day trip to Europe sightseeing with his wife.

Shulkin initially defended the jaunt, which included shopping, attending the women’s final at Wimbledon, and a river cruise, as “nothing inappropriate.” The inspector general, however, stated in a report that Shulkin’s chief of staff had lied to investigators and forged an email to justify Shulkin’s wife’s presence on the trip.

The report also found that Shulkin had misled investigators about the nature of his relationship with the woman who provided Wimbledon tickets for himself and his wife, describing her as a “friend” of his wife’s instead of a business contact. The woman, when asked by investigators, could not remember Shulkin’s wife’s first name.

Sensing increasing pressure due to the ethics investigation, and fearful that he was being undermined by members of his own staff, Shulkin began acting “extremely paranoid” in recent weeks, according to sources familiar with the situation. He went so far as to order an armed guard to stand outside his office.

But establishment veterans groups fought for him to stay put, fearful that a replacement would usher in a more aggressive privatization of VA services. And Shulkin had a good rapport with the president as well.

“Trump liked him,” one source familiar with the dynamics within the V.A. told The Daily Beast earlier in March, “and the rest of them hated him.”

In the end, that wasn’t enough to save his job.

Shulkin’s departure is the latest in a recent string of casualties in an administration where numerous senior officials have broken for the exits. In March alone, the White House has lost a director of the National Economic Council, a secretary of state, a national security adviser, and a communications director.

The purge comes five months after Trump mused that his cabinet amounted to “one of the finest group of people ever assembled.”

The question now facing the VA is whether Trump’s chosen successor—who has medical and military experience, but little track record as a manager—can effectively steer the federal government’s second-largest agency, and one recently racked by controversy and infighting.

“Firing a VA Secretary is easy compared to finding someone who can effectively do the job,” said Paul Rieckhoff, executive director of the group Iraq and Afghanistan Veterans of America, in a statement on Wednesday evening. “Veterans have seen far too many Secretaries come and go over the last decade and a half. Now that a change of leadership has been announced, we look forward to learning more about Dr. Ronny Jackson’s vision and qualifications.”

Concerned Veterans for America, a right-leaning veterans service organization, didn’t mention Jackson by name in its statement, but executive director Dan Caldwell said the group is “hopeful that this change will end the recent distractions at the VA and put the focus back on advancing policy that will ensure veterans get the health care and other benefits they have earned.”