The head of the Veterans Affairs Department has repeatedly said that the agency needs to hire more doctors, nurses and other providers “taking care of people on the front line,” even as President Trump seeks to shrink the federal government.
But the V.A. has eliminated thousands of medical positions that were left vacant after a wave of resignations and retirements last year, according to a New York Times analysis of internal agency records that have not previously been reported.
The cuts include empty slots for more than 1,500 physicians and 4,900 nurses. In total, the V.A. chose not to hire replacements for roughly 14,400 unfilled medical vacancies at its health care division. Those jobs were the equivalent of about 5 percent of the V.A.’s medical staff as of December.
While the reductions are smaller than those Mr. Trump has made at other agencies, the V.A. has long struggled to hire medical providers. More than 90 percent of the department’s facilities reported “severe shortages” of doctors last year, according to a 2025 report by the department’s inspector general. Nearly 80 percent reported severe shortages of nurses.
The move to shrink the V.A.’s health care division represents a striking turnaround after years of growth supported by members of both parties. A separate Times analysis of public federal work force data found that in 2025 the total number of doctors and nurses working at the department fell for the first time in at least 20 years.
Peter Kasperowicz, a spokesman for the V.A., said in a statement that the positions being eliminated were “not needed” and that the department was “working much better under President Trump than it did under President Biden.”
He said that the measure of the V.A.’s success should be how well the department performs, not how many people it employs.
Mr. Kasperowicz said that the agency had reduced its backlog of veterans waiting for benefits, increased the number of medical appointments for veterans, opened new health care clinics, invested in upgrading its facilities and offered appointments outside of normal operating hours.
Anna Kelly, a White House spokeswoman, said that “personnel levels will not change, and V.A. health care facilities will continue to hire for any jobs they need to fill.”
The V.A. secretary, Doug Collins, had previously said that most of the vacancies being eliminated had not been filled “in a year or more.” Other officials at the V.A. have said the cuts were largely unneeded positions left over from the Covid-19 pandemic.
But The Times’s analysis found that roughly 10,500 of the eliminated medical positions, or 73 percent, had people working in them during 2025 or 2026. Only 5 percent had been vacant since 2023 or earlier.
Medical care for veterans is a sensitive political issue. The agency provides care for more than 9 million veterans, a constituency sought after by both parties. Even as the Department of Government Efficiency sought to trim the government last year, the Trump administration tried to shield the V.A. from major impacts, pledging to focus cuts on the agency’s bureaucracy.
But DOGE’s changes, like abruptly canceling hundreds of contracts, generated chaos in some parts of the V.A. The Times found that critical cancer research at the agency stalled while mental health providers were forced to treat patients in cramped spaces with little privacy. And many health care workers decided to leave on their own.
More than 20 current and former V.A. health care workers — some of whom spoke on the condition of anonymity — told The Times that they worried staffing shortages would disrupt patient care.
Geddes Scott, 55, retired in the fall after 30 years as a nurse at the V.A., in part, he said, because he felt his medical center was understaffed. He and his colleagues at a New York City hospital were increasingly being asked, he said, to work back-to-back eight-hour shifts. Mr. Scott said he worried that harried, exhausted nurses might make mistakes — the wrong dose of a medication, or incorrect administration of an injection or documentation done incorrectly. The stress and fear began to consume him.
“You have people’s lives in your hands,” said Mr. Scott, a union official with the American Federation of Government Employees V.A. Council in New York and New Jersey.
Mr. Kasperowicz, the V.A. spokesman, said that Mr. Scott’s hospital did not have a “policy” of nurses working back-to-back shifts.
Following intense public pushback last year, Mr. Collins abandoned a plan to get rid of 80,000 employees across the department, which also includes divisions that handle benefits, run cemeteries and manage legal issues, in addition to operating hundreds of hospitals and clinics.
“We are going to maintain mission-essential jobs like doctors, nurses, and claims processors,” Mr. Collins said at the time.
Ultimately, the V.A. avoided mass layoffs. Instead, the department shrank by about 29,000 workers — to roughly 451,000 employees — mainly through the deferred resignation program offered across the federal government, retirements and other voluntary departures.
The elimination of the vacant jobs could reignite questions about V.A. staffing.
Mr. Collins told Congress last month that his plans would not affect health care for veterans and were designed to redirect resources “directly to the field.”
“Do we need more doctors? Yes,” he said at a Feb. 11 congressional hearing, adding: “We’re not fully staffed, and we haven’t been for 50 years.”
The V.A. began eliminating unfilled jobs in November, saying in an internal memo it planned to “level-set V.A. positions to align with budget and sustain progress made during this year’s work force reshaping efforts.”
In addition to medical provider jobs, the V.A.’s health care division eliminated about 11,700 other vacant positions. Those included roles for social workers and psychologists, who are not classified as medical workers in federal records, as well as support staff like secretaries, police officers and custodial workers. Social workers and psychologists are cornerstones of the agency’s efforts to combat veteran suicides and homelessness.
The Times analysis of vacancies eliminated was based on internal data that the V.A. provided to Congress in February. The records cataloged the number of unfilled positions cut at the Veterans Health Administration from November through mid-January. The existence of Mr. Collins’s plan to eliminate vacancies was reported earlier by The Washington Post.
In a statement in response to questions for this article, a spokeswoman for Senator Jerry Moran — a Kansas Republican who leads the Senate’s V.A. committee — said Mr. Moran was “assessing any impacts these changes are having or will have on veteran care and has asked V.A. to provide additional information about their work force strategy.”
Mr. Collins has also begun executing a $1 trillion plan to expand private medical care for veterans, a key Republican policy goal. Democrats have accused Mr. Collins of cutting the V.A. to bolster his case for increased community care, as the initiative is known.
As with any large organization, staff turnover is normal at the V.A. But in the past the department made up for its losses with new hires.
In 2025, however, hiring slowed significantly at the same time departures surged, according to The Times’s analysis of public federal work force data released by the Office of Personnel Management.
Last year, the number of V.A. doctors fell 4 percent, those figures show. The number of nurses fell 3 percent. All told, the number of staff dipped in almost every medical job category, including roles such as pharmacists and dentists.
The staffing declines have been especially acute in some states. For example, the number of V.A. doctors fell by 10 percent or more last year in Alaska, Mississippi, Maine and West Virginia.
Mr. Collins has often acknowledged the need for more providers.
“I need more good doctors,” he said at a news conference last year. “I need more good nurses. I need more who are taking care of people on the front line.”
At the same time, a decline in support staff has put further strain on medical workers, current and former V.A. employees said.
Heather Fallon, a registered nurse in the emergency department at a V.A. facility in North Chicago, said nurses in the E.R. are now being routinely pulled away from direct patient care to fill in for support staff, transporting patients around the hospital and answering the phones.
“A lot of that is just pure secretarial work — we just don’t have anyone at the desk to do that sometimes,” said Ms. Fallon, who spoke as a union steward for National Nurses United. “We are unable to spend as much time at the bedside as we would like to.”
Ms. Fallon also said that the health center regularly does not have enough ultrasound technicians available, which she said means that patients — who sometimes need ultrasounds to detect blood clots and other ailments — have been sent to hospitals outside the V.A. system for those services. The Times reviewed emails showing multiple instances over the past year when there was “no ultrasound coverage due to staff shortage.”
Mr. Kasperowicz said there was “no staff shortage in the emergency department” at Ms. Fallon’s hospital and that wait times were in line with prior years. He said the facility had “24/7 ultrasound coverage” but refers patients “to community care providers if additional capacity is needed.”
For V.A. mental health providers, one of Mr. Trump’s most consequential decisions last year was ending remote work.
The department had pioneered the use of telehealth to reach patients in rural areas where it was difficult to hire mental health specialists. But Mr. Trump’s in-office mandate meant psychiatrists, psychologists and social workers originally hired for remote work now had to jam into crowded offices to conduct telehealth appointments with patients who were often hundreds of miles away.
Some responded by leaving. Last year, the V.A. lost about 200 psychiatrists overall, a 6 percent drop, according to additional internal agency data reviewed by The Times.
“Psychiatrists have so many job opportunities,” said Dr. Kevin Rowe, 39, who left the V.A. last year for a new job at a private hospital in Canada. “If something isn’t working, you leave.”
Mr. Kasperowicz said the V.A. was “no longer a job where the status quo is to phone it in from home.”
The agency also lost doctors in other medical specialties where there is high private-sector demand, including internal medicine, radiology, anesthesiology, cardiology and surgery, the internal V.A. data show.
Dr. Katie Phelps, 62, a psychiatrist, left the V.A. last spring after remote contracts were terminated. She had intended to work into her 70s, but saw no way to commute to federal office space.
Dr. Phelps said that the departure of medical staff was “very worrisome” and that most of her colleagues were already overloaded before the exodus began.
During her 11 years at the V.A., she said, veterans frequently expressed anxiety that their mental health providers would leave without warning; veterans, she said, “were continuously reassured, ‘you are not going to lose your providers.’”
But in the tumultuous early months of 2025, Dr. Phelps said she had to end treatment with many of them abruptly.
“There was quite a lot of unintended collateral damage,” she added. “That is the saddest part of all of this.”
Nicholas Nehamas is a Washington correspondent for The Times, focusing on the Trump administration and its efforts to transform the federal government.
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