Formerly known as the Chief Medical Director of Veterans Health, the Undersecretary is the highest official directly responsible to the Secretary for the Veterans Health Administration, which is the largest agency within the department.

Although the position is no longer required to be held by a licensed physician (as of 2004),[1] senior medical professionals such as hospital administrators are typically the preferred selectee for nomination, based on both demonstrated ability in the medical profession or health care administration, and with substantial experience in Veterans healthcare or similar programs.

From 2017 through July 2022, the position was vacant, with the last Senate-confirmed holder being Dr. David Shulkin, who was elevated to become the Secretary on February 14, 2017.

As was the norm during much of the Trump administration, the position was filled by a myriad persons designated as acting undersecretary.

[3] On March 19, 2022, President Biden announced his intention to nominate Dr. Shereef Elnahal to serve as undersecretary.