The National Institutes of Health lost another senior leader as NINDS director Walter Koroshetz announced his departure, adding to a series of exits that leave several institutes under interim leadership. Reporting in the science community highlights institutional instability and the operational burden posed by repeated leadership turnovers. The departures raise concerns about continuity for flagship research programs, grant review processes, and strategic initiatives. Academic and industry stakeholders are monitoring how interim appointments will affect funding priorities and regulatory science partnerships with NIH.