secretary for health is a four-star admiral if they hold an active-duty appointment to the regular corps. Exceptions There are several exceptions to the limits allowing more than allotted four-star officers within the statute. The secretary of defense can designate no more than 19 additional four-star officers, who do not count against any service's general- or flag-officer limit, to serve in one of several joint positions. A four-star officer serving as chairman or vice chairman of the Joint Chiefs of Staff does not count against his or her service's general- or flag-officer cap. These joint positions include the commander of a unified combatant command, the commander of U.S. Forces Korea, and the chief of the National Guard Bureau. Officers serving in certain intelligence positions are not counted against statutory limit, including the director of the Central Intelligence Agency. Finally, all statutory limits may be waived at the President's discretion during time of war or national emergency. Appointment Four-star grades go hand-in-hand with the positions of office they are linked to, so these ranks are temporary. Officers may only achieve four-star grade if they are appointed to positions of office that require and/or allow the officer to hold such a rank. Their rank expires with the expiration of their term of office, which is usually set by statute. Four-star officers are nominated for appointment by the president from any eligible officers holding a one-star grade or above, who also meets the other requirements for the position, under the advice and/or suggestion of their respective executive department secretary, service secretary, and if applicable the joint chiefs. The nominee must be confirmed via majority by the Senate before the appointee can take office and thus assume the rank. The Senate (normally in committee) may hold hearings to consider any nominee for appointment or reappointment to four-star grade, but usually only convene for nominations of the chairman of the Joint Chiefs of Staff, vice chairman, service chiefs, unified combatant commanders, and the commander of U.S. Forces Korea. It is extremely unusual for a four-star nominee to draw even token opposition in a Senate vote, either in committee or on the floor, because the administration usually withdraws or declines to submit nominations that draw controversy before or during the confirmation process. For example, upon encountering opposition in the Senate, the administration declined to submit nominations for General Joseph W. Ralston to be chairman of the