Acclaimed heart surgeon Dr. Marc Ruel chooses Canada over U.S. amid political uncertainty

Dr. Marc Ruel turns down a move to a top American university hospital following U.S. President Trump’s multiple comments about Canadian annexation.

Dr. Marc Ruel, a world-renowned heart surgeon and innovator, has turned down a prestigious leadership role at a top U.S. hospital, citing concerns over American annexation rhetoric.

The University of Ottawa Heart Institute (UOHI) surgeon was set to become chief of the division of adult cardiothoracic surgery at the University of California, San Francisco (UCSF), a role he accepted in late 2024.

“When I looked at this opportunity in the U.S., there were a few things that were very important to me. One was to work for a public school of medicine or public faculty of medicine who cares and emulates and embodies the same kind of inclusivity principles that are dear to all Canadians,” said Dr. Ruel. “And UCSF is exactly that, the top school of medicine the top research-intensive, and funded, probably in the world. I also felt it’s a good representation of Canadian healthcare institutions, of our healthcare system, and our education system. In a way I was a little bit of an export that Canada could offer to a more global platform.”

But with political discussions in the U.S. questioning Canada’s sovereignty, Ruel made the unexpected decision to stay.

“Many of the internal policies and decisions that they make are frankly none of my business,” he said. “The tipping point was really the notion of annexation, that Canada is not an independent country, especially two countries that have been the closest sister and brother of countries for more than 200 years. That discourse was very troubling to me, and I felt as a proud Canadian in my patriotic conscience I could not partake in that.”

For Ruel, if the notion of loss of sovereignty to his “beloved country” became more inflamed within the U.S., he wanted to be north of the border.

“My mandate, I felt, was something different and we had to rally, embrace together, and elbows up as we love to say,” added Dr. Ruel. “Like all of us Canadian, I felt compelled by that in my own way and wanted to do all I could towards that.”

For nearly 30 years, Ruel has been at the forefront of cardiac innovation in Canada. He pioneered multi-vessel minimally invasive coronary artery bypass surgery-techniques that have made operations safer, faster, and more effective for patients worldwide.

“Essentially, if your loved ones need three or two or four bypasses, we can offer this without splitting the breastbone,” he said. “We train people from every single continent. We’ve trained in Ottawa almost 200 surgeons and teams who have come from other institutions, including very famous Ivy League American universities coming to learn this operation.”

UOHI president and CEO, Dr. Rob Beanlands says while Dr. Ruel’s departure was bitter-sweet, the team is proud of his achievements.

“Any time you have a world-leading surgeon like Dr. Ruel, it’s a plus for any organization,” Dr. Beanlands said. “This is what we’re about, giving the best care to our patients and our community and Marc’s been a big part of that. So, we’re very pleased that he’s sticking around in Ottawa at the Heart Institute. I’m obviously pleased for the institute and for patients but also as a friend it’s personally important that he’s here and we’re very grateful for that.”

Ruel credits his colleagues, staff, and Canada’s healthcare system for his success, and plans to remain in Canada’s capital, practicing world-leading care.

“The Heart Institute, its environment, its staff, its community, and the model that we emulate here has totally shaped me,” added Dr. Ruel. “I am a product of this institution and obviously of our Canadian healthcare system and the supportive environment to develop new four raises into cardiac surgery innovation. I’m not sure it would’ve been possible anywhere else, so I am very, very thankful.”