Renowned Ottawa heart surgeon Marc Ruel was planning a move to the United States last year, with the University of California, San Francisco “thrilled to announce” that he would be leading a heart division in their surgery department.
But Donald Trump’s threats toward Canada were such that Ruel has now decided to remain in Canada.
“Canada is under duress right now,” he told CBC. “I felt my role and duty at this point was to directly serve my country from within.”
Ruel is not the only medical professional now reluctant to work in the United States.
That means Canada’s health-care system could stand to benefit from the political upheaval unleashed by the U.S. president, as American physicians look to move north and Canadians forgo opportunities south of the border.
For over a decade, Ruel served as the head of cardiac surgery at the University of Ottawa Heart Institute, developing world-leading techniques in less invasive bypass surgery.
Ruel says he considers his skills a product of Canada, abilities that he was ready to share globally when he accepted the position at UCSF last year.
“In the western United States, no one does this more advanced, minimally invasive multiple bypass surgery,” he said.
Ruel has not previously spoken publicly about his decision to remain in Canada, partly to avoid wading into politics.
“I don’t want to do politics, I’m a surgeon, I’m not a politician and I respect every nation’s choice to choose their own destiny,” he said.
But Trump’s imposition of tariffs and threats to annex the country that’s historically been its closest ally has made geopolitics an unavoidable issue.
“I had to most unfortunately change my decision,” Ruel said. “I say unfortunately because there were patients there in California, I can tell you, who we’re looking forward to having this type of surgery.”
Given the broader context, Ruel says staying put was the best decision.
“I’m very happy to be here and to serve, as well as I can, my fellow Canadians,” he said.
Meanwhile in the U.S., many physicians are considering whether they can continue doing their jobs under a second Trump administration.
CBC spoke with two American physicians seeking to relocate to Canada and a third who recently moved to B.C.
The three declined to speak on the record, citing a fear of retribution for speaking critically of the Trump administration. But they shared concerns over health secretary Robert F. Kennedy Jr. advancing an anti-science and vaccine-skeptical agenda.
This past week, U.S. media reported that Kennedy had hired David Geier, a vaccine skeptic, to study links between immunizations and autism.
Geier, who was censured in 2012 for practising medicine without a license in Maryland, has previously published debunked claims about vaccines increasing the risk of autism, which critics say pre-ordain the outcome of any subsequent investigation led by him.
On Thursday, Kennedy also announced plans to cut 10,000 jobs as part of a restructuring of federal public health agencies.
Concerns over the political climate in the U.S. has opened a “floodgate” of inquiries about moving to Canada, according to recruiter Michelle Flynn.
“The amount of interest has more than doubled over the last several months,” she told CBC.
The CEO of CanAm Physician Recruiting Inc., Flynn recruits U.S.-trained physicians to work in Canada and places Canadian specialists in roles in the U.S.
Lately though, she has struggled to get any Canadians interested in moving south.
“I started a position for an [obstetrician-gynecologist] in the U.S. before President Trump was elected,” she said. “We since have had to scrap that idea totally. Nobody is going to the U.S.”
To deal with the influx of inquiries from American physicians wanting to come to Canada, Flynn said she is now conducting interviews five days a week, up from three days a week previously.
“We’re getting 60-plus physicians coming to and registering on our website a month,” she said.
Canada is now in a better position to welcome U.S.-trained physicians than in the past, as most provinces have removed barriers to licensing in recent years.
Ontario in particular is well placed to receive American doctors, according to the provincial health ministry.
“There is no doubt the U.S. is facing economic uncertainty at the hands of President Trump’s tariffs,” the Ministry of Health said in an emailed statement.
“We have taken steps to break down barriers for internationally educated healthcare workers… working with the College of Physicians and Surgeons of Ontario (CPSO) to remove unnecessary red tape to allow physicians who are trained and Board Certified in the U.S. to practice in Ontario immediately.”
After introducing this new licensing pathway, the CPSO registered 351 U.S. physicians between 2023 and the end of 2024, a spokesperson said.
So far this year, CPSO has received registration applications from 240 physicians who are U.S. educated. Most of them are currently practicing in the U.S., the spokesperson said.
Given the disruption caused by Trump, Ruel believes Canada is “the best-situated” country to face an uncertain future.
“I’m a great believer in the Canadian health-care system,” he said. “It needs some fixes, but I think the basic principles that we have of equity and transferability and access to all are truly important.”
