Leadership, Research, and the Long Game with Dr. Marc Rodger

What does it take to build a career that changes clinical practice, shapes future leaders, and still leaves room for personal passion and fulfillment?

In this episode of Doctors Unscripted, host Dr. Nadia Giannetti sits down with Dr. Marc Rodger, Chair of Medicine at McGill University, Physician-in-Chief at the McGill University Health Centre, and internationally recognized researcher in venous thrombosis.

Dr. Rodger reflects on the path that led him from aspiring community internist to physician-scientist, researcher, educator, and healthcare leader. Together, he and Dr. Giannetti discuss the importance of following opportunities as they arise, the value of formal research and leadership training, and why mentorship has become one of the most meaningful parts of his career.

The conversation also explores major life and career decisions, including Dr. Rodger’s move from Ottawa to Montreal, balancing administrative leadership with active clinical research, and the realities of building a fulfilling life in medicine. Dr. Rodger shares insights into his internationally recognized thrombosis research, his passion for developing future leaders, and the advice he gives young physicians about defining success on their own terms.

To learn more about how the MUHC Foundation supports life-changing research and patient care at the MUHC, visit:  muhcfoundation.com

Transcript

SPEAKER_01 0:08

Hi everyone and welcome to Doctors Unscripted. Today we have a special guest, Dr. Mark Roger, who is the Chair of Medicine at McGill University for Department of Medicine. He is the physician-in-chief at the McGill University Health Center and the Harry Webster Thorpe Professor of Medicine. Prior to his move to McGill, Dr. Roger was a full professor in the Department of Medicine at the University of Ottawa and a senior scientist at the Ottawa Hospital Research Institute and head division of hematology, situated at the Ottawa Blood Disease Center at the Ottawa Hospital. His research focuses on venous thrombosis. He leads multinational randomized trials and cohort studies that seek to change the clinical practice in venous thrombosis. This work has been awarded over 38 million in peer-reviewed funding. His team has confirmed a weak link between thrombophilia and placental-mediated pregnancy complication. And he derived and validated a tool, Men Continue and Her Do2, which I'd love to hear about, that is used worldwide to assist in deciding whether anticoagulants help in venous thrombosis lifelong. I could go on and on. I mean, you have co-founded and co-directed the CIHR-funded CAN Vector Network and has founded the International Network of Venous Thrombosis Clinical Research Networks, Invent, InventVTE.com. And you've actually graduated from University of Ottawa. And I didn't realize this, Mark, that you had done your BSC in physiology at Miguel. He completed his postgraduate training at UBC and University of Ottawa in enteral medicine and hematology and thrombosis. And he also completed an MSc in epidemiology in 2000. I could go on and on, Mark, but I think we want to hear it from you. Welcome, Dr. Mark Roger, to the podcast. It's really a pleasure to have you here today.

SPEAKER_00 2:02

Yeah, and a pleasure to be with you, Nadia. Big fan of the podcast and this initiative. Uh so uh honored, uh honored to be invited.

SPEAKER_01 2:11

Fantastic. So I'm gonna sort of get right into it. You have reached sort of the highest level of um academia, physician in chief, chair of medicine, uh researcher, teacher. I was gonna say the trifecta, but I looked it up. The word for you is really quadrifecta, I think, or quadfecta. So um, which is obviously, you know, we don't meet many people like you, and I haven't interviewed many people like you. And I guess my main question to you to begin is you know, you look back at your journey, was this premeditated or did this happen organically?

SPEAKER_00 2:49

Yeah, you know, Nadia, that that's a great question. Uh, I I'm gonna say a little bit of both. Uh, you know, I I I've always been quite uh ambitious uh and and you know uh a bit of an overachiever. Uh, you know, even sort of back in uh uh high school days, uh I played uh volleyball for the provincial national uh the provincial team and then played volleyball for the junior national team. And uh, you know, kind of achieving and uh trying to sort of be on the podium has kind of been a uh a huge uh uh you know sort of motivator. Of course, that's a double-edged sword, right? Uh one sacrifices a lot uh when one is trying to sort of uh uh achieve excellence. Um, but at the same time, you know, uh I did follow opportunities as they were presented, and that uh, you know, is very uh uh, as you say, uh organic rather than sort of uh pre-planned. But uh yeah.

SPEAKER_01 3:53

You you know, looking at your at your CV, you did do a master's in Epi. How important do you feel that was in helping you advance or develop or then advance your research career? And would you, I kind of want to know for listeners who are out there potentially training, how important is this? Was that like a waste of time or it made a huge difference for you?

SPEAKER_00 4:15

Yeah, a huge difference. You know, you know, again, sir, we were talking about the organic nature of uh uh you know one's career development. I when I when I started my uh uh R1 in internal medicine, my intention was to be a community general internist. Uh and uh we were forced by our program director to do a research project, and uh and and I did a research project uh, you know, a chart review essentially, uh exploring uh uh predictors for pulmonary embolism with a view to sort of developing a simpler um uh clinical prediction rule for pulmonary embolism. And I kind of got hooked uh on uh doing research, and that really sort of altered my career path. And and for sure, doing the masters in Clinapi provided me with uh, you know, sort of the methodologic rigor, but also the ability to speak to the methodologists to be able to, you know, conduct good trials, uh, conduct good observational research, uh um in invaluable, uh invaluable training for sure, and uh a huge part of uh, you know, what I've been able to achieve.

SPEAKER_01 5:28

Okay, so that's that's very helpful. Um, what about other? I get the sense, having you know spoken to you a few times, that you do like the sort of courses that people take along the way, whether they're leadership courses or admin's course. I mean, there's so many things that we learn in medical school that we don't use, and many things that we do do that we don't learn, right? And you kind of learn it as you go. So, how how do you feel about those kind of leadership courses? Have you done extra training to get to where you are?

SPEAKER_00 5:56

Yeah, absolutely. So, you know, you know, again, as careers evolve, uh, you know, I kind of went from uh again being a clinician scientist and uh, you know, uh I you know contributing to changing practice in uh a couple of areas. And uh, you know, I kind of did get to a stage where I kind of felt that I'd been there, done that, uh, and that my next thing and and uh uh you know something that that I'm passionate about is mentorship and seeing other people develop um their careers. Um, you know, I'll never forget uh one of the highlights of my career was uh one of my medical students in uh he was a first-year medical student at the time, uh, who's now this the chief of hematology in Ottawa, uh getting a New England Journal publication as a first author. And uh, you know, that was a I it was a I it wasn't my achievement, but I felt uh, you know, that that that it really was. So um, you know, sort of developing uh infrastructures uh for others to succeed was kind of I I came to that stage of my career and recognized that in order to uh be a successful leader, uh that leaders aren't uh born, they're taught. Um, and and as such, did a lot of leadership development courses uh through the Canadian Medical Association Physician Leadership Institute. It's not a formal degree, but just uh, you know, I do at least one leadership development course a year. And uh I mean I learned so much from those uh courses uh and I apply them every day now in my current role. Yeah.

SPEAKER_01 7:35

Have you ever taken a sabbatical? Have you ever gone away sort of for six or twelve months in your career?

SPEAKER_00 7:41

Yeah, I did. I did uh in 2010. Uh I took a sabbatical for uh six months um to set up uh one of the trials that I was doing uh in the UK. Uh and uh had uh the privilege of working with uh Ian Greer, who was uh uh the dean of the medical school at the time at the Holy York Medical School, where I did the sabbatical, but he was also uh uh a pioneer in in venous thrombosis and pregnancy uh prevention studies, and uh um uh he he was kind enough to uh lead the this study uh in the UK for us. So yeah, it was a wonderful experience.

SPEAKER_01 8:24

So basically, if you're you know, somebody's coming to you for advice or somebody's coming to you for, you know, potentially looking for a position, you would be obviously in favor of, you know, some sort of formal research training and potentially leadership training if they want to advance and even uh, you know, being going away on a sabbatical, or or obviously going away on a fellowship, but a sabbatical. Um, and you feel that that's helped bring you to where you are right now, I imagine is what you're saying.

SPEAKER_00 8:55

Yeah, exactly. Yeah, no, there's uh there's no question that uh um, you know, again, sort of opportunities present themselves. And um uh, you know, I think the most important thing uh uh piece of advice that I give to people is to follow your passions. Okay. Uh and you know, some people are passionate about research, changing practice, some people are passionate about understanding a basic uh or or developing a basic understanding of uh some phenomena in in medicine or biology, and they're passionate about that. Uh, some people are are passionate about creating uh infrastructures for care, for research. Uh, you know, my advice to to them is always to uh to follow your passions and and for sure, formal training in whether it's in research, whether it's in leadership, and obviously in in uh subspecialty and specialty care uh is a key ingredient uh to be able to have the tools to be able to deliver on those passions. So um yeah, for sure.

SPEAKER_01 9:55

Fantastic. I want to shift gears a little bit. So, you know, it's interesting. I'm thinking of my 25 years at the MUHC. We don't see, you know, a lot of people tend to stay on the treadmill, and we don't really see many people who would leave. I don't know why or what it is about Miguel that seems to keep people here. Um you actually made a big move, right? You were at the time, you were obviously a, you know, a very successful researcher, you had you were head of the division of hematology at University of Ottawa, you grew your division, you made it more academic, you know. If I remember from conversations, it's a big, you know, you're established, you've got your your family life, you've got your world in in Ottawa, and then you make a move to a new city. I mean, you had uh you had you know you had gone to med school here, so you had familiarity uh with with with Quebec and with Montreal. What goes through your mind in making that decision? Because we don't see many people, as I said, leaving here. So so it's a big, you know, as far as I'm concerned, it's a big move. You're starting over. Uh, what goes through your mind? How do you make that decision?

SPEAKER_00 11:07

That's a great question, Adia. And and I mean, to be honest, it is uh it's a huge pro-con list. Uh, and it's uh it's a family decision. Uh, it's not just a personal decision, and it's not just a decision that is based on uh uh you know uh uh simply one's career, it's also based on one's uh personal life and uh etc. Um, but I did get to a stage uh where I'd completed two terms as uh as uh division chief of hematology. I really enjoyed that leadership experience. I really enjoyed, again, building infrastructures for others' success. Uh and and I was ready for another challenge. Uh and I saw this position uh at McGill. Uh, you know, I I also have to tell you, I I grew up on the West Island of Montreal, uh, and uh, as you know, uh did my bachelor's degree at McGill. Um, I love Montreal. Uh it's a great city. Uh, you know, we're in the throes of the passions of uh uh playoff hockey right now, and it right, you know, it reminds me of the the things that uh that I really enjoyed about uh about Montreal. Uh so you know it it really was about uh pursuing again an opportunity, uh an opportunity to uh be the uh physician-in-chief at the MUHC and and McGill and do what I did in Ottawa, but on a bigger scale.

SPEAKER_01 12:43

This podcast is being brought to you by the MUHC Foundation. The MUHD Foundation funds cutting edge research at both the MUHC and its research institute and supports excellence in patient care for millions of Quebecers. You can follow them on social media or take a look at their website at www.muhc.com, muhc foundation.com big differences as a physician between Montreal and Ottawa or Ontario, and you you're allowed to use the word the word that I hear you use often, the word epic. Tell tell us for this podcast. Just just was that was that is that something that um you think would be transformative from much? Is that is that really a very big difference for you from a clinical point of view?

SPEAKER_00 13:40

Yeah, listen, uh absolutely. It it was a painful transition going to Epic, which we did go live June uh 1st, 2019. So the last month of my uh uh role as uh as um uh division director of hematology in Ottawa. Uh and uh, you know, I I I use the analogy of Buckley's uh it tastes awful going down, but it works. Um so you know, it it was a difficult, it was a difficult transition uh and for uh a month. Um, but you know, by the time uh I left to come to Montreal, everybody was singing the praises of Epic. Um, you know, from the fact that you can read each other's notes, the fact that you can read each other's notes in real time, that you don't need to find the paper chart, uh, write in the paper chart, uh, you know, uh ordering medications uh with uh the order going directly to the pharmacy as opposed to somebody carrying the piece of paper or tubing the piece of paper or faxing the piece of paper to pharmacy, the drug being barcode dispensed and uh barcode administered uh to the patient, you know, the accountability uh down to the second traceability. You know, I could just go on and on. There are just so many examples of uh practice of medicine being safer uh in an epic world. And you know, Natty and I have the privilege and and responsibility of of reviewing uh quality of care uh within our mission. And and and uh you know, there's no so many times that I say to myself this wouldn't happen in an environment where epic is being used. Um so yes, I do wish that for our patients.

SPEAKER_01 15:32

Uh I mean you've lived it, right? So you see, you see the difference. You see the difference in in clinical practice. What about uh outside? Is it was it hard to sort of you know start over again? Uh, you know, outside. I mean you're you have a life outside medicine, and it's hard to start over as a doctor, but you're also sort of, you know, you have I know you have kids that are basically still in Ontario. Is that how you know, is that very difficult? Like, what would you say to somebody who's contemplating this? Like, look out for or be prepared for what?

SPEAKER_00 16:05

Yeah, you know, again, you gotta go back to the pro-con list. Uh and um, my my kids were at the stage that they had essentially flown the coupe. Um, so you know, if we were gonna make this kind of transition from a family perspective, uh, you know, the the the timing was uh largely right. Um and you know, I the practical geographic reality is that Ottawa's only an hour and a half, two hours away, right? So, you know, it wasn't uh like moving across the country or to uh you know uh to another continent. Um, you know, of course, the best laid plans are get foiled. Uh two months after arrive, we had a pandemic.

SPEAKER_01 16:48

Uh and there were you got right in there again.

SPEAKER_00 16:51

You'll see the Quebec uh uh police officers at the border preventing us from traveling back to Ottawa for weekends uh with family, etc.

SPEAKER_01 17:02

So but the proximity was that was a factor in the decision making process.

SPEAKER_00 17:06

Yeah, for sure.

SPEAKER_01 17:07

No, there's no question that that you know it's a it's a it's a quick drive away, so that does make it um obviously a little bit easier. Um, from your uh coming back a little bit to your academic career, because you're still running large-scale clinical trials. Where do you want to go from here? I want to just go back a little bit to academics. You know, you've done this, you've done this men continue and hers do too. That is a tool that you developed for thrombosis, right? For helping prediction uh of using anticoagulation and thrombosis. Is that correct? Yes, you want to tell us a little bit about that and where do you want to go from here, Mark? Like in terms of your you're still moving forward, I think it seems like full speed in your in your research career, despite your you know being a high-level, you know, uh in a high-level administrative position, where do you want to go from here?

SPEAKER_00 17:57

Yeah, I guess you know, to start uh Nadia, research is a team sport. Um, you know, I kind of uh and again at the stage of my career, uh, because of the responsibilities that I have uh administratively, uh, that you know, I I mainly act as uh um uh a co-investigator or co-principal investigator uh on a couple of large trials. We're doing a multinational randomized trial comparing resuvastatin to no resuvastatin for secondary prevention of venous thrombosis. So does it add to the anticoagulant strategies? And that's being uh led and you know administered on a day-to-day basis by a colleague in Ottawa, Aurélien Deluc. Uh, and um similarly doing a postpartum prophylaxis randomized trial in over 8,000 women, again in a multinational uh study. Um, and but that again is being led on a day-to-day basis by Leslie Skies and Calgary. So, you know, I'm kind of uh I kind of provide the eminence grise uh sort of advice when um you know I meet them every couple of weeks uh and and you know sort of help troubleshoot uh issues, but the day-to-day running they're doing. I am doing, I am on my own, uh continuing some uh activity in the area of duration of anticoagulation. So we've kind of we've kind of gotten to the point that if you've had a weekly provoked or an unprovoked uh deep vein thrombosis or pulmonary embolism, uh, you know, whether it is continue on anticoagulants long term for the majority of patients in that category is a real toss-up between risk of recurrence and the consequences of the risk of recurrence and risk of bleeding and the consequences of the risk of bleeding. So I've developed a patient decision aid because I really do think it comes down to patients making an individual choice. Well, that would be which which path do you want to go down? Uh a higher risk of recurrence or um uh with uh uh without anticoagulants or higher risk of of bleeding with anticoagulants. So we're doing a I just got some funding from CIHR for a step-to-wedge randomized trial to uh implement and see the effect of this patient decision made.

SPEAKER_01 20:14

That's impressive, Mark, that you find the time that you find the time to do that. That's really very impressive. Given your very busy schedule, I see how busy you are. My office is next to yours. So, apart from all that, what do you do to take care of yourself? And what do you do for fun? I kind of know, but tell us for the podcast.

SPEAKER_00 20:33

Sure. So to take care of myself and uh you know, with my partner or my my spouse Christine, we both do triathlons. Uh and uh, you know, it just uh it just puts me in the right headspace. Uh we do it together. Uh so you know it's uh it's uh it's an adventure that uh that we and a passion that we pursue uh as a couple. Uh, you know, I always say that my best strategic thinking is done on a long bike, a long swim, or a long run. Uh and so, you know, these things also complement each other. Um and you know, what we do for fun, uh Christine and I are foodies. Uh you know, it was one of the great city for that Procon list for Montreal was the restaurants. I gotta tell you.

SPEAKER_01 21:22

Yeah, I believe it. I believe it.

SPEAKER_00 21:24

You know, we're we're privileged enough to be able to treat ourselves at least once a week to a nice restaurant.

SPEAKER_01 21:30

And uh and uh that's fantastic, fantastic. Why would you tell your younger self?

SPEAKER_00 21:36

Yeah, you know, I I don't have a ton of regrets. Uh, you know, I've I've I've really followed my passions, which is what I tell my kids all the time. Uh, don't do what you think your parents want you to do or what somebody else wants you to do. Follow your passions. Uh and you know, I think uh I think uh for the for the most part I've done that, followed my passions.

SPEAKER_01 21:56

You do look like you're in the right place, Mark. You look like you're very happy and you're in right place and you're doing what what you want to do. I have a last question for you, which I haven't asked anyone else, but I'm going to ask you because you're so accomplished, sort of at multiple levels. So at some point, you know, whatever, you're going to be you're going to retire at some point in the in the in the hopefully distant future. What would you want? You know, you've done so many things. What would you want your legacy to be?

SPEAKER_00 22:21

Yeah, that's a that's a great question, Addie. And it's actually one of the mentorship questions that I always ask my mentees. Imagine yourself on your rocking chair in in retirement and looking back on your career, what are the things you want uh you will have want to have accomplished and uh um and you know tailor your path so that uh you do have that positive rocking chair moment. Yeah and you know for for me I wanted to uh change practice in in uh and in in my area of research my area of clinical passion and and venous thrombosis and uh leave a legacy uh as a leader leave a legacy of infrastructures that allow others to uh similarly uh follow their passions whether it's uh teaching care uh or research uh and um you know I think uh I yeah I don't want to pat myself too much on the back but I think uh I've achieved that in Ottawa and to a certain extent achieved it here and uh um and and but yes one day soon I'll be on that rocking chair you'll be on that rocking chair not too soon but no I do you look I and and uh that's uh you know I I hear what you're saying and uh and I think that's you know that's terrific you're certainly you're certainly doing that here we're very very fortunate uh to have you here to have you know you have you here come here from Ottawa we're very very fortunate uh you've brought a lot to the department and uh and I know it's it's continuing to evolve uh so thank you very much for that um thank you mark I will let you go I know it's your research day today I will let you go but thank you for taking the time and uh and you know thank you for being with us in Montreal we're very very fortunate honestly to have you here so thanks to all our listeners today and I wish you a great day if you like what you've heard please subscribe so you never miss an episode we also would appreciate it if you could take a moment to rate the show or leave a review.

SPEAKER_01 24:32

Thanks so much for listening