Emma Duncan, MBBS, MRCP, FRACP, Ph.D. - President-Elect Candidate

Honorary Consultant in Endocrinology at Guy’s and St Thomas’ NHS Foundation Trust

What prior experience do you bring that you believe will help to accomplish or address the Society’s current goals and issues?

The ASBMR’s mission matches my own aims as a clinician-scientist: to advance musculoskeletal research - in the broadest sense - and to translate research findings into meaningful clinical benefits.  If elected, I would bring a wealth of previous experience with ASBMR, and more broadly, to address these goals:

• A deep understanding of ASBMR’s mission, structures, and governance from long-term service and involvement on our committees and on Council
• Leadership roles and collaborations with multiple other like-minded national and international professional societies, across four continents, including patient and public engagement.
• Clinical expertise in metabolic bone disorders – from common diseases (e.g., osteoporosis, bone and calcium disorders) to rare disorders (e.g., skeletal dysplasias), and service delivery in both public and private systems
• Extensive clinical and basic research in musculoskeletal diseases, particularly in genomics, with detailed in-depth personal experience of research processes from grant writing to reviewing, team creation, collaboration, and project delivery
• Clinical trial organization, participation, and governance (both pharma-led and investigator-initiated), including working with industry partners
• Academic publishing and editorial experience, including strategies to address scientific integrity.
• Mentoring of multiple clinical and research fellows; and promotion of inclusivity, diversity, and anti-bullying strategies across many organizational levels.

What would you like to accomplish during your tenure as a volunteer leader?

My aims would be:

1. Strengthening national and international cooperation with like-minded societies (including patient-support groups):

• • Promoting our shared agenda of musculoskeletal health and healthy ageing for all:
    • Leveraging collective strength for maximal political advocacy
    • Optimizing resources (money, time) by conjoint campaigns (crucial given declining membership and pharma support for most societies)
  • Enhancing member benefits (e.g.: collaborative conference organization, reduced dual membership rates, shared publication access).

2. Promoting member participation and pride in our global bone community:

• • Continuing regular online engagement with both academic and career-development sessions
    • Of special benefit for members unable to travel (e.g., members from low-/middle-income countries or with childcare commitments)
  • Simultaneously, emphasizing the invaluable and intangible benefits of in-person participation (e.g., our annual scientific meeting) for fostering relationships and scientific dialogue, and for personal enjoyment.

3. Improving basic and clinical science integration across our ASM and online presentations

• • e.g.: ensuring cross-cutting symposia, creation of ‘meeting in the mirror’ joint interest basic/clinical sessions, and development of novel dual-applicant translational grant opportunities.

What are one or two ideas that you would like to implement to address issues facing our membership and the Society?

In addition to my suggestions above, I’d like our society to consider the following ideas:

1. Artificial intelligence [AI] offers amazing opportunities (as a single example, the ability of protein prediction algorithms to streamline functional work and advance drug design for skeletal dysplasias). AI also poses risks of fraud and data manipulation, particularly concerning for health sciences; and maintaining scientific rigor and editorial capacity is increasingly challenging amidst surges in papermill- and AI-generated submissions.

I propose an AI taskforce: how to leverage benefits (e.g., real-life data presentation/ scrutiny at ASMs will be increasingly valued for its unarguable robustness) while mitigating risks.

2. Our workforce attrition is a major challenge. We are seeing declining research participation of younger clinicians, premature retirement of senior clinicians, and loss of mid-career scientists (particularly women) due to job insecurity and insufficient funding streams. While our great strength is multi-disciplinarity (from bone microenvironment single cell sequencing to fracture liaison services to exercise physiology) it is also our curse: bone and mineral research becomes nobody’s core business or focused responsibility.  

I suggest a committee tasked with safeguarding musculoskeletal research vibrancy: active listening to members, identification of actionable solutions (i.e., what is within our gift), and implementation thereof.

Biography Information:

I am a first-generation Australian and grew up in Canberra.  I studied medicine at Sydney University, graduating in 1992, with my undergraduate clinical training and subsequent junior residency at the Repatriation General Hospital, Concord.

In 1994 I moved with my husband to Oxford, UK.  Human genetics was at the point of transitioning from monogenic gene mapping to population genetics; and I paused my endocrinology training to complete my doctorate at the Wellcome Trust Centre for Human Genetics focusing on the genetics of osteoporosis.  After finishing endocrinology advanced training – and welcoming our son and daughter to the world - I worked as a specialist consultant physician in Oxford before returning to Australia in 2005.

By this time my hope was to be able to integrate both research and clinical practice in my professional life.  In 2010 I was appointed inaugural Clinician-Scientist in Endocrinology at Royal Brisbane and Women’s Hospital, and Professor of Medicine at both University of Queensland and Queensland University of Technology.  I re-established my research programme in bone and genetics, greatly enabled by technological developments in population genetics (genome-wide association studies) and rare bone diseases (massively parallel [‘next-generation’] sequencing); and contributed multiple genetic discoveries, in collaboration with colleagues around the world.  I also worked with industry in clinical trials; and cared for patients with bone and calcium disorders.

In 2020, just as the pandemic started, I moved back to the UK to my current position as Professor of Clinical Endocrinology at King’s College London and Honorary Consultant in Endocrinology at Guy’s and St Thomas’ NHS Foundation Trust.

I have been fortunate to serve in elected and appointed leadership roles within many national and international bone and mineral societies.

In Australia, I served the Australian and New Zealand Bone and Mineral Society [ANZBMS] and my local bone community, from coordinating local bone research networking opportunities to Programme Organising Committee Chair for national and international conferences through to ANZBMS President (2015-17). 

I’ve also been honoured to serve ASBMR in multiple roles including as member of Council (2019 – 2022) and as a committee member of the Innovation, Professional Practice, Women in Bone and Mineral Research, Nominating, and Finance Committees.  I have served as Associate Editor for JBMR, and on its Editorial Board.  I have contributed to our annual scientific meetings on the Advisory Committee and as lead chair for various themes, as well as session chairperson, abstract reviewer, and mentor.  I have also served as Global Ambassador since this role’s inception.

Beyond ASBMR and ANZBMS, I have collaborated with many other professional societies and organisations including: the International Federation for Musculoskeletal Research Societies, the International Osteoporosis Federation, Osteoporosis Australia, fellow societies in the Asia-Pacific region particularly the Japanese Society for Bone and Mineral Research, The Society for Endocrinology (UK), the European Calcified Tissues Society, the Paget’s Society, and the Royal Osteoporosis Society. 

These many leadership opportunities have given me in-depth understanding and experience in governance (including the critical importance of diversity, inclusion, and equity), conference organisation, academic publishing, political advocacy, working with pharma, cross-society collaboration, and co-engagement with patient/participant organisations for advocacy and research co-production, all fundamental skills for working together to deliver ASBMR’s mission.

These roles have also enabled me to demonstrate my integrity, teamwork, diligence, enthusiasm, respectfulness, sense of humour, and kindness.  I also bring my experience in research excellence and critical cross-disciplinary and intersectional thinking as a clinician-scientist, along with in-depth understanding of clinical and basic research processes and challenges.

ASBMR celebrates and promotes the highest standards of musculoskeletal research excellence.  Since my first ASBMR meeting in 1997 a quarter of a century ago, it has been exhilarating to watch – and participate in - the translation of basic science into new therapeutic developments, benefiting individuals with bone-related disorders world-wide.

Our society also cares deeply about the professional development of each of its members.  As a younger member I benefited from the wisdom and experience of senior colleagues who generously gave their time to support me - from the academic interest of a senior researcher who came to discuss my poster with me at that very first meeting, to the kindness of a mentor discussing how to balance clinical and research commitments alongside a young family.  Now as a more senior member, I am honoured to serve as a mentor and advocate for others, and to work alongside my ASBMR colleagues and bespoke committees to ensure all members have the support and opportunities to enable their career progression towards their full potential.

Our membership is our greatest strength.  Together it is within our gift to find and implement actionable solutions to the challenges of a post-pandemic 21^st century.  We can champion our vibrancy and scientific excellence; we can actively promote diversity in our science and in our membership; we can ensure our personal connections in a time of digital isolation; and we can use our large resources strategically towards meeting our collective mission of improving lives.

If I were president, I’d like us to consider the following:  

1. Strengthening national and international cooperation with like-minded societies (including patient-support groups);
2. Promoting member participation and pride in our global bone community;
3. Improving basic and clinical science integration across our ASM and online presentations;
4. And two major issues facing us as a society:
   • The impact of artificial intelligence
   • The challenge of workforce attrition.