• Juliet Compston, M.D.

    • Dec 14, 2017

    Juliet Compston is Professor Emeritus of Bone Medicine at the University of Cambridge. She earned her MB BS degree at The Middlesex Hospital Medical School, University of London and her M.D. at the University of London in 1979. Prof. Compston has made significant contributions to the understanding of osteoporosis over the last three decades, and has been instrumental in developing guidelines for treatment. Her research is focused on the pathophysiology and treatment of osteoporosis, and in particular where osteoporosis is secondary to conditions such as obesity, cystic fibrosis, organ transplantation, and HIV infection. She has published over 400 peer-reviewed journal articles and is currently Editor-in-Chief of the Journal of Bone and Mineral Research. She has received many honors including the National Osteoporosis Society Kohn Foundation Award (2006) the IBMS John G. Haddad Jr. Award (2009), and the ASBMR Fredric C. Bartter Award (2009). In 2014 Prof. Compston was appointed an Officer of the Order of the British Empire for services to the treatment of osteoporosis.


    What inspired you to start a career in science?

    I decided that I wanted to study medicine when I was about thirteen years old, after the experience of watching my mother go through a serious illness. After obtaining my medical degree I trained as a gastroenterologist under the mentorship of Dr Brian Creamer at St Thomas’ Hospital in London and we saw many patients with severe malabsorption who had bone disease, either osteomalacia or osteoporosis. Brian encouraged me to learn to do bone biopsies and to develop bone histomorphometry in his laboratory, following a visit to Dr Philippe Bordier’s laboratory in Paris. We published several papers in the Lancet showing the presence of osteomalacia in patients with Crohn’s disease who had undergone massive small bowel resections and also in patients with primary biliary cirrhosis. This experience of clinical research, and how it could translate into clinical practice, motivated me to combine research with the practice of clinical medicine.

    What do you feel is your most exciting achievement/discovery in the field? What are you most proud of in your career?

    There are two studies that I remember particularly. Both involved bone biopsies and bone histomorphometry. One was in people who were undergoing liver transplantation. We got bone biopsies in the same patients before and after transplantation, and looked at the changes in bone turnover. It was the first of that kind of study ever done in that group of patients. We showed that there was a marked increase in bone turnover following transplantation. The other study was in premenopausal women taking gonadotrophin-releasing hormone agonists for endometriosis. We demonstrated the rapid destruction of bone architecture that occurs with acute oestrogen deficiency in premenopausal women. I am most proud of those two studies because they showed both the mechanisms and the consequences of bone loss. In addition, they involved bone biopsies, which are not always easy to obtain in a group of patients, particularly before and after treatment.

    What has been the biggest challenge in your career?

    Probably it was during the period when both my husband and I were both looking to progress our careers. He is also an academic clinician. We made the decision that his career would come first. So when my husband was appointed as Professor of Neurology in Cardiff, I left my job at St Thomas’ Hospital in London and moved to Cardiff with him. There was no suitable job available for me, and during the five years we were there I had to raise my own salary from grants, which was quite tough and meant that there was no long-term security for my employment.  

    You are an emeritus Professor at the University of Cambridge. When you became a professor there were relatively few women professors. Did you experience some difficulties in establishing a career in an environment that was historically male dominated? What has changed since you started and what do you think can be done to increase the number of women in science?

    Cambridge has been slow to embrace gender equality in terms of people’s abilities and contribution. Certainly, as a woman I was in a minority in the department when I first went there in 1989. It was clear that some of the male staff found it difficult to relate to me in the same way as they did to their male colleagues. It was difficult for me to have a voice in committees and discussions, and I often felt excluded from the main group and that my opinions were not valued.

    Things have definitely improved. For instance, Cambridge University now has an Athena SWAN award for gender equality. But there is still a long way to go. In my mind, it is largely a matter of changing perceptions. Particularly in the older generation of men, there is the perception by some that women are intellectually inferior. They sometimes feel uncomfortable working with women and do not regard them as equals. It has probably been ingrained since they were very young, and it is difficult to change. However, I must stress that there have also been male colleagues and peers who have been hugely supportive and have really helped me in my career.

    For many women, balancing a demanding academic career with a family is very difficult. Often women end up leaving academia or not advancing in their career. You have a family and a successful career. What is your advice on how to balance a successful career while maintaining a healthy family life?

    You have to decide what you want out of life. You can’t do everything. You can’t run a big department and be a full-time mother. You have got to decide what your priorities are and how you want to balance them. Everyone is different. Some people want to give themselves to their work one hundred percent and less to their family. And there are other people who feel differently. I was always one of those other people. Ever since my daughter was born, I worked part-time. What that actually meant was that I worked as many hours as someone who was full-time, but it gave me the flexibility to do my work, writing and reviewing, around my daughter’s needs. I also think that time management is absolutely essential: planning things, prioritizing tasks and knowing how long things take. And the other thing is that you have to recognize what you are good at and what you are not so good at. Choose the things you are good at and play to your strengths.

    What advice do you have for young women wishing to pursue a career in academic research?

    First of all, if you are strongly motivated to do it, that is a fantastic thing. But there are some downsides to academic research. It is highly competitive and in the present financial climate, it is particularly difficult. But you should not let that put you off if you are strongly motivated, because there are many rewards and there is much that you can contribute to the field and to people around you. My advice is: if that is what you really want to do, go for it. Choose a good mentor! That is so important in all kinds of ways, such as in support, seeking advice, and getting through the more difficult times. Nowadays, I think it is very difficult to survive without a good mentor. And also, choose carefully where you go. Make sure that there is a strong support system with the resources you need, and the personal support and input from other people. 

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