After completing his undergraduate medical degree in South Africa, Mr Smith developed extensive experience in trauma and orthopaedics in Baragwanath Hospital, Soweto and Groote Schuur Hospital, Cape Town. He has also worked in Germany where he studied aspects of hip and knee replacement sugery. In 1991 he received the Lillie Research Fellowship and continued his studies in total joint replacements at the Arthroplasty unit at Harvard Medical School and Massachusetts General Hospital, Boston, USA. After becoming a consultant in Bristol, he implemented the use of risk based methodology for total joint replacements at the Avon Orthopaedic Centre in Bristol. He continues his research into aspects of lower limb arthroplasty (primary and revision hip replacements), impaction bone grafting in revision hip surgery and the design of hip prosthese. He is an organiser of 'Debates about Hip Replacements', an annual event in Bristol attended by experts in their field from the UK, Europe and the USA. He is a member of the American, Eurpean and British Orthopaedic Research Socities as well as British and European Hip Society. He was one of three nominees for President of the British Hip Society.