James Smith, MD, MS received his undergraduate training from the University of California, Berkeley, where he obtained a degree in molecular biology with high honors. He then enrolled in the University of California's Joint Medical Program, a partnership between Berkeley's School of Public Health and San Francisco's School of Medicine where he earned a master's degree in health and medical science in 2000 and a medical degree in 2002. Smith completed his general surgery and urology training at the University of Utah in Salt Lake City, returning to the University of California, San Francisco as an Andrology Fellow in 2007 for advanced clinical and clinical research training in male reproductive and sexual health under the guidance of Tom Lue, MD and Ira Sharlip, MD.  In 2009, he was awarded a K12 MRHR (Male Reproductive Health Research) grant to continue his investigation into male reproductive health.

As Director of Male Reproductive Health at UCSF, Smith directs the multidisciplinary team providing male fertility preservation counseling and treatment; evaluates and treats men with male reproductive health problems, desire for vasectomy, low testosterone, and erectile dysfunction. He specializes in the use of minimally invasive vasectomy, microsurgical vasectomy reversal, advanced sperm retrieval techniques, microsurgical varicocele repair, and microsurgical spermatic cord denervation. Smith is an active member of the American Urological Association, the American Society for Reproductive Medicine, Society of Reproductive Surgeons, Society for the Study of Male Reproduction, Society for Male Reproduction and Urology, American Society of Andrology, and the Sexual Medicine Society of North America.