Paul Smith trained in Glasgow, London and the United States at some of the premier training centres in the world.

He has been a consultant in practice for over twenty five years. In that time, he has founded the Congenital Hand Surgery Centre at The Great Ormond Street Hospital, now one of the largest services in the world, and was instrumental in founding RAFT (the Reconstruction of Appearance and Function Trust) – a postgraduate institution funding research into plastic surgery. Paul was also responsible for founding the Hand Therapy Service at the Wellington Hospital, which has now become the London Hand and Wrist Unit. He has been awarded several prestigious prizes both at home and abroad, including the Pulvertaft prize for hand surgery, awarded by the British Society for Surgery of the Hand. He also was awarded first prize in the Resident Competition by the American Association for Hand Surgery.