Smart then moved to London, where he was given an appointment at
Great Ormond Street Hospital (taking charge of the
X-ray department). His interests shifted towards
orthopedic medicine, particularly
manipulative surgery, and he received a
Doctor of Medicine degree from Edinburgh in 1912 for a thesis on
faradism. in 1917. He subsequently served in the
Aegean and in the West Indies before
demobilisation in 1919. After the war, he returned to medicine. He was involved with the
London Clinic for Injuries. He was employed as
George V's manipulative surgeon and was appointed a Commander of the
Royal Victorian Order in 1932; he also received decorations from Spain and Monaco recognising his service to their courts. In 1933, he was promoted to Knight Commander of the Royal Victorian Order. When
Edward VIII succeeded to the throne in 1936, he appointed Smart to the new office of Manipulative Surgeon to the King, which he held during the reign of
George VI, who he attended to during the king's illness in 1948, for which service Smart was promoted to Knight Grand Cross of the Royal Victorian Order in 1949 (the same year he was appointed Extra Manipulative Surgeon to the King, an appointment which was renewed under
Elizabeth II from 1952). Meanwhile, he had been a consultant to the
Royal Air Force during the Second War. == Later life ==