Alexander Keliimoeanu O'Haleakala Smith was born in Hilo Hawaii. Sadly, his family moved to East Lansing, Michigan when he was 6 months old. He is a proud graduate of the University of Michigan, though in sporting events he roots for both Michigan State University and the University of Michigan.

Dr. Smith received his medical school training in the UC Berkeley/UCSF Joint Medical Program. He completed a primary care internal medicine residency at Brigham and Women's Hospital (BWH) followed by two fellowships, a one-year clinical fellowship in Palliative Medicine at BWH and Dana Farber Cancer Institute, followed by a two-year General Internal Medicine Fellowship at Beth Israel Deaconess Medical Center, including an MPH from the Harvard School of Public Health. Dr. Smith returned to UCSF in July 2008 as faculty in the Division of Geriatrics.

Dr. Smith's research is focused on improving quality of life and patient-physician communication for older adults, particularly those with a limited prognosis.

Dr. Smith has been funded by multiple National Institute on Aging Grants, including 2 R01s, Co-PI of a P01 Research Project, a K24, and a K23. He is a prior recipient of Beeson, SGIM/T Franklin Williams Scholar, Greenwall Faculty Scholar, NIA Diversity Supplement, and National Palliative Care Research Center awards.

Dr. Smith is co-founder of ePrognosis.org, an online compendium of prognostic calculators, and with Dr. Eric Widera, he co-founded GeriPal, a geriatrics and palliative care podcast for every healthcare professional.

Dr. Smith is a Executive Editor at JAGS where he co-leads the Junior Reviewer Program for early career faculty-researchers. Dr. Smith plays a major role in organizing the next generation of geriatrics and palliative care researchers through individual mentoring and participation in the National Palliative Care Post-Doc Research Collaborative. He is Director of UCSF's NIA funded T32 program.

From 2017-2019 Dr. Smith served as President of the UCSF Medical Alumni Association.