John Alexander James was born in 1887 at Broughton Creek, later to become Berry, on the South Coast of New South Wales. His father was Charles Edward James, an English-born Wesleyan clergyman who became a Presbyterian minister. In the late 1890s the family moved to Brisbane where John James attended Brisbane Grammar School, excelling academically and in sport. He matriculated in 1905 and was accepted as a medical student at Sydney University, being awarded Blues in rugby and cricket. He graduated MB ChM in 1911 and worked as a Resident Medical Officer at the Royal Prince Alfred Hospital and the Coast Hospital.
After the war, he resumed employment at the Coast Hospital in 1919. He travelled to England in 1922 to study surgery, achieving Fellowship of the Royal College of Surgeons (FRCS) in 1925.
He returned to Australia and was appointed medical superintendent of The Canberra Hospital from 1926 to 1929. C. S. Daley, the Secretary of the Federal Capital Commission, declared that securing John James’ services for the Canberra Hospital was “the best day’s work the Commission ever did…we had to have a first class surgeon in the National Capital”.
John James supervised the development of the hospital from what was derisively called a “first aid post” to a modern institution with more than 100 beds, a well-equipped operating theatre and an X-ray unit.
In 1929 John James married Sheila Cary, a theatre sister at the hospital, and they travelled to England and Europe, returning in November 1930 to establish a surgical and general practice at 21 Torrens Street, Braddon.