He trained in Auckland, New Zealand and Bristol, UK with a special interest in clinical immunology. He has overseen the NZ kidney allocation scheme since 1998. He is an active clinical transplant physician and is head of the Department of Renal Medicine at Auckland City Hospital. Ian is a member of the Declaration of Istanbul Custodial Group and the TTS Ethics Committee. He completed a sabbatical in 2015 focusing on the ethics of live donor transplantation especially the issue of the balance between patient autonomy and professional protectionism (paternalism).