James grew up in Wellington, New Zealand. He completed a Bachelor of Science with Honours at the University of Otago, before relocating to Australia to study medicine. James graduated from medical school at Flinders University in 2006, after which he moved to Victoria.

James completed his orthopaedic training via the Victoria / Tasmania training program in 2018. Following successful completion, he was awarded fellowships of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.