Fife was a surgeon specialising in diseases of the eye. He was one of the early founders of the Newcastle-upon-Tyne Medical School. While in his mid-thirties, he combined with others in 1832-33 and 1833-34 to hold sessions of medical instruction in Bell's Court, which led to the opening of the Newcastle School of Medicine and Surgery on 1 October 1834.

His political achievements were not inconsiderable though we may look less favourably today on someone who was knighted for ordering that bayonets should be used to break up a Chartist demonstration ('the battle of the Forth') during his first period as Mayor.

He introduced the Turkish bath into the Newcastle Royal Infirmary in 1860 and edited The Manual of the Turkish bath: heat a mode of cure. He was also a shareholder in the London & Provincial Turkish Bath Co Ltd, proprietors of David Urquhart's inspirational London Hammam at 76 Jermyn Street, London.