From NCPedia:
James Strudwick Smith, physician and politician, was born in Orange County of unknown parentage; he may have been the illegitimate son of William F. Strudwick, for whom the court issued bastardy charges in 1788, omitting the name of the female involved. The Strudwicks were near neighbors of the Reuben Smith family of the Hawfields. James Strudwick Smith's many-faceted career brought him both fortune and misfortune. He studied medicine with Dr. James Webb of Hillsborough in 1810 and then, with the help of friends, completed two courses of study at the University of Pennsylvania in the winters of 1810–11 and 1811–12 but left without pursuing a degree because of insufficient funds. Later, when the state of North Carolina contemplated reestablishing a medical society, Smith, hoping to be made president, applied for his diploma and paid the necessary fee. His degree was granted on 26 June 1821, and his diploma was dated 1822.
More at:
http://ncpedia.org/biography/smith-james-strudwick
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