Archibald McDonald joined the Department of Surgery, University of the West Indies in 1987. He developed an interest in Traumatology and Emergency Medicine. He established the first Accident and Emergency Department in Jamaica at the UHWI in 1993. He started the DM Programme in Emergency Medicine and collaborated with colleagues to establish a post basic training for Emergency Room Nurses.

His research has played a pivotal role in defining the epidemiology of Injuries in Jamaica and has informed national policies on injury prevention and management. He assisted with the development of the Jamaica Injury Surveillance System and established the Trauma Registry in the Department of Surgery, UWI.  He has published 65 papers and nearly 70 abstracts in peer reviewed journals to date.

Over the years Professor McDonald served as Head of the Department of Surgery, Radiology, Anaesthesia and Intensive Care (2002–2005), Chair of the Department of Surgery Research Committee, Supervisor of the DM Emergency Medicine, and he was the Faculty's Representative on the Campus’s Budget Monitoring Committee. Professor McDonald was appointed Dean of the Faculty of Medical Sciences in 2005. Professor McDonald can be credited with guiding the Faculty of Medical Sciences to full accreditation from the Caribbean Authority of Medical Education and Other Health Professions (CAAM-HP).  He introduced the Doctor of Dental Surgery Programme to the Mona Campus in 2010. He facilitated the introduction of Masters programmes in Sports Medicine and Forensic Science. Professor McDonald facilitated the expansion of the Faculty and conceptualized and developed the state of the art Faculty of Medical Sciences Research and Teaching Complex.

He served as Chief Executive Officer of the University Hospital of the West Indies in 2007. The impact of Professor McDonald’s work in trauma, Hospital Emergency Services, University Administration and Medical Education has been felt throughout the Jamaican Community and the wider Caribbean. He was awarded the Vice Chancellor’s Award for Excellence in the category, Outstanding Service to the University Community in 2008.