Professor Mackay graduated MBChB from the University of Glasgow in 1959, gaining his MD in 1973. He became a Member of the Royal College of Physicians and Surgeons of Glasgow in 1962 and then a Member of the Royal College of Physicians of Edinburgh in 1963. Mackay then went to become a Fellow of the Royal College of Physicians and Surgeons of Glasgow in 1973, a Fellow of the Royal College of Physicians of Edinburgh in 1975, and a Fellow of the Royal College of Surgeons of Edinburgh in 1994.

He worked as an Honorary Consultant Physician at the Victoria Infirmary in Glasgow, as well as being a Professor and then Dean of Postgraduate Medical Education at the University of Glasgow.

He was President of the Royal College of Physicians and Surgeons of Glasgow from 1994-1997.
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