From 1913 to 1933 he held the office of Vice Chancellor (renamed Pro-Chancellor in 1927) of the University of Birmingham, during which time and under his guidance the research departments in mental diseases and cancer were founded.

His association with the university had begun in 1885 when he was appointed Demonstrator of Anatomy at Queen's College and he was for many years on the teaching staff of the Medical School, becoming Professor of Pathology in 1885.

At the outbreak of the First World War he was 59 and placed his services at the disposal of the Royal Army Medical Corps, acting as consulting surgeon in the Southern Command, subsequently being posted at the rank of colonel to the Western Front from October 1916 to August 1917.

He died from heart failure at his home (whilst in his garden) at 6 Manor Road, Edgbaston on Saturday 27 April 1940, just three days before his 85th birthday.

The Birmingham Mail reported that the eloquent testimony to the esteem in which Sir Gilbert was held was manifested at the funeral, which the Lord Mayor also attended.