McKechnie also held the positions of senior surgeon, member of the Board of Directors, and Life Governor at Vancouver General Hospital.

[1] He helped found the American College of Surgeons and the North Pacific Surgical Society, and was president of the Canadian Medical Association in both 1914 and 1920.

He was elected the Member of the Legislative Assembly for Nanaimo in 1898, and served as a Minister without portfolio in the provincial government of Premier Charles Augustus Semlin.

[1] He lectured in medical history at the University of British Columbia[2] before being elected to its senate in 1912[1] and becoming its second chancellor in 1918, holding the latter position until his death in 1944.

[3] During this time, he wrote several articles for medical journals, published a book about the history of medicine on the Northwest Coast, and started the British Columbia Place Names project.