Unfortunately for Trey Smith, I think you are correct. He does not have the respect at the NFL to not practice. He will start out towards the bottom of the totem pole and must work his way to the top. The only way to do this is through rigorous practice at a high level. Not sure if the NFL will feel confident Smith's system can take it without forming more blood clots. Fortunately, for Tennessee, I think Smith is more likely than not, to stay at Tennessee.
Of course, I am not Trey Smith's doctor, or even a doctor period, just my opinion from 500 miles away.