San Francisco 49ers starting quarterback Alex Smith, who has struggled with shoulder and forearm problems since suffering a Grade III separation of his right shoulder on Sept. 30, will likely need at least two more weeks of rest and rehabilitation, and even then might still require surgery to repair the damage. The first overall choice in the 2005 draft, Smith was examined on Tuesday by noted orthopedic surgeon Dr. James Andrews in Birmingham, Ala. Sources close to Smith said Andrews apprised the third-year veteran that the shoulder separation was not significantly improved and might actually be worse in some ways than when he initially viewed the original MRI of the injury three weeks ago. A 49ers spokesman said the team's medical staff had not received the Andrews report.