If the surgeon failed in an operation his patient would normally die and there would be no one to pay him and it would also damage his future chances of finding employment. (Grigsby 2).
As today, there was a long period of education that a medical practitioner would have to undergo. Only the sons of the nobility could afford to be sent to the university. They would enter to university around the age of fourteen. The general education would take around six years, after which they had two years of debate and then they could complete the examinations to get a bachelors degree. A master's degree would take another year of study and the student could go on to pursue of specific area of education such as medicine. This final segment was around twelve years in length. Upon graduation, the pupil was near thirty-five years old. (Krzywicka 2) Medicine was not restricted to those who wanted to be a physician; it became a general study for others as well. According to Maggie Krzywicka, "Medicine became a standard part of the medieval curriculum, and it is not uncommon to encounter educated clerics requesting medical handbooks and both seeking and giving medical advice." (1) Those who wanted to become physicians had to undergo many years of training to earn their degree. It can easily be seen why they were on the top of the hierarchy and did not want others trying to attempt in their area of expertise.
The area of medicine was also greatly influenced by religion. Much of the early medicine was practice by clergymen and other religious groups. As a result, much of the folk remedies and chants had to be replaced by Christian ones, such as the Lord's prayer or famous hymns. At first, herbs and drugs were scorned by the church, but as science began to overtake myth, they were accepted if Christian chants were used with them. (Krizywicka 4) The clergy began to fade and just to treat the poor and not accept and payment, but to do it out of charity.