In the 19th century, the functions of the Ottoman central administration, which entered a process of modernisation in every field under the influence of internal and external dynamics, increased. With the modernisation process, the state started to perform many services on its own and established first Mekteb-i Tıbbiye-i Şahane and then Mekteb-i Tıbbiye-i Mülkiye to solve the health problems of its subjects. These schools also endeavoured to fulfil the requirements of a modern state. While maintaining a centralised approach in the fields of education and health, the modern state was able to solve the health problems of the people and take preventive measures thanks to the physicians trained at the school. After graduating from the Mekteb-i Tıbbiye-i Mülkiye, municipal physicians were assigned to the towns. These people, who fulfilled their duties to keep people living in good conditions and prevent epidemics, were accompanied by civil servants. Together with their attendants, the physicians treated the sick, the elderly and the needy both in the centre of the accident and in the towns and villages of the accident. In the mid-19th century, the small number of physicians made them sought-after in Anatolia. These physicians, who endeavoured to make the people feel the presence and power of the state in the field of health, faced various problems in the places where they were assigned. Although the boundaries of the municipal medical service were drawn by regulations, they were forced to work under the difficulties of inadequate personal rights, complaints that they were extorting money from the patients they treated, problems related to compulsory service and the heavy war environment brought by the century. In this study, the problems faced by municipal physicians professionally are analysed from structural and functional perspectives by identifying them from Ottoman archive documents