Leading up into the Edo period, there were many cases where the most outstanding private civilian doctors in Kyoto and the other provinces were given office and rank and appointed as Tenyakuryo physicians (goteni); candidates--both young and old--for official posts of Tenyaku Taijo (Senior Secretary of the Bureau of Medicine) rank or lower were chosen from among the teni (doctors) either due to their superior skills or due to a long record of distinguished service.
江戸時代に至っては、京都や諸国の優秀な民間医が官位を与えられて典薬寮医師（御典医）に登用されるケースが多くなり、典薬大允以下の役職は、典医の中から技術の優劣や年功の長幼によって選ばれた。