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After graduating with a B.A. from Harvard in 1878, Sachs travelled to Europe and studied under some of the more prominent physicians of the time, such as Adolf Kussmaul (1822–1902), Friedrich Daniel von Recklinghausen (1833–1910), Friedrich Goltz (1834–1902), Rudolf Virchow (1821–1902), Karl Friedrich Otto Westphal (1833–1890), Theodor Meynert (1833–1892), Jean-Martin Charcot (1825–1893), and John Hughlings Jackson (1835–1911).
In 1879 he obtained his medical doctorate from Strassburg, and afterwards was a medical assistant in Strassburg under Adolf Kussmaul (1822-1902) and Oswald Kohts (1844-1912), and later in Berlin under Oskar Lassar (1849-1907).