To be promoted to Attending Physician, once the required years of service are met, you just need to apply for the attending exam. After passing, you'll automatically be promoted to the attending title.
However, there is a quota for attendings, associate chief physicians, and chief physicians in the hospital.
Better hospitals may softly persuade some average resident doctors to leave.
Either honestly wait in line for an opportunity or resign and leave.
Except for the well-connected ones.
Some highly capable resident doctors manage to grab a formal position, and with this status, the hospital will surely give them preferential treatment.
Otherwise, if a doctor or nurse with a formal position decides to slack off, even the dean will have a headache.
There are plenty of ways for the leadership to deal with contract workers.
After being given a hard time a few times, they'll naturally leave.
