Choice

Although not directly (and indirectly) involved in the process, I must say I understand very well the difficulty of recruiting new physician trainees as mentioned by MT.

In fact, it is quite a positive feedback and vicious cycle: If the department is well run and in harmony, everyone would like to stay; promotion prospect diminishes and there would be fewer place for new comers. The good thing is only the best applicants would be selected.

What you may not notice is the inadvertent effect: Consultants of those less advantaged hospitals (a term of my invention, hope you like it) tend to accept mediocre applicants - because, even if interns with an excellent academic record and working performance accept the job, they would inevitably default and take up a "better" offer.

PS. The unexplainable fact is, some consultants of those more advantaged hospitals continue to have a peculiar taste of picking new trainee - and do not see the simple fact that a healthy department needs people of different skills.

See what Florentino Pérez achieved in Real Madrid.