Because the boards aren't like the intern exam, where not passing means an intern is still an intern; the boards are an external governing body of medicine that voluntarily certifies doctors that they're excellent per their standard. Kepner, despite failing her boards, still completed her general surgery residency, which gives her general surgery attending status.
In the real world, she would not have been hired as an attending since hospitals use board certs as a way of hiring the best of the best; because Hunt is chief, he has discretion to hire Kepner as an attending because she has the minimum qualifications: she's completed her GS-residency, and she holds a medical license to practice unsupervised medicine.
It's standard procedure that accepting settlement releases any and future liability from the party offering the settlement. So it wasn't that Derek was swaying against the settlement because Bayview Aeronatics was going to hide something, he was saying that not taking the settlement allows them to cause financial hardship toward the airline once the results are released.
Board certification is a voluntary process; it doesn't automatically exclude a doctor from holding attending-status. Attending status comes from completing residency, which Kepner did. In the real world, she would not have been hired as top-tier hospitals and medical centers use board certs as a criteria for hire - it's very very very rare these days where an attending is not board-certified.
Alex can't officially run pediatric surgery. He's currently unqualified; he's not even a peds surg attending: he's still only a peds surg fellow. He needs a year and half more as a fellow before he can become an attending in peds surg, and probably neeed more experience before he can be the peds surg chief.
The pilot wasn't at the settlement hearing because, as an employee of the airline, he's handled differently that the passengers; most likely he's under investigation too as he was the pilot.
And my theory is that Kepner won't be a GS-attending; it's far more likely that she'll be a trauma surgical fellow working in Hunt's department.
In the real world, board certs, although voluntary, are essential to be hired at top-tier hospitals and medical centers. There is a certain suspension of disbelief when it comes with GA. It's the same thing when the Chief allowed George to re-take the intern exam.
Kepner was planning on re-taking the boards because her contract wasn't renewing. It was only after she got back to Iowa, three months later, that Hunt offered her a job. She'll most likely take the boards again off-screen come next year so she can be board-certified.
Plus, ABS is public record. You can look up if your doctor is board-certified, and generally, you'd have to question why an attending surgeon/physician isn't and you'll most likely not choose them to treat you.
Originally neurosurgery was Kepner's focus, but ever since her trauma certification (when Hunt was awarded the $1 mil surplus), Hunt took her under his wing and was training her to be a trauma surgeon.
It's most likely that she's a trauma surg fellow since Hunt is the Chief, and trauma surg is still his department, so he probably created a fellowship position for April.
Technically they're all general surgery attendings, in terms of authority, because they finished their general surgery residencies. They don't hold the title of attending in their respective specialities, with the exception of Meredith and Bailey, because they all declared specialities outside of GS. Karev with peds, Avery with plastics, Yang with cardio, and now Kepner with trauma: they're surgical fellows.
Just like Hopkins created a fellowship position for Alex, Hunt, as Chief, could create a trauma surg fellowship as well, especially since trauma is still his department.
Regarding Alex, the job was created for him specifically. If he didn't take it, the peds fellowship program at Hopkins would have been just the fellows they initially hired.
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