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Interns can't do much besides working in the doctors office of an emergency department. You can't use them elsewhere (you could assign them to the ready room of the ED, but they did nothing there).
Resident seems to be the level where the first medical specialization slot like "Acute medicine" or "Internal medicine" is available.
Fellow seems to be the level where the second specialization slot (like "Advanced diagnostics" or "Anesthesiology" is available.