Move into a subspecialty fellowship or formal department-leadership rung (medical director, residency program director) — the gap between internist and department-head surgeon is mostly subspecialty-depth and leadership signal, both addressable.

Take an ownership stake in a clinic or join a physician-owned group — at this stage, equity in a practice is the lever that converts steady salary into a real market_value (transferable book of patients + AR).

Add light academic output (1-2 case reports or society talks per year) — even modest publication signal lifts you from interchangeable attending toward named referral source.