Dr. Taylor Maddox (Courteney Cox) joins Sacred Heart as new chief of medicine and Dr. Cox tries to avoid her. J.D. struggles to manage new interns. Carla helps Elliot put her ego in check and Elliot apologizes to Keith for their break-up. The Janitor is caught tormenting J.D. by Maddox and is fired.
J.D. and Turk set aside their personal plans to comfort George Valentine (Glynn Turman), a terminally ill patient with ischemic bowel disease who will probably die in the night. J.D. and Turk decide to stay and talk George through his fears of death.
Dr. Cox requests Dr. Kelso's help to oust Dr. Maddox from Sacred Heart. Carla decides to take self-centred, incompetent intern Katie (Betsy Beutler) down a notch by teaching her a lesson.
J.D. and Elliot reflect on their past break-ups when they try to encourage Dr. Kelso to branch out beyond the coffee shop and decide to give their relationship another try. Dr. Cox, Todd and Turk work together to help two kidney transplant patients. The Janitor is re-hired as he tricks payroll into thinking he was not fired and that they forgot his paycheck. A flashback shows him firing his replacement.
J.D., Elliot and Dr. Cox each choose an intern to work with. J.D. picks Denise (Eliza Coupe), who lacks compassion towards patients. Elliot's intern, Katie, tries to use her to land a case study with Turk, who picks Ed over Katie due to his multicolored pen. Dr. Cox chooses Ed (Aziz Ansari), who is lazy and overconfident. Sesame Street cameos from Oscar the Grouch, Grover and Elmo.
Elliot seeks Turk's advice on reigniting romance with J.D., who in turn tries to teach Denise to use compassion while dealing with patients. Dr. Kelso recommends Dr. Cox for the job Chief of Medicine, who is conflicted over taking the role.
As his increasing workload from being Chief of Medicine begins to take a toll, the unimaginable happens when Dr. Cox reaches out to Dr. Kelso for friendship.
Ted finds it hard to take an initiative when he falls in love at first sight. Meanwhile, Dr. Cox finds it difficult to handle multiple situations.
Elliot is faced with J.D.'s absence at the hospital. Meanwhile, Carla tells Turk that she is pregnant again. Turk takes this seriously as the whole hospital does not really care due to this not being their first-born child. This is the first episode in the entire series in which J.D. does not appear.
All of the new interns get assigned to do a role of each doctor by Turk and J.D. The sketch show ends with a sketch of Turk and J.D. portrayed as a couple in love, indicating that the whole hospital thinks of them that way. Both Turk and J.D. begin to think they should stop their behavior in the hospital, but both find it too hard to resist. Meanwhile, Elliot tries to get Denise to get out of the hospital to have fun with the other interns. Meanwhile, Carla makes the Janitor believe that he is l
Turk gets an idea about a risky procedure from watching SportsCenter that may restore a paralyzed teenager's ability to walk. Jordan gets mad at Dr. Cox when he wears their wedding ring. Lady refuses to hold Janitor's hand, which upsets and confuses him.
Narrated from the perspective of the hospital's new interns. J.D. assumes the role arguing with Dr. Cox over hospital's various needs. However, his successes do not go over well with Turk.
A full moon and some bad luck bring Sacred Heart's new interns their roughest cases yet. Meanwhile, Elliot ponders her future as a doctor after she finds out the source of a patient's mysterious illness, and then has to tell that patient.
The Janitor and Lady invite the Sacred Heart staff to their fake wedding in the Bahamas hoping to score some loot but their scheme is about to backfire...
The tropical seaside wedding goes ahead as the Janitor and Lady tie the knot which affirms the relationship of another couple.
As J.D. plans to move closer to Sam, he reaches out to make peace with Kim (Elizabeth Banks) and finds that she has a new man in her life, Elliot's ex-boyfriend Sean (Scott Foley). Meanwhile, Turk rallies the troops at Sacred Heart to help him campaign for a promotion to chief of surgery while Dr. Kelso is admitted to the hospital after eating a tainted muffin and treats himself, much to the irritation of the hospital staff.
Change begets change when J.D. considers taking a new job so he can live closer to his son and Kim, Turk begins his new role as chief of surgery, and Ted and Gooch take their relationship to the next level.
J.D. is planning on leaving Sacred Heart but before he goes there are a few things that he wants to do including; getting a hug from Dr. Cox, and learning the Janitor's real name. Elliot is ready for the next step in her and J.D.'s relationship and she begins moving her furniture into J.D.'s apartment.