J.D. has finally earned the spot as brightest student, but he's got competition: Nick Murdoch, who seems to be nicer, friendlier and has a better butt than him. But even J.D. can't hate the guy, for he is so nice. But he is surprised when he finds Nick sitting in a corner crying because he can't take the pressure of medical internship. Meanwhile, Turk is having problems at the operation table and doesn't tell Carla, who keeps bothering Dr. Cox about it. And Dr. Cox gives Turk a very unique suggestion on how to calm down before surgery.

When a rampaging Dr. Cox suddenly shows up at his door in a strange funk, J.D. sees a possibility of a breakthrough in their relationship - until he learns that Cox loses control in almost an annual rite. Meanwhile, Turk elects to partner with Elliot on a research project so that he can maneuver her back with his buddy J.D., and Carla struggles to fulfill a comatose patient's final request - playing heavy metal music in his room.

It's J.D.'s last day as an intern, and soon he will become a resident. Carla and Turk are arguing about dating other people. Elliot finally rebels against being everyone's doormat, and J.D. is just trying to stay out of people's way.

Jordan has returned to get a physical and a new patient, Mr. Bober, has been admitted, because he needs his gall bladder removed. He really needs the surgery, but doesn't have the insurance to pay for it. They enlist the help of Dr. Cox, Dr. Wen and Jordan.

All of the male doctors are euphoric due to the visit of Julie Keaton, the pharmaceutical sales rep, except for Dr. Cox, who still believes in treating patients for their best health, instead of trying to get some attention from the hot Ms. Keaton.

Meanwhile, J.D. and Elliot argue over a risky decision regarding one of Elliot's patients. Turk tries to talk Carla into entering a practitioner nurse course, so she won't be so underestimated by the doctor's staff.

Dan decides to stay with J.D. for a while after their mom's new fiancé kicks him out, but after spending some quality time with him at the hospital, Dan isn't sure if he likes the cynical person his little brother has become.

Elliot tries to deal with her own problems of a long distance relationship and decides to try moonlighting as a pet examiner with Carla to save up money.

J.D. hooks up with Danni again, after Sean returns, but he can't forget about his passionate night with Elliot.

Meanwhile, Dr. Cox realizes, that he might actually have a crush on the one doctor he loathes.

When Molly takes a job at a different city, she and J.D. end up having a night of kissing, and he tries to rush to sleep with her before she leaves.

Dr. Cox goes on ambulance duty with a maniac, who he eventually finds out is a woman who has lost her son to an accident.

A man injured in a bar fight teaches Turk and J.D. a lesson about living life to the fullest.

J.D. is annoyed, that Julie doesn't laugh, so Elliot encourages him, to tell her his feelings, and Turk tries to use psychology to fix the issue.

Meanwhile, Carla is upset, when the Janitor refers to a new nurse as a "hot young Carla," which intensifies her growing concern, that she is too old to conceive.

J.D. feels that the same things happen over and over again at the hospital. Dr. Cox returns to work, but Elliot believes that he has lost his usual confidence. Elliot calls Dr. Cox on his behavior. Carla gets fed up with Turk, because he still can do a lot of stuff, but she can't since she is now pregnant.

The hospital is seen through the eyes of Dr. Kelso, who befriends an Iraq War veteran.

The soldier's stay sparks a political debate among staff members.

The Sacred Heart staff has to deal with their inner child, when J.D. and Turk remember their first prank, Dr. Cox has a ten year old Leukemia patient and Dr. Kelso celebrates his birthday.