Dr. Kelso's beautiful but unethical replacement, Dr. Maddox, shakes things up at Sacred Heart, while J.D. struggles to manage a new crop of incompetent interns and Carla helps Elliott put her ego in check.

J.D. and Elliot's relationship seems to have been rekindled when they encourage Dr. Kelso to find his true happy place.

J.D. and Turk gather up a new crop of interns as they organize their annual (and historically unfunny) sketch show.

Change doesn't come easy for the gang when J.D. considers moving closer to his son. Meanwhile, Turk gets comfortable as chief of surgery, while Ted and Gooch reach a new level in their relationship.