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The final 10 fellowship candidates compete ferociously when House splits them into two teams by gender. They are assigned to diagnose and treat a wheelchair-bound man with muscular atrophy who is slowly suffocating.
House has relented to interviewing potential team members, but he's doing it his way. He called in all 40 applicants for the open three positions on his team and puts them to the test in a Darwinian trial period. As he drills the fellows and arbitrarily fires some along the way, an Air Force fighter pilot named Greta asks him to secretly treat her. She is a candidate for NASA's astronaut training program. House sets the applicants against one another to help treat the pilot with an unusual neurological disorder.
When a 20-year-old funeral home cosmetician, Irene, has a massive seizure, she hallucinates the cadavers in the funeral home have come to life, House and the remaining seven fellowship candidates must figure out why.
After losing his original diagnostic team, House decides that he doesn't need fellows as he feels that he can handle a case all on his own but after taking a long time to solve a case, Cuddy insists that he start looking for possible doctors to join his new team. House grudgingly accepts and gets forty applicants together and has a reality show style contest to see which lucky three applicants will stay on to get the vacant fellowship openings. Meanwhile, Cameron and Chase come back to work at the hospital, while Foreman starts work in a job similar to House's at another hospital. However, Foreman is soon fired for doing exactly what House would do and winds up back at Princeton-Plainsboro. House wants nothing to do with him, but Cuddy insists he can only hire two new fellows and must have Foreman on his team to keep an eye on him.