When Dr. Kelso challenges the residents by offering a trip to a medical conference in Reno as a reward to the individual, who presents the most interesting case study, J.D. refuses to play along, earning him the respect of Dr. Cox. In the meantime, Turk misses his opportunity to ask for a new laser on the one day of the year, that Dr. Kelso grants favors, so he is forced to find another way to come up with the goods.

Elliot sleeps with a handsome doctor she hardly knew and soon becomes the hospital tramp. Turk suffers from his back after operating with Dr. Amato, a very short surgeon. J.D. finds out that wearing a white coat doesn't make him a better doctor, but is upset by having Dr. Cox throw in his face that he made another mistake. And Dr. Kelso is just dying for an opportunity to lash out his anger on Dr. Cox.