J.D. has become chief resident and is flaunting his new title and pay check all over the hospital. J.D.'s new sense of pride seems to be especially hurtful to Turk, who is still a resident and currently being denied more difficult surgeries by his new attending physician. Turk's ego is further hurt when J.D. doubts his abilities as a surgeon. J.D. and Elliot's relationship has taken a turn for the worse when J.D. is accidentally called the co-Chief Resident and Elliot the Chief Resident. This mix-up lifts Elliot's post break-up spirits. Dr. Cox and Jordan are having relationship problems as well when they find out that their divorce was not final. Dr. Cox's other annoying woman in his life, Dr. Molly Clark, faces off with him over a plastic surgery patient.

When J.D. decides to use a tape recorder to gather his thoughts, the voice-overs transfer to Elliot, who makes new friends with Molly and gets the courage to tell-off her foil Dr. Cox. However, Eliot soon realizes that Molly is not quite the person she thought she was when her felon boyfriend is admitted to the hospital after stealing a car and crashing it into a telephone pole. Meanwhile, in the world of the newlyweds, Turk is constantly waking up Carla when he goes to bed; and J.D. has concerns that Dr. Cox may have ruined his credibility with the new residents.