It's J.D.'s last week as a resident as he tries to smooth over his relationship with Elliot after their break-up. The former couple squabble over having to share time with newlyweds Turk and Carla, who have their own issues when Carla starts to change everything about her new hubby. Professional yet quirky new psychiatrist Dr. Molly Clock starts her first day at Sacred Heart turning heads and forging new relationships with the staff. She befriends a lonely Elliot and tries her best to help J.D. and Dr. Cox with a patient offering profound and helpful insight. Meanwhile, when Turk's car blows up, Carla lets him pick out the new ride only to find that instead of a car, he buys a Vespa scooter further proving Carla's point that she needs to always be in control.

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.