J.D. is sick of perfect intern Keith and he's not the only one. Elliot's relationship with Keith is revealed, so the other interns think that he is getting special attention. In the meantime Dr. Cox boasts about being named "The Best Doctor in the City" by a local magazine, thus Dr. Kelso assigns him to the most difficult patient in the hospital to deflate his ego. Also, Turk and Carla continue to struggle in their quest for conception.

Turk finds out, that Carla is pregnant, before she does, so J.D. convinces Turk to tell the entire hospital staff to surprise Carla with the news. But Carla wants to personally share her baby news with everybody, so Turk and J.D. have to quickly contain the hospital gossip. Meanwhile, when Elliot puts Dr. Cox into an embarrassing situation, he decides to get even with Elliot through Keith and Carla.