J.D. and Turk go to a medical convention in Phoenix, Arizona, where they run into J.D.'s ex-girlfriend Dr. Kim Briggs, who has a surprise for J.D. Meanwhile at Sacred Heart, the janitor pretends to be the chief of medicine and Dr. Cox starts to put doubts about the wedding into Elliot's mind.

In the season finale, J.D. and Elliot start thinking about their future and if they both made a mistake in not being with each other. The Janitor activates the "Brain Trust" to come up with the perfect wedding gift for Elliot.