Susan throws herself into her work to escape her stressful personal life, earning recognition from Weaver and Mark, who begin preliminary discussions on next year's chief resident. Carter needs a pediatric rotation with Doug, and fast, to graduate med school. Doug takes up with his father's girlfriend. Shep overreacts and attacks an Asian boy interfering at a scene. Mark and Jenn try to discuss their divorce amicably, with unforeseen results. Benton is named Resident of the Year. Harper leaves for an OB rotation at Parkland in Dallas.

Carol is pushed to the breaking point after another day when politics triumph over health care, and she quits. Mark "trades his soul" when he agrees to back Weaver for ER attending, in exchange for her support of Susan for chief resident. Jeanie takes an HIV test and informs Benton he should get himself tested as well. Carter invites Benton to his med school graduation, which he himself misses in order to keep a young patient company. Shep's refusal to see a psychiatrist risks his relationship with Carol.