One of Meredith's oldest friends, Sadie, becomes an intern at Seattle Grace, but Mer's friends are less-than-welcoming to her; Lexie leads her fellow interns in secretive, unorthodox surgical training sessions; and a new surgeon, Virginia Dixon, brings rules and order to the OR.

Cristina is awarded the first solo surgery among the residents, but must give it up and choose her replacement. Meanwhile Mark performs a cutting edge procedure to restore a patient's ability to speak -- and impresses Lexie in the process -- and Callie can't figure out if Sadie is just friendly or flirtatious.