The med students are coming around to the end of their first semester of med school and begin to figure out their medical specialty. The students are also in charge of giving a speech at a ceremony to thank the families of the cadavers that they have been studying.
Lucy is assigned "Hell Week" leader, while Drew has to cope with his new position as study group leader.
Meanwhile, Turk's position as Chief of Surgery is undermined by the appearance of Dr. Russell Vaughn.
When Dr. Cox finds a cheat sheet in the unisex bathroom during a test, he locks up all five students who left the room during the test, until one of them would come forward and admit the cheating. Drew wants to take his relationship with Denise to the next level. Turk has to take care of a lesbian couple.moreless
New realities are experienced when Lucy prepares for a dissection exam, while J.D. and Elliot prepare to have their baby, and Dr. Cox has to face his mortality.
Lucy needs to find a good answer to why she wants to become a doctor, in order to pass her white coat interview with Dr. Cox.
Meanwhile, Denise needs some relationship advice for her issues with Drew.
Lucy has problems taking blood from live humans, while J.D. even on his last day still wants to get Dr. Cox' approval.
Meanwhile, Denise is afraid not to be the person with the pants on in her relationship with Drew.
J.D. and Turk have time to party, when their wives are out of town, so they prepare for the big med school party. Meanwhile, the students need some help with the final interviews of dying patients, and Dr. Kelso tries to say a proper goodbye to Ted and Gooch as they leave to see the world.moreless
While old acquaintances become teachers, new students are introduced at what used to be Sacred Heart. The hospital was torn down and rebuilt at a med school campus, where J.D., Turk and Dr. Cox are teachers now.