This episode is written ridiculously well. Nearly every other sentence is a joke. But maybe that works against it as well.
Scrubs usually has multiple plots interwoven with the different characters, but in this episode, it didn't work out for me too well. Maybe it's because all of the plots involve radical change, and seeing as how that's the theme of the episode, maybe it was supposed to feel this abrupt and rushed. I'm not kidding when I say this episode has above average jokes and writing, even for Scrubs. Some of the lines here are very clever, but I found it to be too fast-paced. Also, JD got way too mad at Turk over something so small, which was unlike him. I mean, replacing Turk with Hooch? It seemed way out there.
If this episode was paced over two episodes and the plots were fleshed out a little better to make it seem less abrupt, I'd give them both 10's.