The new chief of medicine turns out to be as callous as Dr Kelso, JD gives up on his intern class after they let him down, and Eliot is too self-absorbed to realise that Keith is still hurt from their break-up.
JD enlists the help of Elmo from the Muppets to teach the gift of compassion to a blunt intern Denise but is disappointed when even Elmo can't make Denise more empathetic. Elliot's intern meanwhile, boasts that she has her mentor wrapped under her little finger.
Dr. Kelso and Dr. Cox try to oust Dr. Maddox (Courteney Cox) from Sacred Heart; Carla decides to take a self-centered, incompetent intern down a notch.
The new interns are put to the ultimate test when they're asked to perform in the annual sketch show.
A full moon and a healthy dose of bad luck bring Sacred Heart's new crop of interns their roughest case load yet, while Elliot has a revelation about her future as a doctor.