The episode begins with the Meredith and gang depressed and sitting outside the hotel, discussing how bad their tests went. They are also wondering if Alex made it. Meanwhile, Jackson’s mother tells Richard, that she has just found out that one of his doctors hasn’t passed the test. She doesn’t know though, who it is, she then says “if it’s Jackson, he will blame me forever”. Flash back to six hours earlier. The doctors are being tested in various rooms, by their respective examiners. They are given various scenarios by the examiners, which the doctors then are given time to explain, how they would deal with. Meredith is feeling nauseous while at her test, but pulling on somehow.
Meanwhile, Alex is stuck in traffic trying his best to get to the venue of the test. Alex then pays the cabbie and runs to the venue. Meanwhile, Julia tells Mark that he wants to have a baby with him. Meanwhile, Arizona brother’s best friend has come in for the treatment of his cancer. He was diagnosed with it sex years ago. Mark in the meanwhile, tells Derek about what Julia told him earlier. Meanwhile, Owen tells Miranda to woo the new candidates. Owen is afraid the hospital might lose some good doctors after boards, so he wants some new candidates who can replace them. Meanwhile, Teddy is slowly warming up to Owen. Meanwhile, Christina and Meredith come out of their rooms, and Meredith still affected by a stomach bug runs to the sink to vomit. Meanwhile, Alex reaches his designated examination room. He is told by the examiners that he fails the first of two sessions, and hence has to max in the other 2 sessions. Meanwhile, Jackson confronts his mother about her sleeping with Richard. She tells him she has needs. Jackson tells her to leave him alone.
It also turns out that, she is the examiner for some candidate in a room right next to Jackson’s. The second round also begins for the rest, when they are presented with further scenarios to deal with. Meanwhile, April is overtly nervous and at the edge of her seat, while giving the exam. She completely loses her composure as the exam progresses. Meanwhile, Jackson is agitated by his mother laughing loudly in the nearby room. Meanwhile, Christina has all the answers, and yet her examiners don’t seem too impressed. Meanwhile, Arizona’s brother’s friend’s situation has deteriorated, because of him waiting 6 years to get treated. Meanwhile, Miranda is trying to keep her patience and woo the newbies, although she clearly isn’t happy with some of the questions they are asking. Meanwhile, during a break, Jackson sees April act all neurotic, and joins her in complaining about how badly his own exams are going. April feels it’s all because she broke her promise to Jesus and slept with Jackson.
Jackson tells her the reason why he is being neurotic. He is worried what his mom would think if he fails. April tells Jackson that “the problem isn’t that I broke my promise, the problem is that, it felt good”. The two then discuss how they made love, and Jackson locks the restroom door from the inside, and the two again have sex. Meanwhile, Miranda, Owen and the gang, discuss which of their understudies is going where. Later, Meredith tells Derek over the phone that her flu has worsened. She feels she can’t keep going, and asks Derek what she should do. Derek tells Meredith “whatever you decide I will still love you “. He then wishes her luck and bids her goodbye. The exam is in its last legs, with the final round beginning. April is now completely calm and clear in her head in this round, and gives her examiners more composed and well thought out answers. Meanwhile, Jackson too is similarly calm and composed in this round, and answers the question posed to him confidently. Meanwhile, Arizona’s friend is being operated on by Miranda and Callie, while Arizona reminisces about her past with him, and also tells them about the thing he has done in his life.
Suddenly Callie sees something unusual while operating, and makes some excuse to get Arizona out of the room. She then tells Miranda that the patient’s condition is serious, based on what she is seeing. Meanwhile, Derek tries giving Lexie cryptic advice regarding Mark and her relationship, in front of Mark, while they are operating on a patient. Somehow Mark feels the message is for him, and thanks Derek for his crafty advice. Meanwhile, Arizona is informed by Callie that her friend’s condition is serious and his cardiac tumor has spread to some of his vital organs. Miranda tells her that “at this point there is very little we can do”. Meanwhile, Meredith is doing her best to answer the questions posed to her despite her feeling sick. She then suddenly can’t hold it in anymore, and pukes in a bin kept nearby. Meanwhile, Christina’s examiner is still grilling her, and posing the most challenging questions at her. The two then seem to have a difference in opinion, regarding a particular procedure. Meredith in the meanwhile is still puking into the bin, with her examiners looking on in dismay.
The examiners tell her that she can take the exam next year, and that this time wouldn’t be counted as a failure. Meredith replies “you guys are doctors, can’t you handle a little vomit”. She then proceeds to answer their question, with confidence. Meanwhile, Christina and her examiner, get into a debate, with the examiner calling Christina hostile. Christina then speaks her minds and tells him that she doesn’t agree with the procedure he suggested earlier, for a particular operation, and that she would have carried it out differently. The examiner then ends the exam, saying he has heard enough. “I think we have had enough of an education today” he tells a shocked Christina. Christina reminds them that, there is still 20 minutes left, the examiner tells her there is no need; he wishes her luck, before leaving. Meanwhile, Alex’s examiners give him a tough time for being late, he tells them that he was late for a good reason, and he then angrily proceeds to explain it to them. He after his outburst asks his examiners if he passed. Alex is then shown coming out of his exam room and throwing his bag to the ground, in anger.
Meanwhile, Richard bids Jackson’s mother a goodbye. She tells him before leaving that, she doesn’t regret the night she spent with him. The two plan their next rendezvous, before parting ways. Meanwhile, Lexie at last comes out and tells Mark that she loves him. Mark is dumfounded on hearing this. Lexie in the meanwhile, keeps repeating to him that she loves him. She tells Mark that her relationship with Jackson would never work out, as she doesn’t love Jackson, but him. Just then Julia comes in, and Mark is unable to respond to Lexie. Meanwhile, Arizona comes and reprimands her friend for delaying treatment for so long.
She tells him that he is dying. He tells her that he didn’t come earlier, because of what happened with her brother Tim. He didn’t want her facing the same pain again. Meanwhile, Meredith and gang are waiting eagerly for their results to come online. Jackson, Meredith and Christina are then overjoyed to find out they passed. Alex too it turns out has passed. April in the meanwhile is the one who has failed. The episode ends at this point.