Competition heats up as several of the doctors fight to become the new face of Seattle Grace; April brings in an emergency case, and Jackson and Alex work with a transgender teen couple. Meanwhile, the hospital implements new policies which test the patience of the staff.

Jackson is given the daunting task of delivering disappointing news to the doctors. Meanwhile, Derek's sister Amelia drops by for a surprise visit, Richard surprises Catherine in Boston and when Bailey gets frustrated by the slow pace of her research, she makes a risky decision.

Owen becomes invested in a patient when he realizes she may have served in the military, April’s mother pays her daughter a visit and bonds with Jackson, and Derek plans a family dinner. Meanwhile, a patient’s diagnosis causes Bailey to reconsider her own health issues and Dr. Herman drops a bombshell on Arizona