When the Chief makes an announcement that a solo surgery is up as an award, the residents are sent into a frenzy all trying to get an edge over one another. Meanwhile, Derek asks Bailey for advice after Cristina continues to interfere in his relationship with Meredith. Elsewhere, Erica uncovers a shocking connection between a resident and a patient.

As Meredith, Derek and all of their friends prepare for the big wedding, a group of college students, injured in a car crash as they were heading to their graduation ceremony, is admitted to the ER. Meanwhile, Izzie fears the worst when she begins experiencing familiar symptoms.

Several weeks after her near-death experience, a recovering Izzie returns to work. Meanwhile, nervous that there will be layoffs in the hospital in the wake of an announcement from the Chief, the Seattle Grace residents compete to survive the cuts, including Cristina, who attempts to work alongside Arizona in pediatrics. And Bailey and Alex's patient's already complex case is further complicated by her schizophrenic son.

As Adele's condition continues to deteriorate, Richard considers altering their living situation; an explosion at a local coffee shop results in a busy day in the ER for the doctors; Callie takes Meredith under her wing by helping her study for her boards; Lexie joins Arizona and Alex in peds, as they continue to care for intern Morgan's premature son; and when Jackson snaps at a patient, Mark encourages him to find ways to relieve his stress. Meanwhile, Cristina lets her suspicions get the best of her.

A devastated Cristina presses Owen to confess the intimate details of his affair; Mark takes his new authority very seriously when he steps in as chief for the day and butts heads with Richard over a patient's liver transplant; and Callie deems Meredith ready for the boards, while the rest of the residents continue to stress about the exam. Meanwhile, Callie, Arizona and Bailey plan a much needed ladies night for Teddy.

The doctors reach out to Bailey but she continues to shut everyone out; after an incident with Ethan's grandmother, Owen fears the child could end up in foster care. A new craniofacial specialist arrives at Grey Sloan Memorial Hospital to work on a young patient. Meanwhile, a magician's assistant is rushed into the ER after a magic trick goes terribly wrong.

Maggie gets upset when Meredith dodges her questions about DC; Bailey and Ben become concerned about Ben’s brother after he is admitted to the hospital, and Dr. Herman starts to warm up to Arizona. Meanwhile, Richard feels manipulated by Catherine.