J.D. and Turk are both facing the same dilemma, appearing masculine. J.D. wants to set a manly example for his son, while Turk undergoes a surgical procedure that causes him to feel insecure. Meanwhile, a disagreement with Kelso has the Janitor creating a hospital newspaper.

Turk learns Spanish as an anniversary gift for Carla. Dr. Cox tries to help Dr. Kelso cut back on the sweets. J.D. and Elliot have conflicting opinions about dealing with a burn victim who is about to graduate high school.

Sacred Heart hospital is signed up for RateYourDoctor.org. a website where patients are able to grade their doctors, by Dr. Kelso. The use of the website does not have the effect Dr. Kelso was aiming for, now the doctors are just aiming to be number one. Elliot is having a dilemma when it is revealed [...]

J.D. decides to grow up in order to better care for his son, but when he stops engaging in Turk’s antics, Turk brings it upon himself to bring back J.D.’s immaturity. Meanwhile, Eliot decides to throw Kelso a birthday party, but when his age is revealed, big changes are made at Sacred Heart.

Carla worries that she’s losing her Latin identity and fears that her daughter may never learn about her heritage. J.D. lands himself in hot water when the staff realizes that he uses nicknames because he doesn’t know anyone’s real name. Upon hearing this, the Janitor proposes a challenge — J.D. must identify everyone by name [...]

When the Janitor watches “An Inconvenient Truth,” he decides to become an Enviornmental Officer (with peculiar motivational methods) at Sacred Heart. J.D. must deal with an inconvenient truth of his own when Dan returns to town and tells him he has to grow up.

Kim goes into labor and both she and J.D. begin to worry about their future together as well as being parents. Dr. Cox refuses to give his daughter a shot, thinking she’ll always associate her father with pain; Turk and Carla try to complete a video game so it doesn’t distract them from being good [...]

As Eliot begins to plan her wedding with Keith, J.D. continues to question his true feelings for her. In an attempt to ease his best friend’s mind Turk takes him to a surgeon’s convention in Phoenix, but the plan backfires when J.D. runs into his ex-girlfriend Kim and comes face to face with the unexpected. [...]

When Eliot’s engagement ring doesn’t fit, Keith agrees to a “redo” in which the particular Doctor plans her own engagement. Carla, Jordan and Eliot’s sorority sister Melody gather to help plan the “surprise.” Meanwhile, the men of Sacred Heart are suffering from too much talk and not enough action as J.D. continually gets shot down [...]

J.D. feels a little left out when Eliot’s wild sorority sister, Melody comes to town. Not able to deal with being the third wheel he turns the girls against each other in the hopes that he will once again be Eliot’s priority friend and, if he is lucky, that he might get to “mash” it [...]