Dr. Cox has trouble adjusting to his new job as Chief of Medicine, and Carla gets in trouble with the other nurses because of her relationship with the doctors.
- From Hero to Mentor: Cox and Kelso now spend time hanging out together outside the hospital, and Kelso warns him that he won't be able to work the floor like he used to. He'll be tied up in red tape and bureaucracy, and will barely be able to spend any time with patients.
- He also comes to JD and explains to him that JD has to step into the role that Cox used to fill in the Cox-Kelso dynamic. The Chief is swamped with demands from everyone and needs someone to demand he pay attention to patients' needs when it's really important.
- Magical Realism: Cox asks what grand ceremony JD has prepared to congratulate him on his first day as Chief. In desperation, JD starts tapping on a coffee mug with a pencil, cuing a musical percussion montage.
- Sure, Let's Go with That: Elliot's not allowed to sing "Swing Low, Sweet Chariot".Elliot: I just can't hit the low notes.
Carla: Yeah. That's why.
