One of Meredith's oldest friends, Sadie, becomes an intern at Seattle Grace, but Mer's friends are less-than-welcoming to her.

Cristina is awarded the first solo surgery among the residents, but she is forced to give it up and choose her replacement; Lexie is impressed when Mark performs a cutting-edge procedure; Callie doesn't know if Sadie is friendly or flirtatious.

Now that Derek has the engagement ring, he searches for the perfect way to propose to Meredith, as Lexie demands that Mark go public with their relationship, and Bailey, encouraged by her work on recent cases and by Dr. Dixon, considers a new direction for her medical career.