The five interns finally have to face one of the biggest test of their careers, which will influence the rest of their lives as surgeons. Meredith is still feeling guilty about her stepmother’s death, but feels confident that she will pass the exam, despite warnings from both Cristina and Richard. However, after her father, Thatcher, causes a scene at the hospital, Meredith finds herself unable to focus and doesn’t write anything on the exam paper. Meanwhile, George gets accepted in the Mercy West Hospital surgical residency program and has to face a decision which will change his relationship with Izzie forever. Callie’s suspicions of her husband’s unfaithfulness grow and is thrilled about George’s transfer to a different hospital. Alex learns that Ava’s memory has come back, but he becomes infuriated with her after learning that she is not willing to let her family know where she is. Bailey realizes that Callie’s chances of becoming Chief Resident have increased considerably, while Burke cannot get Cristina to talk to him about their upcoming wedding. The attending physicians work with three injured mountain climbers who left their friend behind in order to save their own lives. Derek continues to feel pushed out by Meredith, and Burke’s stag party he flirts with another woman. Joe and his boyfriend consider adopting a baby, but things go bad for them when their surrogate mother collapses. Addison makes the shocking discovery that Adele, Webber’s wife, is pregnant. Webber eventually bumps into her, but Adele hides in the ladies’ bathroom, and when he finally enters he finds her collapsed on the floor.