Christina and Owen cannot still see eye to eye about their unplanned pregnancy. Meredith has to face the consequences of her actions last season and April steps up as chief resident. Meredith and Derek try to maintain and fix their rocky relationship, which causes some issues with the adoption. The residents perform their first surgeries alone. When Ben finally returns, he finds that Bailey has already moved on. Christina makes a decision about her pregnancy. Meanwhile, Jackson’s mother comes for a transplant at Seattle Grace. Meredith struggles no to interfere with Derek’s work at the hospital.

Callie and Christina have to perform a hard spinal surgery. Owen enters the doctors into a softball game against another hospital, the Seattle Prebysterian. Alex struggles to keep Zola at the hospital. Lexie is jealous that Mark is dating another woman. Richard tries to fix the working relationship between Meredith and Bailey. A medical miracle leaves the residents feeling inspired. When Arizona makes friends with a new pediatric associate, Alex feels threatened. When Henry reveals that he wants to attend medical school, a fight ensues between him and Teddy. Louise O’Malley returns to Seattle Grace, which causes residents to miss the days when they still had George. Henry is brought in for an emergency surgery, and Teddy is called away for another case. When a patient experiences complications after a surgery, Callie and Jackson come under fire. Meredith and Derek receive news about Zola. When Alec and Meredith travel to another hospital to watch a newborn who is sick, they encounter a situation that could be potentially life threatening. April adapts to her new role as the Chief Resident. A giant sinkhole that has opened up in the middle of Seattle causes a massive crisis that lasts for some time.