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In order for Carter to change from his surgical residency to an emergency medicine residency, he agrees to work without pay.
He is part of an influential and wealthy family and does not need to work, enabling County General to take him on despite its lack of funding for an additional position.
He gets off to a rocky start when on his first day at County, he nearly vomits in the emergency room after seeing a critically wounded patient and has to be consoled by Chief Resident Dr. Carter has a dedicated and compassionate approach with his patients.
Initially interested in surgery, he switches to the ER, much to his surgeon mentor Dr. During his surgical residency Carter lamented the lack of patient connections and specifically regretted the lack of thorough follow-up and care.
Greene demands that he go to an inpatient rehab center for medical doctors in Atlanta or be fired. Benton convinces him and boards the plane with him.
It is named after his stillborn son - "The Joshua Makalo Carter Center." Afterwards, he goes to Paris, where Kem is visiting her mother. Carter returns to Chicago and bids adieu to his friends and colleagues.
They reconnect and he offers to go to Africa with her so they can start afresh. In Season 12, Carter appears in a four episode arc, working with a fellow doctor in Darfur, Sudan, where he is joined by Dr. Pratt informs him that Luka and Abby have reunited and are expecting a baby.
Knight dies from her injuries while Carter's injuries leave him with lifelong kidney problems.
As a result of Carter's chronic battle with pain, survivor guilt, and resistance to getting help, he eventually develops a narcotic addiction and begins making mistakes at work.