Dr. Silva welcomes Martin back to medical school and congratulates him on his marriage. Leora, permitted to write once a week, tells Martin that she has been dropped from the school of nursing because of absence and of being married. She is secretly studying shorthand and trying to learn typing so that she can earn money as a stenographer. Martin decides to return to Wheatsylvania and demand that his father-in-law support Leora and finance a course in stenography for her while her husband is finishing his degree. After much wrangling, the request is granted, and Martin and Leora leave for Zenith with the promise of seventy dollars a month from the Tozer treasury.
Martin finds Leora a room in Zenith nearer Mohalis than her hospital had been. This is their first home. She studies in the Zenith University of Business Administration and Finance. It takes her six months to learn enough stenography to work in an insurance office. At least two nights a week Martin spends with her. Though she knows little of medicine, she understands his philosophy and the basis of his work. She makes him physically comfortable and keeps out of his way while he studies. She gives him security. He has transferred his admiration and loyalty from Gottlieb to Silva.
A year and a half whirl by between Martin's marriage and his graduation. Clif Clawson is a buoyant companion until he leaves for New York and a new motor agency. Mr. Tozer becomes more cordial although he sends irritating fatherly advice with every check.
The seniors are all trying to decide which branch of medicine to pursue after graduation. Should they remain general practitioners or become specialists? Angus Duer chooses surgery, Fatty Pfaff obstetrics. Martin considers first one specialty, then another, before deciding that after his internship is over he will accept Tozer's offer to help him set up office as a country doctor in Wheatsylvania. Angus stands first and Martin seventh in the class. Now he is Martin L. Arrowsmith, M.D., house physician in Zenith General Hospital.
Martin's student days are over, and his internship is beginning. His marriage has had a wonderful effect on him since he has practically quit drinking and finds complete contentment in his relationship with Leora. Yet the thought of Gottlieb and scientific research will occasionally intrude, and he still dreams of a small laboratory of his own. The idealist in him is not entirely subdued.
The first phase of the novel, Martin's schooling, is now complete, and the narrative moves on to his internship. Leora, the ideal wife for a man of Martin's temperament, gives him security and contentment. She assumes her part of their financial burden as well, although she is not well equipped for a career outside the home.