A Change Is Gonna Come (Grey's Anatomy)

"A Change Is Gonna Come" is the first episode and the season premiere of the fourth season of the American television medical drama Grey's Anatomy, and the show's 37th episode overall. Written by series creator Shonda Rhimes and directed by Rob Corn, the episode aired on the American Broadcasting Company (ABC) in the United States on September 21, 2006.

The episode primarily focused on Cristina Yang (Sandra Oh) dealing with the aftermath of Preston Burke's (Isaiah Washington) departure and the dissolution of their engagement, Izzie Stevens (Katherine Heigl) struggling with her romantic feelings towards the married George O'Malley (T. R. Knight), and Callie Torres (Sara Ramirez) learning to deal with her new position of Chief Resident. Also dealt with was Alex Karev (Justin Chambers) coping with Rebecca Pope's (Elizabeth Reaser) departure, and Meredith Grey (Ellen Pompeo) facing the conclusion of her relationship with Derek Shepherd (Patrick Dempsey), while dealing with the arrival of her half-sister, Lexie Grey (Chyler Leigh), who enrolls in the surgical program at the hospital.

Although the episode was fictionally set in Seattle, Washington, filming occurred in Los Angeles, California. It was the first not to feature Washington, due to his being fired from the series at the conclusion of Season 3. The episode also was the first to not feature Kate Walsh (who portrayed Addison Montgomery) as a series regular, as she transitioned to become the main character in Grey's Anatomy's spin-off Private Practice; however, Walsh did appear in the subsequent seasons in guest star capacity. It also marked Leigh's promotion to series regular status, following her guest appearances in the last 2 episodes of the previous season. Also featured were one-time guest actors Mark Pellegrino, Stephania Childers, Sandra Thigpen, and Steven Porter.

The episode was viewed by 20.93 million Americans in the United States upon its original airing, ranking #2 in the time-slot and #3 for the week, and garnered a 7.3 Nielsen rating in the 18–49 demographic, seeing a decrease from the previous episode, which received an 8.0 rating. It received mixed-to-negative reviews from television critics upon telecast; however, Cristina's storyline received critical acclaim.