It utilized some of the most mediocre of 2009's CG capabilities to make a semi-successful attempt at capturing the actors' faces, ranging from Callie at the most accurate graph of Sara Ramirez to Bailey looking like a completely different person to Chandra Wilson.
The story of the game was written by the television writers, so what it lacks in looks it makes up for in plot. This is consistent throughout the different game modes available: finding your way around the hospital, finding your way through the characters' personal lives, and the mini game surgeries available.
It plays a lot like a widget game, with every gameplay option available to players accompanied by a mini game. It was released for both Nintendo and PC.
- Absentee Actor: Though it is set in the fourth season, it was released just as the fifth season ended. This was probably development time, but may be a reason why Erica (who had left the show by this point) is barely present in the game even though she features on the cover. Also why Owen and Arizona aren't in the game even though they were main characters on the show.
- Action Commands: The mechanics are arguably so simple it's impossible to fail — this is remedied by setting time limits on everything in the game, not succeeding in enough time to jab at your screen results in losing a heart.
- Adaptational Ugliness: The fault of CG character mapping has severely obscured some of the characters, most notably Derek, with McDreamy looking a lot more McNightmare-y.
- And Now for Someone Completely Different: You know how the show has an ensemble cast that switches character and storyline almost every scene? So does the game. You get to play as all of them as the uncontrollable plot progresses, so they switch out of nowhere, including the game-only characters.
- Canon Foreigner: Damon and Vince.
- Contamination Situation: When the actual plot really gets going, it's trying to contain one.
- Digitized Sprites: Though there appears to be some polygon overlay, this is obviously the primary method used to import the actors' likenesses with minimal effort, though the marketing claim that they look just like real is pushing the truth.
- Direct Continuous Levels: The game progresses around the hospital, with the story and movement going through "Acts" without physically moving, representing an episodic story arc.
- Gameplay-Guided Amnesia: Downplayed. A player could question why the surgeons of Seattle Grace are failing simple surgeries, it's even lampshaded by Cristina if you fail when playing as her, but there's a lot going on that it's not too unusual, and the implication is that they know what to do but they (well, the player-as-character) needs to make it happen perfectly and in a set time, so it can be given a Hand Wave as "seriously, these surgeons stress a lot".
- Girl-on-Girl Is Hot: Most of Erica's encounters are just Mark coming on to her and alluding to this.
- I Am Spartacus: At the end of Chapter 4, Bailey, Callie and Izzie all attempt to take the blame for trying to break Tuck out of quarantine.
- It's Up to You: Played with. Though it is not just up to one character to do everything in the game, it is up to one player, as it's all done through switching perspective.
- Mini-Game: Story + mini-games.
- Hot Coffee Minigame: Enjoy being a part of Meredith's sex life.
- One of Our Own: Cristina contracts diphtheria and attempts to treat herself in secret for as long as she can for the sake of a fellowship offer. Meredith ends up exposing her, which puts a brief strain on their friendship.
- Optional Sexual Encounter: Half the game is progressing Meredith and Derek's relationship - you make the action call.
- The Plague: The diphtheria outbreak through Seattle Grace that the surgeons try to contain and not contract.
- Power Levels: Depending on how many hearts you make it through a scene with, you will be ranked on a 1-5 scale that seems to make greater leaps the higher it goes: Intern — Resident — Chief Resident — Attending — Chief of Surgery.
- Repeatable Quest: The story will need you to save your patient. Try again until you stop killing them.
- Sliding Scale of Gameplay and Story Integration: Bumps around. It doesn't feature classic gameplay and is story-centric, forcing game mechanics into the storyline. That said, where traditional game elements are used (i.e. heart meter), it fits well with its story purpose of representing how well and quickly choices are made/actions performed by the idea that your heart would be racing if you weren't doing well and so slipping up too much would have the same effects.