After watching 199 episodes of Grey’s Anatomy, a lot has changed, yet some things remain the same.

This sneak preview clip from tomorrow night's "Puttin' on the Ritz" really drives both points home.

Meredith is no longer the dark, twisty, occasionally boozy intern we fell in love with back in early 2005. She's matured and has grown along with Derek, thriving as part of an adorable family unit.

Still, we've known from the start that surgeons are competitive, and one who has to stay out of the OR for an extended period of time can become very scary. Maternity leave? Not going so hot.

Check out the scene from this week's 200th episode below and see what we mean ...

While Meredith and Derek made a mutual decision to take maternity and paternity leave following the birth of baby #2, turning off the fire that fuels them professionally is a challenge.

According to house guest Callie, they've made everything a competition, and the fundraising ball - which we've gotten our first look at here, and in the 200th episode photos - is no exception.

In "Puttin' on the Ritz," the hospital board is on hand to raise some cash, with Jackson awarding 10 percent of the funds to the department who raises the most. So it is game on, people.

How will it play out? Share your thoughts on the clip above and all things Grey's!

Steve Marsi is the Managing Editor of TV Fanatic. Follow him on Google+ or email him here.