The longer Martin Arrowsmith is in medical school, the more he challenges his professors openly in class (except for Gottlieb, who he worships). He doesn't understand why they're learning half of the stuff they are, especially when much of it is just doctor hearsay and has never been proven.
He also becomes closer with Madeline over his second year. He's a little put off by the swanky parties she takes him to, but when he sees how much the young men chase after her, he decides that he must have her for himself.
One night, Martin visits Madeline at her place. But he realizes that Madeline's mother is there, and no matter how long he sticks around, the mother won't go to bed. Finally, he gives up on being alone with Madeline. She walks him to the door, and he uses this chance to steal a kiss from her.
One day, Clif Clawson tells Martin that pretty soon, Madeline will start choosing his outfits and treating him like a trained dog. Martin argues back, but sort of agrees. Nonetheless, it's during this conversation with Clif that Martin decides he wants to marry Madeline.
The next time Martin sees Madeline, they're hanging out on a rooftop. She starts spilling her guts about all her insecurities. She thinks no one will ever marry her, and Martin takes this opportunity to propose.
Martin thinks that convincing Madeline's mother will be difficult, but the woman gives them her blessing and says she'll pray for them.
Martin plans on going to Canada that summer and working as a waiter with Clif Clawson. Madeline isn't a fan of Clif, though, and she's not a fan of the idea either. She doesn't want Martin running around the world with his buddies now that he and she are engaged. Martin accuses her of being a nag, and she accuses him of being a rude and inconsiderate jerk. Get used to this line of conversation between them… it doesn't get any better.