Towards the end of the second season, he was shot, which affected his control of his right-hand. His temporary fix to this possibly long-term problem was to work together with Cristina during every one of his surgeries so that she could take over in case he might have trouble with his hand. The arrangement fell apart after Cristina, reacting to growing stress after George O'Malley (T. R. Knight) caught onto their secret, went to the Chief and confessed everything. Initially, he was engaged in a cold war with Cristina, where neither of them spoke. However, after she broke the silence, he proposed to her and she accepted his proposal. Before their secret was revealed, Burke was to become the next Chief of Surgery, but he had to compete with his fellow attendings for the position. He has since recovered from the injury, after Derek operated on him. For the remainder of the season, Preston and Cristina prepared for the wedding and experienced normal stresses that result from such a process, such as meeting each other's parents.