Josh caught Kendall, Greenlee and Simone breaking into his father's clinic, but agreed to keep their secret -- in exchange for Kendall getting him a job on Erica's new show. He couldn't understand why his father didn't want him anywhere near Erica, assuming it was because of a past the two of them shared. He hooked up with Danielle Frye at a party, believing she was an experienced woman of the world rather than a virginal and under-aged teen. He apologized to her after learning the truth, and the two agreed to remain friends. He also became friends with Babe Carey, which annoyed Erica to no end considering what Babe had done to Bianca -- to the point where Erica forbade Josh from having anything to do with Babe. He even agreed to pretend to sleep with Babe so that Jamie Martin would dump her.
Josh wasn't satisfied with simply being a producer of Erica's show and wanted to take over the whole thing. He began sabotaging Erica, even drugging her, and set new hire Amanda Dillon up as the patsy. Although initially Erica had believed it was Amanda, she eventually caught on and fired Josh. Around the same time, Erica started acting markedly different around Josh, which he couldn't quite understand. He saved her life after the Mardi Gras ball, which led to Josh, who had gone to medical school at his father's request, getting a job at the hospital. Although most of Pine Valley had no use for Josh, he was determined to make a name for himself as a doctor and was thrilled when Jeff Martin came to town and hand-picked him for a special assignment.
Josh was unable to come to terms with what he saw as his mother and father not wanting him. He began to lash out and . He embezzled millions of dollars for Zach Slater's casino, and it made him a wanted man. Had it not been for Kendall intervening, Zach very well may have had Josh disposed of -- permanently. Josh fled town for several months. He eventually made the mistake of deciding to return -- to steal even more money from Zach. A masked Josh held casino patrons at gunpoint before making a run for it. Erica recognized a ring that the gunman was wearing and knew that the intruder was Josh. She tried to plead with him and offered to give him the money that he wanted, but the pleas didn't work. During a hostage situation where Josh held Reese Marshall at gunpoint, Zach fired off a single round and shot Josh in the head. He then urged the medics to do everything they could to keep Josh's heart viable for transplant.