Exploring English as a Medium of Instruction for the Teaching of Medicine in Saudi Arabia

Higher Education Institutions have recently taken initiatives to achieve internationalisation, prepare students for future careers and improve their language competence through the implementation of English-Medium Instruction (EMI). However, despite the popularity and extensive application of EMI in many foreign language (FL) countries, implementing EMI policy in HE institutions is still widely debated and a number of challenges have been raised regarding the teaching and learning of content in English. Much of the research in this area focusses on teachers’ and students’ perceptions of EMI and practice in various disciplines such as Mathematics and Science, however, very little attention has been paid to the implementation of EMI in the Medical discipline in FL contexts (e.g., Saudi Arabia). Thus, this study critically explores how EMI is implemented in medical schools in Saudi Arabia. It specifically focusses on teachers’ and students’ perceptions of medium of instruction (MoI), the challenges they face when teaching and learning medicine through English only and strategies they employ to overcome those challenges. These perceptions are then compared to their actual practices in the classroom and in study groups. To achieve this goal, a mixed methods approach (qualitative and quantitative) was adopted. A questionnaire was distributed to 40 content teachers and 373 medical students in four medical schools in two cities in Saudi Arabia. An in-depth semi-structured interview was conducted with 26 content teachers and 60 medical students. Further, ten classrooms and seven study groups were observed. The data was analysed quantitatively and qualitatively. Specifically, the questionnaire data was analysed using the Statistical Package for the Social Sciences (SPSS) software; interview data was analysed using thematic analyses and the observations were analysed using both Polio and Duff’s (1990) techniques as well as that of Systemic Functional Linguistics. The findings of the study reveal that the majority of teachers and students supported EMI over Arabic medium instruction for teaching and learning medicine for three reasons: 1) developing students’ knowledge competency in the international language of medicine, English, 2) improving their English proficiency and 3) preparing them for academic and professional careers. Yet despite these sentiments, many of the teachers and students called for an Arabic-supplemented EMI classroom for facilitating content understanding, ensuring student comprehension of the knowledge in both English and Arabic and saving teaching time. Although these participants largely supported EMI policy, they indicated that they experienced a number of challenges. Particularly, students experienced numerous challenges including reading and understanding medical materials, writing for medical contexts, and speaking fluently. Notably, these challenges were more salient in the students’ first and second years, but gradually disappeared after their progression to a higher level. Teachers also highlighted the limited class time as problematic, preventing them from delving deeply into the content. In order to facilitate the teaching and learning of EMI medical content and to overcome these challenges, the teachers and the students adapted various types of strategies including; translanguaging (i.e., “the process of making meaning…gaining understanding and knowledge through the use of two languages” Baker, 2011, p. 288), English medium strategies (e.g., teachers simplify their language), and multimodality (e.g., figures, human models and technology). Based on these findings, the thesis concludes with some implications and recommendations for teachers and decision makers.