Objective: To improve English language of newly admitted 1st MBBS students from vernacular medium by implementing English Language Proficiency Program (ELPP).

Method: English Language Proficiency Program of 40 hours’ duration was implemented for 38 Gujarati vernacular medium students of 1st MBBS. ELPP was delivered by Expert English language teacher. ELPP includes reading, writing, speaking and grammar. ELPP was evaluated through Pre and Post-test for English language component like, reading & comprehension, vocabulary, grammar & written expression. Student feedback was also taken at the end of program.

Results: English language proficiency programme significantly improved the vocabulary and written communication, however no significant improvement was observed in grammar and reading comprehension. Majority of students rated the course as good to excellent. Large numbers of students felt that the course was useful and improved their communication skills.

Conclusion: English language course for student of 1st MBBS vernacular medium was received well. Student also rated the program as useful for improving their language proficiency and communication skills.

English language is the medium for teaching and learning in most of the medical schools of world. Medicine is a branch where continuous up-gradation of knowledge is required (1). Most of the International medical journals, books and websites provide their information in English language. All most all the medical entrance exam is taken in English language.

Medical institutes all over the world check English language proficiency (ELP) of medical students and medical professional for academic and recruitment purpose. It is found that there is a high correlation between perform ance in ELP test and their performance in the professional examinations (1, 2). Poor proficiency in English language is usually associated with poorer performance of students in professional examinations (2, 3). Thus for medical profession, a good English language proficiency is essential (1, 3). Poor English language has been found to affect the comprehensive ability of students and thus hampers understanding of conceptual medicine (3, 4, 5).

In India, more than 780 languages are spoken and students prefer vernacular language during primary and secondary school education, but English language is the medium for learning in all medical schools. Therefore, students those who are coming from vernacular medium have difficulty to understand and communicate their medical subject knowledge in English language. To learn medical science successfully, students of vernacular medium are required good proficiency in English language (3, 4, 5).

At Pramukhswami Medical College, Karamsad, every year 40% to 60% students come from Gujarati medium. Therefore, considering the need of English proficiency, Pramukhswam i Medical College, Karamsad in collaboration with H.M. Patel Institute of English Training & Research, Sardar Patel University had designed an English Language Proficiency Program (ELPP) for the first year medical students of the 2010-11 academic batch. The objective of the ELPP was to improve the English proficiency amongst the students coming from vernacular background. The program was later evaluated for its efficacy. The program was conducted as a curriculum innovation project of the GSMC￾FAIMER Fellowship 2010.

An “English Language Proficiency Program (ELPP)” was designed by Pramukhswami Medical Colege, Karamsad in collaboration with H.M. Patel Institute of English, Sardar Patel University, V.V. Nagar. Validation of this program was done by internal as well external faculties and changes were made accordingly. Program was implemented after the approval of our institute’s Human Research Ethics Committee (HREC).

The Program consisted of three steps. The first step was to evaluate the baseline English language proficiency. The evaluation was done by pre-intervention test for all the students of the First MBBS Academic Year 2010-11. A total of 86 students took the test, of whom 38 students were from Gujarati medium (vernacular) and 48 students were from English medium. The test was designed to assess student’s English proficiency with reference to Grammar, Vocabulary, Comprehension, Reading and Writing skills. Each component was tested for 10 marks or score with total 50 marks or score. After the test only 38 students from Gujarati medium were ready to join 40 hours English Language Proficiency Programme and 48 students from English medium had refused to join the programme. All 38 students from Gujarati medium were recruited as participant for the study after their voluntary consent.

The second step was implementation of English Language Proficiency Programme to the participants. ELPP was a 40 hours’ program which was implemented during the first semester of the First MBBS course. During the intervention, students were initially introduced to the English language by the faculty members who are coming from H.M. Patel Institute of English, Sardar Patel University, V.V. Nagar, Anand, Gujarat, India for a period of 9 hours over a period of 3 weeks. During these period participants were taught about the basic of learning grammar and vocabulary (English and Medical). This was followed by practice sessions for the participants for understanding written and spoken English. This happened for a period of 21 hours spread over to 15 weeks. The practice sessions consisted of listening to Audio-clips, watching Video-clips, doing group activities. The students were also given home assignments for a period of 10 hours to improve their reading and writing skills by asking them to write short essays on predetermined topics. During the whole intervention, students were provided with resource materials which included Oxford practice Grammar Book for self-reading and practice, Appendix of medical terms and word roots for medical subjects of First MBBS i.e., Anatomy, Physiology and Biochemistry (7).

The intervention was followed by the third step wherein post-intervention assessment of the students was conducted. The post-intervention test was similar to the pre-intervention test in terms of objectives and content. After the post-intervention assessment of the students, a qualitative feedback on ELPP was obtained from the participating students.

Statistical Analysis

The results of pre-intervention test and post-intervention test were compared statistically using the student paired t-test for evaluation of English language proficiency programme.

There was statistically significant improvement in English Language skills of participant. As shown in Table I, participants pre-test score increased from 25.75±4.53 to 28.97±5.67.

ELPP significantly improved the vocabulary and written communication of the participants. Reading and grammar skills were also improved but they were statistically not significant. As depicted in Fig. 1, 46% participants rated overall program as a good and 30% rated it as a very good. Fig. 2, shows course usefulness and 69% participants rated it as a useful course. Fig. 3, shows effectiveness of faculty members.

In our study, vocabulary and written communication improved significantly amongst the students. Although, the improvement in grammar and reading comprehension were not statistically significant but, there was an increase in the post-test scores in these areas also.

The need for additional English teaching was also inferred in a study at Australia, where it was concluded that the students with poor English oral communication skills should be encouraged to speak English away from the medical school and should be offered additional tuition so that their skills in other languages are not lost to the health care system (5, 6, 7); whereas Diane Malcolm investigating successive English learners after completing EAP (English for Academic purposes) program in an Arab medical school found out-of-school exposure and practice of English as an effective means for improving English proficiency (8). Here, the most common reported ways to improve English were watching TV and movies and speaking with native speakers. Administering STAL (Screening Test for Adolescent Language), Chur Hansen A. et al (2) found that a satisfactory performance in medical communication skills was not associated with language background or overall performance on the STAL (Screening Test for Adolescent Language). This may be owing to the English learning of these students before entering to the medical schools.

The major finding of our study was that the students opined about this program that they found it very useful to improve their English language proficiency.

Conclusion

English language proficiency programme (ELPP) for student of vernacular medium from 2010 batch was received well. Students have rated the program as useful for improving their language proficiency and use of English language as a communication skill. Such English language courses should be continued for the coming years.

Limitations of the study

The outcome of the study was judged by the score obtained in a single test and based on subjective feedback.

1. Chur-Hansen A. Language background, proficiency in English, and selection for language development. Med Educ September 1997; 31(5): 312-319.
2. Chur-Hansen A, J Vernon-Roberts, S Clark. Language background, English language proficiency and medical communication skills of medical students. Medical Education July 1997; Volume 31, Issue 4, pages 259-263.
3. Janet G. English Language Proficiency and the Prediction of Academic Success; TESOL Quarterly, September 1987; Volume 21, Issue 3, Pages: 505-521.
4. Sara K. Teaching English at Damascus University Medical School. East Mediterr Health J 2009 May-Jun; 15(3): 653-664.
5. Richard B. Hays, Patricia Pearse, Christopher W. Cooper and Leonie Sanderson. Language background and communication skills of medical students. Ethnicity& Health 1996; Volume 1, Issue 4.
6. Eseonu, Kelechi, Wedderburn, Catherine, Maurice, James. Clinical communication for international students in the UK undergraduate curriculum. Clinical Teacher September 2011; 8(3): 186-191.
7. SC Hayes, D Farnill. Medical training and English language proficiency. Medical Education January 1993; Volume 27, Issue 1, pages 6-14.
8. Diane Malcolm. Investigating successful English learners in Arab medical schools. Proceedings of the Independent Learning Conference 2003.