Challenges and coping strategies for achieving terminology precision in EMI medical writing among Saudi medical students.

This study examines how Saudi medical students manage the accuracy demands of English academic writing in an English-medium instruction (EMI) context, with particular attention to medical terminology work and the instructional conditions that shape students' strategy use. Although EMI is institutionalized in Saudi medical education, many students enter university from Arabic-medium schooling, making early academic writing in English a site of heightened risk for misrepresenting medical meaning. Using a qualitative, interpretive design, data were generated through semi-structured interviews with 15 s-year medical students enrolled in an English academic writing course. Classroom observations in two course sections were used to contextualize participation norms and routine classroom structures. Data were analyzed using reflexive thematic analysis. Findings show that students experience medical terminology and meaning precision as the central challenge in writing about medical topics in English. To manage this challenge, they report recursive strategies across planning, drafting, and revision, including Arabic-mediated idea development, translation for conceptual clarification, stepwise terminology verification, and peer-supported checking before finalizing English phrasing. Findings also indicate that course expectations, feedback, and participation norms shape whether strategies are enacted publicly or remain private, with Arabic-mediated meaning work often occurring internally, through personal note-taking, or through peer interaction. Overall, the findings position meaning verification and terminology control as central to disciplinary writing competence and suggest the value of instructional routines and feedback practices that make accuracy-oriented verification more systematic and learnable within EMI medical writing.