This study revealed the teaching and learning process of EMP at the Faculty of Medicine. As the entire language module has not been built on needs analysis, it did not serve the students' needs properly. This underscores the argument that the first step in any ESP course should be needs analysis. In addition, the study showed that the assessment method is not an authentic and valid process because there is a mismatch between the students' results and their actual level regarding EMP. This mismatch can indicate that medical students are aware of their deficiencies and can assess their level of English. On the subject of materials, the study proved that following the textbook suggested by the faculty without modifications is not an answer or fulfilment to the students’ lacks and needs. The main aim of this study was to carry out a needs analysis which is the core of EMP. Medical students must specify their needs and wants in order for the course to be tailored to them. This study uncovered a big gap between the needs and the practices introduced in the EMP class. The needs were presented in depth, based on classroom observation (second-year class) and interviews with medical students, medical doctors, medical lectures, and English teachers. Forty-five interviews were conducted, and eleven sessions were observed in the needs analysis stage. Reading was the most critical need that all the participants confirmed in the interviews. Travelling, attending conferences, and writing were among the essential needs that the participants expressed. Since the students will need to translate a part of medical literature, translation was considered one of the academic needs requiring attention. The gap made by not identifying the needs showed that most second and third-year students are unaware of what EMP means. When they reach the fourth and the fifth year, where they need to use and translate medical literature, they start recognizing that EMP is not about terminology. Instead, they also need it as a fixed component in their academic and professional career.