ABSTRACT Informed by the theoretical concepts of ‘practiced’ language policy and space, the study investigates the language practices of English-medium Bachelor of Medicine and Bachelor of Surgery (MBBS) programs for international students, focusing on the interactional norms of language choice in a Chinese hospital where international students are interned. In accordance with the tenets of Interactional Sociolinguistics, data were gathered through observation, audio recordings, and interviews with 15 international medical students and clinical supervisors over the course of one year. The study found that three mediums of interaction were adopted across different spaces in the hospital: an English monolingual medium, a Chinese monolingual medium, and an English and Chinese bilingual medium. The findings suggest that ‘practiced’ language policies are never static or prescribed, but rather constructed in relation to personhood, type of activity and place in multiple social spaces. The study offers implications for international medical education and the promotion of an inclusive language environment.