English-Medium Instruction (EMI) has gained prominence globally as higher education institutions (HEIs) adopt English to teach academic subjects, particularly in non-Anglophone regions. This review explores the implementation and impacts of EMI on students' English proficiency and content learning in various contexts, including Taiwan, the UAE, Malaysia, and Thailand. EMI has been driven by globalization, institutional internationalization, and the perceived advantages of enhancing students’ career prospects and mobility. While EMI has successfully improved English language skills, its effects on content learning remain inconclusive, with studies showing varied outcomes. Key challenges include linguistic barriers, cultural mismatches, insufficient institutional support, and concerns over linguistic and cultural identity erosion. Notable issues such as limited English proficiency often hinder students' ability to fully engage with course material, leading to disparities in academic outcomes. The review also highlights the diversity of EMI implementation across educational levels and regions, ranging from partial integration in Chinese universities to fully English-medium programs in European HEIs. The findings underscore the importance of policy support, bilingual teaching strategies, and adequate teacher training to address the challenges associated with EMI. Ultimately, while EMI enhances international competitiveness and student employability, its broader implications for equity, cultural preservation, and effective content delivery warrant further investigation. This review calls for more rigorous research to explore the intersection of language proficiency, academic ability, and content mastery in EMI settings.
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