Pragmatism in Non-Anglophone EMI Medical Study Abroad: Japanese Students’ Motivations and Experiences in Hungary

• In Event: Navigating Cross-Border Higher Education: Student Perspectives

Proposal

The expansion of English-taught programs in non-Anglophone countries has reshaped international student mobility (Studyportals, 2024). Traditionally, students gravitated toward Anglophone destinations such as the United States, the United Kingdom, Canada, and Australia. However, recent trends show increasing mobility toward non-Anglophone OECD countries, reflecting a shift from “vertical mobility” (from developing to developed countries) to “horizontal mobility” among academically and economically comparable nations (Teichler, 2015).

Medical education exemplifies this shift. Once dominated by students from low-income countries seeking training in high-income nations, medical student mobility now increasingly occurs within Europe and among OECD countries. Between 2013 and 2016, horizontal mobility in medical education rose by 25% (OECD, 2019). English Medium Instruction (EMI) has played a strategic role in this transformation, enabling universities in non-Anglophone countries to attract international students by offering medical degrees in English.

Japanese students have traditionally studied abroad in Anglophone countries for language acquisition and cultural exposure (British Council, 2014). However, recent data show a rise in degree-seeking mobility to non-Anglophone countries (Matsuzaki & Kato, 2025). From 2017 to 2022, countries such as the Czech Republic, Hungary, and Austria have seen notable increases in Japanese student enrollment (UIS, 2024). Hungary, in particular, has emerged as a key destination, with over 90% of Japanese students enrolled in medical faculties, comprising nearly one-third of the Japanese population in the country (Hungarian National University Office, 2023).

According to Nara (2017), more Japanese students are pursuing medical education in Hungary with the intention of taking Japan’s national medical licensing examination. Among those who have passed the exam, the proportion of overseas graduates—particularly from Hungary—has been steadily rising (Ministry of Health, Labour and Welfare, 2019).

While medical schools in non-Anglophone countries are often framed as a “second chance” for students facing barriers to domestic medical education (Ishikura, 2020), this characterization warrants reflection. Medical education is inherently demanding, and mastering its content in a non-native language adds complexity. This raises the question of whether a pathway that is both rigorous and linguistically challenging can truly be considered a “second chance.”

To explore this question, this study investigates the motivations, academic and social experiences, and career outlooks of Japanese students enrolled in EMI medical programs in Hungary. In February 2024, semi-structured interviews were conducted with two students, and the data were analyzed using thematic analysis (Braun & Clarke, 2021). Student motivations were examined using the framework by Hovdhaugen and Wiers-Jenssen (2023), which categorizes international students into three types: Explorers (seeking cultural experiences), Differentiation seekers (pursuing unique academic or career opportunities), and Pragmatists (driven by professional goals and limited domestic options).

Both participants expressed a strong desire to become medical doctors, and their decision to study in Hungary was primarily pragmatic. Faced with the difficulty of entering Japanese medical schools, they viewed Hungary’s EMI programs as a realistic and attainable pathway. Influencing factors included the presence of a Japanese-speaking administrative office, domestic entrance exams held in Japan, relatively easier admission requirements, and the proven track record of Japanese graduates passing Japan’s licensing exam.

A key reason for choosing Hungary is the “Hungary Medical School Office,” a dedicated agency that facilitates the entire process. Through their support, students receive assistance with entrance exams, enrollment, travel arrangements, and academic and daily life support.

While instruction was in English, the primary source of academic stress was not language barriers but the rigor of medical education itself. Contrary to common EMI challenges, students identified the complexity of medical content and their own preparedness as the main difficulties. The EMI program operated separately from the local-language track, resulting in minimal interaction with Hungarian students and limited engagement with Japanese or international peers. This isolation stemmed from intense academic demands and lack of time, rather than linguistic or cultural factors. Academic challenges shaped their study abroad experience more than social or linguistic issues.

Research highlights that dropout rates in Hungarian medical schools are high, especially among international students. According to Pusztai et al. (2022), this is largely due to financial burdens and insufficient social integration. These findings underscore the need for targeted support systems, which were also reflected in the participants’ experiences.

Both students encountered challenges in daily life due to limited Hungarian proficiency—particularly in administrative procedures and housing—but their strong professional aspirations helped them contextualize these difficulties as minor. Moreover, both demonstrated high adaptability to intercultural environments, likely minimizing the impact of social and linguistic difficulties. This can be attributed to their possession of “mobility capital”: one had participated in a university exchange program in a non-English-speaking country, while the other had lived abroad before high school. These experiences equipped them to navigate unfamiliar cultural contexts.

Initially motivated by the possibility of passing Japan’s licensing exam, both students later recognized that earning a degree in English expanded their global employability. They expressed a sense of limitless potential for their careers. This optimistic outlook may be attributed to their status as fifth-year students nearing graduation, suggesting a shift in perception over time (Hovdhaugen & Wiers-Jenssen, 2023).

This study reveals that Japanese students’ enrollment in non-Anglophone EMI medical programs is not merely a second-best alternative but a strategic and pragmatic choice for professional development. The phenomenon is shaped by the interaction between institutional strategies offering EMI programs and individual agency in navigating educational and career pathways. While the participants demonstrated strong adaptability due to prior international experiences, it remains unclear how students without such mobility capital navigate EMI medical study abroad. Future research should explore the experiences of students with limited intercultural exposure to better understand the support structures needed for diverse learner backgrounds. As EMI continues to expand in fields tied to national qualifications and public health systems, further attention is needed to understand its societal implications.

Author

• Kumi Matsuzaki, Graduate School of Nagoya University/Japanese Red Cross Toyota College of Nursing