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It is now widely accepted that the English language has become the language of international communication. The widespread need for English as a second or foreign language puts a great pressure on the educational resources of many countries. ESP courses require specific language and skills that are related to communities of practice and disciplines. Careful examination of the attitudes and perceptions of learners and instructors is seen to be important in determining the problems of ESP courses. This study focuses on an ESP course offered at Tabriz faculty of Medical Sciences in Iran. The instruments used in this study were questionnaires for 200 medical students, interviews with 5 teachers and observation by the researcher. The data from the questionnaires was analyzed by using the SPSS programme, version 16. Results showed that ESP instruction was limited to training special vocabulary and reading and translating numerous texts. Of course, such methods didn't reflect students' interests and resulted in low motivation of learners and their poor participation. This study assumes that the English language is used widely in the medical field. Therefore ESP courses for medical students should be based on target needs of students representing communicative use of language rather than linguistic categories.