English as a lingua franca is crucial in the medical field, enabling access to international research and facilitating communication in diverse healthcare settings. This study aimed to characterize the current state of English language teaching at Kazakhstani medical faculties, evaluate students' needs and self-efficacy in general and medical English, and identify challenges and opportunities for course improvement. A mixed-method approach was used, including syllabus analysis, surveys of lecturers and students from multiple universities, and interviews with both groups. The current state of English language teaching at Kazakhstani medical facultiesreveals several challenges and areas for improvement. Key issues include students' difficulty with fluent colloquial speech, limited resources and instructional time, classroom organization difficulties, and inadequate school-level preparation. Evaluating students' needs and self-efficacy beliefs in English for general and medical purposes revealed more substantial confidence in general English skills than in medical-specific communication. Both lecturers and students highlighted speaking skills as a critical area for development. Lecturers also emphasized aligning course content with real-world medical contexts, focusing on medical terminology and professional communication. To address these challenges, expanding instructional hours, modernizing teaching resources, integrating digital tools, and incorporating experiential learning are recommended better to equip medical students for their professional communication needs.