Submitted: 16 February 2025 You are already at the latest version This qualitative narrative synthesis examines the impact of English as a Medium of Instruction (EMI) in medical education through an English Language Teaching (ELT) lens. By reviewing studies from Scopus, Web of Science, and other reputable sources, we identify key themes: cognitive load in learning medicine in a second language, disparities in learning outcomes, faculty challenges, and pedagogical innovations.