MEDICAL STUDENTS’ PERCEPTIONS AND TARGET NEEDS IN ENGLISH FOR SPECIFIC PURPOSES COURSES

This study aims to identify the target needs of students in English for Specific Purposes (ESP) courses at a private university in North Sumatra, Indonesia. The participants in this study were 10 students majoring in medicine. This study employed a qualitative descriptive method to explain students' perspectives of the ESP courses. The research data were obtained through surveys and interviews. The findings reveal that the participants expect the ESP courses focus on the target needs of their academic and professional lives with an emphasis on drilling their skills in the four aspects of language. In addition, it also shows that students have a positive perception of the ESP courses at the university. The findings of the study also declared that the ESP program should focus on the effective use of language and improve their language skills in reading, writing, listening, and speaking.


Introduction
English for Specific Purposes (ESP) is a growing branch of teaching English as a Foreign Language (EFL). ESP can be defined as a learner-centered approach to teaching English as an additional language and focuses on developing communicative competence in various majors such as academics, medical, accounting, business, teaching, IT, agrology and engineering. It aims to develop students' language skills in the field they are studying. For instance, medical students need to learn and develop their English for medicine; IT students need to learn and know the English terms of IT, or if they are students majoring in business management, they need to learn and develop their English language skills to learn business developments abroad. Therefore, the term needs analysis emerged in ESP. This proves that an ESP course at a university can help students improve and develop their English skills according to the academic needs in their major studies (Richards, 2010;Saragih, 2014).
ESP course within a university dis efined as the teaching and learning of English as a foreign language tailored to the needs of students based on their major studies. This is following with Hutchinson and Waters' (1987) explaination saying that needs analysis was largely derived from the ESP field. Need analysis mostly comes from the ESP field and it is a cornerstone of ESP. Similarly, Kim (2006) also noted that needs analysis had been affected by the emergence of ESP.
Need analysis is activities involved in gathering information for developing a curriculum based on student needs. This means that needs analysis includes all activities used to gather information about students' learning desires and needs. Needs analysis is the main step to know the goals, aspirations, and needs of students in the design and development of any educational program. Need analysis defined as systematic procedures to recognize the needs of students and improve the learning programs (Altschuld and Witkin, 1995). Brown (1995) also explains that needs analysis in language programs aims to identify the language forms that students need to use in the target language to understand and produce the language.
English language course at a university is arranged based on the principle related to the purpose and needs of students in their major studies. Especially for medical studies, an ESP course for medical studies intends to help them develop their language skills for their professional life future. In this case, the students are expected to be able to develop their four aspects of language skills. However, in practice, it is often found that the ESP courses do not really meet the students' needs.
Although quite a few tudies have been conducted to investigate topics related to ESP courses especially those offered in medical studies, many of them focuses on diverse topics except students' perception and expectation. Some studies discussed the effectiveness of teaching ESP courses for medical students (Jezo, 2014); some others on the design of an ESP course through needs analysis approach (Lodhi, 2018) and students' perception of using electronic learning tools in ESP program (Alizadeh, 2018).
To fill the research void in the current literature, this study was conducted with the aim to identify the target needs of medicals students in taking ESP courses as well asw to exploir thir perception of the currently offered ESP courses in terms of its suitability with their needs. Particularly, there are two research questions addressed in this study: 1. How do the students perceive of the current ESP courses? 2. What are the students' target needs in the ESP courses?
Thus, the focus of this study is on recording students' perceptions and their opinions regarding their needs in the ESP course. The findings of this study will be worthwhile for lecturers who teach ESP courses, especially in the faculty of medicine y to recognize of what medical students need. Furthermore, medical students might be aware what they need during have ESP course classes at university. Hutchinson and Waters (1994) argue that ESP is an approach used in learning English by using methods or strategies based on the objectives of students wanting to learn English. This is in line with what Nunan (2004) has described, ESP is an important sub-component in language teaching, through its approach in developing curriculum, designing material, pedagogy, testing, and research. ESP is generally used in teaching foreign languages for particular utility in certain fields of science and professions. ESP can be comprehended as a benefit in the role of English as a means of communication both oral and written. Therefore, ESP can be seen as a different approach, concept, and method from General English.

English for Specific Purposes (ESP)
ESP material refers to the needs of students (Ramirez, 2015) where the syllabus and materials are determined in all essentials by previous analysis of the communication needs of the learners (Donough, 1984). Donough (1984) also stated that the materials and syllabus, as well as the objectives of ESP, should be designed and developed based on the students' needs. Hence, educators must know what students' reasons to take ESP courses are and There are three main characteristics of ESP, namely 1) ESP is goal-oriented learning. In this context, learners learn the English language not because they want to know the language as a language and the culture it contains, but learners learn ESP because they have certain goals in each other's academic and professional fields; 2) ESP substance is designed and expanded based on the needs analysis concept. The needs analysis concept aims to specialized, relate and juxtapose what students need in both academic and professional fields; and 3) ESP is more aimed at adult learners than children or adolescents because ESP is generally taught at the secondary academic and work professional levels.
ESP course within a university has become a crucial and innovative activity in teaching English as a second language. Most of all universities in the world including Indonesia have listed ESP courses in various majors such as medicine, engineering, economics, business, and so on. This indicates that ESP course is being used as an approach to help learners use English in academic, professional, and work in accordance with their major studies (Saragih, 2014). To achieve this goal, there is a need analysis in ESP because they have a correlation wherein running the ESP courses, educators must first do a need analysis on students so that the ESP learning objectives are achieved as expected.

Need Analysis
Need analysis is a vital part of ESP. Need analysis is the initial step in designing the curriculum and syllabus as it is prepared according to students' needs. Need analysis relates to the students' future study and professional needs and what they want to achieve from the language class. In addition, need analysis enables educators to understand the abilities that students already have before entering the English class and what they have not mastered in English. So, need analysis is directly related to activities in collecting information that will form the basis for designing a curriculum that will meet the needs of students (Iwai, et al., 1999).
Need analysis can be used to identify the language skills to focus on and to determine the context for the ESP course. In addition, need analysis can develop students' attitudes towards the introduction of need-based English courses. Therefore, need analysis has a utilitarian goal to modify or reshape courses compatible with the need of specific learners and the demands of specific target situations systematically. In this case, the educators are tasked with identifying the needs of students and designing ESP courses according to their target needs (Basturkmen, 2010).
Analyzing the students' needs serves as a precede to the design of an ESP course, as it determines the 'what' and 'how' of the ESP course. The results of the analysis will help to select and prioritize what students may need to do. Furthermore, the ESP course aims to enable students to understand and master the target situations where students can use the language they have learned. In the ESP course design process, the first thing to do is to identify the target situation and then to do a careful analysis of the language features of the situation (Gass, 2012).
In Indonesia, as one of the countries that stipulates English as a foreign language, it is assumed that almost all majors at the university have ESP courses in it, including one of them is the medical department. Therefore, this study will find out how students perception of the ESP course and what their target needs are during ESP course at university.

Research Method
This study employed a qualitative research design to find out and understand the problem(s) of groups or individuals have. This helps students to be aware and know how their views and perceptions of ESP courses at university. This qualitative research used a case study design to recognize and excavate how an individual or group develops their skill from time to time (Creswell, 2014).
This research was conducted at a private university in North Sumatra, Indonesia. The participants of this study were ten (N=10) ESP students of the Faculty of Medicine. The participant's mother tongue is Indonesian. Six (N=6) participating students were female and four (N=4) were male with an age range from twenty (20) to twenty-seven (27). At the start of the study, students were informed about the purpose of the study and they voluntarily participated.
The data for this study was collected through two instruments which include 1) a survey conducted during the class meeting; and 2) an interview conducted with the participants to explore their perceptions referring to the needs of the target skills. During the interview, participants were asked about their perceptions of target needs in the ESP course.
In this study, content analysis was used to identify different views that had been collected through the instruments. Therefore, the results of the participants' experiences can be fully understood, the common themes are presented as findings from this study.

Results and Discussion
Two research questions were proposed to guide this study; one related to the students' perceptions of the ESP courses they were taking and the other the students' target needs in the ESP courses. The findings are elaborated as follows:

Students' Perceptions of the Current ESP Courses
To explore how the students perceive of the current ESP courses, 10 students were interviewed. Almost all of them felt that ESP course is important and has an important role for their future job. However, a closer look ata the the data reveals the mismatch between what the current ESP courses offers with what the students expect to learn from the course. In other words, the ESP courses do not provide learning objectives whiac are compatible to their needs as medical students.
Based on the students' report, mostly, the ESP learning only focuses on learning English in a general context with little to no relation to medical science. One of the tasks we do is to write papers for weekly presentations at each meeting [Abdul -Medical student].
In responding to the findings of the first research question, mostly participants said through their interviews that the ESP course had a crucial role for them as medical students. They said that the ESP course is an approach in learning English that helps them to learn English and develop their English skills. This finding supports what Lodhi (2018) claimed that English plays an important role in every academic activity of medical students. It means ESP courses can guide students to carry out academic activities even in English. ESP course can identify the needs of medical students because in designing the ESP course it must be adjusted to the needs of the target students.
However, the current ESP course learning has not provided learning that is in accordance with the needs of students. The learning provided only focuses on developing English itself and does not relate it to medical science. In fact, English proficiency can be used in various academic activities such as discussions on medical issues, in presentations and attending seminars and conferences, for reading articles and journals, for writing laboratory reports, and writing research articles (Gaffas, 2019). Therefore, this study will describe the students' target needs in the ESP courses in the second subsection of the findings.

Students' target needs in the ESP courses
To recognize the target needs of the medical students, 10 participants were interviewed. There are various statements regarding the students' target needs in the ESP course. Most students consider ESP learning as a valuable contribution to helping them learn new terms. In this case, they mentioned their needs regarding the understanding of the four language skills, as shown in the following excerpts: I need to learn English to know more medical term and to understand the content of textbooks, articles and journals. [Egi, Medical student] My target needs in the ESP course are to be able to communicate my patients, to add informations that are happening in medical science. Beside, I expect that in the ESP course, there will be learning where students are trained as speakers. This is because it will be the right provision for me when attending international conferences [Nanda, Medical student].
I expect that I will learn how to write articles and journals for publications [Putri -Medical student].
In this case, almost all participants opined that they need the four language skills; listening, reading, speaking, and writing. They furthermore explained the importance of mastering the four skills for them in doing their academic activities such as listening skill and speaking skills help them while they are in seminars and conferences, reading skills can help them understand while reading textbooks, articles, journals or the result a laboratory report, then writing skill guide them in writing laboratory report, articles and journals.
Therefore, the participants state that they need to practice the four language skills in each of their academic activities. It is also approved by Jezo (2014), who stated that mastery of vocabulary can guide medical students in understanding English medical textbooks, understanding related to articles and journals as well as when interacting between doctors and patients or doctors and nurses. Besides, Kawagoe (2009) argues that medical students Nationally Accredited SINTA 3, and indexed in DOAJ and Copernicus need to read books and journals in medical genres, speak with colleagues, to contribute in conference international, write articles for journal publications, and to continues their study to abroad.
Based on the results of the interviews, it can be concluded that the ESP course is very much needed and beneficial for them. There are diverse opinions but almost all point to one thing, namely the ESP course helps them in exploring the sciences in the medical field. Mostly their reading books are written in English, therefore the reading skills trained them to understand the reading text of the books they read. The ability to write is very important, especially when they are asked to write an article. Speaking skills will help them when they attend international seminars and when they communicate with foreign people who are studying or working in the same field. Furthermore, listening skills will guide them while they are in seminar conferences.

Conclusion
This study reported the students' perception of the target needs in the ESP courses. The conclusions of the study were made according to the findings obtained from the data provided by the participants. The main point of this study is to elaborate the perception of the students and identify the language needs of medical students. They said that they needed to take an ESP course to develop their English language skills. Moreover, in the ESP course, they realize that they learn English appropriate to the needs of their target so it helps them to carry out their academic activities.
Furthermore, this study elaborates the target needs of medical students in the ESP courses. The finding illuminates that the target needs focus on mastering the four skills to develop their ability and knowledge related to English in their major study. Various academic activities require them to have the ability to use English; first, listening and speaking skills are needed while they are in seminars, conferences, and other scholarly networking events particularly in international context; second, reading and writing skills are needed for them when writing articles and journals for publications.