Critical Discourse Analysis in a Medical English Course: Examining Learner Agency through Student Written Reflections Theron Muller University of Toyama Introduction This chapter presents a pedagogical investigation of three students’ written reflections on a short Medical English course taught at a Japanese public university. This research has several complimentary objectives. One is to examine what insights the students’ written reflections offer into their agency as enacted in (and in response to) the course. Another is to determine whether and to what extent the course goals of promoting criticality were accomplished. A final objective is to evaluate the efficacy of the research methods employed here—examination of students’ reflective assignment writing as a means of revealing in-course, in-context agency and development, particularly over short spans of time. This investigation is multidisciplinary in the sense that it intends to engage conversations from English for Specific Purposes (ESP), from the language learning agency and motivation literature, and from the doctor-patient discourse analysis literature. In ESP, contexts discussed tend to describe classrooms where language learners will go on to complete the majority of their coursework in English, or where their workplaces will require the use of English in particular circumstances (see, for example, Belcher, 2006; Flowerdew, 2005). Contexts such as Japanese medical education, where students have English as a foreign language coursework but where their content classes are taught in their first language, are less well represented and can present unique challenges to ESP teachers and course designers, as the English needs learners have can be ambiguous or seem distant from the students’ everyday experiences. This chapter shares the solution to this dilemma implemented at one institution, where criticality in ESP course design (Belcher, 2006; Fairclough, 2010) has been used to help raise students’ awareness of the unequal 1