In the past, Naming English as a separate subject seemed relatively easy. The textbook selected and graded items of language which were put into content and then practiced intensively. New items were carefully controlled so that the student could cope quite easily. Now that English is used as a medium of instruction, however, all this has changed. Unknown items of grammar and vocabulary appear in texts which attempt to explain new and often difficult information. Difficulties with the language interact with difficulties as regards the subject matter.