A thorough analysis of students' needs will enable teachers to build up a profile of a typical learner.The objective of this study was to determine the current and target English language skill level and use the findings as guidelines in designing a uniform course.The investigation was carried out at the Congress of Biomedical Science Students of Serbia held in Lepenski Vir in 2009. The investigation was conducted using a questionnaire and included 277 medical students of all study years and from all university centres of Serbia.The obtained results do not vary significantly among universities. The students marked writing and translation as their weakest skills and pointed out that their greatest problem areas were also vocabulary and grammar. On one hand, writing was ranked high among the skills which needed improvement but on the other hand, it was believed to be the least important in medical career. Speaking and listening were shown to be the most important for medical students.In designing the course, teachers need to be able to use approaches and methods flexibly and creatively in order to bring about positive results. Since course design is a dynamic process, teachers have the responsibility of negotiating a plan of work with the learners.