Background <p>English proficiency in higher education is strongly associated with a student’s overall academic performance. For instance, written assignments, which are a key component of continuous assessment, heavily depend on the student’s proficiency in English. Therefore, students with good English proficiency are more likely to perform better in these types of assessments. In the Malaysian context, studies have shown that English proficiency is still lacking among undergraduate university students. These studies were based on students’ perceptions of their own English proficiency. Readability tools provide an objective way of assessing a student’s English proficiency. Hence, the aim of this study was to objectively evaluate English proficiency by analysing the readability of reflective reports written by first-year medical students.</p> Methods <p>Reflective reports written by first-year medical students (<i>n</i> = 114) as part of an assignment, were used to assess the English proficiency in this study. Typically, these reflective reports were the opinion of the student on a particular activity or topic and were on average, 1000 words long. These reports were analysed using four different types of well-established English proficiency assessment tools: Flesch-Kincaid Reading Ease, Flesch-Kincaid Grade level, Gunning Fog, and SMOG index assessment. The reflective reports were categorised into grade levels based on the respective rubrics. The average readability indices from the four tools were calculated, graded, and assessed according to the rubric for each of these indices to determine if they matched the expected level for a first-year undergraduate medical student.</p> Results <p>Our study findings revealed that 61.8% of reports matched the level of English standard for a first-year university student using the Flesch-Kincaid Reading Ease Analysis. Using Gunning Fog analysis, we found that 10–20% of reports fell in each of the “college” categories - college freshman, college sophomore, college junior, college senior, suggesting that most of the students had good English proficiency. Consistent across all four assessments is that approximately &lt; 10% of the reports were below the required English proficiency (8th to 9th grade or high school junior).</p> Conclusion <p>Our findings highlight that most students in the first year of medical school had English proficiency matching their education requirements. Though this is encouraging, it is also important to note that there are students with poor English proficiency. Future studies can be focused on studying the reasons behind low English proficiency among these students, as well as how it may affect them psychologically and their academic performance.</p>