Background: A considerable amount of researches has been done to explore the key factors that affect learning a second language. Among these factors are students' motivation, attitude, learning strategies, and learning environment. Such issues have not been explored officially at the College of Applied Medical Sciences at the University of Dammam in Saudi Arabia, even though English is used as the medium of teaching and learning. Objectives: First, to explore the learning strategies used to study English as a second language. Second, to investigate students' attitude towards the speakers of English. Third, to assess students' perceptions toward their learning environment. Fourth, to identify students' motivations for studying English. Fifth, to explore any possible relationships among learning strategies, attitudes, motivation, learning environment, English language proficiency grades of students, and their grades for their general medical courses. Methods: A cross-sectional study was conducted in May, 2008. A total of 110 questionnaires were completed. Results: Students utilize all types of learning strategies. There were significant correlations between the achievement in English and performance in general medical courses, learning strategies, motivation, age, and formal level at which student started to learn English. Conclusion: The study showed that students utilize all types of language learning strategies. However, cognitive strategies were utilized more frequently than others. Students have relatively more positive than negative perception scores toward their learning environment, teacher, courses, and people spoke English. Achievement in English was associated positively with performance in the general medical courses, motivation, and learning strategies. Students were motivated more instrumentally than integratively.
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