English as a medium of instruction (EMI) programs are an increasing phenomenon in European universities. This paper takes an ethnographic approach to understanding the impact of EMI on pedagogy in a private university in eastern Ukraine. Fieldwork was conducted over the 2010-2011 academic year in nine English-medium and three Russian-medium classes. Data indicated that EMI education posed staffing challenges, as teachers were either language experts with low content knowledge or were content experts with anxiety about their English language skills. In addition, it was at times difficult to obtain textbooks and other print resources in English. Some teachers found teaching in a foreign language necessitated adjustments to speaking pace, discipline, and general classroom discourse. Despite these issues, teachers and students saw teaching and learning in English as a worthwhile opportunity.