In an increasingly globalised world, English-medium tertiary education has become increasingly prominent and sought after. However, non-native speaker (NNS) school-leavers entering an English-medium university, whether as NNS local students or as international students, not only encounter those challenges faced by all freshmen students, but often also soon realise that there is a gap between the English language skills with which their school education had equipped them and those needed for effective English-medium tertiary study. Their lack of competence in academic writing presents perhaps the greatest challenge. This paper will examine data relating to NNS students' experience as freshmen writers. These data are derived from a longitudinal study aiming to understand the language-related challenges faced by first and second year NNS students in an English-medium higher education institution in Hong Kong. The paper concludes by proposing two collaborative initiatives whereby English language teachers work with content subject teachers with the aim of providing language enhancement support that is relevant to the student's programme of study and integrated into their content studies. With a global increase in the number of NNS students studying in English-medium universities (Murray 2016, "Standards of English in higher education." Cambridge: Cambridge University Press), the challenges and possible ways of addressing these that are discussed in this paper are potentially directly relevant to universities in whichever country they operate.