Communicating effectively in a foreign language requires a level of understanding that goes far beyond the learning of vocabulary and grammar. Textbook English is seldom the language of the workplace. Apparently familiar words and phrases may both amuse and confuse the learner when used in different contexts. Nowhere is this more evident than in the field of healthcare. The Arakelian Programme introduces international nurses to the culture of the health service in the United Kingdom. Catharine Arakelian has demonstrated tremendous insight into the development of communication and language skills. Her approach makes learning English a fun experience. The exercises encourage good listening and observation skills, essential elements of mastering a foreign language.