This volume has shown that English-medium instruction (EMI) in Japan is growing and is beginning to assume perhaps not a central, but a meaningful role in the higher education sector. The chapters have shown how, with careful planning and close collaboration among academic content instructors, language-teaching specialists and administrators, and with the help of teaching assistants, EMI programs can be successful. They can provide quality international experiences for students, and have the potential to inspire other internationalization efforts across campus (see for example Yamamoto & Ishikura, Chapter 5; Birchley, Chapter 8; Iyobe & Li, Chapter 14; Kuniooshi & Nakakoji, Chapter 16). However, the growth in EMI has not been without challenge. Chapters in this volume have highlighted issues at both the national policy and institutional levels. For example, Mulvey in Chapter 3 and Poole in Chapter 6 both show that there are challenges maintaining momentum for reform in the face of pressures and constraints from within universities, and Chapters 9–13 all highlight problems supporting both faculty and students involved in EMI classes. Universities are also having trouble designing EMI programs with a shared sense of direction and clear program goals (Birchley, Chapter 8). In addition, there are open questions raised by Kuwamura in Chapter 17 concerning such things as EMI's potential to facilitate learning and increase diversity in higher education. These questions need to be addressed as EMI becomes more widely established.

The challenges in implementing EMI can be seen as roadblocks in the path to internationalization of universities. However, are these roadblocks unique to the current internationalization efforts, or are we perhaps seeing the most recent iteration of an ongoing structural characteristic of the Japanese higher education sector? Although EMI is an area which is currently receiving a great deal of investment and attention, this is not the first time that innovations have entered Japanese higher education. The sector faced surprisingly similar challenges in the past.