In 1997, the Medical Faculty at Hong Kong University adopted a predominantly problem-based learning (PBL) curriculum. At the same time, a sizeable PBL component was added to an already established English as a Second Language (ESL) Course for Medicine to help first-year students develop PBL discussion skills. However, it was felt that not enough was known about exactly how PBL tutorials were structured and what roles the students and tutors were playing and should be playing in order to implement an effective course. Seven first-year tutorials (around 12 hours of discourse) were video taped and transcribed. A genre analysis was done on all seven tutorials. The genre analysis identified a consistent structure in all the tutorials. Three compulsory stages were identified as well as three optional: Orientation ^ Explication ^ (Application) ^ Investigation ^ (Round Up) ^ (Reflection). Also, two overall macro moves were identified, that of the Question and the Answer. It is recommended that all stages be made compulsory in the Medical Faculty and that these be presented to students in the ESL classroom and the linguistic features of each practiced in order to give students full access to the discourse and therefore their own learning opportunities.