This article analyzes English proficiency as a requirement for graduate studies at the Federal University in São Paulo, Brazil, analyzing students' performance on the proficiency test and their self-assessment and the importance they ascribe to the language during this phase of their training. An exploratory study was conducted with quantitative and qualitative approaches, document analysis, questionnaires, and interviews. Graduate students rated their own English reading skills as good. They considered a command of the language essential for their professional work and acknowledged that most research in the health field is published in English. One out of four students failed the proficiency test on the first attempt. Their speaking and writing skills were limited, and the majority needed another professional to prepare an abstract in English. They considered a command of English essential for professionals seeking to stand out in a competitive world, but viewed the formal English requirement for graduate studies as an overburden. English is not most researchers' first language, thus creating a dilemma for readers as well as authors who wish to attract attention to their work. Although English is acknowledged as the lingua franca of science and mediates the current scientific publication process, the issue has become increasingly controversial.