Effective patient communication is vital in medical training. At a Hungarian Medical university, international students in the English-medium program are required to study Hungarian for two years to prepare for clinical rotations in Hungarian hospitals. The final language assessment traditionally included an audio-based listening exam, but both students and teachers raised concerns about its difficulty and its lack of relevance to real-life clinical interactions and the students' actual language needs. A needs analysis was conducted with 52 second-year international medical students through focus-group interviews after they took the exam to address these issues. Based on the feedback, a video-based exam format was developed and piloted. The new format incorporated visual cues such as gestures and facial expressions, better reflecting face-to-face patient communication. A total of 38 third-year students who had previously taken the audio-based version of the exam participated in the pilot, with focus-group interviews conducted to directly compare the two formats. The majority of the students found the video-based exam more engaging and relevant to their clinical experience. The findings suggest that the video-based exam better prepares students for real-life medical communication and provides a more meaningful assessment experience, bridging the gap between language learning and clinical practice.