The profound integration of the global healthcare system on the Fourth Industrial Revolution has positioned English as a pivotal tool in shaping professional competence and adaptability for the healthcare workforce. However, contemporary higher education practice is grappling with a paradox: the significant disparity in the initial proficiency levels of non-English major students and the lack of differentiation within standardized training programs. These barriers, compounded by an inadequate perception of the role of English for Specific Purposes (ESP), have resulted in a teaching and learning environment characterized by a reactive approach and a deficit in intrinsic motivation. This study established a comprehensive system of management solutions for competency-based English instruction tailored to students in the health sciences. The research findings have standardized the theoretical framework for competency while repositioning the management of instruction as a systematic process aimed at optimizing the formation of professional-specific competencies for learners. On identifying the influential factors, the study addresses the theoretical and practical gaps in managing English teaching and learning under a competency-based approach with the specific demographic of medical students. Consequently, it provides a crucial scientific foundation for educational institutions in Southern Vietnam to innovate their management modalities, thereby contributing to the enhancement of training quality and the competitive edge of the future medical workforce.