Academic writing is a salient skill for medical students all over the world. Academic writing starts with composing effective paragraphs, laying the foundation for students' advancement in writing during college. This study investigated common mistakes in English paragraph writing committed by the first-year medical students of the Medicine Faculty at Kabul University of Medical Sciences. Additionally, it measured the challenges that Medicine Faculty students tackled in paragraph writing. This quantitative study was conducted through an action research design. The data were collected from 52 medical students, and their work was analyzed using the developed rubrics. The data were analyzed in the SPPS 26 version, and the descriptive statistics were reported. The findings revealed that participants obtained the highest means in the mechanics of paragraph writing (22 out of 25), and they received the lowest means (12 out of 25) in the contents of a paragraph. In English for Medical Purposes (EMP), students should improve their content finding, paragraphing, summarizing, and referencing skills for their assignments and research writings. Medical students should give detailed attention to every characteristic of academic paragraph writing because they give readers a full grasp of the contents of their written works.