Vancouver is the numbered referencing style used across medicine, nursing, dentistry, pharmacy and most biomedical journals.
Instead of naming authors in the text, you place a number at each citation, and the numbers lead to a reference list ordered by first appearance. It keeps clinical writing compact, which is why journals and health science programs prefer it.
The style grew out of the uniform requirements agreed by medical journal editors (now the ICMJE Recommendations), and its detailed rules are set out in the US National Library of Medicine's Citing Medicine.
Universities and journals publish their own versions, so small details vary. This guide covers the shared core and flags where you should check your own instructions.
Vancouver citations in brief
In Vancouver style, cite each source with a number, in round brackets (1) or as a superscript, in the order you first cite it, and reuse the same number whenever you cite that source again. The reference list is numbered in that same order, not alphabetically. A journal reference looks like this: Author AA, Author BB. Title of article. Abbreviated Journal Title. Year;Volume(Issue):pages.
How the Vancouver System Works
The first source you cite becomes 1, the second becomes 2, and so on. If you cite source 1 again on page eight, it is still 1. The reference list then gives the full details in numerical order, so a reader who sees a number can find the source at once.
| Rule | What it means in practice |
|---|---|
| Numbered in order of first citation | Number sources as you meet them in the text, including in tables and figure legends |
| One number per source | Reuse the original number every time you cite the source |
| Brackets or superscript | Use whichever your guide or journal specifies, and only that |
| Reference list in numerical order | Never alphabetical; entry 1 is the first source cited |
| Minimal punctuation | No italics, no quotation marks, no full stops in initials |
In-Text Citations
Place the citation number straight after the fact or the author's name it supports. Many guides place bracketed numbers before full stops and commas, while superscript numbers often go after punctuation. Check which your guide wants, then apply it everywhere.
Single source: Early mobilization reduces length of stay after hip surgery (3).
Several sources: Several trials report similar results (3,5,8).
A range: This finding has been replicated widely (4-7).
Naming the author: Okafor et al. (6) found that...
With a page number for a quotation: "Delays in escalation were common" (2 p14).
When you name authors in the sentence, give the first author's surname and "et al." for three or more authors, or both surnames for two authors, followed by the number. Do not add the year: the number does the work. Page-number formats for quotations vary more than anything else in Vancouver, so this is a detail to confirm in your guide.
Author Names
Vancouver writes surnames first, followed by initials with no full stops and no spaces between them. Authors are separated by commas, and the list ends with a full stop.
| Number of authors | How to write them |
|---|---|
| One | Smith AB. |
| Two to six | Smith AB, Jones C, Patel RK. |
| More than six | List the first six, then et al. (many guides and the ICMJE sample references) |
| Organization | World Health Organization. |
| No author | Start with the title |
Citing Medicine itself lists all authors but allows a limit, and some journals cut to three authors before et al. This is one of the most common differences between versions, so follow your guide.
Journal Articles
Journal titles are abbreviated in the form used by the NLM Catalog (for example, N Engl J Med, BMJ, J Adv Nurs). The date, volume, issue and pages run together with set punctuation. Page ranges are often shortened by dropping repeated leading digits, so 284 to 287 becomes 284-7.
Format: Author AA, Author BB. Title of article. Abbreviated Journal Title. Year Month Day;Volume(Issue):pages.
Example: Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002 Jul 25;347(4):284-7.
More than six authors: Rose ME, Huerbin MB, Melick J, Marion DW, Palmer AM, Schiding JK, et al. Regulation of interstitial excitatory amino acid concentrations after cortical contusion injury. Brain Res. 2002;935(1-2):40-6.
Article titles are in sentence case with no quotation marks, and the journal title is not italicized. Month and day are optional for journals with continuous pagination, so many university versions give the year only.
Online Articles and DOIs
For an article you read online, many guides add the DOI at the end. Some follow the full Citing Medicine form for internet journals, which adds [Internet] after the journal title and a [cited] date.
With DOI: Osei A, Hughes D, Nair P. Nurse staffing and patient falls: a longitudinal analysis. J Adv Nurs. 2024;80(4):1550-63. doi:10.xxxx/jan.15xxx
Internet form: Osei A, Hughes D, Nair P. Nurse staffing and patient falls: a longitudinal analysis. J Adv Nurs [Internet]. 2024 [cited 2026 Mar 3];80(4):1550-63. Available from: https://doi.org/10.xxxx/jan.15xxx
Books and Book Chapters
Book titles are in sentence case and not italicized. Give the edition (except the first), the place of publication, the publisher and the year, separated by the punctuation shown.
Book: Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA. Medical microbiology. 4th ed. St. Louis: Mosby; 2002.
Edited book: Gilstrap LC, Cunningham FG, VanDorsten JP, editors. Operative obstetrics. 2nd ed. New York: McGraw-Hill; 2002.
Chapter: Meltzer PS, Kallioniemi A, Trent JM. Chromosome alterations in human solid tumors. In: Vogelstein B, Kinzler KW, editors. The genetic basis of human cancer. New York: McGraw-Hill; 2002. p. 93-113.
Websites, Reports and Guidelines
Online sources need the [Internet] marker, the date you cited the page, and "Available from:" with the URL. Clinical guidelines and organizational reports are cited with the organization as author.
Web page: World Health Organization. Hypertension [Internet]. Geneva: WHO; 2023 [cited 2026 Feb 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension
Guideline: National Institute for Health and Care Excellence. Hypertension in adults: diagnosis and management [Internet]. London: NICE; 2019 [updated 2023; cited 2026 Feb 10]. (NICE guideline NG136). Available from: https://www.nice.org.uk/guidance/ng136
Report: Organization name. Title of report. Place: Publisher; Year. Report No.: xx.
Other Sources at a Glance
| Source | Key pattern |
|---|---|
| Thesis | Author AA. Title [dissertation]. Place: University; Year. |
| Conference paper | Author AA. Title. In: Editor AA, editor. Conference title; Date; Place. Place: Publisher; Year. p. pages. |
| Newspaper article | Author AA. Title. Newspaper name. Year Month Day;Section:page (col. x). |
| Legislation | Follow your national or local guide; versions differ by country |
| Image or figure reproduced | Cite the source it came from, with the figure number |
Worked Example: One Paragraph and Its References
Text: Falls remain a leading cause of harm in hospital (1). Staffing levels have been linked to fall rates on medical wards (2,3), and Osei et al. (3) found the association strongest on night shifts. National guidance recommends multifactorial risk assessment for older inpatients (4). As noted above, staffing explains only part of the variation (2).
Reference list:
1. World Health Organization. Falls [Internet]. Geneva: WHO; 2021 [cited 2026 Feb 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/falls
2. Author AA, Author BB. Title of the staffing study. J Abbrev. 2022;15(2):101-9.
3. Osei A, Hughes D, Nair P. Nurse staffing and patient falls: a longitudinal analysis. J Adv Nurs. 2024;80(4):1550-63.
4. National Institute for Health and Care Excellence. Falls in older people: assessing risk and prevention. London: NICE; 2013. (Clinical guideline CG161).
Source 2 is cited twice and keeps its number both times. The list follows the order of first citation, so the guideline is 4 even though it begins with N.
Vancouver Compared with Other Styles
| Feature | Vancouver | Harvard or APA | IEEE |
|---|---|---|---|
| In-text | Number (1) or superscript | Author and year | Number in square brackets [1] |
| List order | Order of first citation | Alphabetical | Order of first citation |
| Journal titles | NLM abbreviations, no italics | Full, italic | IEEE abbreviations, italic |
| Typical fields | Medicine, nursing, health | Humanities, social sciences, nursing (APA) | Engineering, computing |
If you are switching from an author-date style, the Vancouver citation generator can turn your source details into entries, which you then order by first appearance and check against your guide.
Laying Out the Reference List
Put the list at the end under the heading "References". Each entry starts with its number, usually followed by a full stop or set in square brackets, depending on your guide.
Most university versions align the text of each entry so that the numbers stand out on the left, which you can do with a hanging indent. Single or double spacing follows the rest of your document unless the guide sets its own rule.
Only sources you actually cite belong in the list. If your module also asks for a bibliography of background reading, put it under a separate heading after the references, ordered alphabetically, and do not give those entries numbers. Never fold background reading into the numbered list, because every number must lead back to a citation in the text.
Tables, Figures and Sources You Read About
Citations in tables and figure legends are numbered according to where the table or figure is first mentioned in the text, not where it physically sits on the page. If you reproduce or adapt a figure, cite its source in the legend with a number, as you would in the text.
When you read about a study in a review rather than reading the study itself, cite the review you read. Some guides allow a note such as "cited in", but most health science programs prefer that you find and read the original before citing it, especially for key clinical claims.
Markers in health subjects often check whether the cited source really says what you claim.
Common Vancouver Mistakes
- Sorting the reference list alphabetically instead of by first citation.
- Giving a source a new number the second time it is cited.
- Mixing brackets and superscript in one document.
- Full stops or spaces in initials (S. D. Halpern instead of Halpern SD).
- Full or italicized journal titles instead of NLM abbreviations.
- Missing [Internet] and [cited] dates for web pages, where the guide requires them.
- Renumbering by hand after editing and leaving gaps or duplicates; check the sequence after every revision.
How We Help with Vancouver Referencing
Send your draft, sources and the instructions you are writing to: a module handbook, a university Vancouver guide or a journal's author guidelines.
A writer with a health sciences background renumbers citations in order of first appearance, formats each reference with NLM journal abbreviations, checks author limits and online details, and confirms every number in the text matches the list.
Editing stays within your university's rules, the work is plagiarism-checked, and revisions within the scope of your original request are free.
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Frequently Asked Questions
A numbered citation style used mainly in medicine and health sciences. Sources are numbered in the order they are first cited, and the reference list follows that order.
Both are used. Your university or journal will specify one; use it consistently throughout.
Many guides list up to six authors, then the first six followed by et al. Some journals use a lower limit, so check your instructions.
No. It is numbered in the order sources are first cited in the text.
Use the NLM Catalog, which lists the standard abbreviation for biomedical journals, for example J Adv Nurs or N Engl J Med.
Generally no. Titles of articles, books and journals are written without italics or quotation marks.
Use the number you gave it the first time. A source has one number for the whole document.
Author or organization. Title [Internet]. Place: Publisher; Year [cited Year Month Day]. Available from: URL.
Both are numbered styles ordered by first citation, but IEEE uses square brackets, initials before surnames with full stops, and different punctuation and abbreviations.