Vancouver referencing is a numbered style: each source gets a number the first time you cite it, and the reference list at the end runs in that same number order. It is the standard style in medicine, nursing and many health sciences.
It grew out of the uniform requirements for biomedical journals now maintained by the ICMJE, with detailed formats set out in the US National Library of Medicine's Citing Medicine. Universities often publish their own slightly adapted versions.
Vancouver Referencing in Five Rules
- Number sources in the order you first cite them.
- Reuse a source's original number every time you cite it again.
- Use one in-text format throughout: (1), [1] or superscript.
- List references numerically, not alphabetically.
- Give authors as surname plus initials, and abbreviate journal titles.
In-Text Citations
Place the number where you use the source, usually after the relevant fact and before the full stop. Round brackets, square brackets or superscript are all used; choose the one your course requires and stay consistent.
Surgical safety checklists have been linked to fewer complications (1). Early mobilization after surgery may shorten length of stay (2,3).
Several Sources at Once
- Separate numbers: (1,3,5)
- A continuous run: (2-4) rather than (2,3,4)
- A mix: (1,4-6,9)
When you cite a source again, use its original number. If source 2 reappears in your conclusion, it is still (2). Giving it a new number creates duplicate entries.
You can still name authors in your sentence, as in "Haynes et al. (1) found...", but the number is what identifies the source.
The Reference List
References appear under the heading References, numbered in the order they were first cited. There is no alphabetical order.
The journal article pattern shows how dense the style is: Author(s). Title of article. Abbreviated journal title. Year;Volume(Issue):Pages. The semicolon before the volume and the colon before the pages do a lot of work, so copy them carefully.
| Element | Vancouver rule | Example |
|---|---|---|
| Authors | Surname then initials, no full stops in initials | Haynes AB |
| Number of authors | List up to six; with more, list six then "et al." | ..., Dellinger EP, et al. |
| Article title | Sentence case, no quotation marks | A surgical safety checklist to reduce... |
| Journal title | NLM abbreviation, no full stops | N Engl J Med |
| Date, volume, pages | Year;Volume(Issue):Pages, with the second page shortened | 2009;360(5):491-9 |
Reference Examples
Journal Article (More than Six Authors)
1. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491-9. doi:10.1056/NEJMsa0810119
Book
2. Marieb EN, Hoehn K. Human anatomy & physiology. 11th ed. Harlow: Pearson; 2019.
Chapter in an Edited Book
3. Chapter Author AB. Chapter title. In: Editor CD, editor. Book title. 3rd ed. Place: Publisher; Year. p. 142-58.
Web Page
4. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management [Internet]. London: NICE; 2016 [cited 2026 Oct 9]. Available from: https://www.nice.org.uk/guidance/ng51
Online sources carry "[Internet]", a cited date in square brackets in year, month, day order, and "Available from:" before the URL. Note "ed." for edition and "editor" after an editor's name.
Journal Abbreviations and Reference Managers
Journal titles are abbreviated using the NLM Catalog, so British Journal of Surgery becomes Br J Surg and New England Journal of Medicine becomes N Engl J Med.
You do not need to memorize abbreviations. Searching for the article on PubMed and exporting the citation gives the abbreviated title, and reference managers such as Zotero, EndNote or Mendeley format and renumber Vancouver references automatically.
Check exported references against the source. Exports sometimes carry errors in capitalization, author names or page numbers.
Quotations and Secondary Citations
Clinical writing in Vancouver style relies mostly on paraphrase, so direct quotations are rare. When you do quote, use quotation marks and the source number; add a page number only if your course guide asks for one.
If you read an idea in one source that was reporting another, cite the source you actually read. Better still, find and read the original, since numbered styles make it easy to cite it directly once you have checked it.
Vancouver vs Author-Date Styles
| Feature | Vancouver | APA 7th / Harvard |
|---|---|---|
| In-text | Number | Author and year |
| Reference order | Order of first citation | Alphabetical |
| Authors | Surname and initials, no punctuation | Surname, initials with full stops |
| Journal title | Abbreviated | Full and italicized |
| Typical fields | Medicine, nursing, health sciences | Social sciences, education, business |
Vancouver keeps sentences free of names and dates, which suits dense clinical writing with many sources.
Common Vancouver Mistakes
| Mistake | Fix |
|---|---|
| Giving a reused source a new number | Reuse its original number |
| Alphabetizing the list | Order by first citation |
| Full stops in initials | Write Haynes AB, not Haynes, A.B. |
| Full journal titles | Use NLM abbreviations |
| Mixed in-text formats | Choose brackets or superscript and keep to it |
| Missing cited date for web pages | Add [cited year month day] |
Variants to Watch
Universities and journals adapt Vancouver. Some use square brackets, some superscript, some list three authors before "et al.", and some allow page numbers for quotations. Your course guide always takes priority.
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Frequently Asked Questions
It is one numbered style. IEEE and AMA are also numbered but format references differently.
Usually not. Some versions allow a page number for a direct quotation, so check your course guide.
Up to six. With more than six, list the first six followed by "et al."
It uses a reference list of works cited. Some courses also ask for a separate bibliography of works consulted but not cited.
In the NLM Catalog, or by exporting the citation from PubMed.
Include them if available. Citing Medicine places the DOI at the end of the reference.
Avoid it. Name the author instead, as in "Haynes et al. (1) reported...", or rewrite the sentence so the number follows the claim.