Vancouver is the citation system of biomedical and clinical research. Most medical journals worldwide either use Vancouver outright or use a closely related house style derived from it. If your work is destined for a clinical journal, a medical thesis, or a public-health publication, Vancouver is very likely the system you are working in.
The canonical references are the ICMJE Recommendations at icmje.org and Citing Medicine, the National Library of Medicine’s detailed style guide, at ncbi.nlm.nih.gov. The ICMJE Recommendations set the high-level conduct and publication rules; Citing Medicine handles the citation forms in depth. This blog post is an orientation. It is not a rulebook and does not replace either of those canonical sources.
Where Vancouver came from and who uses it
Vancouver originated at a meeting of a small group of medical journal editors in Vancouver, Canada, in 1978. That meeting evolved into the International Committee of Medical Journal Editors (ICMJE), which now sets common publication guidelines for hundreds of medical journals. The citation style developed at and following the original meeting carries the city’s name and has remained the dominant system for biomedical writing ever since.
Disciplines that use Vancouver include medicine, public health, nursing, dentistry, pharmacy, veterinary medicine, clinical psychology in many journals, and most of the broader biomedical sciences. If your target journal is indexed in MEDLINE/PubMed, it almost certainly accepts Vancouver-format citations even where it does not strictly require them. Always check your specific journal’s author instructions for any local variations.
The mechanics: spelling, punctuation, and usage
Vancouver does not formally specify a single English variant, and journals using Vancouver vary by region. US-based journals (most NLM-indexed publications) use American spelling. UK-based journals (such as BMJ titles) use British spelling. Choose the variant your target journal expects; consistency across the manuscript is what matters.
Punctuation
Vancouver itself is light on broader punctuation guidance, deferring to the journal’s house style. Citation punctuation is specified precisely: where commas, periods, and semicolons go inside a reference list entry follows a settled pattern documented in Citing Medicine. Within citations, no commas separate elements that are conventionally adjacent (such as year and volume in many forms).
Numbers
Biomedical writing is dense with numbers. Vancouver journals typically use figures for all numerical quantities, including small whole numbers when they refer to measurements, patient counts, doses, or statistical values. Numbers that begin a sentence are written as words. Units of measurement follow SI conventions where applicable.
Capitalisation and italics
Article titles in references use sentence case (capitalizing only the first word, the first word after a colon, and proper nouns). Journal title abbreviations follow the standard NLM abbreviations and are not italicized in Vancouver, unlike many other styles. Book titles are not italicized either; they appear in plain type with sentence case. This is a meaningful visual difference from APA, Chicago, or MLA.
The citation system, at a glance
Vancouver is a numeric citation system. Each cited source is assigned a number in the order it is first cited in the text, and that number is used for every subsequent citation of the same source. Citation numbers appear in the running text either as superscript numerals or as Arabic numerals in parentheses, depending on the journal. The full bibliographic information appears in the reference list at the end of the paper, in numeric order matching the citation sequence.
Like IEEE, Vancouver citations carry no author or year in the running text. The number does the work, and the reader looks up the full information in the reference list. The difference between Vancouver and IEEE is in the detailed conventions for what a reference list entry looks like, especially for biomedical source types.
In-text citations
Citation numbers sit at the end of the relevant clause or sentence, either as superscript numerals or in parentheses on the baseline. The exact placement (immediately after the word, after the punctuation, before the punctuation) varies by journal; ICMJE leaves the choice to the publication.
Examples to internalize
Four in-text citations following Vancouver conventions. Sources are invented for illustration. Each appears in both superscript and parenthetical forms so you can see the visual difference.
- Single citation, superscript form: Patients with the condition show elevated markers.3
- Single citation, parenthetical form: Patients with the condition show elevated markers (3).
- Multiple citations in sequence: Several recent studies converge on this finding (3, 7, 11) or alternatively (3-7) for a continuous range.
- Citation incorporated into the sentence: As Okonkwo et al. (3) demonstrated, the convergence is observable across cohorts.
The reference list
The reference list starts on a new page after the body of the paper with the heading References at the top. Entries are numbered in the order they first appear in the text, formatted with a hanging indent. Each entry is preceded by its citation number, typically with a period after the number (as opposed to the bracketed numbers IEEE uses).
Each entry follows the four-part skeleton: who, when, what, where, with citing-medicine-specific element forms. Author lists use surname followed by initials (no periods between initials). Up to six authors are listed in full; for seven or more, the first six are listed followed by et al. (some journals require all authors regardless of count).
Examples to internalize
Four sample reference list entries. All authors and titles are invented.
- Journal article: 1. Okonkwo AC, Patel R, Stein M. Convergence properties of biomarker estimators across cohorts. J Clin Inq. 2022;14(2):121-44.
- Book: 2. Stein M. Quiet revisions: editing as a craft. Chicago: Bracewell Press; 2019.
- Chapter in an edited book: 3. Choi J. On voice. In: Stein M, editor. The shape of scholarly prose. Chicago: Bracewell Press; 2021. p. 88-112.
- Online article: 4. Patel R. Form and feeling in recent criticism [Internet]. Mod Lett Rev. 2022 Mar 14 [cited 2022 Apr 1]; Available from: https://example.org/mlr/12345
Things to remember about the reference list
- Numeric order matching the order of first citation. Not alphabetical.
- Number followed by a period at the start of each entry.
- Author surname followed by initials without periods between initials, and without commas inside the name itself.
- Up to six authors listed in full; seven or more, the first six and then et al.
- Sentence case for article and chapter titles, with no quotation marks.
- NLM-standard journal abbreviations, no italic.
- Volume followed by issue in parentheses, then a colon, then the page range with a hyphen.
- Semicolons separate elements that other styles would separate with commas. The pattern is consistent and worth internalizing.
Footnotes in Vancouver
Vancouver does not use footnotes for citation. Citations stay in the numeric system, and the reference list carries the bibliographic detail. Footnotes are reserved for table notes, figure legends, and the occasional content note where a publication permits them. Most clinical journals discourage footnotes in the body of the paper, preferring all explanatory material integrated into the running text or placed in tables and figures.
What RightMyWork does with Vancouver
When you pick Vancouver on the upload screen, the editor applies Vancouver conventions across your document. In-text citation numbers are checked for consistency with their reference list entries. Reference list entries are reviewed for the author-name format (surname plus initials, no periods, six-author cutoff), NLM-standard journal abbreviations, sentence-case article titles, and the semicolon-separated element pattern. Citation numbering against text-appearance order is checked.
Every change lands as a tracked change in Word. Citations that point to numbers without matching reference list entries are flagged. Reference list entries that are never cited are flagged. Where the editor cannot confidently apply a rule (an unusual source type, an unfamiliar journal abbreviation, a regional convention), it surfaces a query rather than rewriting silently.
Where to go from here
For the rules in their canonical form, the ICMJE Recommendations cover the high-level publication and conduct guidelines, and Citing Medicine provides the detailed citation forms by source type. The NLM Catalog is the authoritative source for journal title abbreviations.
When you are ready to apply Vancouver to your draft, the upload form on the homepage is one click away. The first 3,000 words on a new account are free.