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Learning Resource Centre - references according to the Vancouver Style

The Vancouver Style, or Uniform Requirements Style, is based on an ANSI standard adapted by the National Library of Medicine (NLM) for databases such as Medline. It was developed in Vancouver in 1978 by editors of medical journals who now meet annually as the International Committee of Medical Journal Editors (ICMJE). Over 500 medical journals (including BMJ, CMAJ, & JAMA) use this style.

In the text:

  • References are numbered consecutively in the order they are first mentioned. Place each reference number in parentheses, throughout the text, tables, and legends. If the same reference is used again, re-use the original number. (See number 3 in the example below.)
  • Direct quotes are to be used very sparingly. If a direct quote is necessary, place quotation marks around the quote and number the reference as usual. (See number 6 in the example below.)
  • Tables are numbered consecutively. Supply a brief title for each table and give each column a short heading. Be sure that the table is mentioned in the text. If the data is taken from another source, include the source in the list of references at the end of the paper. Place explanatory matter in a note, not in the heading. For notes use the following symbols in this sequence: *, +, **, ++, etc.
  • Internet sources may, in time, be deleted, changed, or moved, so it is a good idea to keep a hard copy for your records. Also, take care to critically evaluate the reliability of the information.
  • Personal communication used as a reference should be avoided, unless it provides essential information not available from a public source. Do not number this type of reference; instead cite the name of the person and date of communication in parentheses in the text. Use this method to cite a conversation or to cite notes taken by a student in class. (See the example below).


Recently, the health sciences community has reduced the bias and imprecision of traditional

literature summaries through the development of rigorous criteria for both literature overviews(1-3)

and practice guidelines.(4,5) Even when recommendations come from such rigorous approaches,

however, "it is important to differentiate between those based on weak vs. strong evidence."(6)

Recommendations based on inadequate evidence often require reversal when sufficient data

become available, (John Doe, April 1, 2002) while timely implementation of recommendations

based on strong evidence can save lives.(3)

On the references page:

The last page of your paper is entitled REFERENCES. No footnotes or bibliography are used.

List all references in order by number, not alphabetically. Each reference is listed once only, since the same number is used throughout the paper.

List each author's last name and initials; full first names are not included. List all authors, but if the number exceeds six, give the first six followed by "et al." (see example 1 below). For books with chapters written by individual authors, list the authors of the chapter first, then the chapter title, followed by "In:", the editors' names, and the book title (see example 6 below).

Book titles, chapter titles:
Capitalize the first letter of the first word in the title. The rest of the title is in lower-case, with the exception of proper names (see example 3 below). Do not underline the title; do not use italics.

Journal citations:
List the abbreviated journal title*, period, year, semi-colon, volume, issue number in parentheses**, colon, page range, and a period.
For example: Brain Res. 2002;935(1-2):40-6.

* To find the abbreviation go to PubMed Medline's Journals Database, and search by journal title. If the title is not found, abbreviate according to the style used in Medline.
** The issue number may be omitted if the journal is paginated continuously through the volume.

For journals, the entire page range of an article or chapter is given, not the specific page on which the information was found. For books, no page numbers are given, with two exceptions: the page number of a dictionary entry is included (see example 7), as well as the page range of a chapter with its own author (see example 6).

Examples: An example of a reference page appears below. For more examples, please consult:

  • Uniform Requirements for Manuscripts Submitted to Biomedical Journals, PE/1475/INT/2006, located in the reference section of the Learning Resource Centre.
  • Writing and Editing for Biomedical Publication, International Committee of Medical Journal Editors website
  • Sample References, Uniform Requirements for Manuscripts Submitted to Biomedical Journals
  • Citing Medicine – more sample references

Can't find what you're looking for?
If you are part of the Michener community, please ask the Learning Resource Centre staff for assistance.
416-596-3123; 1-800-387-9066;



Journal article, personal author(s):
1. 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.

Journal article, organization as author:
2. Diabetes Prevention Program Research Group. Hypertension, insulin, and proinsulin in participants with impaired glucose tolerance. Hypertension. 2002;40(5):679-86.

Book, personal author(s):
3. Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA. Medical microbiology. 4th ed. St. Louis: Mosby; 2002.

Book, organization as author and publisher:
4. Royal Adelaide Hospital; University of Adelaide, Department of Clinical Nursing. Compendium of nursing research and practice development, 1999-2000. Adelaide (Australia): Adelaide University; 2001.

Book, editor(s):
5. Berkow R, Fletcher AJ, editors. The Merck manual of diagnosis and therapy. 16th ed. Rahway (NJ): Merck Research Laboratories; 1992.

Chapter in a book:
6. 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.

Dictionary entry:
7. Dorland's illustrated medical dictionary. 29th ed. Philadelphia: W.B. Saunders; 2000. Filamin; p. 675.

Newspaper article:
8. Tynan T. Medical improvements lower homicide rate: study sees drop in assault rate. The Washington Post. 2002 Aug 12;Sect. A:2 (col. 4).

Legal material:
9. Regulated Health Professions Act, 1991, Stat. Of Ontario, 1991 Ch.18, as amended by 1993, Ch.37: office consolidation. Toronto: Queen's Printer for Ontario; 1994.

10. Anderson SC, Poulsen KB. Anderson's electronic atlas of hematology [CD-ROM]. Philadelphia: Lippincott Williams & Wilkins; 2002.

Journal article on the Internet:
11. Abood S. Quality improvement initiative in nursing homes: the ANA acts in an advisory role. Am J Nurs [serial on the Internet]. 2002 Jun [cited 2002 Aug 12];102(6):[about 3 p.]. Available from:

Book on the Internet
12. Foley KM, Gelband H, editors. Improving palliative care for cancer [monograph on the Internet]. Washington: National Academy Press; 2001 [cited 2002 Jul 9]. Available from:

Encyclopedia on the Internet
12.A.D.A.M. medical encyclopedia [Internet]. Atlanta: A.D.A.M., Inc.; c2005 [cited 2007 Mar 26]. Available from:

Internet homepage/website:
14. Canadian Cancer Society [homepage on the Internet]. Toronto: The Society; 2006 [updated 2006 May 12; cited 2006 Oct 17]. Available from:

Part of an Internet website:
15. American Medical Association [homepage on the Internet]. Chicago: The Association; c1995-2002 [updated 2001 Aug 23; cited 2002 Aug 12]. AMA Office of Group Practice Liaison; [about 2 screens]. Available from:

Note that the bold headings are for the purposes of this guide only; do not include the headings on your own REFERENCES page.


Avoiding Plagiarism: Why Use References?

Plagiarism is taking, using, and submitting the thoughts, writings, etc., of another person as one's own. Often students are uncertain when to acknowledge sources, or when to assume that a concept or theory belongs to the domain of general knowledge. If in doubt, include a reference. Types of concepts that require a reference include: discoveries, theories, controversies and opinions. Don't forget to acknowledge the source of illustrations, charts, and tables of data. For more information and specific examples, consult "How Not to Plagiarize"

There are several reasons for including a reference:

  • it is ethical to credit others for their contributions to your writing;
  • it may be a legal obligation in the case of copyright;
  • to protect you in the case of questionable allegations;
  • to reflect your prior reading effort;
  • to show the sequence of events involved in the resolution of a scientific problem, as part of your argument.

It is often necessary to reduce a concept or theory into a few sentences. While the words may be your own, the concepts or theories are not; and you must give credit to your sources. The use of paraphrasing, rather than direct quotes, is often preferred because it helps with creating flow in building logical arguments.

Quotations are to be used very sparingly.
The chief drawback is that the text becomes more choppy and difficult to read. Using the author's own words in a direct quote is usually justified for only the following reasons:

  • credibility, an argument gains credibility by quoting a known authority;
  • power, an argument gains power by the skillful weaving-in of knowledge into the text;
  • eloquence, an argument gains eloquence by using a direct quote that illuminates the concept.


  1. Are the problem statement and objectives clearly and concisely written?
  2. Have the objectives, hypotheses, and research questions been adequately addressed?
  3. Are the findings, conclusions, and recommendations clearly stated and do they match the objectives, hypotheses, and research questions?
  4. Where necessary, are significant or potentially controversial statements supported by the literature?
  5. Are there weaknesses in logic or mistakes in spelling or grammar?
  6. Are concepts and technical terms adequately explained?
  7. Could a major point be better presented by a table or graph?
  8. Is the report/article objective in tone?
  9. Does the title adequately describe the contents?
  10. Is the use of headings and subheadings consistent throughout the paper?
  11. Is each paragraph essential? Does one paragraph flow naturally into the next?
  12. Are pages, tables, and charts numbered correctly?
  13. Are all the references necessary?
  14. Are quotations correct?
  15. Have you included a table of contents?
  16. If needed, have you included an abstract or summary of the report?
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