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Vancouver Referencing System

The Vancouver Writing Style – Numbering System


This guide to the Vancouver style of writing is intended for undergraduates studying medicine at various academic institutions.

The Vancouver Style uses a numbering system whereby every reference is assigned a number as it is inserted in a text. Even when you name an author within your text, it is still necessary to use a number. The first number given to a reference should be re-used every time that particular reference is mentioned in a text. For example, the number 1 is assigned to the first mentioned reference, number 2 to the next reference, etc. If the reference numbered 1 is cited later in a text, it will be given the same number i.e. 

In all cases, references are presented in numeric order in end-of-paper bibliographies. It is important that bibliography entries follow a prescribed format as per the examples shown below. Please note that all examples provided here are fictional and are used for explanation purposes only. 

Numbers may be placed on the outside of the last punctuation mark as a way of preventing disruption to the general flow of a text, or they may be placed just inside a punctuation mark. Some universities prefer the latter method.

It is recommended that journal article titles be abbreviated in the manner shown in the style manual. Medline uses abbreviated journal titles and a list of these is available in a database entitled PubMed Journals.

Citations within a Text Should be Numbered

References should be numbered in consecutive order from the first time they are mentioned. As well as in-text, references should be identified by parenthesized Arabic numbers in legends and tables in the following manner: (1), (2), (3), etc. Square brackets [ ] should not be used nor should superscript be used for citations. 

Where more than one information source is being cited at the same time, the format is (1-2), (1-3), etc.  

Adding Page Numbers to Cited Works

There is no provision in the Vancouver style for this scenario so it cannot be done in RefWorks – an online tool for creating bibliographies. To add a particular page number, place it within the text i.e. when citing a table or figure within a text. Example: 

Alan Freeman says, “Justice requires that medicine is provided in a fair way for everyone and not for profitable purposes” (p.302) (2)

Then in the bibliography, this should appear as:

1. Freeman A. After release: the fair use of medicine. Medicare.  2011 Dec 4;411(8371):302-4. 

Bibliography References

Only works that have been cited in a paper should be included in a bibliography.

The Process for RefWorks

When using RefWorks, the “Uniform - Uniform Requirements for Manuscripts Submitted to Biomedical Journals” should be used. This style is specific to the University of Leicester’s Specific Style” and as such is automatically available to every user. Because the Vancouver writing style is not consistently updated, some material types are not correctly documented.  

Citing Articles from Journal

Jones P, Jenkins C, Carrington T, O'Brien B. Primary disease-causing bacteria. UK J Crit Respir Care Med. 2010;287:521-8.

Journal titles should be presented in abbreviated form, ending with a period or full stop. The abbreviations found in PubMed and Medline can be used.

Where a journal title is not on the list, it is permissible to use the full title of the journal. Writers should not make up abbreviations of their own!  

In the above example, the publication year is 2010, the volume number is 287 and the page numbers are 521-8 i.e. page numbers 521 to 528 – it is permissible to shorten a page number in this manner.  The part number can be omitted – except where numbering begins in every part of a journal at page number 1 or the journal part is in supplement form. The issue date (e.g., Apr 4) can also be omitted. To leave these elements out, it will be necessary to remove this data from the RefWorks record. It is permissible, however, to retain part numbers and issue dates.   

Where the number of authors for a work is six, all should be listed. If a work has more than 6 (six) authors, the first six should be listed followed by the term ‘et al.’  

Where there is no author or they are unknown, the field for the author should be left blank in RefWorks. The terms “Anon.” and “Anonymous” should not be used. Example: 

Pancreatic cancer and drinking coffee (Editorial). AM Med J. 1978;192:549 

Where an article from a journal is read online you should, in the strict sense, include the URL and access date i.e. the date the writer accessed the article. It will be necessary to ensure this piece of information is entered in RefWorks – the Reference Type can be listed as “Journal, Electronic”. Example: 

Metcalfe B, Green J, Wyle C, Hoffman K, Lyons M. Dangers of smoke generated by cooking: An interim study. WHO International Health [Internet]. 2010 Apr 24 [cited 3rd July 2011];7:11.

Citing a Book

The following are examples of how to cite a book that has been authored by one or several authors: 
Brown C. Paediatric care. 3rd ed. New York: Mills-Sanders; 2009.

Citing edited books: 
Wallis G, editor. Microbiology and medicine: Guide to microbial diseases: Diagnosis, patient immunity, and disease control. 12th ed. Minnesota: Lincoln Lilyman; 2010.

When citing chapters in edited books, it is necessary to provide details about the author(s), chapter titles, editors, and book titles. Example:
Ferris PJM. Flu Viruses. In: Wood L, editor. Microbiology Medicine: guide to viral infections: diagnosis, patient immunity, and virus control. 21st ed. Minnesota: Lincoln Lilyman; 2010. p. 471-84.

The names of the first 6 (six) people who authored the book and the editors should be included in the citation. If a book has been imported from a library, you might find that it only lists the first 3 (three) authors’ names and the editors. The RefWork record can be edited to include the other editors, but listing these first 3 (three) authors is acceptable.

There is no field for Type of Reference in RefWorks for e-books, so e-books must be cited as if they were print versions. When e-books are read on iPads, they should be cited as if they were print version books.  

Citing a Website

No-Holds Medicine [Internet]; [cited 3rd May 2004].

If a “publication” date cannot be found (as shown in the following example), the field for the date can be left blank in RefWorks.

Where the older version of RefWorks is being used, it is not possible to have website authors in the Uniform Requirements style. Where an author needs to be included in RefWorks, their name should be placed at the start of the field for title. Authors are accommodated in the latest RefWorks version.  

Citing Tables, Figures and Images

If your paper includes tables, figures, or images, a reference must be cited so that readers can see where this data was obtained from. A caption should be included as per the following example:  

Table 2. Duration of hospital stay by patient gender, adapted from Walls, 2010 (2)

Figure 2. The thorax, from Brinks, 2011 (2) Figure 1. 

The idea of numbering tables and figures is to make them easier to mention or refer to in a text. If you are using MS Word, it is easy to add a caption to an image by right clicking on the required image and selecting the “Insert Caption” feature, but RefWorks cannot be used to generate numbers for tables and figures.   

RefWorks can be used to add citation numbers. Then the reference will be added to the bibliography. 

NB: You may find there is a problem adding citations where captions are embedded in text boxes. The citation numbers may be out of sequence. To get around this problem, place captions outside the boxes. 

When it is necessary to add page numbers to citations, please check the relevant section above – Adding Page Numbers to Cited Works.

Citing Slides and/or Lecture Notes

It needs to be made clear in the source’s title that the source contains lecture notes, slides, or a module from a handbook. Therefore, as an example, add the following to the source title “Notes or slides from a lecture delivered at the New York School of Medicine on 3 Apr 2014...”, or “Module from handbook, Receptors and membranes, 2010/13”.

For those who use RefWorks, the item will need to be added manually in the form of “personal communication” with this additional information placed in the field labelled “Description.” It will then be displayed in the bibliography.

In terms of author, a lecturer or professor’s name may be used or the name of the person leading the module. In the event you do not know who these persons are, use the name of your school for author.

Guidelines for Citing an Institution’s Work

Where the version read is in print, it should be treated as you would a book.

In the case of reading an online (web-based) version, this should be treated in the same way as webpages. In the older version of RefWorks, add the name of the institute at the beginning of the work’s title. The institute’s name can be entered as author in the newer version.   

Citing British National Formulary (BNF)

The guidance provided in BNF (a UK-based pharmaceutical information or reference book) should not be followed since it leaves out essential information. You should instead do the following:

Ear Inflammations. in: Joint BNF Committee. British National Formulary. [36] ed. London: British Medicine and Pharmaceutical Society [Internet]. [updated June 2011; cited 8th August 2011].

Place everything from this citation into the RefWorks title field, both in the new and older versions. 

For example, when citing reports from the British Cancer Society or Heart Foundation, treat print versions as you would books and treat online versions as webpages. Include the organization’s name at the beginning of the title field in the older RefWorks version.  

Citing Summaries of Clinical Reports/Knowledge

Treat these, as you would do with website citations. In the RefWorks older version, put the name of the institute, Clinical Knowledge Summaries, at the beginning of the field for title and place the last update date in the field labelled ‘Last Updated, Full Date.’ When using the newer version, use the name of the institute for author name.

Citing a Religious Text

Fictional examples of Bible citations:

John 5: 3-10, Holy Bible. New VaticanVersion.

The version should be included but the publication date or publisher name is not necessary.   

Fictional examples of Qur'an citations:

Qur'an 19: 24. Translated by Mohammed Hussain, M.M.S. Cambridge: Cambridge College Press; 2009.

The above recommendations are founded on real example citations from a reliable source. Citations should be correct and complete as in:

Sedgewick P, Larkin LA. Correct citations: the essential guide to referencing. 3rd ed. New York: Brook Havers; 2003.

Citing Secondary Sources or References

A secondary source is a situation where the writer has not actually viewed an original source but has seen it referred to in another book or publication.

It is recommended to use secondary sources or referencing sparingly rather than as a standard method. Where humanly possible, try to locate the original reference source. If every effort has been unsuccessful, and a reference to a particular source can only be found in secondary material, then use it as follows: refer to both authors in your paper, but cite only the source you have actually read. In your text, for instance, say:   

Bragg, cited in Nokes (2), states …

And for the bibliography entry:

(2) Nokes, J. …

How Frequently Should Sources be Cited?

If  the same particular source is used several times in the same paragraph, does it need citing every time you use it?

From the referencing, it should be clear which elements of information come from the source. Nonetheless, it is better not to cite the one source too frequently in the same paragraph. So, instead of doing this:   

Only the kidneys are affected by renal disease (2). Other organs are impacted by the side effects of treatment (3).

Try this:

Mullins (2) explains how renal disease only affects the kidneys, but side effects from the treatment can additionally impact other organs.