The Vancouver Style: Numbering Rules for Medical & Health Sciences

If you are a medical student at Universiti Malaya Medical Centre (UMMC), a pharmacy student at USM (Kubang Kerian), or studying dentistry at IMU, you will likely never use APA style.

You live in the world of Vancouver Style.

Also known as the “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” (URM), this style is the gold standard for medicine. Why? Because when a doctor is reading a clinical trial about a life-saving drug, they don’t want to be distracted by long names like (Schwarzenegger, Stallone, & Willis, 2025) in the middle of a sentence.

They just want a small number (1) so they can keep reading the data.

However, Vancouver is strict. It has rules about “Journal Abbreviations” and “Author Counts” that are completely different from APA or IEEE. Here is your guide to surviving the Vancouver style in Malaysia.

More on Citations/References.

1. The Core Logic: “Order of Appearance”

The most important rule in Vancouver is that the Bibliography is NOT Alphabetical.

• APA Rule: List references A-Z by surname.
• Vancouver Rule: List references 1-100 based on when they first appear in the text.

The Implication:

• If you cite Ali in the first sentence of Chapter 1, Ali is Reference #1.
• If you cite Ali again in Chapter 5, he is still Reference #1.
• If you insert a new paragraph in Chapter 1 with a new source, every single number in your thesis shifts. (Reference 2 becomes 3, 3 becomes 4, etc.).
  • Warning: Never type these numbers manually. One edit will destroy your entire thesis. Use EndNote.

2. The “Bracket” Dilemma: (1) vs [1] vs ¹

Unlike APA, which has one standard format, Vancouver has three common variations for in-text citations. You must check your specific Thesis Manual (e.g., formatting guidelines for USM School of Medical Sciences).

Variation A: Parentheses (The Most Common)

“Diabetes prevalence in Malaysia has risen significantly (1).”

Variation B: Square Brackets

“Diabetes prevalence in Malaysia has risen significantly [1].”

Variation C: Superscript (The Cleanest)

“Diabetes prevalence in Malaysia has risen significantly.¹”

The Trap: Do not mix them. If you start with (1), do not switch to superscript halfway through Chapter 3.

3. The “6-Author” Rule (The Biggest Difference)

This is where students get confused between APA and Vancouver.

• APA 7th Rule: List up to 20 authors in the bibliography.
• Vancouver Rule: List the first 6 authors, followed by “et al.” if there are more.

Example (Reference List):

Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347(4):284-7.

Note: If there were 7 authors, it would look like:

Halpern SD, Ubel PA, Caplan AL, Smith J, Jones M, Wilson K, et al.

4. Journal Abbreviations (Index Medicus)

In Vancouver style, you NEVER write the full name of a journal. You must use the official NLM (National Library of Medicine) abbreviation.

• Wrong: New England Journal of Medicine
• Right: N Engl J Med
• Wrong: Journal of the American Medical Association
• Right: JAMA

How to fix this: If you are using EndNote, you must install the “Journals Term List.” If you don’t, EndNote will print the full name, and your supervisor will circle it in red.

5. Citing Clinical Guidelines and Govt Reports

In Malaysian medical theses, you will often cite the Ministry of Health (MOH) or CPG (Clinical Practice Guidelines).

Format:

Author/Organization. Title. Place of Publication: Publisher; Year.

Example:

Ministry of Health Malaysia. National Health and Morbidity Survey 2019: Non-communicable diseases, healthcare demand, and health literacy. Kuala Lumpur: Institute for Public Health; 2020.

6. Summary Checklist for Med/Pharm Students

1. Check the Bracket: Is it (1), [1], or superscript?
2. Check the Order: Is Reference #1 the first thing you mentioned in the Intro?
3. Check the Authors: Did you stop listing names after the 6th author?
4. Check the Journals: Is it Am J Cardiol or American Journal of Cardiology? (Must be abbreviated).

Struggling with EndNote? Medical theses often have 300+ references. One broken link can ruin the numbering sequence.

• [Citations & References Adjustment] – We fix your EndNote library, correct the journal abbreviations, and ensure your bibliography is perfectly formatted in Vancouver style.
• [Manuscript Style Formatting] – We ensure your thesis layout meets the strict UMMC/USM Health Campus requirements.