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AMA (11/e) Style Guide

A guide to help users create citations using AMA (American Medical Association) style

In-Text Citation Basics


References are numbered in consecutive order by means of superscript Arabic numerals in the text, tables, or figures.

It is acceptable for a reference to be cited only in a figure, table, or box and not in the text if it is in sequence with references cited in the text.

For example, if Table 2 contains reference 13, which does not appear in the text, this is acceptable as long as the last reference cited (for the first time) before the first text citation of Table 2 is reference 12.

Use superscript arabic numerals to cite material, e.g., 1    The first reference used in a written document is listed as 1 in the reference list.

Where to place the superscript? 

  • The superscript number 1  is inserted into the document immediately next to the fact, idea, concept, or quotation being cited.  Example. This drug is used to treat hepatitis.1
  • If citing directly (word for word), indicate it is a quote by using double quotation marks around the original phrase. The superscript then appears after the quotation mark. Example: "The basic ideas of a 'living-food' or 'raw food' diets are consuming all or primarily uncooked foods."4
  • Outside periods and commas. Example: Storing latex at high heat may cause degradation, 2,3-5,7  but it is difficult to keep materials cool in a desert environment.
  • Inside colons and semi-colons. Example: Some physicians choose to store prescription pads in locked cabinets 8; others keep them in their coats at all times. 9
  • When more than 2 references are cited at a given place in the manuscript, use hyphens to join the first and last numbers of a closed series; use commas without space to separate other parts of a multiple citation.  Example: As reported previously,1,4-7,19,24
  • Avoid placing a superscript reference citation immediately after a number or an abbreviated unit of measure to avoid any confusion between the superscript reference citation and an exponent. See Examples:


The 2 largest studies to date included 262 and 183 patients.


The 2 largest studies to date included 26 patients2 and 18 patients.3


The largest lesion found in the first study was 10 cm.2


The largest lesion found in the first study2 was 10 cm.

If a reference is used multiple times in one paper, use the same number throughout.

At the end of the document, include a reference list with full citations to each item. Name it References. Order citations as they appear in your paper.

You may use author names in your text, as long as these mentions are accompanied by numbered citations. Use last names only.  For items with one or two authors, include both names. For items with 3 or more authors, include the first author's surname and then 'et al' or 'and colleagues'.

Two author Example: 

  • Smith and Jones2 reported on the questionnaire.

More than two authors:

  • Hammersmith et al3 reported on the survey.

The format for authors in in-text citations is different than what is required of listed references. In the list of references all authors should be given unless there are more than 6, in which case the names of the first 3 authors are used followed by “et al.


In-Text Citation Examples

Use In-Text citations when paraphrasing or using a direct quote.

A direct quote is taken word-for-word from the original text. Indicate it is a quote by using double quotation marks around the original phrase. The superscript appears after the quotation mark. See examples below for both paraphrasing and using a direct quote:

Finding treatments for breast cancer is a major goal for scientists.1,2 "Some classes of drugs show more promise than others. Gradishar evaluated taxanes as a class."3 Other scientists have investigated individual drugs within this class, including Andre and Zielinski 2 and Joensuu and Gligorov. 4 Mita et al's investigation of cabazitaxel 5 seems to indicate a new role for this class of drugs.


1. Cancer Research Funding. National Cancer Institute. Publication date unavailable. Updated June 6, 2011. Accessed November 3, 2012.

2. Andre F, Zielinski CC. Optimal strategies for the treatment of metastatic triple-negative breast cancer with currently approved agents. Ann Oncol. 2012;23(Suppl 2):vi46-vi51.

3. Gradishar WJ. Taxanes for the treatment of metastatic breast cancer. Breast Cancer (Auckl.). 2012;6:159-171.

4. Joensuu H, Gligorov J. Adjuvant treatments for triple-negative breast cancers. Ann Oncol. 2012;Suppl 6:vi40-45.

5. Mita AC, Figlin R, Mita MM. Cabazitaxel: more than a new taxane for metastatic castrate-resistant prostate cancer? Clin Cancer Res. 2012;18(24):OF1-OF6.


When citing different page numbers from a single reference source at different places in the text, the page numbers are included in the superscript citation and the source appears only once in the list of references. 


These patients showed no sign of protective sphincteric adduction.3(p21),9

Westman5(pp3,5),9 reported 8 cases in which vomiting occurred.