AMA citation style uses superscript numbers in your sentences and a numbered reference list at the end, ordered by when each source first appears rather than by author name. The rules come from the AMA Manual of Style, 11th edition, written by JAMA Network editors for medicine and the health sciences.
If your pre-med, PA, pharmacy, physical therapy or public health course asks for AMA, this guide puts everything in one place: the core rules, the reference page, real examples for the sources health students cite, how to handle ChatGPT, and how AMA differs from APA. Plenty of nursing programs use APA instead, so check your syllabus before you start.
AMA citation format comes down to three moves: number your sources in the order you first cite them, mark each citation with a superscript number, and list the sources in that same order at the end. This table covers the details you'll use on every paper.
| Element | AMA rule | Example |
|---|---|---|
| In-text marker | Superscript Arabic numeral, no brackets or parentheses | …clinical knowledge.¹ |
| Numbering | Order of first citation; a repeat source keeps its first number | First source cited = 1 |
| Placement | Outside periods and commas, inside colons and semicolons, after closing quotation marks | trials,² / two factors³: |
| Several sources | Hyphen for 3 or more in a row, commas otherwise, no spaces | ¹⁻³ / ²,⁵ / ¹,⁴⁻⁶ |
| Reference list | Titled References, numbered, in citation order, not alphabetical | 1, 2, 3… |
| Authors | List up to 6; with 7 or more, list the first 3 and add et al | Singhal K, Azizi S, Tu T, et al. |
| Author format | Surname plus initials, no periods, no “and” | Christiansen SL |
| Article titles | Sentence case, no italics or quotation marks | Large language models encode clinical knowledge. |
| Journal names | NLM abbreviation, italic, no periods | N Engl J Med |
| DOI | Lowercase doi: prefix, no period after, no access date needed | doi:10.1001/jama.2023.1344 |
| Web sources | Accessed date, then the URL last with no period | Accessed October 10, 2026. https://… |
Every example here follows the 11th edition (2020), which is still presented as current on the official AMA Manual of Style site.
An AMA in-text citation is a superscript Arabic numeral placed right after the fact, idea or quotation it supports. There are no author names or years in parentheses, which keeps dense clinical writing easy to read.
The first source you cite becomes 1, the next new source becomes 2, and so on. If you cite source 1 again on page 6, it's still 1. Never give the same source a second number, and never put two sources under one number.
The superscript goes outside periods and commas but inside colons and semicolons. It also goes after a closing quotation mark. For example:
Join three or more consecutive numbers with a hyphen and separate everything else with commas, with no spaces anywhere: ¹⁻³, ²,⁵ or ¹,⁴⁻⁶. Two numbers in a row take a comma, not a hyphen, so write ¹,² rather than ¹⁻².
Don't place a citation right after a number or unit of measure, because a reader could mistake it for an exponent. “The largest lesion measured 10 cm²” reads like square centimeters. Move the citation instead: “The largest lesion in the first study² measured 10 cm.”
For a direct quotation or a specific passage, add the page in parentheses right after the reference number, all in superscript: ³⁽ᵖ²¹⁾ means page 21 of source 3. Use pp for more than one page, as in a superscript 5(pp3,5). The source still appears only once in your reference list.
You can name authors in the text as long as the number follows. Use surnames only. Name both authors of a two-author source; for three or more, give the first surname plus “et al” with no period.
Unpublished data and personal communications, such as an email from a preceptor, are cited in the text in parentheses and left out of the reference list. New York Medical College's AMA 11 in-text guide has more examples.
The AMA reference page is a numbered list titled References that includes each source once, in the order you first cited it. It is not alphabetical, and its numbers must match the superscripts in your text.
Library guides show entries left-aligned and single-spaced, with no hanging indent. If your instructor sets different spacing, follow the instructor.
Write each author's surname, then initials with no periods or spaces, and separate authors with commas. Don't use “and” or an ampersand. List every author up to six. With seven or more, list the first three and add et al.
Article, chapter and web page titles use sentence case: capitalize only the first word, proper nouns and abbreviations such as US. They aren't italicized or put in quotation marks. Book and journal titles use title case and italics. In a journal article title, the first word after a colon stays lowercase unless it's a proper noun.
AMA uses the National Library of Medicine's journal abbreviations, set in italics with no periods. To find one, search the full journal name in the NLM Catalog of journals referenced in NCBI databases, open the record and copy the “NLM Title Abbreviation.”
| Full journal title | NLM abbreviation |
|---|---|
| The New England Journal of Medicine | N Engl J Med |
| American Journal of Public Health | Am J Public Health |
| JAMA | JAMA |
| Nature | Nature |
One-word titles such as Nature or Pediatrics are never abbreviated, and newspaper names aren't abbreviated either.
If a journal article has a DOI, end the reference with it in this form: doi:10.1001/jama.2023.1344. Use a lowercase “doi” with no space after the colon, skip the https://doi.org prefix, and don't add a period at the end. A DOI doesn't need an access date because it's a permanent link. If an article's DOI is missing from your PDF, look it up with Crossref's free search.
Use a URL only when there's no DOI. Any reference that ends in a URL gets “Accessed Month Day, Year.” right before the URL, and the URL comes last with no period after it.
Below are AMA citation examples for the sources health students cite most, each with the pattern first and a real reference second. Italics in the patterns show where they go in your paper.
Pattern: Author AA, Author BB. Title of article. Abbrev Journal Name. Year;Volume(Issue):pages. doi:xx.xxxx
Four authors: Flanagin A, Bibbins-Domingo K, Berkwits M, Christiansen SL. Nonhuman “authors” and implications for the integrity of scientific publication and medical knowledge. JAMA. 2023;329(8):637-639. doi:10.1001/jama.2023.1344
Seven or more authors: Singhal K, Azizi S, Tu T, et al. Large language models encode clinical knowledge. Nature. 2023;620(7972):172-180. doi:10.1038/s41586-023-06291-2
The Singhal paper has 32 authors, so only the first three appear. If a journal uses an article number (an e-locator) instead of page numbers, put it where the pages would go.
Pattern: Author (if named). Title of page. Name of website. Updated Month Day, Year. Accessed Month Day, Year. URL
Example: Clinical safety: hand hygiene for healthcare workers. Centers for Disease Control and Prevention. Updated February 27, 2024. Accessed October 10, 2026. https://www.cdc.gov/clean-hands/hcp/clinical-safety/index.html
CDC pages show a single date under the title without a label, and library guides such as UNC's AMA style guide treat it as the updated date. If a page gives only a “Last Reviewed” date, as many NIH pages do, Midwestern University's guide writes it as Reviewed plus the date. If there's no date at all, go straight to the accessed date.
Library guides cite an UpToDate topic like a chapter in an online book. Midwestern University's AMA 11 guide uses this pattern:
Pattern: Author AA. Title of topic. In: Connor RF, ed. UpToDate. UpToDate; Year. Accessed Month Day, Year. URL
Copy the authors and title from the topic page. Some schools list Wolters Kluwer as the publisher or use the topic's last-updated date, so match your library's version if it differs. Some instructors also want you to cite the original studies an UpToDate topic summarizes.
Pattern: Brand name. Package insert. Manufacturer; Year.
Example: Synthroid. Package insert. AbbVie; 2024.
Use the revision year printed on the label. You can find current labels on DailyMed, the National Library of Medicine's drug label database.
Cite a guideline the way it was published. When it appeared in a journal, use the journal article format with the organization as a group author:
Example: US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918-1930. doi:10.1001/jama.2024.5534
When a guideline exists only on an organization's website, use the web page format with the organization as the author.
Pattern: Chapter Author AA. Chapter title. In: Editor AA, Editor BB, eds. Book Title. Edition. Publisher; Year:pages.
Example: Boushey CJ. Application of research paradigms to nutrition practice. In: Coulston AM, Boushey CJ, Ferruzzi MG, eds. Nutrition in the Prevention and Treatment of Disease. 3rd ed. Academic Press; 2013:99-105.
Boushey wrote the chapter and co-edited the book, so her name appears in both places. Leave out the edition for a first edition, and skip the publisher's city, which the 11th edition no longer requires. For a whole book, drop the chapter details: Harvey RA, Ferrier DR, eds. Lippincott's Illustrated Reviews: Biochemistry. 5th ed. Wolters Kluwer Health; 2011.
Pattern: Creator (if known). Title of video. YouTube. Month Day, Year. Accessed Month Day, Year. URL
Example: JAMA Network. Narcolepsy: a review. YouTube. October 8, 2026. Accessed October 10, 2026. https://www.youtube.com/watch?v=yAcIDIs4JGE
Name a creator only when you're sure who made the video, not just who uploaded it. Library guides disagree on whether to italicize video titles, so follow your instructor or pick one approach and stay consistent.
If your paper is built around a clinical question, our guide to writing PICOT questions can help you frame it before you start collecting sources.
In AMA style, you disclose AI use in your text instead of listing ChatGPT in your reference list. Section 3.15.13 of the AMA Manual says descriptions of large language models and chatbots belong in the running text, much like reporting statistical software.
The description should name the tool, its version and its maker, and say how and when you used it. If the AI use was part of your research methods, give your prompts too so someone else could repeat the work. The manual puts writing and editing help in the Acknowledgment section and research use in the Methods section. The George Washington University AMA guide on generative AI summarizes these rules.
For a class paper, a short statement at the end usually covers it. Here's an illustrative template:
I used ChatGPT ([version], OpenAI) on [date] to suggest PubMed search terms for this paper. I chose and read every source, wrote all of the text myself and take full responsibility for its content.
Three cautions:
For APA, MLA and Chicago formats, see our guide on how to cite AI and ChatGPT.
Here is a short paragraph cited in AMA style, followed by its reference list. The paragraph is illustrative, but the sources are real and every citation follows AMA 11.
One large language model scored 67.6% on US Medical Licensing Exam-style questions, beating the previous best result by more than 17%, yet human reviewers still found key gaps in its answers.¹ Medical journals have responded with clear rules. JAMA Network policy says AI tools “do not qualify for authorship,”² and the International Committee of Medical Journal Editors (ICMJE) takes the same position: authors should disclose how they used AI³; the humans who submit the work stay responsible for it.²,³ Singhal et al¹ argued that careful evaluation is still needed to build safe, helpful models for clinical use.
References
Here's what to notice:
AMA and APA are different systems: AMA uses numbered superscripts and a reference list in citation order, while APA uses author-date citations and an alphabetical list. Here is the same JAMA editorial in both styles.
AMA 11: Flanagin A, Bibbins-Domingo K, Berkwits M, Christiansen SL. Nonhuman “authors” and implications for the integrity of scientific publication and medical knowledge. JAMA. 2023;329(8):637-639. doi:10.1001/jama.2023.1344
APA 7: Flanagin, A., Bibbins-Domingo, K., Berkwits, M., & Christiansen, S. L. (2023). Nonhuman “authors” and implications for the integrity of scientific publication and medical knowledge. JAMA, 329(8), 637–639. https://doi.org/10.1001/jama.2023.1344
| Feature | AMA (11th edition) | APA (7th edition) |
|---|---|---|
| In-text citation | Superscript number: knowledge.¹ | Author and year: (Flanagin et al., 2023) |
| Reference order | Numbered, in order of first citation | Alphabetical by first author's surname |
| Layout | Numbered entries, no hanging indent | Half-inch hanging indent, double-spaced |
| Authors listed | Up to 6; with 7 or more, first 3 and et al | Up to 20; with 21 or more, first 19, an ellipsis, then the last author |
| Name format | Flanagin A, Christiansen SL | Flanagin, A., & Christiansen, S. L. |
| Journal name | NLM abbreviation, italic | Full title, italic, title case |
| Year | After the journal name | In parentheses after the authors |
| DOI | doi:10.1001/jama.2023.1344 | https://doi.org/10.1001/jama.2023.1344 |
| Typical users | JAMA Network journals; many medicine, pharmacy and PA courses | Psychology, education and many nursing programs |
When you switch from APA, watch for three old habits: adding the year in parentheses, alphabetizing the list and writing “et al.” with a period. For the full APA rules, see our APA style guide.
To set up an AMA paper, follow your instructor's layout for the title page, font, margins and spacing, then apply AMA rules to your citations and references. The AMA Manual is written for journal manuscripts, so it doesn't give student papers a title page template the way APA does.
Superscript the whole citation string, commas and hyphens included. Microsoft's superscript help page and Google's Docs shortcut list have the full details.
Type References at the top of the list and turn on automatic numbering: Numbering on Word's Home tab, or Ctrl+Shift+7 (⌘+Shift+7 on a Mac) in Google Docs. If you add a new source in the middle of your paper, every later number shifts, so renumber both the text and the list before you submit.
Skip Word's endnote tool for AMA. It assigns a new number each time you insert a note, while AMA reuses a source's original number every time you cite it again.
Reference managers such as Zotero include an AMA style; in Zotero it's called AMA Manual of Style 11th edition. Proofread whatever it produces, because imported records can carry title-case article titles, missing issue numbers or unabbreviated journal names.
The most common AMA citation mistakes are alphabetizing the reference list, misplacing superscripts and formatting authors or journal names the APA way. Check your paper against this list before you submit:
Want a second set of eyes before you submit? Our tutors work with students in medicine and the health sciences, nursing and pharmacy. They can review your own draft and reference list and show you what to fix. Request feedback on your paper when you're ready.
Yes. AMA marks each in-text citation with a superscript Arabic numeral, such as ¹ or ²⁻⁴, with no brackets or parentheses. The number goes right after the fact or quotation it supports, outside periods and commas and inside colons and semicolons. In Word, press Ctrl+Shift+Plus sign (Command+Shift+Plus sign on a Mac). In Google Docs, press Ctrl+period (⌘+period on a Mac).
No. An AMA reference list is numbered in the order you first cite each source, so the first source you mention is reference 1 even if its author's name starts with Z. This is one of the biggest differences from APA and MLA, which both alphabetize. When you cite a source again later, reuse its original number instead of adding a new entry.
No. AMA uses superscript numbers and a reference list in citation order, while APA uses author-date citations like (Flanagin et al., 2023) and an alphabetical list. AMA also abbreviates journal names, lists up to six authors before switching to et al, and writes DOIs as doi:10.xxxx. JAMA Network journals and many medicine and pharmacy courses use AMA, while many nursing programs use APA.
Yes. Any AMA reference that ends in a URL gets “Accessed Month Day, Year.” right before the URL, because web pages change. Include the published or updated date too if the page shows one. Journal articles with a DOI don't need an access date, since a DOI is a permanent identifier that keeps pointing to the article.
Use the same number every time. If the CDC page you cited as source 2 comes up again in your conclusion, cite it as ² again and don't create a new entry. To point to a specific page of the same source, add the page inside the superscript, such as ²⁽ᵖ¹⁴⁾, and keep a single entry in the reference list.
Yes. AMA uses the National Library of Medicine's journal abbreviations, set in italics without periods, such as N Engl J Med or Am J Public Health. Search the journal in the NLM Catalog and copy its NLM Title Abbreviation. One-word titles such as Nature and JAMA stay as they are, and newspaper names are never abbreviated.
Use the 11th edition of the AMA Manual of Style, published in 2020. As of October 2026, the official AMA Manual of Style site still presents it as the current edition. The 11th edition dropped the publisher's city from book references and removed the period after DOIs and URLs, so guides that show “New York, NY:” in book references are out of date.
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