Marian Mostovy
Medical Writer and Editor

Earlier this year the Oxford University Press published a new edition of the American Medical Association’s style manual, globally considered the holy grail for medical writers. Arriving 13 years after the previous edition, this latest version drops or adapts citation elements that have lost their usefulness and brings media that didn’t exist a decade ago—like blogs, Twitter, and podcasts—into its canon. 

Below are a few of the guide’s changes concerning reference citations. These are ones that as a medical writer, copy editor, and proofreader, I welcomed with a silent “yea!”

Drop the Period 
When a digital object identifier, or DOI, is included for journal references, no period follows. Ditto for URLs. Also, URLs are now to be the last item in a reference, similar to a DOI. The rationale for the changes: making the DOIs and URLs easier to cut and paste.1

Harman S, Verghese A. Protecting the sanctity of the patient-physician relationship. JAMA. Published online October 29, 2019. doi:10.1001/jama.2019.17965

The Disappearing City 
Book references no longer require the city and state of the publisher, in part because location is not a key piece of information needed for finding a source in our digital world.1

Christiansen S, Iverson C, Flanagin A, et al. AMA Manual of Style: A Guide for Authors and Editors. 11th ed. Oxford University Press; 2020.

Simplifying Website Information
When referencing website content, the word “website” no longer needs to follow the name of the site. Neither is “Published” used before the publish date. Keep using “Updated” and “Accessed” for those dates though.

Zika travel information. Centers for Disease Control and Prevention. January 26, 2016. Updated August 11, 2016. Accessed June 18, 2019.

Social Media Becomes Mainstream
BlogsTwitterFacebook, and other social media as well as apps and podcasts have come of age with formats of their own.

Gray T. Advice after mischief is like medicine after death. AMA Style Insider blog. February 11, 2019. Accessed March 10, 2019.

Bracket-less Is More 
When referencing a news release or brochure, the old AMA guidance was to enclose the format in brackets and include the place of publication. Brackets and publication city and state are no longer advised.

Device reduces risk of brain injury after heart valve replacement. News release. JAMA For the Media. August 4, 2016. Accessed August 18, 2016.  

They Is Okay 
The AMA publication offers a plethora of other changes—including those pertaining to tables and figures as well as ethical and legal issues such as authorship and intellectual property. But I was particularly pleased to see a usage update that makes the awkwardness of “he/she” and “he or she” phrasing a thing of the past: the AMA has accepted “they” as a first-person singular pronoun and “their” as a first-person singular possessive. AMA joins the Chicago Manual of Style and AP Stylebook with this change. If you still have your third grade teacher in your head saying that isn’t correct, try rewording the sentence. 

Old: Every child should get his/her flu shot this year. 
New: Every child should get their flu shot this year.
Rewording (for traditionalists): Children should get their flu shots this year.

A Few Tips

  • Be consistent
    The AMA manual is a guide. It says so right in its name: AMA Manual of Style: A Guide for Authors and Editors. So while the new edition fills in some prior gaps, there may be sources that aren’t covered—or are covered but not explained in detail. In those instances, be creative with the format but above all be consistent.
  • Go to the source
    For more on references and a wealth of other information for medical writers and editors, go to the source. You can get a copy of the AMA manual or an online subscription at As of this writing, the site features a video introducing the 11th edition and a comprehensive presentation on the recent changes. 
  • Keep a copy handy 
    Finally, for those of us who are sometimes short on short-term memory, there’s a handy feature for AMA Manual of Style online subscribers: you can print a PDF of specific sections for your own use. It’s an easy way to collect the information you reference frequently. I print out sub-chapters and stash them in a folder I can grab while working, but you might consider doing the same thing digitally—whichever makes the AMA Manual of Style most convenient for you!


  1. Christiansen S, Flanagin A. What’s new in AMA style? Presentation at: American Medical Writers Association (AMWA) 2019 Medical Writing & Communication Conference; November 6–9, 2019; San Diego, CA. Accessed October 22, 2020.
  2. Fischer L, Frank P. Electronic references. In: AMA Manual of Style Committee, eds. AMA Manual of Style: A Guide for Authors and Editors. 11th ed. Oxford University Press; 2020. Accessed November 15, 2020.

Marian Mostovy is a veteran writer and editor specializing in medical, pharmaceutical, and life sciences content. She has worked for leading companies such as McKesson, National Medical Care, and Philips as well as trade publications and medical communications agencies. Marian’s range covers B2B and B2C content for web pages, promotions, long-form articles, blogs, white papers, newsletters, and social media. As a writer/editor for Encompass, she acts as a gatekeeper for accurate, consistent, and user-friendly communications.