'In Hospital' or 'In the Hospital'?

Whether to use "the" before "hospital" is a well-established, but mysterious, difference between British and American English.

Samantha Enslen, Writing for
2-minute read
doctors in hospital in Britain or in the hospital in America

Cathy from Maryland wrote,

"I have a question for you. When I read a novel that's written in England, they refer to being 'in hospital.' Americans refer to it as being 'in the hospital.' Why do British people say 'in hospital,' and Americas say 'in the hospital?'"

Cathy is right. People in the UK say they are “in hospital,” and people in the US say they are “in the hospital.” There doesn’t seem to be any logical reason why we use the word “the” here. It’s rarely added for similar terms. 

For example, if you were attending college, you wouldn’t say you were “in the college.” You’d say you were “in college.” And if you had ended up on the wrong side of the law, you wouldn’t say you were “in the prison.” You’d say you were “in prison.” 

There are certain instances when you would use the word “the” though.

  • When we leave off “the,” we’re indicating that we have a certain ongoing relationship with these institutions. We’re a student at college, for example, or an inmate in prison. Since people in Britain and America have different healthcare systems, maybe the British feel that they have more of a relationship with their hospitals than we do in America, but that’s just a wild guess.
  • We do sometimes use the word “the” with similar words like “college” or “prison” though, and when we do, we’re usually saying something different; we’re specifying a place. For example, you could say that you’re visiting “the college” your mom attended. Or that the electricity was out in “the prison” nearby. 

To wrap up, “in hospital” versus “in the hospital” are regional difference between UK and US English. There’s no established reason these differences developed — at least none that we can pinpoint for sure.

Samantha Enslen runs Dragonfly Editorial. You can find her at dragonflyeditorial.com or @DragonflyEdit.


Murphy, Lynne. The Prodigal Tongue, pp. 178–179. Penguin Books, 2018, accessed August 4, 2019. 

Stasz, Clarice. Elizabeth (Bess) Maddern London. Jack London Resource Page, 2005, accessed August 4, 2019. 

The Quarterly Register and Journal of the American Education Society, Vol. I., pp. 230. Flagg and Gould, 1829, accessed August 4, 2019. 

Image courtesy of Shuttertstock.

About the Author

Samantha Enslen, Writing for Grammar Girl

Samantha Enslen is an award-winning writer who has worked in publishing for more than 20 years. She runs Dragonfly Editorial, an agency that provides copywriting, editing, and design for scientific, medical, technical, and corporate materials. Sam is the vice president of ACES, The Society for Editing, and is the managing editor of Tracking Changes, ACES' quarterly journal.

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