October 7, 2026

When I joined the Medical Transcription industry in February 2003, little did I know that I was about to embark on a journey that would introduce me to an entirely new dimension of the English language. I was 25 years old at that time and had previously worked in the Electronics industry. I entered the Medical Transcription field primarily because it offered a better salary, which would enable me to support my father in managing our family, which included three daughters.

The company I joined was headquartered in Toledo, Ohio, USA. As part of our initial training, we were taught American English grammar by an American instructor for approximately a week. This was a completely new experience for me, as I had grown up learning and using British English.

One of the first things I noticed about American English was that certain words were spelled differently from their British counterparts. In many cases, a letter was omitted - for example, colour became color, favour became favor and centre became center. At first, I wondered why these differences existed. Gradually, I came to understand that language can evolve differently in different parts of the world and can also become an expression of a nation's distinct identity.

To understand how these differences emerged, it is useful to look briefly at history. The British Empire spread the English language to many parts of the world including Australia, New Zealand, India and other territories. The British also established settlements in North America, beginning with Jamestown, Virginia, in 1607.

As the British colonies in North America expanded, tensions gradually developed between the colonists and the British government. These tensions eventually culminated in the American War of Independence. Under the leadership of General George Washington and with the support of the Continental Army and its allies, the American colonies fought for independence from British rule.

The conflict finally came to an end with the signing of the Treaty of Paris on September 3, 1783, through which Great Britain formally recognized the independence of the United States.

Following independence, the newly established nation began developing its own institutions and a distinct national identity. Language naturally became one of the areas in which this identity evolved. American scholars, writers and lexicographers began documenting and standardizing forms of English that differed in certain respects from British usage.

One of the most influential figures in this development was Noah Webster. He believed that the United States should have a distinctive form of English that reflected its own national identity. Through his dictionaries and spelling reforms, Webster helped popularize several American spellings that differed from British conventions. Some words were simplified by removing letters that were considered unnecessary, while other spellings were altered to reflect American usage.

This was fascinating to me because, until then, I had simply accepted British English as the standard form of English. My introduction to Medical Transcription opened my eyes to the fact that English was not a single unchanging system. It was a living language that had travelled across continents, adapted to different societies and gradually developed regional identities.

What began for me as a career decision motivated largely by financial necessity therefore became an unexpected learning experience. Medical Transcription not only introduced me to the specialized language of medicine but also gave me an opportunity to understand, appreciate and work professionally with US English. 

Let us come to learn the differences in both US and UK English grammar difference:

US English vs UK (British) English

           Most Commonly Used Words

         The ‘o’ factor (Common words)

       The ‘re’ factor (Common words)

The ‘iza/ise’, ize/ise’, lyse/lyze factor (Common words)

Most Commonly Used Medical Words

The other factor (Common words)

The ‘and’ factor:

The comma is used before the ‘and’

Example: ldli, vada and sambar (UK English) – idli, vada, and sambar (US English)

The ‘comma and semicolon ’ factor

“He played splendidly”; “he won the match for his team”. (UK English) - semicolon and comma are placed outside the quotes.
“He played splendidly;” “he won the match for his team.” (US English) - semicolon and comma are placed inside the quotes.

We call ‘fullstop’ after a sentence. They call ‘period’ after a sentence.

Some Interesting Differences I encountered in US English

The ‘Date-Month-Year’ Factor

One of the first differences I noticed while working with US English was the way dates are written. In British and Indian English, the usual format is day/month/year, whereas US English commonly follows month/day/year.

When I first encountered this format, I found it rather unusual. I wondered why the month was placed before the day. Since there are only twelve months in a year, whereas a month can have thirty or thirty-one days, I initially felt that placing the month first could make dates easier to identify and record in certain contexts.

I remember an interesting incident that brought this difference home to me. On one occasion, I filled out a railway reservation form for my onward and return journeys and went to the booking counter. The lady at the counter looked at my form and then looked at me and asked, somewhat curiously, as to whether I worked for an American company. To which, I replied “Yes.” She immediately responded with a smile, “Please don’t bring in Americanism here!” My professional exposure to American English had become so natural that I had unconsciously started applying its use in my day-to-day life.

The ‘Last Name-First Name’ Factor

Another difference I encountered was the way names are sometimes arranged in American professional and administrative contexts.

In many American forms, databases and official records, a person's last name (surname) may be entered before the first name, often separated by a comma. For example, if a person's name is Anil Kumar, it may be recorded as: Kumar, Anil

This format is particularly useful when names are being arranged alphabetically by surname. In my work in Medical Transcription, I frequently came across this style and I gradually became accustomed to identifying which part of a person's name was the given name and which was the family name.

The ‘Zed versus Zee’ Confusion

Another small but memorable difference was the pronunciation of the letter Z.

Right from our school days in India, we were taught to pronounce the letter as “zed.” We grew up reciting the alphabet as “ABCDEFG…..XYZ” (pronouncing “Zed”). When I began working for the Americans, I discovered that they pronounced the same letter as “Zee.”

At first, this was another small cultural difference that caught my attention. Later, I realized that such differences in pronunciation and usage are a natural part of the way English has evolved in different parts of the world.

My professional exposure to American English also made me notice how strongly American language has had influence in India. A familiar example is Zee TV, whose name uses the American pronunciation of the letter ‘Z’. So, whenever there is an American investment in a particular organisation or TV channel, they influence their English, simply because they are main investor.

Technology has perhaps had an even greater influence. Microsoft Word, one of the most widely used word-processing applications, has traditionally offered English variants such as American English and British English for spelling and grammar checks. Many users simply continue with the default language (US English) settings without changing them because they are unaware of it.

As a result, we may unknowingly adopt American spellings in our everyday writing. Words such as color, favor, center and organization can become familiar through repeated exposure, even when we were originally taught the British spellings colour, favour, centre and organisation.

This made me realize that language is influenced not only by dictionaries and classrooms but also by technology, business, media and global communication. What began as a difference between two varieties of English has gradually become part of our everyday linguistic environment.

For me, these differences became particularly interesting because I had grown up with British English but spent nearly two decades working extensively with American English in India. Medical Transcription therefore became more than just a profession. It introduced me to a different linguistic system and made me consciously observe how language changes, adapts and spreads across borders.