I decided to make sure that I know this important difference between American and British English, so I wrote what I have found out so far and I would be grateful to anyone who reads this and tells me whether I am wrong, or not.

In British English when people say to hospital or in hospital when talking about somebody being there as a patient they don't use the definite article : "I had to go to hospital", "She spent two weeks in hospital". And the meaning is that somebody was there as a patient.

If then for some other reasons British English speakers will use the definite article which will change the meaning itself, I noticed that, in American English, native speakers often use the the and if they need to show that somebody is in church to pray, in school as a student, in hospital as a patient, in prison as a prisoner, they use 'in' and not 'at'. Do American English speakers use 'at' like British English speakers use 'the' to give the sentences a different meaning?

Are my sentences correct? Do they show American English usage?

  • He is in the school. (enrolled as a student)

  • He is at the school. (for some different reasons)

  • He is in the hospital. (as a patient)

  • He is at the hospital. (visiting somebody)

  • He is in the church. (to pray)

  • He is at the church. (for some different reasons)

  • He is in the university. (as a student)

  • He is at the university. (not as a student)

  • He is in the college. (as a student)

  • He is at the college. (Not as a student)

  • He is in the prison. (as a prisoner)

  • He is at the prison. (not as a prisoner)


9 Answers 9


AmEng speakers do NOT use definite articles all the time; whether we do or not depends on what we want to say, and how we want to sound saying it. In particular, the use of the definite article with the present tense of the verb "to be" depends (in the words of a famous American) on what your definition of "is" is. Several of your example sentences sound distinctly unnatural to my USAite ear. Here are my suggestions based on my own usage:


  • He is in school. - He is a student; specific time does not matter. Perhaps it's Friday night and he's partying right now.
  • He is in the school. - This does not sound natural at all to an American ear.
  • He is enrolled in the school. - He is a student.
  • He is at school. - He might be a student OR a teacher, but he is on the premises at this moment.
  • He is at the school. - "The school" is a local landmark, and he's there right now.


  • He is in hospital. - He's an inpatient. This is valid, but not usual American usage. Anglophiles (Americans who like to drop Briticisms into their speech to appear more sophisticated) will sometimes use this.

  • He is in the hospital. - He's an inpatient.

  • He is at hospital. - We don't say this.

  • He is at the hospital. - He might be an outpatient, or he might work there; either way, he's there right now.


  • He is in church. - Services are in progress right now, and he's there.

  • He is at church. - Interchangeable with "in church".

  • He is in the church. - He's inside the building; no information is conveyed about what he's doing there (he might be polishing the floor, for example.)

  • He is at the church. - He's on the church grounds, not necessarily inside the sanctuary.

University/ College:

  • He is in university. - Americans don't usually say "in university"; "in college", however, means that he's a student.

  • He is enrolled in university. - He's a student.

  • He is at university. - He's a student. This is much more common than "in university", for some reason.

  • He is in the university. - Again, we don't say this.

  • He is at the university. - The university is a local landmark and he's there now. (Who is he - student, professor, tourist? Not enough information.)


  • He is in prison. - He's a prisoner.

  • He is at prison. - We don't say this.

  • He is in the prison. - He's inside the building. He might be a prisoner, a warden, a visitor...

  • He is at the prison. - He's on the grounds, not necessarily inside the building - he might be waiting in the car while his wife visits her brother.

  • 4
    I generally agree, but would take he is in the school much the same as you have explained he is in the prison. As far as in the university, I think the reason this is not used is that universities are generally spread across a campus, rather than being a single building. Additionally, I've never seen/heard an American omit the article before university.
    – yoozer8
    Commented May 7, 2012 at 23:36
  • 2
    @Jim - I thought of mentioning the distinction between "college" and "university" (generally, a university may contain multiple colleges) but thought it might take us too far afield. As far as the article is concerned: "at university" sounds valid but British; "in university" just sounds alien. However, "at college" and "in college" both sound perfectly fine. Why? I have no freakin' clue.
    – MT_Head
    Commented May 8, 2012 at 0:18
  • @Jim - Also, I think that most of the weirdness about in the could be avoided by using inside the instead. Sorry to go dark here, but when there are news reports of school shootings they generally don't say "the gunman is in the school"; they say "the gunman is inside the school". At least that's been my observation.
    – MT_Head
    Commented May 8, 2012 at 0:22
  • @MT_Head Note that relatively few American universities are super-entities made up of several preexisting colleges in the way that Oxford and (the British) Cambridge are. Instead they were conceived as a single school from the beginning and the distinct colleges (as in The College of Arts and Sciences, The College of Engineering, and so on) are just administrative arrangements. Commented May 8, 2012 at 18:18
  • @dmckee - I'm not sure that the distinction between historical conception and administrative arrangement actually makes a difference in how we use the words, though... Whatever the reason, Americans don't usually say "My kid is in university", but we do say "My kid is in college" as often as possible, until all of our friends are sick of hearing it.
    – MT_Head
    Commented May 8, 2012 at 20:37

In AmE, for your examples:

  • No. He is in school. (enrolled as a student)

  • Yes. He is at the school. (for some different reasons)

  • Yes. He is in the hospital. (as a patient)

  • Yes. He is at the hospital. (visiting somebody) or could be a patient, too.

  • No. He is in church. (to pray)

  • Yes. He is at the church. (for some different reasons)

  • No. He is at/attending college. (as a student)

  • Yes. He is at the university. (not as a student)

  • No. He is in/at college. (as a student)

  • Yes. He is at the college. (not as a student, the physical place)

  • No. He is in prison. (as a prisoner)

  • No. He is in the prison. (not as a prisoner)

The general rule is 'in X' for being part of the institution, but 'at the X' or 'in the X' for being physically related to the building (but note that this doesn't always work: 'in the hospital'). And the institution is 'in college' even if it is nominally a university.

  • I remember a Jewish friend of mine in high school saying something about being "in temple". It struck me the same as when British friends say "in hospital", but of course it is perfectly parallel with "in church".
    – iconoclast
    Commented Nov 2, 2012 at 0:35

I am a native English speaker in the U.S. This is how I would word your sentences:

He is in the school. (Enrolled as a student) — He is in school.

He is at the school.(For some different reasons) — Okay as worded.

He is in the hospital. (As a patient) — Okay as worded.

He is at the hospital. (Visiting somebody) — Okay as worded.

He is in the church. (To pray) Can also say, "He is in church."

He is at the church. (For some different reasons) Can also say, "He is at church."

He is in the university (As a student). He is at the university.

He is at the university. (Not as a student) — Okay as worded. You would need to add other words to make it clear if he is a student or just a visitor.

He is in the college. (As a student) — He is in college.

He is at the college. (Not as a student) — Okay as worded.

He is in the prison. (As a prisoner) — He is in prison.

He is at the prison. (Not as a prisoner) — Okay as worded.

  • 2
    I would say that "in the church" might be used to describe someone as inside the church building, but "in church" would imply being there during a worship service. I also find "in the university" to be slightly funny but acceptable. I'd normally say "in college" since as an American I don't draw as sharp a distinction between college and university as the rest of the world seems to. In fact, I think all the sentences you've crossed out seem grammatical to me under the right circumstances. The shooter might be "in the school" and the visitor might be "in the prison".
    – iconoclast
    Commented Nov 2, 2012 at 0:23

I'm an American and I don't claim to know much about British English, but I can discuss nuances of American usage, and you can compare to British.

This brings to mind the time when my wife got a job working at a prison. Her mother called, and I said, "Oh, didn't you know? She's in prison." Of course she wasn't really "in prison", she was just "in the prison" or "at the prison".

You are correct that we never say someone is "in hospital" or "at hospital". It's always "in the hospital" or "at the hospital". If you say that someone is "in the hospital", that would normally be taken to mean he was a patient, but not necessarily. An American might also say someone was "in" to distinguish from "out", or one building from another. Like, "I was waiting for you at the pharmacy, but when you didn't show up I went in the hospital to look there." "At the hospital" almost always means not as a patient. Like, "I was at the hospital visiting grandma" or "I was at the hospital deliverying the mail".

With school the usage changes ... for no reason apparent to me. We say a student is "in school". That can either mean that he is in the school building at this moment, like, "Where is Bob?" "He's in school". Or it can mean that he is enrolled as a student, whether he is presently in the building or not. Like, "Does your daughter have a job yet?" "No, she's still in school." It could be night-time or a weekend so she's not actually in the school building at the moment, but she is still a student. "At school" is usually used to refer to a student who is enrolled and is on campus at this moment. "In the school" would mean in the building, whether as a student or a teacher or visiting. "At the school" usually means a non-student who is in the building or on campus. Just to make things complicated, a student who lives at school part of the year -- a boarding school or college -- can be said to be "at school" during the period that they are there rather than at home. So you might say "Sally is at school" when it is the time of year when she is residing in the town where the school is located, even if she is not actually on campus at that moment.

Whew, I didn't realize this was so complicated until you asked!

College and university work the same as school.

Church is different, probably because people don't "enroll" in church. (I suppose you could say that being a member of the church is the same idea. Whatever.) "In church" generally means in the building to worship or participate in some church activity. "In the church", "at church", and "at the church" would all normally be understood to mean physically in the building, but not necessarily to worship. "In" would normally be understood to mean literally in the buildling, while "at" and "at the" could mean in the building or generally on the grounds. Like if someone is there playing on the church softball team, we'd generally say they're "at the church" rather than "in the church".

  • I assume when you said "Oh, didn't you know? She's in prison." you meant it as a joke--you wouldn't normally use "in prison" to mean the same as "in the prison", would you?
    – iconoclast
    Commented Nov 2, 2012 at 0:29
  • @iconoclast Correct. If you say, "Bob is in prison", you mean he's a convict. If you say, "Bob is in the prison", that would mean he's in the building, but he could be a convict, a guard, or simply visiting. In my wife's case, she was there as a teacher, so we'd say she was "in the prison" or "at the prison".
    – Jay
    Commented Nov 2, 2012 at 14:04
  • I know that if I say "Bob is in prison" I mean he's a convict. But I was just clarifying what you mean, since it seemed that you may have been implying you have a dialect very different from any I've encountered. It wasn't 100% clear whether you meant it as a joke or whether you were saying that in your dialect "in prison" is ambiguous.
    – iconoclast
    Commented Nov 2, 2012 at 15:18
  • Yes, it was a joke. Leaving out an article seems a trivial difference, but it completely changed the meaning of the sentence.
    – Jay
    Commented Nov 2, 2012 at 20:35

He is in the hospital. (as a patient)

He is at the hospital. (visiting somebody)

A point about this. This seems to be correct for American English.

From my British perspective, these are sentences for referring to a particular hospital. Someone might say these when it is clear from the context of a conversation, that they are referring to a particular hospital.

In the general sense, the word "the", would not be necessary. For example, if you talk about someone who was taken to a hospital but, you don't need to specify which one in particular; you could say "He is in hospital." (as a patient). This is the normal way to say it, in the UK.


If I were to come up with a rule for a non-native American English speaker to decide whether or not to use an article, it would be for that person to discern whether the location implies a proactive/routine action or a passive/non-routine reaction by the subject:

At home - proactive routine action

At lunch - proactive routine action

In bed - proactive routine action

On vacation - proactive non-routine but repetitive action

In/at church - proactive routine action

At work - proactive routine action

At/in school (college, university) - proactive routine action

In court - Routine action for legal profession, non-routine proactive action (defending oneself)

In prison - Routine proactive action (serving sentence)

In surgery/recover/care - non-repeating reactive, but strong action implied

At sea - routine proactive action (dangerous travel)

Hospital fits more into the mindset of 'hotel' for Americans, where services are provided to a passive subject, in other words, the subject is on the receiving end whereby the location implies a 'reactive' situation.

In the hospital - non-routine, reactive

At the hotel - non-routine, reactive

On the bus/train/boat/plane, etc. - could be routine, but definitely passive

At the bank - possibly routine but reactive

At the store/laundromat/garage, etc. - non-routine and specificity is required.

The concept of a hospital may not have had the institutional significance in America it had in England and Europe when much of the usage was set in place. It would be interesting to research documents for examples of the term 'in hospital' vs 'in the hospital' from pre-revolutionary/post colonial America forward. It could well be that in a growing country lacking major institutions such as hospitals, most medical care was received at home.

Just my two cents!

K.E. Cole

  • Actually, in pre-revolutionary times, both the U.S. and the U.K. used in the hospital. So researching American documents won't tell you about this history of the usage—you would need to research British documents. Commented Jun 15, 2019 at 17:33

As someone from upstate NY, I consider my AmE to be pretty standard, and this is how I would use those phrases:

In school: In the school building while it's in session. I wouldn't tend to use this one for other things that are at the school but not classes.

At school: interchangeable with in school.

At/in THE school: this would be more for parents, as well as kids not during school (e.g. for a school dance).

In the hospital: This is usually used for serious instances, or being hospitalized for a long amount of time.

At the hospital: This could be used for either visiting someone or a brief thing, ex., "I'm at the hospital for a checkup/X-Ray/whatever".

We don't say "at hospital" or "in hospital". Same goes for "university". College I'll get to.

At college: this is rare and sounds weird. One might say "in school" referring to the college.

At the college: this is referring to a specific college, whereas "at the hospital" is general.

In college: this denotes that the subject is attending a college/university.

We hardly ever use "university" unless we're actually saying the name of the university, or occasionally "a university" or "the university" but it's rarely preceeded by a preposition.

In prison: doing time. The subject is a prisoner.

In the prison: this one is iffy and could go either way. It's rarely said. It could work for, say, a prison guard.

At the prison: visiting, or working.

I hope this answers all, or at least most, of your questions.


From the Bank of Canada's latest monetary policy statement:

Before turning to your questions, let me spend a few minutes highlighting the main points of discussion that took place within Governing Council.


Governing Council carefully considered how best to incorporate the effects of the Brexit vote into the outlook.

In both cases, the U.S. English version would insert "the" before Governing.

  • British English would also normally state "the Governing Council", unless "Governing Council" were the formal name of an official body.
    – TrevorD
    Commented Jul 14, 2016 at 22:50

I've always suspected that the reason that Americans say 'in/to/at THE hospital' is simply due to the fact that they have a privatised healthcare system which means that their hospitals are seen as individual entities, operating as separate businesses, so whenever one hospital is being talked about it is always a particular one. In the UK, we think of all hospitals as the same, in the sense that they all offer the same type of NHS treatment - you go in, you are given treatment or a bed without paying for it and then you are discharged - and are therefore somewhat indistinguishable from each other in the public's imagination. The concept of 'being in hospital' is the same to us, whichever hospital it is makes no difference. The American system is more choosy; an American saying 'She had to go to THE hospital' has the same ring to it as if one were to say 'She had to go to the bank/the store/etc'. 'She' in the sentence is making use of a business, undertaking a transaction, because American healthcare isn't free like ours in the UK is. I'm sure this has something to do with it.

Further to the above - of course, there is always scope to use the definite article in British English when a specific, qualified hospital is being talked about - e.g. 'She's being treated at the hospital on the outskirts of the city, not the one in the centre'. However, most of the time the definite article would just not be used. Even if my grandmother had been ill for several weeks and I had visited her numerous times at the same place, if someone inquired after her health I would still say 'She's in hospital', never 'THE' hospital - the concept of 'hospital' is lofty enough to simply not require the article.

There has been some discussion above regarding 'university' in British English - in the UK nowadays, nine times out of ten you will hear people say that they are 'at uni' i.e. they are a university student - this is a ubiquitous colloquialism that has become widely heard and accepted. People very rarely say 'university' and they would only say 'college' if they were referring to a Further Education institution (i.e. somewhere they attended after leaving school, but before going to university (e.g. to do their A-levels, or perhaps as a night school later in life)) - nobody refers to 'uni' as 'college' (as appears to be standard practice in the States).

  • 3
    Welcome to ELU.SE. You can edit answers if you have something to add to an earlier contribution (I've done that for you here). Please take a moment to find upvoted answers to see the type of answer this site is looking for — in particular, askers find references and concrete examples useful, rather than what might be interpreted as conjecture. We also provide help on answering questions.
    – Andrew Leach
    Commented Jul 7, 2014 at 21:42

Not the answer you're looking for? Browse other questions tagged or ask your own question.