New Research Calls for Stronger Medical Training on Cannabis Use in a Rapidly Changing Healthcare Landscape

A new study published in JAMA Network Open is pushing medical schools to strengthen how they educate future doctors about medical cannabis, reflecting how quickly laws and patient behaviors are evolving in the United States. With 38 states, three territories, and Washington, D.C. now allowing medical cannabis—and 24 states, including Maryland, permitting recreational use—the need for clinicians who understand cannabis science, safety, and patient care has never been greater.

Yet despite this major legal shift, most medical students and healthcare professionals still feel underprepared to guide patients who use cannabis. That is the central issue highlighted by the research team behind this study, which includes Dr. David Gorelick, Clinical Professor of Psychiatry at the Maryland Psychiatric Research Center and long-time cannabis researcher.

The paper presents a structured list of six core competencies that medical schools should integrate into their curricula. These topics are designed to ensure that newly trained physicians are equipped to address both medical and non-medical cannabis use in everyday clinical practice. Because whether practitioners realize it or not, they are almost certainly treating patients who are using cannabis—sometimes medically approved, sometimes not, and often without clear professional guidance.

Why Cannabis Training Is Becoming Essential in Medicine

Cannabis use is increasing across many patient groups, not just recreational users. Studies from the University of Maryland School of Medicine (UMSOM) show that cannabis use among pregnant women increased by 170% between 2009 and 2016, a striking example of how widespread and varied cannabis consumption has become.

Despite this trend, previous surveys reveal an educational gap:

• Only 8% of medical school curricula mentioned medical cannabis in the 2015–2016 academic year.
• 66.7% of medical school curriculum deans said their graduates were not adequately prepared to prescribe or discuss medical cannabis.

This disconnect leaves many clinicians unsure about how to answer patient questions regarding cannabis products, therapeutic uses, dosing, safety concerns, drug interactions, or legal issues. With patients increasingly turning to cannabis—sometimes instead of traditional medications—this knowledge gap can have real clinical consequences.

The new study directly addresses this by assembling 23 experts from 26 different institutions, bringing together specialists in psychiatry, addiction medicine, primary care, pharmacology, and other fields. Their goal was to define the specific cannabis-related knowledge physicians should have before beginning professional practice.

The Six Recommended Cannabis Competencies for Medical Students

The expert panel refined their discussions and evidence into six clearly defined competencies. These outline what every graduating medical student should understand about cannabis and how to apply that knowledge in clinical settings.

1. Understand the basics of the endocannabinoid system.
   This includes knowing how the body’s own cannabinoid receptors work, the role these receptors play in regulating functions like mood and pain, and how cannabis-derived compounds interact with these pathways.
2. Describe the main components of the cannabis plant and their biological effects.
   Students should learn about cannabinoids such as THC and CBD, how they differ, how they are consumed, and what physiological and psychological effects they typically produce.
3. Review the legal and regulatory landscape of cannabis in the U.S.
   This means understanding how cannabis laws differ between federal and state levels, what is permitted in various jurisdictions, and how these rules affect clinical practice and patient counseling.
4. Describe the evidence base for conditions commonly treated with cannabis.
   This includes knowing which conditions have meaningful scientific support for cannabis-based treatments, and where the evidence is weak, inconclusive, or nonexistent.
5. Understand the potential risks of medical cannabis use.
   This covers short-term and long-term risks, side effects, dependency potential, effects on cognition, issues in pregnancy, risks with co-occurring mental health conditions, and drug interaction concerns.
6. Understand basic clinical management with medical cannabis.
   Students should learn how to evaluate whether cannabis is appropriate for a patient, how to discuss dosage and product forms, how to monitor outcomes and side effects, and how to integrate cannabis safely with other treatments.

These competencies serve as a starting point for medical schools to build structured, evidence-based cannabis education into their existing programs.

How the University of Maryland Is Already Preparing Students

The University of Maryland School of Medicine (UMSOM) is cited as an example of a school making progress in this area. According to Dr. Joseph Martinez, Associate Dean for Medical Education and Student Experience, UMSOM already includes lectures on cannabis in the first two years of medical school.

Students also gain clinical exposure during rotations, where they treat patients who use cannabis along with other legal or illicit substances. Dr. Gorelick notes that the UMSOM curriculum already includes most of the newly recommended competencies, though he hopes to see further expansion in clerkships and residency programs.

Cannabis and Public Health in Maryland

Beyond academia, the state of Maryland is also taking steps to improve cannabis-related education for healthcare workers. Dr. Gorelick serves on the Maryland Cannabis Public Health Advisory Council, which advises the state government on public health strategies involving cannabis.

The Council’s 2025 report, scheduled for release in December, includes its own list of core competencies meant for all healthcare professionals in Maryland—not just physicians. This reflects the growing recognition that every clinician, regardless of specialty, will encounter patients who use cannabis products.

Additional Context: How Cannabis Education Is Evolving Nationally

As legalization spreads, more medical organizations are acknowledging the need for structured cannabis training:

• Healthcare programs outside psychiatry—such as oncology—are exploring cannabis modules to help clinicians counsel patients using cannabis for symptoms like nausea, pain, or appetite loss.
• With dispensaries becoming more common, many patients turn to non-medical staff for dosing and product advice, making medical involvement increasingly important.
• Cannabis science itself is quickly evolving, with increasing research into cannabinoids, synthetic compounds, and therapeutic applications.

On the other side, risks such as cannabis use disorder, impaired driving, adolescent vulnerability, and potential impacts on mental health continue to generate discussion. Clinicians must be able to navigate these nuances with clear, evidence-based guidance.

Why This New Training Framework Matters

The authors of the new paper hope their recommendations will lead to more consistent and comprehensive cannabis education across medical schools nationwide. With cannabis becoming a normal part of patient care, physicians need reliable scientific knowledge, not assumptions or stigma.

By laying out specific competencies, the study provides a blueprint that any medical school can adopt—and adapt—to prepare students for a future in which cannabis is simply part of everyday clinical practice.

Research Paper:
Developing Medical Cannabis Competencies (JAMA Network Open, 2025)