Medical marijuana is legal in 29 states plus the District of Columbia, but recent medical school graduates say they don’t feel prepared to recommend the plant to patients.
Researchers at Washington University School of Medicine in St. Louis, Missouri, conducted a survey of deans, residents, and fellows from 127 North American medical schools, and found that 66.7 percent felt their graduates were ill prepared to recommend medical marijuana. (Because medical marijuana is still federally illegal and not an FDA-approved medication, it can only be “recommended,” as opposed to “prescribed.”) Another 25 percent said their graduates weren’t even ready to answer patients’ questions on medical cannabis.
The survey evaluated the curriculum database maintained by the Association of American Medical Colleges (AAMC), finding that a standard medical school education is devoid of materials on medical marijuana, not to mention the endocannabinoid system.
“Medical education needs to catch up to marijuana legalization,” said senior author Laura Jean Bierut, MD, the Alumni Endowed Professor of Psychiatry at Washington University and a member of the National Advisory Council on Drug Abuse. “Physicians in training need to know the benefits and drawbacks associated with medical marijuana so they know when or if, and to whom, to prescribe the drug.”
In addition to the 101 replies they received from survey participants throughout the 127 medical schools, the researchers also surveyed 258 residents and fellows who earned their medical degrees around the country before arriving at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis to complete their medical training. Ninety percent of them said they didn’t feel prepared to recommend cannabis, while 85 percent said they never learned about medical marijuana during medical school or residency.
In fact, according to the AAMC database, only nine percent of medical schools have offered students the opportunity to learn about medical marijuana.
“As a future physician, it worries me,” said lead survey author Anastasia B. Evanoff, a third-year medical student. “We need to know how to answer questions about medical marijuana’s risks and benefits, but there is a fundamental mismatch between state laws involving marijuana and the education physicians-in-training receive at medical schools throughout the country.”
For now, doctors are left in the position to self-educate about the cannabis plant. Many doctors who specialize in writing medical marijuana recommendations in places like California may know a bit more about the plant than those who have specialized in other branches of medicine, like osteopathy or endocrinology. Nonetheless, doctors in all fields need know if or how their patients are affected by their own cannabis use, so they can evaluate the extent to which other medications are working.
Some medical marijuana programs, such as in the state of New York, require doctors to go through a four-hour online training course before they can become certified to recommend cannabis medicine. This however, is not the norm, and is controversial: Some appreciate the education, but others wonder why they have to go through so much work to recommend a medicine with no physiological risks.
The debate itself speaks to the need for a more standard medical education about cannabis overall, whether or not a doctor wants to recommend it.