In recent years, the evolving legal landscape surrounding cannabis in the United States has catalyzed a paradigm shift in both public perception and medical practice. As of 2025, Maryland has joined 37 other states, alongside three territories and the District of Columbia, in legalizing cannabis for medical use. This expansion of legality has spurred a notable uptick in the interest and usage of cannabis and related products among patients. However, despite this surge, a significant gap persists in the preparedness of healthcare professionals to counsel patients effectively on medical cannabis. A groundbreaking consensus statement published in JAMA Network Open—co-authored by Dr. David Gorelick, a Clinical Professor of Psychiatry at the University of Maryland School of Medicine—sheds light on the critical need for integrating comprehensive cannabis education into medical training.
The systematically developed statement emerged from a collaborative effort involving more than 20 experts from 26 institutions, aiming to delineate core competencies that medical students and clinicians must acquire to navigate the complexities of cannabis therapeutics. The impetus behind this initiative lies in the disconnect between the rapidly evolving cannabis legal framework and clinical realities, and the inadequacy of existing medical curricula to address these changes. Remarkably, historical data reveals that merely 8 percent of medical school programs referenced medical cannabis during the 2015-2016 academic years, while two-thirds of curriculum deans acknowledged their graduates’ lack of readiness to prescribe or advise on cannabis-based interventions.
Cannabis medicine occupies a unique intersection between botany, pharmacology, and legal regulation. At the molecular level, the endocannabinoid system (ECS) governs a myriad of physiological functions through endogenous ligands and G-protein coupled receptors, primarily CB1 and CB2. Understanding this system is pivotal for clinicians to comprehend how exogenous cannabinoids—such as tetrahydrocannabinol (THC) and cannabidiol (CBD)—modulate neuronal activity, immune responses, and metabolic processes. The consensus statement emphasizes that foundational knowledge of the ECS should constitute a core element of medical education to inform clinical decision-making.
Beyond the ECS, the cannabis plant itself is an intricate phytochemical repository. It produces over a hundred cannabinoids alongside numerous terpenes and flavonoids, each contributing to the plant’s therapeutic and psychoactive profiles. These compounds exhibit a spectrum of biological effects, from analgesic and anti-inflammatory properties to psychoactivity and potential adverse reactions. Medical curricula should thus encompass detailed pharmacological profiles of cannabis constituents, enabling future physicians to tailor treatments based on specific cannabinoid ratios and patient needs.
The legal and regulatory frameworks governing cannabis in the United States present an additional layer of complexity. While medical cannabis is legal in 38 states, 24 states permit recreational adult use, including Maryland, significantly complicating clinical practice scenarios. Physicians must navigate a patchwork of federal and state laws, which remain often contradictory and in flux. The consensus document advocates for robust instruction on the regulatory landscape, encompassing prescribing protocols, patient eligibility, and the implications of cannabis legality on patient privacy and workplace policies.
The empirical evidence underpinning medical cannabis use currently spans a range of conditions, including chronic pain, epilepsy, multiple sclerosis, and chemotherapy-induced nausea. Nonetheless, the quality and quantity of scientific data vary widely across indications, necessitating a critical appraisal of existing literature. The consensus statement calls for medical education programs to impart rigorous training on evaluating clinical trials, understanding bias, and integrating emerging data into evidence-based practice. This analytical approach is indispensable to foster informed counseling and ethical prescribing practices.
Potential risks associated with medical cannabis, such as dependency, psychiatric sequelae, cognitive impairment, and drug interactions, warrant thorough clinician understanding. Medical students must be adept at identifying contraindications and managing adverse effects, including understanding pharmacokinetics in diverse patient populations. The curriculum content should also address vulnerable demographics, such as pregnant women—a group that saw a staggering 170 percent increase in cannabis use between 2009 and 2016, according to UMSOM studies—which presents unique challenges in risk-benefit analyses.
Clinical management with medical cannabis demands a nuanced approach encompassing patient assessment, dose titration, monitoring outcomes, and recognizing when referral to specialists is warranted. The consensus identifies this as a critical competency area, proposing that medical students and residents gain hands-on exposure through clinical rotations where patient care involves cannabis use. This experiential learning facilitates practical knowledge integration and enhances patient-centered care.
The University of Maryland School of Medicine exemplifies proactive adaptation to this educational imperative. Its curriculum incorporates extensive cannabis-related lectures in the pre-clerkship phase and clinical experiences during patient rotations, enabling students to engage directly with cases involving cannabis as part of comprehensive treatment plans. This forward-thinking approach aligns closely with the consensus recommendations, positioning UMSOM at the forefront of cannabis education.
The societal relevance of cannabis competencies extends beyond academia. Dr. Gorelick’s role on the Maryland Cannabis Public Health Advisory Council underscores the public health implications of integrating cannabis education across healthcare professions. The Council’s 2025 report, slated for release in December, endorses a set of core competencies for all clinicians, reinforcing the necessity of this knowledge in safeguarding public health within a rapidly transforming legal and clinical landscape.
This unfolding integration of cannabis into healthcare is not merely a response to legal change but reflects an evolution in medical science and public health policy. The imperative to equip physicians with expertise in cannabis therapeutics stems from the real-world context wherein patient cannabis use is ubiquitous, often undisclosed, and intersected with complex clinical decision-making. Hence, embedding rigorous scientific education on medical cannabis is crucial for ensuring safe, effective, and ethical patient care.
In summary, the consensus statement published in JAMA Network Open delineates six foundational cannabis competencies necessary for contemporary medical practice: a thorough understanding of the endocannabinoid system, detailed knowledge of cannabis plant constituents, mastery of legal and regulatory frameworks, proficiency in evaluating the scientific evidence for cannabis use, recognition of potential risks, and skills in clinical management. This framework sets the stage for transforming medical education to meet the challenges and opportunities presented by the era of legalized cannabis.
As the scientific community continues to unravel the complexities of cannabis pharmacology and its therapeutic potential, medical education must evolve in tandem to prepare a new generation of physicians. Only through comprehensive training can clinicians effectively address patient cannabis use with confidence, competence, and compassion, ensuring that this rapidly advancing field enhances patient outcomes rather than confounds clinical care.
Subject of Research: People
Article Title: Developing Medical Cannabis Competencies A Consensus Statement
News Publication Date: 7-Oct-2025
Web References:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2839750
https://www.medschool.umaryland.edu/profiles/gorelick-david/
https://www.medschool.umaryland.edu/news/2024/umsoms-kahlert-institute-for-addiction-medicine-hosts-inaugural-research-symposium.html
Image Credits: University of Maryland School of Medicine
Keywords: Cannabis, Education, Public health
