A new study shows that very few medical students are being trained on how to prescribe medical marijuana, even though it is now a legal medicine in 29 states and the District of Columbia.
Researchers at Washington University School of Medicine in St. Louis surveyed medical school deans, residents, and fellows, and examined a curriculum database maintained by the Association of American Medical Colleges (AAMC). They discovered that medical marijuana is rarely being addressed in medical education.
“Medical education needs to catch up to marijuana legislation,” said senior author Laura Jean Bierut, M.D., 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.”
Doctors are being asked to guide patients through areas in which most have no training, she explained.
The research team sent surveys to medical school curriculum deans at 172 medical schools in North America, including 31 that specialize in osteopathic medicine, and received 101 replies.
Two-thirds (66.7 percent) of these reported that their graduates were not prepared to prescribe medical marijuana. A quarter of deans said their trainees weren’t even equipped to answer questions about medical marijuana.
The researchers also surveyed 258 residents and fellows who earned their medical degrees from schools around the country before coming to Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis to complete their training.
Nearly 90 percent felt they weren’t prepared to prescribe medical marijuana, and 85 percent said they had not received any education about medical marijuana during their time at medical schools or in residency programs throughout the country.
Based on data from the AAMC database, only nine percent of medical schools had taught their students about medical marijuana.
“As a future physician, it worries me,” said first 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.”
Making things even more complicated is the fact that several states have not legalized medical marijuana, and research on the potential risks and benefits of medical marijuana are often contradictory. So what are schools to teach?
“You address the controversy,” said co-investigator Carolyn Dufault, Ph.D., assistant dean for education at Washington University and an instructor in medicine. “You say, ‘This is what we know,’ and you guide students to the points of controversy. You also point out where there may be research opportunities.”
The authors believe that as more states legalize marijuana for medical and recreational use, doctors need to have at least enough training to answer patients’ questions.
“More medical students are now getting better training about opioids, for example,” said Evanoff. “We talk about how those drugs can affect every organ system in the body, and we learn how to discuss the risks and benefits with patients. But if a patient were to ask about medical marijuana, most medical students wouldn’t know what to say.”
The findings are published online in the journal Drug and Alcohol Dependence.