Maryland is one of 38 US states, along with three territories and the District of Columbia, that have legalized cannabis for medical purposes. This legal sea change has generated increasing interest in and use of cannabis and cannabis products, yet most health care practitioners and students feel underprepared to counsel patients on medical cannabis, according to a new paper co-authored by a University of Maryland School of Medicine (UMSOM) faculty member and published in JAMA Network Open.

The paper suggests key content that should be incorporated into medical school curricula so that students will have the tools they need to serve patients in a landscape of increasing legal medical cannabis use, according to study co-author David Gorelick, MD, PhD, Clinical Professor of Psychiatry at the Maryland Psychiatric Research Center. 

“This paper outlines the core competencies that physicians should possess to deal appropriately with their patients regarding medical cannabis,” Dr. Gorelick said. “The goal is to spur medical schools and residency programs to incorporate these competencies into their curricula.”

The core competencies could also help clinicians address a concurrently increasing amount of legal non-medical cannabis use, Dr. Gorelick added, as 24 states, including Maryland, now allow for adult recreational sale and use of cannabis products. 

In collaboration with more than 20 co-authors across 26 institutions, Dr. Gorelick and his colleagues characterized the gap between patient and clinician needs and the current medical school curriculum. They cited past studies showing that only 8 percent of medical school curricula mentioned medical cannabis in the 2015-2016 academic year, and that 66.7 percent of surveyed medical school curriculum deans felt their students graduated without adequate preparation for prescribing medical cannabis. At the same time, the need for cannabis-informed physicians is increasing as more people are using cannabis with or without medical supervision — UMSOM researchers studying cannabis use among pregnant women found that use increased 170 percent between 2009 and 2016, for instance. 

To better meet the needs of patients and clinicians, the authors assembled 23 clinical and scientific experts with varied backgrounds to achieve a consensus on what medical students need to know about cannabis before entering practice. The process resulted in a recommendation of six core competencies addressing the clinical utility, risks, legal landscape, and scientific evidence around medical cannabis. 

The six core competencies are:

1. Understand the basics of the endocannabinoid system.
2. Describe the main components of the cannabis plant and their biological effects.
3. Review the legal and regulatory landscape of cannabis in the US. 
4. Describe the evidence base for health conditions that are commonly managed with cannabis. 
5. Understand the potential risks of medical cannabis use. 
6. Understand basic clinical management with medical cannabis. 

Cannabis in the Curriculum at UMSOM 

Although all healthcare professions will continue to adapt to the evolving legal cannabis landscape, UMSOM is ahead of the curve in providing medical students with training on cannabis. 

”It’s important that medical students be exposed to this information, and we currently provide lectures that cover cannabis fairly robustly in our pre-clerkship curriculum in the first two years of medical school,” said Dr. Joseph Martinez, MD, UMSOM Professor of Emergency Medicine and the school’s Associate Dean for Medical Education and Student Experience. Students also gain hands-on experience in caring for patients using cannabis, as well as any other medications and illicit substances, after they begin their clinical rotations, he added. 

“I’m pleased to say that the UMSOM medical student curriculum appears to incorporate most of the topics recommended in the JAMA Network Open article,” Dr. Gorelick said. “I hope that further progress will be made in including cannabis-related material in the curricula for clinical clerkships and residencies. This will help ensure that future physicians have the knowledge and expertise they need to work with patients who are using or considering using cannabis products.”

Cannabis and Healthcare in Maryland

In addition to his work at USOM, Dr. Gorelick serves as editor-in-chief of the Journal of Cannabis Research and as a member of the Maryland Cannabis Public Health Advisory Council. The Council’s mission is to make public health recommendations relating to cannabis, including issues of healthcare professional training and education. The Council’s 2025 report to the Maryland Governor and General Assembly, which will be released in December, includes a list of cannabis core competencies recommended for all healthcare professionals in Maryland. This recommendation highlights the public health importance of cannabis core competencies for all clinicians. 

“Whether you know it or not, like it or not, no matter how you practice, or where you practice, you’re going to be dealing with patients taking cannabis,” Dr. Gorelick said.  

About the University of Maryland School of Medicine

The University of Maryland School of Medicine, established in 1807 as the first public medical school in the U.S., continues today as one of the fastest growing, top-tier biomedical research enterprises in the world. The School has nearly $500 million total research funding, 46 departments, centers, and institutes, more than 2,200 student trainees and over 3,000 faculty members, including notable members of the National Academy of Medicine. As the largest public medical school in the DC/MD/VA region, faculty-physicians are working to help patients manage chronic diseases like obesity, cancer, heart disease and addiction, while also working on cutting-edge research to address the most critical generational health challenges. In 2024, the School ranked #12 among public medical schools and #27 among all medical schools for R&D expenditures by the National Science Foundation. With a $1.3 billion total operating budget, the School partners with the University of Maryland Medical Center to serve nearly 2 million patients annually. The School’s global reach extends around the world with research and treatment facilities in 33 countries.  In Maryland, the School of Medicine is spearheading new initiatives in AI and health computing and partnering with the University of Maryland BioPark to develop new medical technologies and bioengineering ventures. For more information, visit medschool.umaryland.edu.