A comprehensive review published in the peer-reviewed journal Medical Cannabis and Cannabinoids has found that physicians across the United States often feel ill-equipped to recommend or discuss medical marijuana (MC) with patients, largely due to limited education and training, inconsistent clinical guidelines, and federal-state legal conflicts.
Researchers at the NYIT College of Osteopathic Medicine conducted a scoping review of 41 studies published between January 2013 and February 2025, evaluating the knowledge, attitudes, and prescribing practices of U.S. physicians, healthcare professionals, and medical trainees regarding MC. These studies included electronic surveys, interviews, and evaluations of continuing medical education (CME) courses, with participants representing multiple specialties including oncology, emergency medicine, dermatology, obstetrics, and palliative care.
The review revealed that many physicians—especially those in states where marijuana is not yet fully legalized—lacked confidence in counseling patients on MC’s therapeutic benefits, potential risks, and appropriate use. Physicians practicing in states with legalized MC and those with more years of experience were more likely to feel comfortable discussing and recommending the drug.
The findings underscore a growing disconnect between medical marijuana’s expanding legal availability and the medical community’s readiness to engage with it as a treatment option. Although MC is now legal in some form in 47 states, the District of Columbia, and several U.S. territories, federal classification of marijuana as a Schedule I drug continues to create regulatory confusion. This tension, combined with insufficient integration of cannabis education into medical school curriculums and postgraduate training, has left many providers underprepared.
Physicians in specialties more likely to encounter patients using or asking about MC—such as oncology, palliative care, pain management, and emergency medicine—reported higher awareness of its potential benefits. For example, oncologists widely supported its use for managing cancer-related symptoms such as nausea, loss of appetite, and pain. Similarly, palliative care providers saw cannabis as useful for addressing a range of end-of-life symptoms. However, even among these providers, less than half had actually recommended MC to patients.
Meanwhile, providers such as family physicians, pediatricians, and obstetricians remained more hesitant. Obstetric providers expressed concerns over perinatal cannabis use, often citing the possibility of legal consequences and involvement from child protective services during patient counseling. Many pediatricians did not support MC use for children, particularly in cases of congenital conditions, citing insufficient safety data.
Notably, physicians in states where MC was legal expressed more favorable attitudes, were more likely to have obtained certification to recommend it, and reported greater comfort levels when counseling patients. Older physicians and doctors of osteopathic medicine (DOs) also tended to report greater comfort and more positive views than their younger and allopathic (MD) counterparts.
Despite these trends, the overwhelming consensus among surveyed physicians was that medical marijuana education remains lacking. Many respondents said they received little to no training in medical school or residency, and called for more robust CME programs and standardized clinical practice guidelines. They also emphasized the need for additional scientific research to inform evidence-based prescribing and patient education.
The study also highlights the need to improve the education of medical students and trainees. While most students supported legalization and recognized a role for cannabis in medicine, many lacked the knowledge and confidence to properly advise patients. Academic administrators and medical school deans generally supported integrating MC education into medical curricula, though challenges remain in terms of standardizing such content across institutions.
The authors conclude that to bridge the current knowledge gap, state medical boards and professional associations should expand educational offerings on medical marijuana through CME programs and medical school integration. At the same time, they argue for increased federal support for cannabis research and more uniform regulatory standards to guide physician practices.
As medical marijuana becomes an increasingly common part of patient care in the U.S., the findings stress the urgent need to ensure physicians are equipped with the tools, training, and knowledge to guide its safe and effective use.
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