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Medical education and medical marijuana: How are we educating future physicians?

On Thursday, experts from government, medicine and academia gathered at The University of Tulsa for a daylong exploration of research relating to public health and cannabis use. Organized by the Laureate Institute for Brain Research (a major healthcare partner of TU), the gathering – Cannabis: What We Have Learned through Scientific Research – included remarks from TU President Gerard Clancy.

In addition to being at the helm of TU, Clancy is also a practicing psychiatrist and a medical educator. Recently, he developed a two-hour course for medical students focused on the topic of marijuana use by patients. In his talk, Clancy outlined both the rationale for the course and gave attendees insights into some of its core components and his thoughts on the many things that remain unknown.

Emotion and knowledge

“Any time you talk about marijuana,” Clancy noted, “you are going to have an emotional conversation. That’s true whether you’re talking to patients, law enforcement officers, legislators, business people or other physicians.”

For his part, however, Clancy focused on the principal finding of several studies that reveal medical professionals feel unprepared to prescribe medical marijuana because of the present gap in scientific knowledge around such critical issues as efficacy and potential for addiction. “Marijuana has been around for 6,000 years,” he noted, “but because of the scarcity of research into its benefits and risks, the trust among medical professionals just isn’t there. This is very much a new, mysterious and emerging science.”

President Clancy

Recommendations vs. prescriptions

Clancy’s short course on medical marijuana aims to help students understand the neuroscience of marijuana’s many components, where and when marijuana compounds have been helpful for patients, scientists’ growing concern over heavy marijuana use on the developing brain, legal issues surrounding recommendations to use medical marijuana and the role of physicians in giving such counsel.

That word “recommendation” is especially important, Clancy emphasized, for understanding physicians’ roles. Outlining the critical distinction between “prescribing” and “recommending,” Clancy clarified that while the former is legally prohibited the latter is permitted. “A physician may discuss treatment options, address pros and cons and sign a form authorizing a medical marijuana license. She cannot, however, issue a prescription because that would be an order to a patient to consume a federally controlled substance.”

Best standards of practice

Contrasting this slow-and-careful approach, Clancy shared with attendees a scene of seemingly unbridled availability he encountered in California last summer. Taken aback by the unprofessional pushiness of a medical marijuana vendor in Venice Beach, Clancy was firm in his belief that here in Oklahoma “we cannot allow our clinics to fall to that level of care. We must, instead, follow the best standards of practice.” In the short term, for example, Oklahoma’s insistence on physicians’ board certification is extremely important, he said. “It’s a kind of safety net.”

Clancy drew his remarks to a close, quipping, “One of the things that drew me to psychiatry was that every person who was asking for help was a mix of biology, environment, psychology and other factors. That’s the beauty and complexity of psychiatry.”