Attitudes toward and knowledge of the potential medicinal properties of cannabis among incoming medical students: a cross-sectional survey

Abstract Background Although medical cannabis (MC) is legal in most US states, < 10% of medical schools’ curricula include MC content, and prior research suggests medical students hold variable knowledge and attitudes. This study assessed incoming medical students' knowledge of MC, relationships between knowledge and personal attitudes, the role of personal experience, and support for curricular change. Methods Incoming students at one US medical school ( N = 250, 304 invited, 82% response rate) completed a baseline survey during orientation. Knowledge was assessed across three domains: MC adverse effects (21 items), MC indications (23 items), and THC vs. CBD differences (10 items). Attitudes were measured using a 16-item cannabis survey on a 5-point Likert scale. Spearman's rho correlations, Mann–Whitney U tests, and linear regression examined associations between knowledge, attitudes, and personal experience. Results Students’ accuracy was low on all knowledge assessments: adverse effects (46.1%), indications (53.7%), and THC vs. CBD (45.4%). Yet, 76% agreed cannabis helps patients with chronic, debilitating conditions, and 58.4% supported federal rescheduling. Most students felt unprepared to answer patient questions (61.2%) or counsel patients (67.2%) about MC. Students who knew someone using MC (34.4%) demonstrated greater knowledge of indications ( U = 5047.50, p < 0.001) and THC vs. CBD ( U = 5519.5, p = 0.005). Most supported adding MC content to medical school curricula (80.4%) and residency training (73.6%). Conclusions Incoming medical students hold largely favorable attitudes toward MC that are incongruent with their knowledge deficits, and informal personal exposure—rather than formal education—shapes their understanding. These findings, combined with students' self-reported unpreparedness and support for curricular reform, underscore the need for standardized, evidence-based MC education across medical training.