November 10, 2015  Steve Robinson, MD, forwards this article from 

New York state has launched its continuing medical education (CME) program for physicians who wish to recommend marijuana to their patients, and it appears to be one of the more stringent programs in the United States.

The state’s Compassionate Care Act, which legalized medical use of marijuana, was signed into law in June 2014. Physician training was established by the statute. The state announced availability of the course on October 20.

Physicians who wish to certify that their patients should be allowed to use medical marijuana will be required to take a 4-hour continuing medical education course. It will cost them $250.

“I think many people had hoped it would be free,” Julie Netherland, deputy state director for the Drug Policy Alliance, which backed legalization of medical marijuana, told Medscape Medical News.

Many physicians may have been surprised by the length and cost of the course, because most probably aren’t closely tracking medical marijuana, said Netherland, also a spokesperson for Compassionate Care New York, an umbrella group that includes the Drug Policy Alliance and patient advocacy groups.

New York is the only state among the 23 that have legalized medical marijuana to have such a stringent CME requirement. Massachusetts requires 2 hours, but none of the other states mandate CME.

The New York CME is being provided by TheAnswerPage. Upon completion, physicians will receive 4.5 hours of AMA PRA Category 1 CME credits. The course covers the endocannabinoid system and phytocannabinoids, including pharmacology; administration and dosing, including contraindications, drug metabolism, and drug interactions; physiology; side effects; and cannabis use disorder, among other topics.

Pharmacists who are employed by marijuana dispensaries will also have to complete the 4-hour course, according to the New York State Health Department.

Patients can’t start accessing the state’s 20 dispensaries until they get certification from their physicians that they are eligible, and doctors can’t start that process until January. Once certified, patients must apply to the health department for a registry identification card. They can only be certified if they have cancer, HIV infection or AIDS, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, multiple sclerosis, spinal cord injury with spasticity, epilepsy, inflammatory bowel disease, neuropathy, and Huntington’s disease.

Cost, Time May Dampen Interest

The training requirement has led some to question whether many physicians will want to help certify patients for medical marijuana use.

“The concern is that physicians will be reluctant to take that extra step and pay the $250 to do the extra training,” said Netherland.

The Medical Society of the State of New York alerted its members that the training was available, but has not taken any stance on the training, according to a spokesperson. The New York chapter of the American College of Physicians also notified members about the course in early October, before it went live., an information site and national clearinghouse that connects patients with physicians who are willing to certify them, surveyed 500 New York doctors earlier this year to gauge the potential number who might participate in the state’s medical marijuana program.

The company informed physicians about the training requirements and the certification process, John Nicolazzo,‘s chief operating officer, told Medscape Medical News. Of all those surveyed, “we only had one physician that was actually interested in participating,” he said.

The company recently decided to further query physicians to get at the root of the reluctance. “In most cases, we found that most physicians were deterred simply because of the scheduling of cannabis,” Nicolazzo says. Liability issues were also a concern.

Nicolazzo says his company will soon offer a malpractice policy that will cover any liability that might arise from certifying a patient. also plans to launch a broad CME course on marijuana that will be in-person, not online.