Most respondents, 205 of 253, reported using or prescribing medical cannabis in clinical practice. Only 34 respondents considered their formal education in medical cannabis therapy adequate, and every respondent expressed willingness to receive additional training.

That contrast describes the surveyed group, not all physicians in Poland. Open recruitment and chain referral could overrepresent clinicians with particular interest in cannabis or pharmacovigilance, and the study could not calculate a valid response rate.

Only 19 physicians, 7.5% of the sample, reported ever submitting an adverse drug reaction report related to medical cannabis. Because the questionnaire asked about reporting behavior rather than verified case files, the result does not reveal how many suspected reactions occurred or how many reports should have been filed.

The gap could reflect underrecognition, uncertainty, limited exposure to reportable events, or features of the survey sample. The paper supports better reporting systems, but it does not permit an estimate of underreporting prevalence.

In the adjusted model for general adverse drug reaction reporting, knowledge of pharmacovigilance purpose, having a medical specialization, and working in a hospital or university setting retained positive associations. The estimates were large, with wide confidence intervals that deserve attention.

These associations should not be read as proof that training or institutional employment caused better reporting. Professional context, access to reporting systems, workload, prior experience, and unmeasured differences may still influence the pattern.

The paper argues for education that explains what should be reported, when suspicion is enough, where a report goes, and how the reporting process works. That is more useful than relying on a general sense of professional obligation.

For medical cannabis, training should also support product identification, cannabinoid profile, formulation, dose, route, co-medications, timing, and clinically relevant outcomes. Better documentation cannot prove causality in an individual case, but it can make safety reports more interpretable.

Pharmacovigilance is especially important when products and exposure patterns are heterogeneous. Useful reports connect a suspected reaction to the actual product, route, dose, timing, co-medications, and clinical course while acknowledging uncertainty about causality.

The survey also points to an organizational question. Reporting behavior may be easier where formal safety systems are visible and integrated into workflow, while clinicians in private outpatient care may face fewer prompts and less support.

The clinical lesson is not that medical cannabis is unusually unsafe. The lesson is that a rapidly expanding treatment area needs reporting habits and systems capable of detecting safety signals without waiting for perfect certainty.

I would make adverse-event documentation routine and product-specific. Ask what changed, when it changed, what else the patient took, whether symptoms resolved after stopping or reducing exposure, and whether the event belongs in a formal report.

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