What do we mean by “Psychedelic Knowledge” in Medical Education? A Scoping Review and Taxonomy of Educational Representations

For decades, the study of psychedelic substances was largely confined to the fringes of science, overshadowed by prohibition and social controversy. Today, however, a quiet resurgence is taking place. Researchers are once again investigating how compounds like psilocybin, found in certain mushrooms, and lysergic acid diethylamide, known as LSD, might help treat conditions such as depression and post-traumatic stress. This renewed interest is not just about the chemicals themselves; it is about a broader shift in how medicine approaches mental health. As these therapies move from the laboratory toward potential clinical use, a critical question has emerged: how do we teach doctors to use them? The answer is not simple. Unlike learning to prescribe a standard antibiotic, where the rules are clear and the effects are predictable, working with psychedelics involves navigating altered states of consciousness, complex ethical landscapes, and deep cultural histories. Before a doctor can safely guide a patient through such an experience, they must be trained in a way that goes far beyond memorizing drug dosages.

A team of researchers from universities across Canada and South Africa set out to understand exactly what is happening in medical schools and training programs right now. They wanted to know what "psychedelic knowledge" actually means to the people designing these courses. To find out, they conducted a wide-ranging review of twenty-eight different studies published between 2017 and 2026. These studies covered everything from surveys of medical students to proposals for new training programs for practicing physicians. The researchers did not look at whether the drugs worked on patients; instead, they looked at how educators were trying to teach the subject. They examined the goals of these programs, the methods used to teach them, and the specific types of information being passed on to future and current doctors.

What they found was a field in the middle of a rapid and somewhat chaotic evolution. The literature they reviewed was overwhelmingly recent, with the vast majority of studies published in just the last few years. This suggests that the conversation about teaching psychedelics is brand new. The researchers discovered that the reasons for teaching this material are mostly forward-looking. Most educators are not teaching these topics because they are standard practice today; they are teaching them because they anticipate that the rules will change soon. They are preparing doctors for a future where these therapies might be legal and common, even though the current educational landscape is still catching up. The studies showed that most of the work being done right now is about identifying what doctors think they need to know, rather than proving that they have learned it. The majority of the research relied on asking doctors and students how prepared they felt, rather than testing them on their actual skills or observing them in a clinical setting.

Through their analysis, the team organized the scattered ideas into four distinct categories of knowledge that make up the current understanding of psychedelic education. The first is what they call "Attitudinal Knowledge." This involves how doctors feel about the science and the therapy itself. Do they believe the research is solid? Do they think the treatments are safe? Do they feel the therapy should be part of medical school? This category is less about facts and more about belief and confidence. The second category is "Preparatory Knowledge." This focuses on the sense of readiness. It asks whether doctors feel they have the training, the institutional support, and the resources to handle these therapies if they were to become available tomorrow. It is a measure of how ready the system feels to take the next step.

The third category is "Technical Knowledge." This is the most traditional form of medical learning. It includes the hard facts: how the drugs work in the brain, what the risks are, how to screen a patient to see if they are a good candidate, and how to manage the physical and psychological effects during a treatment session. This is the "what to do" part of the training. The fourth and perhaps most unique category is "Experiential-Relational-Formational Knowledge." This is where the training diverges sharply from standard medical education. It deals with the human side of the therapy. It involves learning how to be present with a patient who is having a profound, altered experience. It covers the development of empathy, self-awareness, and the ability to build a trusting relationship. In some training models, this even involves the therapist reflecting on their own experiences or undergoing supervised personal experiences to better understand the patient's perspective.

The researchers found that these four types of knowledge often overlap in the literature, but they are not always treated with equal weight. In some places, the focus is heavily on the technical details of the drug. In others, the emphasis is on the relational and emotional skills required to guide a patient safely through a difficult experience. The study suggests that the biggest challenge for medical education right now is not just deciding to add these topics to the curriculum, but figuring out how to balance these different kinds of learning. A doctor might need to know the chemistry of a drug, but they also need to know how to listen to a patient who is describing a spiritual vision. The current research indicates that we are still in the early stages of figuring out how to teach this balance effectively.

The review concludes that the field is characterized by a great deal of conceptual variety. Because the term "psychedelic knowledge" is used to describe such different things—from drug interactions to the art of listening—creating a single, standard curriculum is difficult. The researchers suggest that before we can say a doctor is "ready" to practice, we must first be clear about what kind of readiness we are looking for. Are we looking for someone who knows the facts, someone who feels confident, or someone who has developed a specific way of being with a patient? The answer likely depends on the role the doctor will play. A primary care physician who refers patients to specialists will need a different set of skills than a therapist who spends hours guiding a patient through a treatment session.

Ultimately, this work highlights that teaching psychedelics is not just about transferring information. It is about shaping how doctors think about healing, consciousness, and the relationship between healer and patient. The review serves as a map of where the field stands today: a landscape of growing interest, clear enthusiasm, and a recognition that the tools we use to teach these complex subjects need to be as thoughtful and nuanced as the treatments themselves. The path forward requires more than just adding a new chapter to a textbook; it requires a rethinking of what it means to be a competent medical professional in an era where the boundaries of human experience are being explored in the clinic.