Most physicians spend a minimum of 12 years in postsecondary education before they can practice. After earning a bachelor's degree, you need four years of medical school to get general training. By the time a physician reaches residency, she has settled on a specialty. Her residency is designed to provide her with the specialized education she needs to practice as a cardiologist, pediatrician, psychiatrist, family practitioner or other specialty. Sometimes, however, there’s a problem with a job fit or some other issue that makes a doctor decide to change her specialty.

Making the Wrong Choice

The extensive training period can make it more difficult for a doctor to determine if she really likes what she’s doing. A physician does not really begin to practice until she has graduated from residency, or in some cases, from the extended period of specialty training known as a fellowship. An April 2012 article in “Forbes” magazine notes that 41 percent of physicians would choose a different specialty if they could make the choice over again. Only 54 percent of those surveyed would even choose a medical career.

Reverting to the Original Plan

When a physician’s specialty is a subspecialty of another discipline, it might be easier to revert to the original specialty. For example, a cardiologist begins her career in internal medicine and must be certified in that specialty before she can go on to a cardiology fellowship. Should she choose, she can simply drop back into the practice of internal medicine without any extra training, especially if she is a relatively recent graduate. A number of other medical subspecialties begin with internal medicine, such as gastroenterology, endocrinology, oncology and hematology. Other medical specialties with subspecialties include psychiatry, surgery and family practice.

Traveling a Similar Path

In some cases, switching specialties is a matter of extra training on top of the basic specialty. In pediatrics, for example, one of the subspecialty choices is neonatology, the care of critically ill infants in the first few months of life. A pediatrician who is already practicing could go back for fellowship training in neonatology. A general surgeon who wants to specialize in thoracic or vascular surgery would need fellowship training, but would not need to repeat basic surgical training. In other specialties, a physician might add a service to his basic practice, according to a column on the North Carolina Medical Board website, and travel down a different road. For example, the NCMB says an OB/GYN might expand his practice to include Botox injections and cosmetic laser procedures, or a family doctor might focus on dermatology. If a physician makes this choice, he should be careful that he is not practicing too far outside of his training or licensure.

A Real Change

A physician who wants to make a drastic change in specialty must go back to school. As a medical school graduate, she need not repeat her basic education, but she will need to return to residency. For example, a pediatrician who wants to become a psychiatrist must -- at a minimum -- complete a psychiatric residency. She might also need to complete a fellowship, especially if she wants to specialize in a sub-discipline of psychiatry such as child and adolescent psychiatry. A family practice doctor who wants to become a surgeon must complete a surgical residency and possibly a fellowship. Changing specialties in medicine is not necessarily easy, but it can be done.