From F1 visa to J1 visa

  I have some questions about changing my status from F1 visa to J1 visa. I was told that I need to go back to my home country in order to change from F1 visa to J1 visa. Is that the case?  What are the risks involved? I know I need to do waiver if I want to do H1B. 

   Also, I got my PhD in educational statistics and this offer with J1 visa is from School of Medicine, psychiatry department. Will that belong to senstive major?

   We are considering J because the boss doesn't want to spend too much money on H1B premium processing. Regular H1B is ok and she wants me to start early.

   Can anyone help??

   Thanks a million.

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