help needed....please....... urget

[desdoc]

hi

i am a physician from india.... came on a
J1 research visa and got a waiver for the 212 e..

my employer is ready to sponsor a H1.... i am doing a fellowship right now.....
i was doing research and got a waiver on the basis of research and no objection from my country...now i want to start doing clinical and research both...i have a license to practice...
my question is .....
can i straight away apply for a h1 with a clinical job description and get it primium processed ....and when i need a stamp go out of the country to canada to get it....will the change of my job from research to clinical hamper the chances of getting the visa and stamp

or

get a H1 with research job discription and than once i get it i go out and get H1 stamped and than change my job description to clinical....is that a better idea or it does not make a difference.....

thanks for the comments