A medical instrument has a shaft. The shaft has an outer shaft and an inner shaft. The outer shaft encloses the inner shaft. The medical instrument further has an actuator for rotating the inner shaft about a longitudinal axis relative to the outer shaft, arranged at a proximal end region of the shaft. The medical instrument has at least two tappet elements for transferring a rotary movement of the actuator to the inner shaft, which are engaged interchangeably with the inner shaft for transferring the rotary movement of the actuator to the inner shaft. The tappet elements reach through peripherally limited openings in a proximal end region of the outer shaft, which openings are offset with respect to one another in the longitudinal direction.