Twenty-three generalist health managers in Australia who have made a career path change from management in the nursing division were surveyed about factors which they perceived as either promoting or constraining their changes in career path. The most significant influencing factors were determination to succeed, personal skills and abilities, the ability to work as part of a team and track record, with ten factors being rated overall as 'quite important'. The most constraining factors related to the shortage of management positions, turbulence in the health care industry, and political factors connected with the mechanisms for making executive appointments.