Several policy consultations addressing post-registration nursing careers have followed the creation of the specialist community public health nurse (SCPHN) part of the NMC register, for health visitors, school nurses and occupational health nurses. This study surveyed a cohort of students (n = 44) starting a SCPHN programme, to explore what factors influenced their decision to train for this part of the register, and whether these differed according to previous experience or chosen pathway. The most highly rated factors were an interest in health promotion, a desire to work in community settings, and more involvement in the social aspects of health. These factors were closely linked with aspirations of career progression. There was no significant difference between previous experience and factors influencing career change decisions. However, there were some variations between chosen pathways, with occupational health respondents prioritising factors differently to their health visiting and school nursing counterparts. It is recommended that research is conducted into occupational health nursing roles, SCPHN proficiencies reviewed, and more flexible educational programmes developed.