Programs in health administration seek to prepare students for real world challenges of leading in a complex environment. Competency models such as the one produced by NHCL focus on leadership. However, most new graduates of undergraduate programs will not go into leadership roles immediately. There is an extensive literature on transition to practice for graduating nurses, and a modest literature on physician transition to practice from residency, however there is relatively little literature about the transition to practice from undergraduate programs in health administration. To address this knowledge gap, we conducted a longitudinal, interview-based study with twelve graduates from an AUPHA-accredited undergraduate health administration program as they made their transition to practice. Each participant was interviewed five times, once before graduation and quarterly thereafter. The participants reported relatively weak formal organizational socialization, high levels of autonomy, high levels of learning by doing, and high levels of supervisor turnover. These findings suggest the need for undergraduate programs in health administration to emphasize areas of competencies that include managing up and followership to improve the quality of new graduates' transition to practice and success as an early careerist.