In the context of a longitudinal study, we explored factors contributing to midlife career achievement among 108 women physicians. Three groups were formed, based on medical specialty, specialty board certification, and professorial appointment. Using analysis of variance procedures, the career groups were compared on measures obtained during medical school and on marital status, family size, and three health measures in midlife. Of the youthful measures, academic standing, father's socioeconomic status, and early family (specifically father-daughter) relationships were found to be associated with midlife achievement. Furthermore, a clear association was observed between success and good health in midlife. Married women formed the majority in all groups; no differences in family size were found. We conclude that career achievement among women physicians is influenced less by marriage and family size than by motivational and personality factors shaped in early life.