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This paper is focused on the middle management in public sector hospitals. The current situation of middle managers can firstly be understood through a socio-historical approach that allows for a reconstruction of the main stages in the construction of this professional group, which underwent many changes, such as secularization, professionalization, and more recently managerialization, in particular under the influence of New Public Management (NPM) tools applied in hospitals. Secondly, the analysis of individual career paths highlights the socialization processes at work and the transformation of practitioners, often nurses, into managers, leading them to assume new roles away from their original professional settings. This biographic turning point appears moreover as one of the characteristics shared by actors of the various public services in the transformation of front line workers into middle managers. In the context of far-reaching NPM reforms, this kind of professional transformation is not without causing tensions where collective and individual identities are concerned.