The New Zealand Advanced Choice of Employment (ACE) Scheme: analysis after 7 years of District Health Board cooperation in a competitive employment context
Adams, B.M.; O'Grady, G.; Pole, J.Richard.
New Zealand medical journal 123(1318): 34-42
2010
ISSN/ISBN: 1175-8716 PMID: 20651865 Document Number: 646161
The Advanced Choice of Employment Scheme (ACE) coordinates the appointment of postgraduate year 1 doctors in New Zealand (NZ). ACE is a voluntary collaborative operation by all 21 of NZ's District Health Boards (DHBs). This audit evaluates the performance of ACE over its first 7 years of operation. The proportion of applicants successfully matched and the correlation between their preferred and matched DHBs was evaluated. Qualitative performance was assessed through survey of NZ trainee interns (TIs). Nearly all (99-100%) NZ TIs using ACE have been successfully matched each year. Most (96-99%) of the successful applicants have been matched to one of their top-four preferred DHBs, and a mean of 81% to their most-preferred choice. Qualitative satisfaction with ACE was high (90% good). Applicant concerns included the usability of the online application portal and uncertainty about the fairness of the ACE algorithm. The ACE scheme has been highly successful for allocating PGY1 positions over 7 years and achieves generally high applicant satisfaction. DHBs have successfully cooperated despite their competing interest in recruiting top applicants. This study supports the contention that increased collaboration between DHBs may improve efficiency within the NZ health sector.