title: The New Zealand Advanced Choice of Employment (ACE) Scheme: analysis after 7 years of District Health Board cooperation in a competitive employment context.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Plastic Surgery, Middlemore Hospital, Auckland, New Zealand. brandon.adams@actrix.co.nz
authors.forename: Brandon M
authors.initials: BM
authors.lastname: Adams
authors.forename: Gregory
authors.initials: G
authors.lastname: O'Grady
authors.forename: J Richard
authors.initials: JR
authors.lastname: Pole
mesh_terms: D004651:Employment / Q000639:trends*; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency; D009520:New Zealand; D010560:Personnel Selection / Q000379:methods*; D010820:Physicians / Q000600:supply & distribution*; D012189:Retrospective Studies; D013997:Time Factors