The survey by the Irish Association for Emergency Medicine said that eight hospitals have emergency departments where more than half of all registrar posts remain unfilled.
Letterkenny was also found not to have a permanent registrar.
The IAEM said while all Senior House Office vacancies have now been filled, mostly by the recruitment drive from India and Pakistan, just four registrar posts were filled by the same drive.
It said 108 of 152 positions have now been filled, meaning almost a third still require locum staff.
According to the review, there are eight hospitals where half or more registrar posts remain unfilled, including Letterkenny General.
The others are Children’s University Hospital, Temple Street, Dublin; Connolly Hospital, Blanchardstown; Galway University Hospital; Limerick, Mayo, Naas General Hospitals; and Our Lady’s Hospital in Navan.
It also found that three hospitals, Navan, Letterkenny and Naas, have no permanent registrar.
The association said continued reliance on locum senior medical staff is not only expensive but is potentially detrimental to patient care.
It said it will also place in jeopardy the recent success of the reforms undertaken by the Special Delivery Units.
IAEM has urged an immediate Government focus on potential strategies to ensure that the medical staffing of emergency departments is secured.
In the longer term, this is dependent on significant consultant expansion to ensure that patients receive the best possible emergency care.
Heath Minister James Reilly has said that some elective surgeries may have to be delayed while the HSE absorbs staff changes.
Around 8,000 public sector staff will leave their roles in the next month.
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