MOST posts for senior trainee emergency doctors in Scotland were left unfilled this summer, raising fears of a recruitment crisis.

Just seven out of 25 jobs due to start in August were filled by the national selection process, potentially leaving hospitals short of these doctors who are crucial for running services, particularly at night.

Acute medicine departments, where GPs send patients, were also left with gaps. For a total of 22 vacancies, there were 20 applications and just nine positions filled.

The doctors sought, while not fully qualified consultants, are senior enough to be left in charge in an accident and emergency department overnight with back up from consultants on the phone.

Dr Jason Long, chairman of the Scottish board of the College of Emergency Medicine, said: "That is why we are at a crisis point. At the moment we are trying to fill these vacancies with other people. Eventually we will seek some locums, but we are trying to get anyone who has the particular competencies to apply for these."

The revelation comes after The Herald launched a major series investigating whether Scotland's hospitals can cope with the growing number of elderly patients.

We revealed how ministers were warned about problems facing Scotland's accident and emergency departments months before the winter hospital crisis hit and hundreds of patients had to wait more than 12 hours for a hospital bed.

This newspaper is calling for a national review that asks if the NHS has the right beds, with the right staff, in the right place, at the right time to look after the ageing population.

Since the college warned ministers that 21 out of 24 accident and emergency departments were regularly unsafe last year, the Scottish Government has invested in frontline consultants.

However, Dr Long said some of the benefit of these extra staff is lost as they must do "middle grade" work.

Dr Long said: "Those consultants are really getting used to fill gaps as opposed to increasing quality and safety."

He and Dr David Reid, vice-chairman of the British Medical Association's Scottish Junior Doctors' Committee, said anti-social shift patterns such as late-night and weekend working made emergency and acute medicine unpopular.

UK-wide there were 152 applications for 248 emergency medicine posts and Dr Long said the training programme had a quit rate of 43%.

Dr Reid said: "Recently, the demand on hospital services has worsened. It was not a cold winter and there was no flu outbreak to account for it. People on the frontline struggled ... some described it as akin to a war zone. It is understandable why trainees were put off."

Medical students embark on their careers expecting to work anti-social shifts, he said, but when they progress to the final levels of speciality training they are ready to have children and choose specialities like general practice that do not require night work.

Anaesthesia, which also involves late shifts, also struggled to attract enough applicants in Scotland this year, with 29 out of 50 posts filled by national recruitment. Dr Reid said it may be linked to the exam system for this speciality.

He said the forthcoming referendum on independence may also have deterred some junior doctors from

applying for training posts in Scotland. He said: "When I speak to my colleagues in London there is a bit of trepidation about what the future might hold if Scotland becomes independent. At the moment you can move your training around the UK."

A Scottish Government spokesman said there was no evidence of such a factor, given the UK-wide recruitment issue.

He added: "The Scottish Government expects all boards to plan and deliver clinical services, making sure they have the right numbers of staff in the right places. Any central funding for training grade posts that are not filled is passed back to NHS boards so they can engage in recruitment at local level – which is what is happening.

"If posts remain unfilled, the boards will use these funds to invest in alternative options – including hiring medical locums, expansion of other medical grades such as speciality doctors and the expansion of advanced (nurse) practice roles."

NHS Greater Glasgow and Clyde says it has managed to fill all but five of its middle grade emergency posts. NHS Education for Scotland (NES), which oversees the speciality training job recruitment and clearing system, said: "During the recent national recruitment process for medical speciality training posts, over 90% of posts available for training were successfully filled, with 100% fill in early years training posts, and in most specialities.

"There were a number of specialities where recruitment resulted in poor fill rates across the UK. NES is working with the Scottish Government, Medical Royal Colleges, the BMA and the service to understand the reasons behind this, and to develop solutions."