The number of senior doctors working in Aberdeen Royal Infirmary's A&E is projected to fall from 10 in August 2013 to two in August 2014.
A briefing to NHS Grampian has revealed that consultants now fear they may not be able to provide for patients in need in their primary role, for example resuscitation of those with life and limb-threatening conditions.
The consultants are also concerned about the potential impact on all staff who work in the emergency department, unscheduled care and the rest of the hospital.
The staffing issue was due to be discussed by the NHS Grampian board on Friday morning.
The health board said action was already being taken to address shortages.
A statement from NHS Grampian says: "Appropriate medical cover in the emergency department (ED) is of key importance to us and is receiving our closest attention.
"A top-level group involving all ED consultants and senior management has been set up and is meeting on a weekly basis.
"A number of key posts are out to advert and early indications are that appointments will be made."
It continues: "The public can be reassured that this issue is very firmly on our radar screen and that, with colleagues in ED, we will work towards ensuring appropriate staffing levels are in place from August so that safe levels of medical cover is in place.
"We are using all recruitment channels, a number of leads are being followed up and we are confident more appointments will be made."