Trends in Locum Demand by Specialty: Which Specialities Are Growing Most

As healthcare systems across Ireland grapple with ageing populations, staff shortages, and growing patient complexity, the demand for locum doctors in certain specialties is rising sharply. For doctors considering locum work, or thinking of adapting their specialisms, it pays to know which fields are most in demand, and what’s driving that demand. Here’s a breakdown of the specialties showing strongest growth, with insights for 2025-2026.

1. General Practice (GP)

One of the most consistently in-demand specialties for locums is General Practice. Rural areas in Ireland, especially, continue to struggle to maintain full GP rosters due to retirements, emigration of newly-qualified GPs, and expanding demand for primary care.

Key drivers:

• Aging population with multiple chronic illnesses means more GP consultations.
• Policy changes expanding free or subsidised GP access in certain cohorts increasing patient loads.
• High levels of GP emigration (many newly qualified GPs leaving Ireland) create gaps that locums can help fill.

2. Emergency Medicine and Acute Care

Locum roles in Emergency Medicine (EM) and other acute care specialties remain in high demand. Hospitals need cover for unpredictable surges (e.g. seasonal illnesses), staff absences, and maintaining 24/7 services.

Additional aspects increasing demand:

• Reopening elective services places pressure on emergency departments to manage non-elective admissions.
• Rural and peripheral hospitals need flexible acute care coverage.
• Burnout among permanent staff means greater reliance on temporary/locum staff.

3. Surgery & Surgical Subspecialties

Specialties like General Surgery, Orthopaedics, Neurosurgery, Urology, and other surgical subspecialties are showing strong growth in locum demand. 

Reasons include:

• Elective surgery backlogs following pandemic disruptions require catch-up, and locums are a flexible way to expand surgical capacity.
• Some hospitals are expanding surgical services or creating more specialised surgical centres, increasing workforce needs.
• Consultant vacancies and slow pipeline through Higher Specialist Training (HST) create gaps that locums can help fill.

4. Psychiatry & Mental Health

Mental health services are under increasing pressure. Locum psychiatrists are in demand in inpatient psychiatric units, community mental health teams, and for holiday/leave cover. 

Contributors to rising demand:

• Growing recognition of mental health needs post‐COVID, plus increased waiting lists.
• More policy and healthcare funding attention on mental health, with push to widen access.
• Shortages of permanent staff and difficulties recruiting in certain geographic areas.

5. Internal Medicine / Sub-specialties

Internal medicine (acute medicine, general medicine) and its subspecialties (cardiology, gastroenterology, etc.) are also key areas of growth.

Why:

• As people live longer with complex comorbid conditions, demand for specialist care increases.
• Hospitals need flexibility to cover both acute and chronic internal medicine workloads.
• Locums fill gaps during out-of-hours work, leave, or when permanent staffing lags behind demand.

6. Obstetrics & Gynaecology (OB/GYN) and Oncology

These specialist fields are emerging more strongly compared to recent years. Locum demand is rising in OB/GYN (e.g. maternity cover, specialised clinics) and Oncology (due to growing cancer incidence and treatment advancements).

Key pressures:

• Advances in cancer treatments mean more clinics, more follow-ups, more complex care.
• In OB/GYN, services like antenatal care, birthing units, gynaecological surgery need staff cover especially during policy or service expansions.
• Specialist training in some of these fields is longer and more competitive, so pipelines are slower; hence locum roles are essential to plug gaps.

7. Anaesthesia

Anaesthetists are, as in past years, in high demand. Their role touches both surgical and procedural work, critical care, and pain management. Locum anaesthetists often enjoy higher rates but also carry high responsibility.

Regional & System Factors to Watch

• Rural vs Urban Gap: Many of the highest demand specialties are even more in demand in rural or peripheral hospitals. Locums willing to travel may find more opportunities and better rates.
• Training & Pipeline Constraints: Many specialties with growing demand have elongated training paths and limited numbers entering specialist training (HST etc.). Delays in pipeline exacerbate shortages.
• Seasonality & Workforce Turnover: Leave (annual/maternity), illness seasons, and retirement result in periodic spikes in demand especially in GP, ED, and paediatrics.
• Policy Changes & Health System Funding: Government health strategies, increases in free primary care, mental health service enhancements, and targets for waiting time reductions all feed specialty demand.

Implications for Locum Doctors

If you’re planning your locum career, or considering upskilling, here are some strategic pointers:

• Specialty Choice Matters: Specialties like surgery, psychiatry, anaesthesia, and internal medicine are likely to have more locum opportunities and potentially higher compensation.
• Diversify Skills: Even within a specialty, having cross-skills (e.g. in acute care, out-of-hours shifts, telemedicine) helps.
• Geographic Flexibility Helps: Willingness to take roles in rural areas or less well-resourced hospitals can open more, often better-paid, work.
• Stay Up to Date: Keeping licences, certifications, CPD current, and being competent in newer tools (telehealth, digital systems) can give you an edge.
• Watch for Pipeline Changes: If HST or consultant training paths are modified, anticipate changes in what skills or specialties will be in demand.

Conclusion

The locum landscape in 2025-2026 is shifting. While General Practice, Emergency Medicine, and Surgery remain core pillars, specialties such as Psychiatry, OB/GYN, Oncology, and internal medicine subspecialties are seeing growing need. For doctors, this means real opportunity but also the need to plan carefully: choose specialisms with strong demand, remain flexible, and anticipate where gaps are likely to stay unfilled.

Need help finding Locum Doctor roles in Ireland? Locum Express can connect you with top job opportunities and provide expert guidance throughout your move.