One-in-eight full-time posts advertised for hospital consultants received no applicants in 2015, according to a new report.
Another 28 job offers just attracted one candidate.
The stark statistics are revealed in a report commissioned by HSE chief Tony O'Brien into the crisis in the recruitment and retention of hospital consultants.
Earlier this week the HSE was instructed to withdraw an appeal against the payout of back-money to two hospital consultants who won their case for underpayment of full salary in the Employment Appeals Tribunal.
Another 500 doctors have now lodged High Court claims for compensation for failure to deliver on pay increases under their 2008 contract, leaving the State with a potential bill of €350m.
The report, which included input from the various training bodies and hospitals under the chairmanship of surgeon Prof Frank Keane, found a range of weaknesses in the process of the recruitment of retention of consultants. They included waiting in many cases until a hospital consultant has retired before applying to have the doctor replaced.
This has the effect of creating a vacancy in cases where it was known years in advance that a post would become open.
There can be delay in hospitals forwarding a proper job description to allow it be advertised. There is currently no relationship between a post being approved and knowledge of whether there are sufficient candidates here or abroad to fill it.
The report referred to concern from doctors' unions about consultants' pay and the claim that it is not keeping pace with their colleagues in the United States and Australia.
The lower salary for newly recruited consultants also reduces competitiveness.
When doctors take up jobs here they frequently struggle to get enough administrative support and office space.