Objective: To quantify psychological distress experienced by emergency, anaesthetic and intensive care doctors during the acceleration phase of COVID-19 in the UK and Republic of Ireland.Methods: Initial cross-sectional electronic survey distributed during acceleration phase of the first pandemic wave of COVID-19 in the UK and Republic of Ireland (United Kingdom: 18/03/2020 – 26/03/2020 and Ireland: 25/03/2020 – 02/04/2020). Surveys were distributed via established specialty research networks, within a three-part longitudinal study. Participants were Doctors working in emergency, anaesthetic and intensive medicine during the first pandemic wave of COVID-19 in acute hospitals across the United Kingdom and Republic of Ireland. Primary outcome measures were the General Health Questionnaire-12 (GHQ-12). Additional questions examined personal and professional characteristics, experiences of COVID-19 to date, risk to self and others, and self-reported perceptions of health and wellbeing. Results: 5440 responses were obtained, 54.3%, (n=2955) from Emergency Medicine and 36.9% (n=2005) from Anaesthetics. All levels of doctor seniority were represented. For the primary outcome of GHQ-12 score, 44.2% (n=2405) of respondents scored >3, meeting the criteria for psychological distress. 57.3% (n=3045) had never previously provided clinical care during an infectious disease outbreak but over half of respondents felt somewhat prepared (48.6%, n=2653) or very prepared (7.6%, n=416) to provide clinical care to COVID-19 patients. However, 81.1% (n=4414) either agreed (31.1%, n=2709) or strongly agreed (31.1%, n=1705) that their personal health was at risk due to their clinical role.Conclusions: Findings indicate that during the acceleration phase of the COVID-19 pandemic almost half of front-line doctors working in acute care reported psychological distress as measured by the GHQ-12. Findings from this study should inform strategies to optimise preparedness and explore modifiable factors associated with increased psychological distress in the short and long-term.