Wrexham Maelor Hospital must recruit more staff and invest more in facilities, according to a new report.
Betsi Cadwaladr University Health Board has been told it must communicate more clearly and more frequently with consultants and junior doctors and ensure staffing numbers are increased before any new clinical sites are opened in north Wales.
The Royal College of Physicians (RCP) report follows another damning one revealed in October 2021.
A leaked copy to ITV Cymru Wales found the staff at Wrexham Maelor to be some of "the unhappiest" ever seen with a "perfect storm of a collapsing estate".
Surveys have found morale to be a key issue for speciality trainee doctors across Wales.
Figures seen by ITV Cymru Wales from the Royal College of Physicians' 2020 national census show:
43% of senior trainees across Wales felt valued by their health board or hospital
48% felt in control of their workload
30% said they work excessive hours
69% of senior trainees in Wales said their own morale was worse since the pandemic started
77% said team morale was worse since the beginning of the COVID-19 pandemic
Betsi Cadwaladr University Health Board has met with the Royal College to discuss the report about Wrexham Maelor and how they will address the issues highlighted.
Dr Olwen Williams, Vice Chair of the Royal College of Physicians Wales, said: "It is crucial that the health board leadership listens to staff, takes their concerns on board and addresses these issues through genuine clinical engagement.
"The post-pandemic NHS recovery must be patient centred and clinically led: this meanslistening to staff, acting upon their concerns, avoiding the blame game, and cruciallyencouraging them to lead change."
The health board said it is taking the report "very seriously" and has developed an action plan.
Dr Nick Lyons, Executive Medical Director, said: "We're making real progress in addressing the concerns raised, as acknowledged in the RCP's follow-up review.
"This highlights improvements including strengthening medical leadership on site, recruiting a specific medical bed manager and reviewing the management structures for doctors working across unscheduled care.
"We're aware that workload, stress and pressures that our clinicians face have not gone away and are committed to ensuring that colleagues are supported to do their jobs to the best of their ability.
"We will continue to work with our clinical teams to implement the RCP's recommendations."