His morning tea table isn't jam-packed with chocolates and cakes, because the people he sees are so sick they often don't remember him.

But the doctor considered it a great privilege to treat locals in emergency at Tamworth hospital for the past four decades. And, he's been in charge of the department for 27 years.

Now, Dr Ryan will make the move to Orange with his wife Maria, to be closer to family.

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"There has been some extraordinary cases and some really tragic ones too, things that you just never forget," Dr Ryan said. "It is exciting, but it's also tough and traumatic and all of those things."

He said the camaraderie is the thing about country towns that you can't find anywhere else.

"The staff are absolutely brilliant and you often see people on the worst day of their life, so people respond in all sorts of different ways - I've seen all kinds of abuse hurled at the staff ... but they just keep turning up, every day, usually with a smile on their face and cracking a joke," he said.

"It was great to work with them and you make some fantastic friends."

Dr Ryan was one of the first to specialise in emergency medicine in Australia, and in the early days of his career, he was the man who helped mend every seriously ill patient in the region.

"I did the very first ever medical retrieval here in 1987 - I went out and picked up a patient from Bingara and I still have a letter from the doctor about that one, thanking me for coming out," he said.

"We also used to run intensive care as well ... it was crazy busy and you were involved with every sick patient in the North West."

Dr Ryan did a stint as a student doctor at Tamworth in 1985, followed by another two "terms" in the following years. He met wife Maria, a midwife and now lactation expert, at the hospital.

Specialty training called him away from the city for a few years - but the couple came back.

As a pioneer in a rapidly evolving field, Dr Ryan has taken every change and step forward on board throughout his long career at Tamworth hospital.

"When I started, we used to have seven beds and we'd see about 50 or 60 patients a day; now we have more like 40 beds and we see 150 patients a day, and admit maybe 40 of those," he said.

Dr Ryan said he's looking forward to having a few months off to move, settle in and play with his grandkids. But, he plans on getting back to work in a teaching and locum role later.

You might not see the couple around at the pool, or the post office, or Pirates games, or the hospital - but, they said they hold great memories of the city and will miss it.

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