Junior doctors in New Zealand have walked off the job, hobbling hospitals and kicking off a possible second year of public-sector strikes across the country.
About 3300 resident doctors - 80 per cent of the workforce - on Tuesday began a 48-hour nationwide strike after a breakdown in talks over pay and conditions with authorities.
Hospitals say they expect thousands of non-urgent surgeries to be deferred and have called on senior physicians to pick up extra shifts to maintain services.
The doctors, gathering in front of hospitals across the country, say new conditions proposed by health boards could exacerbate already-long shifts and 10-day working rosters, creating dangerous conditions for patients and staff.
"[They] could be required to work for more than 16 hours in a row, without guarantee of rest or safety," NZ Resident Doctors Association president Courtney Brown said.
"It is disappointing and frustrating that we are being forced to strike just to keep our terms and conditions.”
Health authorities, meanwhile, say current work arrangements are too rigid and more flexibility is required.
The dispute is the first of what may be a series of large-scale public sector strikes in New Zealand this year, and continues a 12-month period of industrial action.
About 30,000 of the country's nurses went on strike last year, bringing hospitals to a crawl, before reaching a pay agreement in August.
A similar number of primary school teachers also walked off the job, citing increasing workloads and poor pay increases, and are mulling further action this year. High school teachers also rejected their latest pay offer, with talks now on to try and prevent industrial action in 2019.
The government's pledges to deliver surpluses, pay down debt and not introduce new taxes have restricted spending options and left some organisations in the public sector disappointed.
Opposition politicians have accused the Labour-led government of raising expectations during election campaigning only to fall short while in power.
Ministers, however, say the offers being made are significant increases and that unions are frustrated after nearly a decade of "neglect" under the previous centre-right administration.