District health boards (DHBs) are now preparing for a second two-day strike at public hospitals nationwide next week.
It follows the failure of mediation in Auckland yesterday to solve a deep impasse between them and the Resident Doctors Association (RDA) over rosters.
Junior doctors walked off the job for 48 hours last week and will do so again on Tuesday from 7am until the same time on Thursday.
DHBs said late yesterday afternoon they were disappointed mediation had failed.
RDA senior advocate David Munro said: "In effect, we took every claim off the table but that was not enough. Whilst the DHBs will offer the same pay rise as others have received in health, they will only do so if NZRDA gives up existing provisions that protect RMOs [resident medical officers]."
He said the doctors' union was "beyond frustrated at the fixed position of the DHBs in demanding we give up essential clauses in our contract that safeguard our members".
The regulatory body for all doctors, the Medical Council, stepped in this week and urged cooperation at yesterday's talks.
Both sides agreed to mediation this week, with talks that began mid-morning in Auckland, failing by the afternoon.
Resident doctor at Dunedin Hospital Dr Rosa Tobin Stickings said: "We're fighting to maintain our current working conditions, to maintain the protection that we enjoy in our contract from our union, and to maintain safer hours rosters that we went on strike for in 2016. "
She said junior doctors were also concerned about increased handover time "which potentially impacts the way we train and the length of our training time to become consultants or specialists. None of this has been confirmed from the colleges that control the training that we have in New Zealand".
"We have offered to work in a collaborative way with the senior doctors' union ASMS and also invited the DHBs to address any unintended consequences. The DHBs have declined to be involved in that collaborative approach."
Resident doctor at Auckland City Hospital Doctor Patrick O'Regan told Morning Report the strike would affect several patients and it was not something doctors were taking lightly.
"The primary impact will be on elective operations and outpatient clinics will be cancelled to free up the senior doctors to cover acute services. People won't miss out on any emergency operations or emergency care," he said.
The strike was "necessary", Dr O'Regan said. "We're not happy at all.
"They [DHBs] want to have us move in between cities, have us work more than 16 hours in one go and they want to undermine safer rosters.
"We know our resolve is very strong and they [DHBs] are coming under pressure," he said.
DHBs' spokesperson Peter Bramley said DHBs had been in mediation "looking for ways to settle the current pay round and prevent disrupting some patient services".
He said DHBs had always bargained in good faith with the RDA and were looking forward to discussions about how to reach an agreement.
"Unfortunately the RDA had no new suggestions on the DHBs' proposals to address the crucial issues of supporting local flexibility in rostering to provide better care and training," he said.
He said the issues at stake for hospitals were crucial to supporting the way patient care was delivered at a local level.
"It's hard to find a solution when the RDA is already balloting for more strikes in February - that's hardly good faith and suggests it had already made up its mind to keep striking."
He also said hospitals had been making contingency plans for the strikes and would notify affected patients.
The RDA said it had made attempts to resolve the dispute at the mediation yesterday.
It said efforts included suggesting that the DHBs "withdraw their clawbacks and roll over the current contract with the standard salary adjustments that are being offered to all health practitioners (effectively 3 percent per annum over four years)."
It had offered a change to the safer hours provision in the contact that would allow more flexible rostering, it said.
Meanwhile, details released to RNZ under the Official Information Act show about half of the doctors that would normally be rostered on to work during the strikes last week worked.
Of the usual 3382 junior doctors rostered to work on Tuesday, 15 January, 1711 worked, while 1724 out of the usual 3427 worked on Wednesday, 16 January.
That's less than the about 3300 claimed by some on picket lines.
It's not known how many of those who worked were RDA members, or how many were members of the Specialty Trainees of New Zealand union or on individual employment agreements.