Doctors warn patients are paying the price as overworked specialists forego toilet breaks to stay on top of an insurmountable number of patients and battle burnout.
Thousands of surgeries, appointments and cancer treatments have been cancelled as more than 3500 NSW public hospital doctors down their stethoscopes in a bid to improve working conditions and pay.
A "vicious cycle of burnout" was driving worse care for patients, Western NSW psychiatry registrar Nathan Blake said.
Acknowledging his conditions were reasonable, Dr Blake said he had worked 16-hour shifts in a previous role and understood the anger of doctors.
"You're trying to give all you can to the patients, we've all given so much of our lives (but) it can be really, really difficult to even begin to articulate how challenging that can be when you can't go to the bathroom because you've got so much to do," he said.
The first strike by NSW doctors in 27 years has highlighted the discrepancy in pay between the state and other jurisdictions with doctors routinely moving to Victoria and Queensland for better conditions.
Western NSW kidney specialist Zainab Wajih said conditions were worse in the regions and patients paid the price.
A lack of specialists and other supports had forced doctors to back their skills and manage complex cases themselves, Dr Wajih said.
"I could be earning the same amount of money in Sydney with similar conditions in Sydney, but I choose to stay here because we need more specialists in this area," she said.
"We need to have a budget that allows for more specialists in this area and incentives for people to work in rural and regional towns, whether that's better work hours, whether that's more support from the admin staff or management, or whether that's more pay."
Doctors from more than 30 NSW hospitals went on strike on Tuesday, demanding a 30 per cent salary increase and guaranteed breaks.
But Health Minister Ryan Park has resisted calls for change.
"The government understands there are challenges with doctors' wages in NSW ... but to try and make up 12 years of wage suppression in 12 months is also not feasible," he said on Wednesday.
The government has offered a 10.5 per cent increase over three years.
Another regional intern working at the same Western NSW hospital as her senior colleagues said six years of studying full-time without income had financially crippled her.
"After rent, electricity, food, school and daycare (costs), you're sort of living week to week and it's not something that I even really thought about going through med school," the intern said.
The parent of three, who declined to provide her name fearing repercussions, said understaffing coupled with gruelling shifts without breaks had impacted her home life.
The strike action continues until late Thursday.
