Doctors preparing for their second strike are refusing to accept a pay cut in exchange for less demanding rosters.

Of more than 3400 junior or resident doctors who will walk off the job for the second time on November 23, more than 80 work at Whangarei Hospital.

The doctors went on strike on October 18 and 19, as they have been unable to agree with the country's 20 District Health Boards over rostering practices. The dispute is ongoing, prompting the second strike.

About 120 Whangarei patients were affected by the first strike, with the number of people turning to the emergency department also down during the two-day action.

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Twenty-one operations were delayed and 99 adult and 22 paediatric outpatients' appointments were rescheduled. The strike did not affect Northland's other hospitals.

The junior doctors, 102 of whom work in Whangarei (about 80 are union members), form the engine room of most hospitals.

As part of 2016-2019 collective agreement negotiations with the DHBS, the New Zealand Resident Doctors' Association (NZRDA) said the doctors should work no more than 10 consecutive days, or four consecutive nights. Currently they could be rostered for 12 days or seven nights.

Doctors had spoken of their exhaustion and fear of making a mistake at work as a result.

The NZRDA said the revised offer after the October strike included a clause of $200 for each weekend work, offset by a reduction in salary of about $10,000. This will result in a net pay cut of between $5000 and $7000, the association said.

The offer also included an "expectation" that the consecutive days and nights issue be addressed - not a strong enough commitment according to the NZRDA.

The NZRDA acknowledged that Northland DHB had some of the best rosters in the country, but that there was still work to be done to bring them into line with the current demands.