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Thousands of junior doctors in England began a four-day walkout on Tuesday in what is the latest industrial action called by professionals' group the British Medical Association over pay and working conditions.
The BMA wants a 35-percent pay increase for its members, most of whom work in the government-funded National Health Service, to make up for what it says have been years of below inflation pay rises.
The strike across England, which follows walkouts last month, is expected to be "the most disruptive industrial action" in the 75-year history of the public health service.
The NHS Confederation expects as many as 350,000 appointments and operations could be canceled this week, which is double the amount seen during strikes last month.
Government ministers have said the wage increase demand is unaffordable, with Health Secretary Steve Barclay repeatedly saying the demand was "unrealistic" and not in line with pay agreements in other divisions of the public sector.
In a column for The Daily Telegraph newspaper, he said the government cannot negotiate until the BMA confirms it is pausing the strikes and "moving significantly from its position of 35 percent".
"Without this, I regrettably see no prospect of getting into serious and constructive talks," he wrote.
The NHS Confederation's Matthew Taylor told the BBC the government and unions must urgently call in mediators, such as conciliation service ACAS, for talks, as the ongoing strikes were "extremely worrying".
"It's depressing that there seems to be no movement at all from the two sides of this dispute over the last few days," Taylor said.
A statement on the BMA website claims junior doctors have experienced a cut of more than 25 percent to their salaries since 2008/09.
"The lack of investment in wages by the government has made it harder to recruit and retain junior doctors," the BMA said. "This puts further pressure on the NHS and makes it harder to deliver care to the standards expected by professionals."
The Daily Mail newspaper reported that the union has warned strikes may continue "all the way until the next General Election", which is expected to take place toward the end of next year.
During the strikes this week, the NHS said it plans to prioritize emergency care, with senior doctors called in to fill in for their junior colleagues, but noted that this presents challenges as a quarter of those consultants are away on vacation.
Stephen Powis, the national medical director of NHS England, warned "cover is very fragile".
He told BBC Radio 4's Today program: "We will endeavor to keep patients safe, particularly in those emergency services, but that is becoming harder every time we have this strike action."