Doctors working shifts of up to 17 hours in Hunter hospitals say they are being pushed to breaking point and patient care is being compromised.
The region's biggest hospitals - John Hunter, Maitland, Calvary Mater and Belmont - have been cited by the doctors' union as examples of the problem.
Alexander Whitfield, a Hunter delegate for the Australian Salaried Medical Officers Federation (ASMOF), said "it's very common to have routine rostering of 16-hour, 17-hour shifts".
Dr Whitfield said doctors starting at 8am and finishing at midnight was "quite common".
He said being on call for 24 hours and "even 72 hours" at weekends was also common, particularly for surgical specialties.
"There's always been long hours in medicine, but often the calls are constant. You're potentially being awake for three days in a row. It's really quite dangerous," he said.
Dr Whitfield's comments followed ASMOF releasing a survey of 2500 doctors statewide, including 334 from Hunter New England.
The survey found one in three front-line doctors in NSW public hospitals were considering resigning.
The survey found 64 per cent of doctors believe excessive workloads were affecting their health and wellbeing, while 69 per cent had worked sick or injured.
Dr Whitfield said hospital managers had "recognised this as an issue and a big barrier to people wanting to come and work in Newcastle".
"There's a concerted effort to change it, but those long hours still happen because of staffing and it's hard to change some rosters," he said.
Paul Craven, a Hunter New England Health executive director, said the district had significantly improved "the wellbeing and safety of all medical staff, including junior medical officers".
"Rostering is undertaken in line with safe working standards and fatigue management guidelines," Dr Craven said.
"Regular audits at all our hospitals ensure compliance with NSW Health fatigue standards."
He said this included "no more than seven night shifts in a row, and a minimum 10-hour break between shifts".
"We continually review and refine rostering to ensure fairness and flexibility," he said.
A NSW Health spokesperson said "situations will arise where doctors may be required to work additional hours, including unrostered overtime".
"Junior doctors are not rostered for shift periods totalling more than 14 consecutive hours," the spokesperson said.
Junior doctors rallied in February last year over a "toxic workplace culture and hazardous conditions" at John Hunter Hospital.
This followed a hospital manager referring to the doctors as "clinical marshmallows".
The union this week highlighted a similar issue at Nepean Hospital, in which doctors were criticised for taking sick leave and requesting roster changes.
The union said this included "veiled threats that doctors struggling with unsustainable workloads and severe fatigue should leave the profession".
ASMOF NSW president Nicholas Spooner said doctors "deserve safe workplaces and sustainable workloads", along with "respectful communication free from threats and insults".
Dr Whitfield said communication should not be threatening or derogatory.
"We saw that last year with the marshmallow-gate situation in Newcastle," he said.
"It increasingly feels like the Ministry of Health and local health districts have a lot of disregard or maybe even a hatred towards their medical staff.
"I genuinely think that, from the top, there's a real disrespect and lack of appreciation for healthcare workers, doctors in particular.
"Resource scarcity puts stress on the whole system and the people responsible for managing the rostering."
NSW Health said it "greatly values" junior doctors.
"Reducing overtime and supporting adequate rest is a priority," it said.
Closing submissions will be held at a hearing in the NSW Industrial Relations Commission on Monday on the doctors' push for better wages and conditions.
