July 25 (UPI) -- Thousands of National Health Service resident doctors in England walked out Friday at the start of a five-day strike in a dispute with the government over pay.

The British Medical Association, the doctors' union, said in a post on X that the strike could have been avoided if Health Secretary Wes Streeting had put forward a "credible offer" to address a one-fifth real-terms drop in their pay since 2008.

The 190,000-member union pointed to the inequity that after seven years of study and training, doctors in their first year as a fully qualified resident were paid more than $7 an hour less than a physician assistant in their first year.

"This is why resident doctors in England are taking a stand against the government -- it's time to pay us what we're worth," said the BMA, adding that it was seeking a raise of just $5.39 a hour to $30.45.

The union called on doctors to join picket lines outside designated large hospitals in London and seven other regions of England as the strike got underway at 7 a.m. local time, three days after negotiations with the government collapsed.