A hospital has declared a "level 4" incident and ordered its junior doctors to work as thousands more strike across England.
A spokeswoman for Sandwell Hospital in West Bromwich said it had declared a "level 4" incident and needed its doctors not to strike.
Dr Roger Stedman, medical director at Sandwell and West Birmingham Hospitals NHS Trust, said in a statement: "Over the last two days we have had very high numbers of patients come to hospital, and fewer than usual discharged.
'Because of that we decided to require trainee doctors allocated to ward work to attend Sandwell during today's strike."
It comes as the first strike by junior doctors in 40 years is under way in a row over a new contract.
Around 100 picket lines have been put in place, with a large concentration in and around London.