Doctors' leaders will meet today to consider their next move in the bitter row over the Government's controversial pension reforms, including the possibility of a ballot for industrial action.
The British Medical Association (BMA) said its governing council will consider the next steps following overwhelming rejection by doctors and medical students of the "final" offer on pensions.
The BMA said the changes would see younger doctors paying more than £200,000 extra over their lifetime in pension contributions and work eight years longer, to 68.
Officials have urged the Government to reopen talks with the health unions, but said neither the Treasury or the Health Department had signalled any change to their position.
If a ballot for some form of industrial action is ordered, it will be the first among doctors since the 1970s.
Leaders of a teaching union yesterday rejected the pension changes, delivering a fresh blow to the coalition's hopes of ending the long-running dispute.
The executive of UCAC, which represents thousands of teachers, headteachers and lecturers in Wales, warned that the option of further strikes remained open.
The union leaders, meeting in Aberystwyth, said they wanted to negotiate further with the Government, and will step up its campaign alongside other unions to press for improvements to the offer.
General secretary Elaine Edwards said: "We consulted with members before coming to a decision, and the message has come back loud and clear: the Government's offer is totally unacceptable and teachers and lecturers are prepared to take further action to secure a fairer deal."
The union took part in last year's huge one-day strike by more than one and a half million public sector workers.
The row over pensions remains deadlocked, with some unions warning of fresh industrial action, possibly on March 28.