Junior doctors are escalating strike action planned for next month and will stage a full walk-out for the first time.
The British Medical Association said an all-out stoppage would take place in which emergency care was not provided.
The previous three strikes have left emergency cover in place and the latest strike, scheduled for 08:00 to 17:00 on 26 and 27 April, represents the first time doctors have refused to provide emergency care.
Doctors are striking over Health Secretary Jeremy Hunt’s plan to impose a new contract on them.
The medics say the changes will incentivise unsafe shift patterns, putting patients’ safety and lives and risk. The Health Secretary says the change will help deliver better care at weekends.
The changes are neutral in spending terms.
Repeated polling show the public tend to back doctors in the dispute and blame the Government.
BMA junior doctor leader Dr Johann Malawana said doctors wanted the dispute to be brought to an end.
“No junior doctor wants to take this action but the government has left us with no choice.
“In refusing to lift imposition and listen to junior doctors' outstanding concerns, the government will bear direct responsibility for the first full walkout of doctors in this country.
“The government is refusing to get back around the table and is ploughing ahead with plans to impose a contract junior doctors have no confidence in and have roundly rejected.
“We want to end this dispute through talks but the government is making this impossible.
The Government said the move was “both desparate and irresponsible”.
Anna Quigley, head of health research at pollsters Ipsos MORI, said doctors were taking a risk by extending strike action to emergency cover.
“Each step of the way with these strikes, we’ve taken the pulse of public opinion and found the majority of people support the Junior Doctors even as the action has rolled on from month to month with little hope of swift resolution. However, if emergency care is not provided during strikes the public is much less likely to support them," she said.
“With this new expanded raft of action, junior doctors may risk their solid base of public support and with that, a powerful bargaining tool.”
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