More than 100,000 doctors and medical students will vote on industrial action over controversial public-sector pension reforms - the first time in 40 years.
The British Medical Association met on Saturday to consider the government's changes to the NHS pension scheme that will see doctors forking out more than £200,000 extra over their lifetime in pension contributions and working eight years longer to 68.
Doctors overwhelmingly rejected the "final" offer on pensions and will begin work this week on drawing up a timetable for holding a ballot on industrial action, the first poll of its kind since the 1970s.
But they ruled out strike action because of its potential impact on patients across the country.
BMA chairman Dr Hamish Meldrum said: "Doctors are not asking for special treatment - quite the opposite.
"Just four years ago NHS staff agreed to major reform of the NHS pension scheme to make it fair, affordable and sustainable.
"Now the government wants to go back on that deal."
He said the union had "pursued every avenue" to bring the government back to meaningful talks and the decision to ballot for the first time in 40 years was not taken lightly.
More than 80 per cent of 46,000 BMA members who responded to a January survey said the government's offer should be rejected, with nearly two-thirds willing to take industrial action for a fairer deal.
The association also revealed that more than a third of doctors aged 50 and over intended to retire early if the changes go ahead.
Health Secretary Andrew Lansley said he was "disappointed" by the decision.
Welsh teaching union UCAC also rejected the planned changes on Saturday and warned of further strikes.
The union took part in last year's one-day strike by more than 1.5 million public-sector workers.
Its 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."
Some unions have warned of fresh industrial action, possibly on March 28, as the row over pensions remains deadlocked.
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