The UK's largest health union Unite has unanimously rejected the government's final pensions offer.
Unite's health sector national industrial committee (HSNIC) will now meet on the 11 January to consider its future strategies.
"Our NHS executives unanimously rejects the government's pernicious attempts to make hard working and dedicated NHS staff pay more, work longer and get less when they retire," said Len McCluskey, Unite's General Secretary.
"The government's attacks on public sector pensions are politically motivated, as part of an overall design to privatise the NHS, cut public services, break-up the national pay agreements, and disrupt legitimate trade union activities and organisations."
Unite's rejection comes as the BMA has today (Thursday 5 January) sent out a survey gauging its members' opinions on the potential for strike action over pension reforms.
Members will be asked their views on the government's final pension offer and what action they would be prepared to take if they deem it to be 'unacceptable'.
The survey will be distributed to around 130,000 BMA members and it is claimed the first doctor walk out for almost 40 years could follow if enough negative responses are received.
"We want doctors and medical students to be fully aware of what's coming their way, and to have their say on what happens. Everyone will be affected, and it's up to the whole medical profession to influence what we do next," said Dr Hamish Meldrum, Chairman of the BMA Council.
"Either way, the implications are huge. We face either major, damaging changes to our pensions, or the first ballot of doctors on industrial action since the seventies."
The pension offer currently on the table will see NHS staff less than ten years from retirement not having to face any change to their pension, and those earning less than £26,000 protected from an increase in contributions next year.
The BMA has publicly rejected the deal.