Pay negotiations will not be reopened with resident doctors because the Government "can't be more generous" than it already has been, Downing Street has said.
Medics in England have voted in favour of striking over a wage dispute, the British Medical Association union confirmed on Tuesday.
The industrial action by resident doctors - formerly known as junior doctors - could see walks outs last until January next year.
In response to the announcement, the Prime Minister’s spokesman said: "The NHS is finally moving in the right direction for the first time in 15 years so it's disappointing that the BMA is threatening to undermine that progress with strikes.
"We aren't going to reopen negotiations on pay. Resident doctors have received the highest pay award across the public sector for two years in a row, and we've been clear that we can't be more generous than we already have this year."
The Health Secretary has invited BMA representatives to discuss issues around working conditions and is committed to "working together" to find solutions, he added.
The medics were awarded a 5.4% pay rise for this financial year, following a 22% increase over the previous two years.
But the BMA says wages are still around 20% lower in real terms than in 2008 and are demanding "pay restoration".
In a ballot over whether to strike some 90% of resident doctors voted in favour on a turnout of 55%, just above the legal threshold of 50% required for industrial action.
The ballot gives the BMA’s wing of around 48,000 resident doctors a mandate to call strike action over the next six months.
The union said it would seek fresh talks with the government before announcing strike days.
Another wave of NHS walkouts would be devastating for the Government’s ambition to cut waiting lists, and undermine the implementation of the ten-year plan unveiled last week.
Sir Keir Starmer's "plan for change" pledged that by July 2029, 92% of patients will be seen within 18 weeks for routine hospital treatment such as hip and knee replacements.
Previous strikes by resident doctors and other staff groups saw some 1.5 million appointments, procedures and operations postponed as a result.
Wes Streeting, the health secretary, has warned that the NHS cannot afford to “return to a continuous cycle of stand-offs, strikes and cancellations”.
The waiting list for routine hospital treatment in England is currently at its lowest level for two years, according to the latest figures, with an estimated 7.39 million treatments waiting to be carried out at the end of April.
The union said that there is "still time to avert strike action" as it urged the Government to "come forward as soon as possible with a credible path to pay restoration".
BMA resident doctors committee co-chairs Dr Melissa Ryan and Dr Ross Nieuwoudt said in a statement: "Doctors have spoken and spoken clearly: they won't accept that they are worth a fifth less than they were in 2008.
"Our pay may have declined but our will to fight remains strong.
"We now find ourselves at a crucial crossroads. Last year when in opposition Mr Streeting said that the solution to strikes was to talk to resident doctors - it was as true then as it is now.
"He made a point of acting quickly to grasp the issue and negotiate a solution.
"Only a few weeks ago he again said he wanted to get back round the table with us.
"Now we will see if he can once again make the right decision - he needs to come forward as soon as possible with a credible path to pay restoration."
There are around 77,000 resident doctors in England who work in various settings from GP surgeries to hospitals.
Resident doctor members of the BMA have taken industrial action 11 times since 2022.
A Department for Health and Social Care spokesperson said: "While most resident doctors in the BMA did not vote to strike, it is disappointing that the BMA is continuing to threaten strike action after a pay rise of 28.9% over the last three years.
"The Secretary of State has been clear that he wants to work constructively with all unions, including the BMA, to improve working conditions for NHS staff and avoid strike action, which can be hugely disruptive for patients."
