Junior doctors in England have announced a second round of strike action for four days in April.
The British Medical Association (BMA) said members will stage a 96-hour walkout from 11-14 April, in an escalation of a row over pay and conditions.
A 72-hour strike at the beginning of last week resulted in thousands of operations being cancelled.
The union said it is “with frustration” that they are taking further action, as they accused ministers of “still refusing to make a credible offer – or any offer at all – to resolve our dispute”.
The BMA are arguing for pay restoration to 2008 levels – equivalent to a more than 30% raise.
Other NHS strikes have been paused following a 5% pay deal with unions representing thousands of frontline staff including nurses and paramedics.
While Health Secretary Steve Barclay said he would meet with the BMA, the union claimed he added “unacceptable preconditions” to pay talks, forcing them to go on strike again.
Dr Vivek Trivedi and Dr Robert Laurenson, co-chairs of the BMA junior doctor committee, said: “It is with disappointment and great frustration that we must announce this new industrial action. The government has dragged its feet at every opportunity.
“It has not presented any credible offer and is refusing to accept that there is any case for pay restoration, describing our central ask as ‘unrealistic’ and ‘unreasonable’. Even yesterday they continued to add new unacceptable preconditions to talks instead of getting on and trying to find a resolution. “
The co-chairs said they have “no confidence that without further action these negotiations can be successful”, adding the situation is “entirely of the government’s own making”.
“We want to spend our time looking after patients, not on strike. But with an NHS buckling under a workforce crisis, and four in ten junior doctors looking to leave, we can’t stand by while our pay is further eroded by inflation and an intransigent government,” they said.
“We are not going to stop until we are paid what we are worth, and if ministers don’t accept that when we tell them in person, we will have to tell them from the picket line.”