Junior doctors and medical students across England have voted to reject a contract deal between the British Medical Association (BMA) and the Government.
In a blow to the BMA, which had encouraged doctors to agree the new terms, 58% voted against the proposed contract while 42% voted in favour.
Some 68% of those eligible turned out to vote on the deal - some 37,000 junior doctors and medical students.
Following the result, Dr Johann Malawana, head of the BMA's junior doctors' committee, announced his resignation.