PA
Junior doctors and medical students in England have voted to reject the contract that has been offered to them by the government.
British Medical Association members voted 58% to 42% against accepting the deal.
BMA leaders had urged members to accept the terms, which were announced in May after talks with the government resumed following six strikes.
BMA junior doctor leader Johann Malawana immediately resigned.
In a letter to members, Dr Malawana said the NHS was lurching "headlong into a wider crisis" that was of the government's making.
"I only hope that the next government realises that this vote is a demonstration of just how appalling frontline staff have been treated and undermined."
The BMA still has a mandate to take strike action, but it will be up to a new junior doctor leader to decide what the next steps are.
The government has been pushing ahead with introduction of the contract during the voting period. New rotas were due to start for 6,000 newly qualified doctors in August, with the new pay system due to kick in later in the year.
Much of the rest of the 55,000-strong junior doctor workforce are then due to be moved on to the new contract from that point onwards.
Ahead of the result of the vote being announced, senior sources at the BMA had indicated there was little appetite for prolonging the dispute given the climate in the country following the EU vote.
In May it was announced that talks at conciliation services Acas had finally resulted in a deal being agreed to end the long-running dispute, but the union said it would put the terms and conditions to a vote of members.
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