The British Medical Association has decided to ballot doctors for industrial action over the government's reform of the NHS pension scheme.

The ballot will be the first time that doctors have voted on such action since 1975.

The decision followed an overwhelming rejection by doctors and medical students of the "final" offer on pensions.

The BMA said the changes would see younger doctors paying more than £200,000 extra over their lifetime in pension contributions and working eight years longer, to 68. The highest earning doctors' contributions would rise to 14.5%.

Officials have urged the government to reopen talks with the health unions, but said neither the Treasury nor the Department of Health had signalled any change to their position.

The health secretary, Andrew Lansley, has said the NHS pension scheme is "amongst the best available anywhere".

But a survey of 130,000 BMA members in January found almost two-thirds of the 46,000 who responded said they would be prepared to take some form of industrial action if the government did not change its offer.

The BMA formally became a union in 1971, and has only taken industrial action in 1975, when consultants suspended goodwill activities and worked to contract over a contractual dispute.

Leaders of a teaching union rejected the changes to public sector pensions on Friday, in a further blow to the coalition's hopes of ending the long-running dispute.

The executive of UCAC, which represents thousands of teachers, headteachers and lecturers in Wales, warned that the option of further strikes remained open.

The union leaders, meeting in Aberystwyth, said they wanted to negotiate further with the government, and would step up their campaign alongside other unions to press for improvements to the offer.

The general secretary, Elaine Edwards, said: "We consulted with members before coming to a decision, and the message has come back loud and clear: the government's offer is totally unacceptable and teachers and lecturers are prepared to take further action to secure a fairer deal."