The Irish Medical Organisation (IMO) has said that proposals being put forward for a new Croke Park deal will not be accepted by its members.
As talks between unions and government officials continue, the IMO says it hasn't ruled out walking away from the negotiations.
At the centre of talks this weekend is a proposed pay cut for those earning more than €60,000 a year and changes to premium payments and working hours.
Steve Tweed, Director of Industrial Relations at the IMO, said their presence at the negotiations shouldn't be taken for granted.
"I'm not ruling anything out," Mr Tweed said.
"That includes reaching an agreement with the Government, or at the other end of the spectrum, not reaching an agreement with the Government."