Almost 300 public hospital doctors could refuse to do tasks that do not directly affect patient care from Monday.
Members of the Australian Salaried Medical Officers Federation ACT will strike for better pay after the government "would not budge" during negotiations, union president associate professor Jeffrey Looi said.
ACT Health Minister Rachel Stephen-Smith has defended the government saying negotiations did not reach agreement in the remaining term of government and a further pay deal was not proposed.
Professor Looi said protected industrial action would include stoppages such as not answering calls outside rostered hours and refusing certain administrative duties.
"We're not doing anything that endangers patients. It's more about limiting the contact with the employer," he said.
Out of about 1375 doctors in the public health system, professor Looi said 58 per cent voted on a pay deal offered by their employer, the ACT government.
He said 86 per cent of doctors who voted rejected the enterprise agreement, for the first time in two decades, because their wage increase of "just over 2 per cent a year" did not match the cost of living.
He said doctors would be worse off in terms of "real world wages".
Professor Looi said low wages failed to attract doctors to Canberra, exacerbating "the worst" staffing shortages, overworking doctors and ultimately risking patient safety.
"You can't get doctors from other states to come because [the pay] doesn't even look competitive. If we can't have that parity, people just won't take jobs," he said.
"It's not safe for the public because there's not enough doctors. We don't want there to be shortages. [It's] reflected in some of the problems that people experience with waiting times."
The union and government have had about 30 meetings to negotiate a deal.
A senior doctor employed by Canberra Health Services, speaking on the condition of anonymity, said: "Given what [doctors] endured during the pandemic ... more than two thirds have voted to reject the [pay deal] for the first time. It's unprecedented. [The government] did not negotiate at all."
An ACT government spokesman said it had continued to negotiate to find positive outcomes for doctors. He also said the strike would not impact patient care.
"This has included making an offer of a shorter interim agreement, which would have allowed already agreed provisions and pay increases to be locked in ahead of the caretaker period which commenced on 13 September 2024," the spokesman said.
The union president said a temporary agreement was accepted after their enterprise agreement expired in 2022 in "recognition of COVID circumstances".
"As far as we knew, we were still in the midst of a pandemic. We were convinced the [interim agreement] was supposed to be a temporary one," he said.
"Emergency staff, mental health services, others in pediatrics and community care ... everyone was coming into work and looking after patients. That's our job. We get up every day to do that, we love it, but this offer from the government is greatly disappointing."
Ms Stephen-Smith said the rejected enterprise agreement had proposed a pay rise between 8.1 per cent for senior staff specialists and 13.6 per cent for interns, with backpay, and a one-time $1250 cost of living payment.
"This would mean by December 2025, senior staff specialists would have had an annual base salary of $274,696 not including penalty rates and other attraction and retention payments, and interns would have had an annual base salary of $88,485 not including penalty rates," she said.
"Negotiations conducted in good faith on a new MPEA were unable to reach agreement during the term of government and on advice from the Fair Work Commission the government put the proposed MPEA to ballot.
"This ballot was unsuccessful and discussions on a way forward in the remainder of the term of government did not result in a further proposed MPEA being put to ballot."
She said ACT Labor wanted to ensure health professionals in public health services were among the best paid in the country.
"We look forward to continuing to work with bargaining representatives on this important matter should we return to government," the minister said.
An ACT government spokesperson said the bargaining team was restricted during the ongoing caretaker period and could not make commitments that would bind an incoming government.
"Good faith bargaining will continue once a new government is in place," he said.
