Family doctors will not be given a pay rise this year, the government has announced.
GP pay has proved controversial
They are the only group in the public sector to receive nothing in this year's pay round.
Health Secretary Patricia Hewitt said GPs were already well rewarded, and their profits had soared by 50% since a new contract was introduced.
GP leaders said the announcement was a "grievous insult" to family doctors, and warned many may leave the NHS.
Hospital consultants are to get a flat rate raise of £1,000 per year, while trainee doctors will receive £650.
This adds up to an average 2% pay boost when the pay awards come into force.
The pay deals, decided by pay review bodies and accepted by the government, also give dentists a 2% pay rise.
Nurses, and other healthcare professionals, are to receive 1.9%.
The awards are to be staged, with 1.5% to be given in April and the remainder in November.
But GPs are the only NHS staff to be given no increase.
The decision comes after the Health Secretary told the BBC News website in January that the amount of profit GPs could make under the new contract, introduced in 2004, should have been capped.
Since the deal started, average GP pay has passed the £100,000 barrier.
The BMA said doctors had performed well on targets to improve quality, which was tied to income under the contract.
But Dr Simon Fradd, a former negotiator with the BMA, has said the team were stunned by how good the deal being offered was.
Announcing the pay deal on Thursday, Ms Hewitt said: "GP profits are estimated to have increased by more than 50% since the introduction of the new contract.
"This has come with significant improvements in the quality and range of services for patients, but I welcome that the review body has recognised that GPs are well-rewarded for the work they do."
But Dr Hamish Meldrum, chairman of the BMA's GP's committee, said it was a "black day" for general practice.
"This is a grievous insult to GPs. A zero increase equates to a pay cut.
"For the second year running, not only will GPs get nothing to keep up with the cost of living, they will still have to meet all the annual increases of running their surgeries including paying their staff."
He said GPs had worked "flat out" to deliver top quality care.
Dr Meldrum added that the announcement, combined with a cap on pensions announced previously could cause GPs to leave the health service.
"It would not surprise me if many GPs feel they should cut their losses and leave the NHS. This blow will be the breaking point for many and that will be a dire loss for patients."
Dr Jonathan Fielden, chairman of the BMA's consultants' committee, said the senior doctors would be "angered and demoralised" by the flat rate awards.
He added: "It will be extremely difficult for them to feel motivated to innovative and improve patient care in a service that yet again fails to recognise their huge contribution to the NHS.
Steve Barnett, director of NHS Employers said the awards were a "pragmatic settlement", adding that staged increases would be seen as sensible by employers facing financial pressures.