Intensive talks between the Medical Defence Union (MDU) and the Department of Health resume this morning in a bid to resolve a dispute over an insurance malpractice scheme.
If agreement is not reached this week on who should pay for past claims yet to be settled, consultants will reduce hospitals to emergency cover from next Monday.
This is likely to affect more than 40,000 patients who will have their surgery and out-patient appointments cancelled.
While talks are going on between MDU and Department of Health officials in Dublin, parallel talks will be held in London, involving both parties' insurance or technical representatives.
The Irish Hospital Consultants' Association (IHCA) will meet MDU officials in Dublin this evening to assess progress.
However, both the MDU and the Department of Health have said they will not be discussing the detail of the talks.
The IHCA has already warned the British-based MDU that, if they do not play their part in resolving the dispute, the consultants will embark on a media campaign in Britain to ensure that all MDU members are aware of the issue.
This dispute arose after the Department of Health introduced a new enterprise liability scheme. The MDU, which covered consultants in the past, said it may not be able to cover historic liabilities and offered €60 million to the Department of Health to take on the liabilities.
The Department of Health has said it could not accept this, as the liabilities could be far greater than €60 million.
Yesterday, the IHCA said an agreement on historic liabilities was the only thing that would defer next week's industrial action.
Mr Finbarr Fitzpatrick, general secretary of the IHCA said the Department of Health had left it far too late to address the problem.
IHCA members had a policy of not taking industrial action, he said, but this time consultants had been left with no alternative. "Minister Martin has a week to decide if he wants to go down in history as the Minister who pushed consultants to the brink and beyond. And that's a direct challenge to him," Mr Fitzpatrick said.
A spokesman for the Minister said Mr Martin was hopeful that agreement could be reached and that the stepping up of industrial action would not happen.
Meanwhile, the IHCA said consultants would not be dissuaded from industrial action by reports that their pay might be docked if the action goes ahead.
"That may or may not happen, but it's not a factor," Mr Fitzpatrick said.
He also rejected claims that IHCA was leaving itself open to legal action because it was not a registered trade union.
Mr Fitzpatrick said the union was recognised under part two of the Trade Union Act of 1941 and had immunity from prosecution under the 1990 Industrial Relations Act.
"We haven't the slightest concern about that," he said.