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Tony Mowbray has resigned as manager of relegated Championship club Birmingham City to focus on his health.
The 60-year-old, who had been on sick leave since February, informed the club he would stand down with immediate effect in a bid to ease Blues' rebuilding plans for the start of the new League One season in August.
Blues co-owner Tom Wagner said: “We are disappointed that Tony will not be coming back to lead the team forward but respect his decision to put his health and his family first."
Mowbray, who succeeded Wayne Rooney in early January, won four of his eight games in charge before temporarily stepping down in February.
He then took a full medical leave of absence in March, at which point his assistant Mark Venus also stepped down, allowing former Blues boss Gary Rowett to return.
But Birmingham failed to stay up and Mowbray now wants to "focus on making a full recovery from his surgery and spending time with his family".
Wagner added: "In a short period of time at Blues Tony demonstrated excellent leadership skills and a work ethic that galvanised all around him. He is an outstanding human being and will always be welcome at St Andrew’s."
Although sad to lose the vastly experienced and much respected former Hibernian, West Bromwich Albion, Celtic, Middlesbrough, Coventry City, Blackburn Rovers and Sunderland manager, Blues chief executive Garry Cook expressed his gratitude to Mowbray for coming to such a big decision so soon.
“We have been looking forward to Tony returning to the club and to continue the great work that he started earlier this year," said Cook.
"Unfortunately, it is not to be. Preparation for the new season has already begun and Tony told us that, based on his treatment and recovery programme, he would not be able to do the job that is required before the new season begins.
"I would personally like to commend Tony for informing us of his decision so soon after the end of the season.
"It provides us the opportunity to undertake a rigorous search process to identify the right leader to take our club forward."
Former Burton Albion, Blues, Derby County, Stoke City and Millwall boss Rowett may still be a contender for the job, having lost only three of his eight games in charge after his late-season return as interim boss.
Analysis from Richard Wilford, BBC Radio WM sports editor
Tony Mowbray’s decision to step down permanently from his job at St Andrew’s feels like the final exclamation mark of a season that promised much and ended in frustration and relegation.
One of football’s great enthusiasts, you can only hope he is back to full strength again soon.
He was a breath of fresh air when he arrived in January, with his customary positivity and his ability to bring the best out of all around him.
Birmingham City’s form perked up significantly, and the back-to-back wins over Blackburn and Sunderland in February hinted at a run to Championship safety.
Owner Tom Wagner and CEO Garry Cook may well have viewed Mowbray as exactly the right character to confront the challenge of League One, a path he has trodden successfully before.
Now they find themselves looking for a new manager again - a fourth appointment in 12 months after Rooney, Mowbray and Rowett.
It is one they need to get right, although they will not want to deviate from their desire to see attractive, progressive football being played.
With the eye-opening plans for the future of Blues, it is a very enticing job for an ambitious coach. But it will come with an instant pressure to succeed.
