Snezana Ivanova, who was based in Liverpool, was a charming young surgeon with unwavering integrity and a deep sense of commitment to providing the very best care for her patients. She had an unusual gift and passion for surgical teaching. Snezana was born to Trajan Ivanov and Venka Ivanova in the town of Vladevci, in the Strumica valley, Macedonia, the older of two children. Her parents were farmers. She attended the Kosta Susinov Gymnasium in Radoviš from 1980 to 1984 and showed early promise as an outstanding student, receiving the honours diploma and prize for excellence in 1984 for the extraordinary feat of achieving ‘A’ grades in all 18 subjects. She went on to medical school at the Saints Cyril and Methodius University of Skopje, qualifying in 1990. She worked as a house officer at the University Hospital, Skopje under A Peev and V Gavrilovski between June 1990 and July 1991. Snezana had a burning desire to train as a surgeon. Through serendipity, her local parish priest in Strumica introduced her to Pierre Guillou, then at St Mary’s Hospital, London. She did her initial clinical attachments with Guillou between January 1993 and January 1995. For the next five years, between February 1996 and May 2001, Snezana worked as a senior house officer in various hospitals in England and Wales. She became a fellow of the Royal College of Surgeons of England and of Glasgow in 2000. Keen to get on a surgical registrar training rotation, Snezana worked hard to improve her academic credentials. She was appointed as a research fellow in 2003 in the academic surgical unit, St Mary’s Hospital, London under the supervision of Ara Darzi, where she successfully completed her MD dissertation. Her research focused on molecular biology of pancreatic cancer. Snezana was awarded the certificate of completion of basic surgical training in 2006 and her MD in 2007. Snezana had a great interest in hepatobiliary surgery and liver transplantation, which she pursued as a clinical fellow at the Royal Free Hospital, London under Brian Davidson and Dinesh Sharma between 2004 to 2005 and at King’s College Hospital from 2015 to 2017. Snezana’s real wish was to train as a liver transplant surgeon. Snezana Ivanova worked with steadfast devotion to the NHS. She would sit through her lunch break daily to go through the dictated letters for accuracy. On more than one occasion she confided in me how much pain she endured in her hands while operating as she developed neuropathy secondary to platinum-based chemotherapy. Snezana continued to teach when she could no longer endure the demands of clinical work. She had strong values, always put patient first and would never shirk from reviewing patients, even if it was in the middle of the night. She was popular amongst the nurses and had a strong reputation for her dedication and commitment to patients, and for being reliable and conscientious. Snezana had a passion for teaching and took a particular interest in the MSc students she supervised at St Mary’s Hospital. She frequently taught on the Royal College of Surgeons’ basic surgical skills course and was a clinical examiner for third year medical students at the Royal Free, St Bartholomew’s, the Royal London and St Mary’s hospitals. She enjoyed teaching on the master clinicians mock clinical and viva for the MRCS at North Middlesex and St Bartholomew’s hospitals and on the Manchester MRCS course. She had a special interest in women in surgery, contributing to the Royal College of Surgeons of England careers day for women. Snezana Ivanova never married. She enjoyed life outside surgery, reading and occasionally writing poetry. She loved paintings and arts and culture. She absolutely adored flowers and would always joke that if she could not do surgery she would sell flowers! Snezana loved gardening; she especially liked lilac trees and white daisies. She had a particular way of telling tales and jokes and had an infectious laugh. She was fond of plays and musicals, and enjoyed the vibrancy that London offered. She was an avid Chelsea fan and a museum enthusiast. She had a flair for languages and was fluent in Macedonian, German and Russian. She enjoyed swimming and making soap sculptures. She had recently ‘re-discovered a talent for basketball’. Snezana had a few striking character traits. She had a strong sense of ethics. She abhorred the art of expediency, instead doing only what she thought to be right and refusing to do what she thought was not the right thing to do, sometimes at great cost to her. She always and steadfastly refused favours and did not ask for favours, insisting that any career progress or appointment to training positions be purely on her merits. A very close friend has described Snezana as ‘…a very knowledgeable and adept adult woman with the heart of an innocent young child, with a rare, irreproachable spiritual freedom that few acquire’. She was suddenly diagnosed with advanced ovarian cancer in April 2016 and underwent neoadjuvant chemotherapy and debulking surgery at Hammersmith Hospital. She would take the train from Liverpool to London, where she would get chemotherapy, rest, teach at the Royal College of Surgeons, before returning home to Liverpool by train. After initially responding to treatment, her cancer recurred and did not respond to further chemotherapy. She became very knowledgeable about her condition and was sometimes unhappy with certain aspects of her care. She felt trapped in a clinical trial and believed this contributed to her being denied access to PARP (poly [ADP ribose] polymerase) inhibitors, which she understood could have had a beneficial impact on her. She had initially sought treatment at the Royal Marsden, but I remember when she called me in tears after she was denied treatment there on grounds that she was not a British citizen. Her protests that she was a permanent resident and had been employed by the NHS for over 20 years fell on deaf ears. She found this to be a particularly insensitive and painful betrayal by an organisation she so dutifully served. One of Snezana’s enduring regrets was not having had an opportunity to train in a surgical training rotation, despite having seemingly met all the requirements. But this did not detract her from her devotion to her patients, to surgery and to teaching. Her brother Bogdan, who survived her, likened her achievements to having ‘…climbed Mount Everest alone, without any preparation, any help and any special equipment. And she did it by her great talent and devotion at the expense of a family life’, forged by a ‘very smart mind and a clean soul’. Snezana lived her ideal to the very end, coping with her terminal suffering with great stoicism and dignity. She died in her apartment in Liverpool on 19 January 2018, less than two years after her diagnosis. She was 51. Despite all her suffering, a close friend remarked: ‘She had a heart of gold and would often do things to help others without people ever realising it. They do not make many like her these days.’