Scholarship Experience – Returning back home After a Life-changing Experience Abroad:
Dhariana Acon

International Fellowship: Retuning Back Home After a Life-changing Experience Abroad

Report by Dhariana Acon (Costa Rica)

It’s been 3 months since I moved back to Costa Rica after finishing my one-year of Pediatric Retina training at Bascom Palmer Eye Institute (BPEI), Miami, Florida, under the mentorship of Dr Audina Berrocal. I arrived in Miami in March 2019, after completing a 2-year vitreoretinal surgical fellowship at Association to Prevent Blindness in Mexico (APEC), Mexico City.

My year at BPEI was very special in many ways. In addition to the friendships I made while abroad, I had the opportunity to learn Pediatric Retina from a great physician, outstanding surgeon, and natural born leader. Dr. Berrocal is an inspiration to me and to many young female ophthalmologists. She is supportive of her fellows, generous, attentive, and loves teaching. So, having her as a mentor, was a real honor and I could not be more grateful.  I also feel very fortunate because I was the first recipient of the “Marcelo and Liana Ventura Pediatric Retina Scholarship” offered by the PAAO.

When my year abroad was about to end, I started to feel emotional about leaving Miami. I knew it would be difficult due to the emotional attachment I made with Dr. Berrocal and colleagues. However, what I could not predict was how this experience would actually end. Three months ago, the Coronavirus pandemic was not looking any good, flights were getting cancelled, and airports were closing. So, in a very abrupt and stressful way, I left Miami without having a proper farewell nor having time to say goodbye.

As soon as I arrived in Costa Rica, local COVID-19 cases were already starting to appear. The day after my arrival, all borders were closed, and a lot of restrictions were implemented. Having to start my practice in this new and challenging scenario, full of uncertainties and fear, was not easy. We are currently in the third phase of reopening the economy as the spread seems to be under control. Slowly, we are getting back to our daily routines but, still, the way we interact with people, examine our patients and even how we perform surgery, is very different than it used to be, and probably will remain this way. I understand that accepting and adapting to these changes is part of the challenge; so, since I had no choice and could not see patients for a few weeks, I took the time to rethink about my professional goals, plan my agenda and also my practice.

We are fortunate that Costa Rica has a very well-structured national healthcare system. Similar to what most physicians do in Costa Rica, I will work part time in a public hospital and part time in a private hospital. I am already seeing patients and doing surgery in private practice. In the public hospital I haven’t started yet as everything is in standby, there are no clinics or elective surgeries scheduled because all resources are been used to treat COVID-19 emergency in the country. 

Additionally, I consider academics very important, so getting involved with residency training is also in my plans, for now retina lectures are given virtually weekly.  I have noticed that due to Covid-19 most teaching has been done virtually and surgeries are reduced in eye hospitals and that has also postponed my plans. 

Looking back in my training years, I am uttermost grateful for the opportunity I had to live in three different countries: Costa Rica for Ophthalmology training, Mexico for VR training, and the United States for Pediatric Retina training. All of them with different health care systems, resources, dynamics, and cultures. I currently feel that my biggest challenge is to find a way to integrate all that I have learned during these past years to my reality. My reality, in fact, is very different from the one at BPEI and APEC. The resources I have now for caring for children with retinal diseases are different from the ones I trained with. So being creative and thinking outside the box is part of my strategy to innovate and create new forms of improving pediatric retina care in Costa Rica.

Despite the challenges, I am very excited to be back in my country. I am enjoying working with my colleagues, teaching my residents, and helping my people. But most of all, I am extremely motivated to make a change in Costa Rica. As a reminder, every challenge brings us new opportunities, and in my case, I am ready to make the most out of each of them.