99/99 is worthless nowadays. A ton of FMG's have 99/99, while the people who are teaching anesthesia were by far not the best and brightest in their generation (so they say that the scores have little relevance for them). I have seen cases where people with barely passing scores were hired on completely non-professional criteria, then graduated, even got fellowships, and predictably failed their anesthesia boards, too.
Chances of getting anesthesia as an American citizen who did her medical school abroad are slim; the programs will rather take foreigners. The logic is that the foreigners are among the best and brightest in their countries, while the American FMG's don't exactly qualify under the same criteria.
Doing a surgical internship, instead of a medical one, was dumb IMO. It would have been a good fallback, she would have needed only 2 more years of internal medicine to get board-certified. Many anesthesia programs love taking internal medicine grads, plus a surgical internship is not only harder but teaches fewer useful things for anesthesia.
Anyway, she needs to do something clinical, otherwise nobody will take a chance with her. Ideally, she should get a position in a university hospital that has a big anesthesia residency which is known for taking FMG's. For example, as a "PA" in an university ICU that has anesthesiology attendings. It doesn't matter what you know, but who you know. Good luck!
By the way, why this obsession with anesthesia? The specialty is in deep ****. With a 99/99, she could get into a good program in another specialty and then a good fellowship.
P.S. I would not do another surgical internship. If any, I'd do a medical one this time.
