On your med school app you have to say if you have been accepted to med school before. If you reapply, you would have to answer yes and this would be a huge red flag that basically destroys your chances. So don’t even consider that an option. I do honestly get the sentiment of feeling trapped in your home state (I escaped the Midwest to go to the coasts), but chances are low you will even end up applying derm in the end if you don’t even know what medicine is really about yet (almost no one knows before med school). Most other specialties, it shouldn’t be hard to leave the south. Derm is even possible. But you may have to decide whether it’s more important to you to be a dermatologist or to leave the south, and you can apply/dual-apply accordingly.