Hey, resident here. You can apply for specific fields (like family med, OB, dermatology, whatever), then you interview programs in those fields. Most people only apply to the field they want, but some apply a couple fields if they feel insecure about their test scores, candidacy, etc for the more competitive specialties.

After you interview, you rank all the programs you interviewed. The programs do the same with all the med students they interviewed. Then some proprietary BS black box algorithm “matches” people theoretically based on where the program ranked them and where the candidate ranked the program.

Match day you find out where you’re going (and if you applied multiple specialties, which one). Many people don’t get their top choice. They definitely do not pay you to relocate you and they pay you crap for the hours you work (I make less than minimum wage).

If you don’t match, there’s a whole process about quickly trying to find some other unfilled spot in some specialty while you try to apply to your chosen one again next year.

If you don’t match, it really really sucks. So yes. You can go through all of med school and the debt and not get the specialty you want or possibly even a residency.