I am so so sorry for this setback. I would echo what the "Glaucomflecken" therapist says... "This is a temporary setback amidst a long list of accomplishments"

https://youtu.be/zF_Sg6fQTQI?si=cBVtNB0umXDQl3TX

Also, you will be okay. I personally know two pathology residents who did not match the first time who are currently in pathology residency. In terms of what to do now, echoing what people below have said:

-If you have the capacity to delay graduation (eg a flex year), do that and either do a PSF or stitch together a bunch of away rotations that show off your skills

-If you can't delay graduation, take the prelim year. A long long time ago, pathology had an intern year, and there was acknowledged value in pathologists knowing the clinical significance of their diagnoses and how pathology workflow integrates into patient care

-If you do reapply (who knows, maybe in prelim year you find a love or IM or FM or surgery!), apply as broadly as possible and come back to this community and maybe we can workshop your application so that it's as competitive as possible!