From my understanding (2 doctors immediate family and several others extended fam), it can be quite political. Desirable specialties are competitive, whether for lifestyle (dermatology, radiology, etc.) or prestige/interest (things like pediatric surgery).
Once you get into a specialty, the work does not stop, as there are usually progressive tiers of training and additional programs. You might do first 4 years residency in Dallas, then receive your next placement in Chicago for 2-3 years. These would be great locations, for most, from what I gather.
Most aren’t so lucky.
IIRC the surgery fellowship (8 years after graduating undergrad, 4 years after med school graduation) application process gives a list of 10 cities (hospitals) which the intern is interviewing and applying for. They are allowed to rank their top three cities from this list, but there is no guarantee. They will travel to all ten cities and interview at all the programs.
Medicine is great for someone who wants to be in training until they are mid 30s - and that’s assuming you go directly to med school from undergrad.