You get to rank each site and say specifically what you would like to have and not have. On the very last sheet of the paper you give to clerkship assignment staff you can write a blurb about what you want most and what you are willing to give up. For me, I said I most wanted internal medicine in Seattle and wanted Family Medicine in Bremerton. I was given my top choices for those. But for surgery, I ranked Harborview number 18/20 and ended up with it. It's a trade off, getting something I didn't want but I got the two top ones I requested. It worked out in the end.
We have a weekend off to travel if needed. For the far distances, you can also take Friday off. So when I went from Seattle to Wyoming, I left on Friday, drove all day Saturday and got there late Saturday night. On Sunday, I started studying, preparing food for the week, and made sure I knew where to go for the next day. You take the essentials with you because the school will provide housing with bedding and stuff for you.
The school provides housing. It isn't always the nicest, but it is enough to give you what you need. In some places it is very much a nice place. For example, I crashed for the night in the Billings, MT housing and it was amazing. Huge house with 6-10 medical students staying there. There was a fridge full of beer that the students just kept contributing to and it was perpetually stocked, perfect for the day before the final studying break. I'm in Bremerton now and I have a single person apartment right next door to another medical student so we can visit each other when needed. It's super nice too with weekly cleaning. When I was in Sheridan, WY the housing wasn't that great, but I also couldn't complain. It was free and within 1 mile of the hospital, perfect for call since I could stay home and rush to the hospital within 5 minutes if needed.