I would also keep in mind though that if you don't match, you will most likely have to do a different specialty, considering PM&R will probably be completely filled again. It's only one year. I would consider ranking some advanced positions last and sticking out a year of long-distance relationship if needed. A year of long distance is entirely doable and would not be the end of the world for most relationships. I guess it just depends how comfortable you feel in getting a categorical spot (if you have a lot of interviews with programs that have a lot of categorical spots it could easily be fine, particularly if you are a strong candidate), and how willing you are to take the risk of not getting into PM&R. However, I'm always the "better safe than sorry" type!