You are looking at the AMCAS rules for narrowing down your acceptances to one by April 30
We get it over with in TMDSAS on Match Day (this year it’s Feb 14).
All Texans will come out of Match Day with one school, or sometimes, with zero schools (no match).
If you matched to your fave, you’re done.
If you matched to a school you ranked below #1, you might wait on WLs a bit longer
As
@texasvandy clarified below, a Texan will come out of Match Day holding One TMDSAS school.
If you're a Texan who applied to AMCAS schools as well, you still have to follow their rules to narrow down to one by April 30