In the United States, Railroads use Simplex frequencies in the 160-161mHz range.
There are radio towers spaced along the right of way. Some railroads use the same AAR Channel across their whole division, and some railroads have different channels for each main track.
Dispatchers are located at centralized offices. These offices usually dispatch for several different main lines, or in the case of Union Pacific or Burlington Northern, their centers dispatch for most of the country.
They are able to talk to the trains that are in their district by using a touch screen computer to select which tower/towers they want to talk/listen on.
When listening to railroads, sometimes you might hear DTMF tones, this is the train "toning up" their dispatch. The nearest tower then makes the corresponding button on the touch screen to blink, and the dispatcher then knows which tower to select and talk on, saying something like" UP Omaha Dispatcher answering Benton tower, over"
Then the train and dispatcher talk.
There are no repeaters being used by the train crews. this way they leave their radios on 1 channel, and they dont have to keep changing as they move along the track. When they stop to switch cars, the conductor uses his hand held radio to talk to the locomotive (usually less than a mile, easy for a 5w HT)
Steven