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I would say right now that there is in fact broad variation in competence in the medical profession. You can see from the average medical licensing exam scores of different specialties that the best MDs tend to go into opthalmology, dermatology, and neurosurgery, whereas the worst ones go into family medicine and psychiatry.
About a year ago I had a rather severe case of mononucleosis, and was sick for about a month. I went to my primary care provider after having a 102F fever for about five days straight, but all the tests they ordered were negative, including the test for Epstein-Barr (though that particular test has like a 30% false negative rate), and they weren't able to give me a diagnosis. After the fever dragged on for ten days I went to the ER, where the resident suspected a cyst in my liver due to elevated enzymes and ordered a CT, along with a huge number of other tests. The next day I was seen by an infectious disease specialist, who suspected mono. Eventually a more accurate blood test confirmed the diagnosis. My health insurance covered everything, but in total my ER visit and 1 night stay in the hospital cost the insurance company about $18,000. There was no intervention except to rest, so I chose to go home. The fever went away like two days later.
Hilariously, my friend who's an anesthesiologist and medical school professor gave me the correct diagnosis before I went to the hospital. He advised me to go to the ER just to be safe but suspected mono, despite the initial negative test result. We've collaborated on research and I know him to be exceedingly competent, but this episode just reinforces in my mind that there are significant differences in the competence of physicians.
There definitely need to be more residency openings to keep up with demand, but part of that problem is that Americans are just so unhealthy compared to other developed countries. Japan has an older population, about 3/4 as many doctors per capita, yet they seem to be doing somewhat better.
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