<There are absolutely a good number of people graduating med school each year (about half in US allo and greater from other tracks) whose only options are noncompetitive fields, the majority of which are primary care. This number will absolutely go up if residency slots are increased to address current needs, or more likely, if US med school ranks continue to rise, more US allo students will simply end up in primary care slots at the expense of non-US hopefulls. I actually wouldn't recommend med school to someone who only wants to do a certain competitive specialty -- the odds aren't that good, and there's certainly a good chance you'll be stuck doing something else. But it's a mistake to look at primary care as a dirty word. There are pluses and minuses to all medical fields, and you may be surprised as to what you find enjoyable and what you dislike.>
Agree for the most part with this, though I don't think the number (of US MD students) who really have no choice but a noncompetitive field is as large as that. It's more like the bottom 1/3 of the class. I guess it might depend on which school you go to also (i.e. bottom half of class @Harvard might still have a chance at a number of specialties). Part of this depends on where somebody wants to do residency also. I mean, if you are willing to do ER or anesthesia somewhere cold and rural, and/or at a resource-poor city hospital, you might be able to get a spot even if you aren't necessarily @the top of your class. Sometimes, though, people decide that they'd rather have a cush medicine or peds residency than go to a bottom of the barrel radiology one, etc. Also, some people start out being gung ho to do some sort of surgery that requires 7-9 years of residency and fellowship, and then realize there's no way in hell they want to stay in training that long, or be relatively poor for that long. So then people switch to wanting to do something like IM, peds or maybe ER.
I DEFINITELY agree with lawdoc that folks should reconsider med school if they would only want one of the very competitive fields like derm, radiology, etc. Just because you have your heart set on being a dermatologist doesn't mean you will be able to, even if you bust your a-- in med school. What people forget is the others (med school classmates) were also in the top 10% of their college classes and not EVERYONE is going to get to be in AOA and/or top 20% of the med school class. If you don't think you'd enjoy medicine in general and be open to a number of different fields, don't go to med school. It's too risky.