I can imagine my MSPE served close to nothing but still tried to arrange for it to adjust as far possible as it could to AAMC standards. That is, my dean agreed to scale numbers into some common used terms in the US (superior, outstanding, this sort of thing); mention of my track record for leadership activities upfront; and at the end, in spite of not having a class percentile distribution, they included my placement on national exams, with charts and stuff that could be appealing.
Far as I know, nothing was lost with that document; probably it had little value anyways, but moreso depending on its release date (and to add to what Splik said, the release date was after 80% of my interview invites, so, yeah).
And to further add to Splik's words, no matter how thick the MSPE, and high the step scores....you should land rotations and superstrong LORs and research (and then some) in your field and places of interest. And also be down to earth-ish....I don't mean not applying to MGH, etc., but certainly also
applying to other places. Coming from a country with a lot of focus on going for the US, I can tell you I've seen people do 4 wks at yale and landing surgery the match after that, and people doing rotations, 1-2yrs research at NYP-CUMC and MGH and still no luck.