I can tell you, I've read a few dozen applications at my program and I do read all the comments in the evaluations.
When you have so many you have to read in a limited time, you start to categorize the applicants. Most applicants have good reccomendations with no specific glaring problems. If a glaring problem occurs, I mark it for further consideration. Remember there's a lot of applicants and problems on an evaluation do stand out.
When I mark the application, I double-triple check everything. The problem may have not been as bad as I originally thought when I consider the context, or if it seems out of place given the applicant's other evaluations, I consider it may have been an example of an unfair evaluator, instead of a bad applicant.
I had a horror situation. I wanted to do a radiology elective at a place that had PET scans & fMRIs because the future of psychiatry may incorporate more of these scans in clinical use.
So I called a nearby hospital and ask them if they have them. They say they do and I'd be able to check them out during electives. (I was of course naive to think a local community hospital could possibly have a PET scan--cut me some slack I was a medstudent then.)
Turned out the hospital gave me the wrong information, and the radiologist I was assigned to was one of the biggest pimps I've ever met. The guy kept grilling me everyday on stuff that nothing to do with psychiatry "e.g. what is digoxin?-I answer correctly, what plant does it come from?-digitalis--got it right, then he asks me where does this plant grow--I don't know and he starts screaming at me.
I went through 1 month of that hell, and it had no benefit for me learning-wise. Then he wrote a very bad evaluation because I couldn't answer his pimp-no clinical relevance questions.
When I went through interviews, all the interviewers mentioned how great my evaluations were. I noticed that they did read the radiologist's evaluation and it had a mark on it. I brought it up. They responded something to the effect that since that's the only one and its out of context with the others, they weren't worried about it at all.
As mentioned above, be prepared to defend any problems mentioned. If the Dean's letter mentioned a deficiency--that's more extreme since the Dean is considered to have had a longer, more complete relationship & had time to evaluate that student for 4 years.
