I pay more attention to secondaries. At least they're tailored to our school's prompts.
In our Adcom meetings, our DO faculty will frequently ask to see what the applicants have written about Osteopathy in the secondary.
PS's all gel after awhile.
Most pre-meds place magical powers in PS's as if they alone will somehow get someone an accept.
They don't.
A PS can break you if it's poorly written, has many typos, is full of clichés, has the name of another school in place of ours (I barbecue interviewees over something like this), or telegraph elitism, ego, entitlement or some other pathology. There are people who write it's their destiny to become a doctor, that God ordained it, or that they will engage in some sort of self-harm if not accepted. I am NOT making this up!
I'm sure
@gonnif,
@LizzyM or
@gyngyn can add to this list.