I've read through a number of threads and the general concensus is that the MSPE/Dean's letter from foreign medical schools does not provide useful information to US program directors. Having said that and being an IMG (med school in Germany), can I say that I'm unable to secure the MSPE from my medical school since I graduated well over a year ago and most of the information required is not applicable as the courses were pass/fail?
Note: The ECFMG website states "If you are unable to secure the MSPE from your medical school, you must indicate this on page 12 of the MyERAS application. A neutral placeholder letter will be provided in place of the MSPE. The placeholder letter will be provided to all of the programs to which you apply, and will state, This is in lieu of an MSPE. This will ensure that your application will appear as complete for those programs that require an MSPE before considering your application."
Note: The ECFMG website states "If you are unable to secure the MSPE from your medical school, you must indicate this on page 12 of the MyERAS application. A neutral placeholder letter will be provided in place of the MSPE. The placeholder letter will be provided to all of the programs to which you apply, and will state, This is in lieu of an MSPE. This will ensure that your application will appear as complete for those programs that require an MSPE before considering your application."