I goto PUMS, and from what i understand actually everyone gets a letter from the dean, yes its a almost purely fill in the blank; but honestly no one in the states is going to give a damn about that letter. They know exactly the level of credibility has, so its best to depend on letters of recommendation from your clinical rotations. If you get a recommendation from your target location well all the better no? Anyway this is what the upper years tell me GL...