I have a “bad” habit of not faking interest in stuff such as OB or Peds, particularly when having to do random scut work for no reason, and as a result had a pretty mediocre MSPE although it didn’t have any professionalism issues. On the other hand I did realize this wasn’t doing me any favors so I turned it around in residency and had great LORs as a result. Did you get whatever issue you had corrected?
I’m pretty sure all programs required it for Heme/Onc and I imagine GI is the same. I will say that of the 13 interviews I had, only a single interviewer from a single program EVER asked “hey what’s up with your awful MSPE and then glowing residency letters?” Not to say others didn’t read it but I ended up matching pretty well.