It's the criteria that are stupid, not the people (e.g. program coordinators) interpreting them.
It's not PC's faults that Dean's letters include a magical secret code to help us decipher what degree of a wonderful special flower a med student is.
If the dean's letters just said "this is an average graduate" or "this is one of our top 10 students this year", then the criteria would be more plain.
But we live in a world where students' egos are too fragile for that.
So instead there is a meaningful distinction between the words "excellent" and "outstanding". The PC is often the person with the best grasp of the code, as he/she reads so many apps year to year.
Yeah, but aren't those "magical codes" the result of class rank / GPA anyway? From what I've been told, dean's letters use those words depending on where you were in your class rank. So if someone was in the top 5%, it would say "excellent" and if they were in the bottom 5%, it would say "satisfactory." So really, what is the point? The programs already have your grades on the transcript and for some (most?) they have class rank already too. And even if they didn't, the dean's letter would tell them your class rank. So what's the point of needing a secret code?
There is a lot of redundancy built into the process, and the people overviewing these applications, rather than independently coding the pieces of information to a non-degenerate set of credentials (preclinical grades, clinical grades, board scores, research, funding/publications, medical school reputation, humanitarian ECs, hobbies), are using them summatively.
AOA (is supposed to [but often does not]) reflect purely the transcript. Therefore, if someone has an "AOA-worthy" transcript but no AOA, they should be treated just the same as AOA. AOA in and of itself is just signaling, nothing more than that. It should make it easier for them to scan the transcript, but not be used as an added credential when it is nothing of the sort.
If anything, I've observed at my school how AOA is a political POS and how people get in because they were on student government or because their spouse/fiance(e)/boyfriend/girlfriend was on junior AOA. And I've also seen how perfectly qualified students who came off of LOA (e.g. year off for research, graduate school, etc.) are discarded like radioactive waste even if their transcript is eminently "AOA-worthy."
Likewise, if you get a reward for your humanitarian work, it should just be used to help the reviewer see that you were involved in humanitarian work and then they can evaluate for themselves the value of it. Adding the reward to the EC itself is basically double-counting.
And as for the secret code, please don't get me started. That depends on the competence of the dean writing the letter. I've seen some idiotic letters and they're mostly because the dean has not carefully reviewed the CV and transcript and is instead using AOA and other signaling mechanisms to benchmark the "outstanding" applicants rather than conducting an ab initio analysis.