Can anyone shed light on how big a factor MSPE adjectives at a “top” med school should be when weighing similarly ranked + similarly expensive options?

I truly struggle rationalize why schools like Penn, Feinberg, Stanford, etc. directly compare their own students when these schools already attract incredibly hard workers who will likely crush the demands of med school. Even if their STEP scores, clerkship grades, and narrative descriptions in MSPE letters are great, many students will have to be ranked in lower quartiles than their peers.

Specifically, this research article on the value of narrative descriptions vs final adjectives has me reflecting on the value of the final adjective assessment:

https://pmc.ncbi.nlm.nih.gov/articles/PMC6225414/

Is anyone else in a similar spot of weighing schools with vs without MSPE final adjectives? Specifically, being first-gen in medicine has me concerned about whether I am truly making the best choice for myself. Appreciate any insights!