I see that the the general consensus is of : you'll only get out as much as you put in. But few of us have offered you actual practical suggestions.
i had a similar experience on the first couple of weeks when i started on the wards. here are some things I did that really helped me become pretty damn slick at what i do now
1) pre round yourself - or even better, with fellow student
even if only mentally. go through the list of patients. check out their diagnosis, and look at the investigations ordered. read through the admission notes and see what the impressions of the admitting doctor were. do you think they'd missed anything. was there anything you hadn't thought of yourself? see what the results of investigations are - and take a mental lottery game of which results your seniors will be most interested in. if you've got a good memory, you might even try remembering them so that when boss asks on the round "what was the creatinine?" you can just chime in with the answer. try and think of what else might be useful tests or investigations, and think about "what does this patient need to do to go home from here?", and with that in mind, think of what questions might be asked to the patient on the round.
2) do something useful on the round -
if you just stand, you will invariably fall asleep. have you ever stood in a lecture about hawking radiation, and black hole related phenomena for Ph.D physics students? well probably not, but i guarantee you'll fall asleep there too. Anything which you have little understanding of, and little to contribute, and little interaction will make you fall asleep. i mean how do you fall asleep in the first place? "by staying very still and not doing anything". similarly, in theater, stand up straight and ask about anatomy, ask if you can hold something else, ask if you can close the skin at the end. if you can't think of anything else, ask the surgeon if he has kids, what ages they are, and what he does with his spare time. ask him how he got into surgery - they always have an interesting story. you have to be proactive. dont be afraid. at the end of the day, he's just another human being - and if he doesnt like you, its not the end of the world. so get out of kindergarten already.
if you're rounding - then ask to hold the notes, ask to write in the notes, ask if you can be the one to come back and take the blood test, or replace that IV line, or do the LP or measure the serum rhubarb. the problem is that you've probably been spoon fed for sometime at university - but at some point you have to start being independent too. but they won't load it on you unless you ask for a little, and build up some trust. start with small odd jobs. once they know you can do those and not screw it up, they'll let you do more interesting stuff.
when i did my cardiothoracic run, all i got to do initially was clerking, preadmits, catheters, iv lines, and abg's, plus all the little paperwork. but by the end of the run by building up respect and trust, i was putting in chest drains into unstable patients. it didn't happen overnight. i had to earn that privilege.
3) when the patient has some interesting clinical sign, or feature on the round = ALWAYS make a point to come back and examine them yourself, and demonstrate the sign yourself. if you don't think youll have time. do it on the round itself. take that extra couple of minutes. chances are you will be able to find the team again once they leave the patient. but if you don't take the opportunity to elicit important clinical signs, it may not be there later (as is often the case). as with pre-rounding, bringing a friend really really helps. you will both learn, and it helps to have someone critique your examination technique.
4) when it comes to dividing up jobs for the day. volunteer yourself to do some stuff.
5) im not sure how your system works. but one of the most effective ways to learn is to see sick patients yourself, and admit them to hospital, write up a good set of clinical notes, with a good problem list and a plan of action. figure out when your team or unit is 'on call', or admitting patients, and then hang out and ask to see patients first. always get your senior to just 'cast an eye' over them to make sure they are not distressed, or in pain, or need urgent assessment/intervention. once the patient is stable, your seniors will always appreciate you to come in take the history + examination, do a good thorough job, and buy them some time to do other more pressing stuff. that way, they can come back, review your story - ask any questions you've missed, and not have to go through it all again. it might be a 2hr job for you at first... but for them, its 20 mins, and they wont notice how long you take, especially if they've got plenty of other stuff to sort out.
6) similarly, for patients you DONT admit yourself. always listen to a handover, or patient summary, and try and make a quick 3 liner about the patient, preliminary diagnosis and management plan etc.
e.g 56 y.o gentleman, known coronary art. disease, presents with chest pain, clinically stable, with no signs of heart failure. he has a sig. troponin rise, but no ECG changes. he's commenced on LMWH for NSTEMI.
7) if you still arent learning anything - sometimes you have to appreciate when to just go away, and do something more productive like hanging out with your friends, or watching a movie, or even studying. take the opportunity while you can
