I don't think your work experience in industry will be looked upon negatively, probably more of a positive. The key is framing it right - you've spent more time in the hospital/OR than the vast majority of premeds (outside of those coming from nurse, PA, etc), use that experience to show you know what you're getting yourself into. As for shadowing - probably not a bad idea to shadow a couple people outside of surgery. I didn't have much clinical/non-clinical volunteering, but also had a lot of direct contact with patients included as part of my industry job so up to you. I can't understate the importance of absolutely crushing the mcat - will open more doors than anything else. Also, asked two of the docs I worked with for my LOR's so you should be fine there - will likely need the usual science prof. LOR's as well though.