The experiences will be highly variable, depending on school, students rotation selection, student initiative, etc.
Some hospitals simply will not let medical student write in the chart ... I think in one state, the state board of medicine prohibits hospitals from letting students (MD or DO) write in the chart (inpatient setting) ... Although I do not know if this is true, just a rumor, or my misunderstanding (new jersey)
I was fortunate to have an excellent clinical experience ... All my core rotations as a 3rd year student were at places that have acgme residency programs (except psych and peds). My core surgery rotation was at a large level one trauma center and I participated In a few trauma alerts. Definitely wrote my far share of surgery notes. My medicine rotation was at a large hospital with its owns acgme IM residency. I was expected to see, do the h&p, write daily progress notes, and present every single day ... And participate in overnight call (when the residents and students used to do 30 hr calls). My peds and psych rotations were split between inpatient and outpatient settings, and I worked with FM residents rotating on those rotations. And I didn't have to be proactive to get these experiences. A good school will offer these experiences by default. Now not all the rotation sites will be great or hands on, but the majority should be. With the rapid expands of DO schools (new schools and increase class size), sometimes I wonder if clinical education gets the short change. You can talk about modern lecture halls, pbl vs lecture based curriculum, free laptop vs sim lab, how awesome a match list is, etc. but clinical education is something that DO schools need to pay more attention to. And while students should be proactive, the school should at least help or make it easier.
But this issue is nothing compare to offshore MD schools. With so many students, a guarantee rotation in the US is not guaranteed. And you have to make sure all your rotations are green book approved else you run the risk of not being able to be licensed in some of the states. I have heard nightmare scenarios from former med students from the Big 3 with regards to last minute changes to their clinical rotation(ie., finding out that the medicine rotation will be done in a suburb of Chicago instead of NYC only a few days before the rotation is suppose to start, or being offer a peds rotation at a non green book rotation, with no other alternatives unless that student wants to wait, not enough spots for students to rotate through,etc)
