No doubt about it - shadowing can be awkward.
There's a question about space, positioning, what you can see etc. The doctor may or may not interact or point things out to you. The patient often wants to interact with you, which is fine, but the doctor-patient encounter has to happen eventually and you are getting to experience something that is usually private. Podiatry encounters can be all smiles and laughs - if I sense a bit of humor in people we try to turn "unpleasant" events like nail surgery into something more amusing. If people are smiling and laughing - you can to. For awkward encounters, things going the wrong way, things that are failing, people who are having negative events - put a concerned face on and don't talk. In most circumstances you can thank the patient before you leave the room.
There's usually some introductory small talk - hi, oh you want to study feet etc. After that - the big thing is you really aren't meant to be apart of any further discussion. So don't start asking the patient questions about the feet or wound or anything like that. The doctor might after leaving the room tell you what they think was going on or have more to say or they might not. I try to tell students what I'm thinking, but sometimes I have to go room to room and keep moving. Other people are probably better than me about not falling behind, but the simple truth is that when I have a shadowing student or a resident in my clinic - I'm going to be working on notes into the evening. Just the way of it. Anyone with me will slow me down.
I've had a few students ask me if they can shadow me for "weeks" - like they wanted to come out and spend 8 hours a day with me for 2-3 weeks. I suppose that's how you hit 50+ hours or whatever. I personally can't do that. I want to show you some stuff. I'm more than happy to write a letter because I recognize that you have to have it and that its really a formality. But I'm only down for a few mornings or afternoons and ideally not back to back.
Last thing - I always make students watch nail and callus cutting with me. Not sure if other people are trying to hide or obscure this aspect of the practice, but unfortunately you need to see that a substantial portion of many podiatrists practices is performing this service. There are plenty of doctors who think this is all we can do and all we should do. Its variably the worst part of the job, its often gross, no one else does it, and the pay is often exceptionally poor for it. If you are watching a podiatrist cut nails and think "I won't do this, I'm going to be an ankle surgeon". Guess again. The podiatrist who doesn't bust nails is a rare breed. My dad (who apparently has a high opinion of me) awhile back tried to say to me "Yeah, but you won't cut nails". Sorry dad. Wrong!