Glad for the lively debate about shadowing, and I think there are good points on both sides. I think the problem boils down to, as my baseball nerd friends say, SSS- small sample size. Were you there when it was unusually busy/quiet/understaffed? Did you just get paired with the one resident who was sane/insane/friendly/awful/Pollyanna/negative/dorky/critical/awkward/hated by everyone in the department? You really can't know for sure. I will say that you will probably at least find out about the things that DON'T work in the department- even if you somehow come in on the one day where the radiology reading system is working fine, you better believe someone is going to take the opportunity to complain to you about how it never does.
Still, I have to say, I've found them all to be valuable. Culture is very important to me, and it's the best way to get a feel for that. Had one place where everyone was working to keep up the pace, very high-strung, no-nonsense, no time for questions, get **** DONE. Had another that was loose, friendly, residents and attendings joking around with nurses and techs, everyone knew each other's names. Again, could have just been a good or bad day, but unless you've got a reason to expect some extreme stress or happiness in the group, I feel comfortable saying that was somewhere close to a normal environment. I also learn a lot about the attending-resident relationships; I had one experience where I saw the attending basically kicking back and letting the Resident and Intern handle everything (and aside from coming to him with a couple questions, they did have it handled), while other places had more of a back-and-forth conversation. Just learning about the role you'll be expected to fill. Finally, it may seem a little silly, but I want to know how much of a pain in the ass the charting system is. I am very happy to see a smooth, fully integrated EMR, and I am irritated to see a system that everyone hates, or token EMRs that are there to meet government requirements while all the real work grinds along in paper charts.