i'm still a 4th year and need practice, but here's my advice:
1. i think a neurosurg rotation may be a good one - my impression is that they really don't care about anything but the brain, so you would get to cut skin, drill the skull, and then suture as much as you want.
2. things you can do to make yourself look slick in the or:
-practice palming a needle driver - you can steal a hemostat or something, and practice opening/closing it without putting fingers through the holes
-for a small hemostat, use just the tips of fingers / or just the thumb
-then practice spinning the needle driver in your hand - this allows you to avoid resetting the needle when doing a continous stitch
-you can also practice using the pickups instead of fingers to load the needle - helps avoid needle sticks
3. most important - realize that you will learn eventually, no matter what you do.