Its a great book but very dense. I would try reading 5-10 pages a day during clerkships and try to make multiple passes through it during your clinical year. Consider annotating from other resources if you find some pearls. SUTM was my core resource for my medicine and surgery shelf exams as well as USMLE Step 2 (along with UWorld).
do questions on the shelf/step2 focus on diagnosis and treatment? example: recognize a disease from the question stem then answer a question about diagnosis and treatment
They tend to focus primarily on diagnosis, pathophysiology, less so on management/treatment (which is more Step 3 oriented I believe). Try looking at the sample NBME questions online.
For both the clerkship and Step 2, I used the book in conjunction with UWorld and MKSAP for Students. I read the entire book, highlighting and writing in my own notes from UWorld/lectures. I reread it once for Step 2. Worked pretty well for me.
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