The best way is:
Read the Big Robbins sections along with your classes (so it is in manageable chunks) and then look at RR Path and Goljan audio from that point on. After the initial read, it should only be used as a reference.
I agree with this. These are all just my opinions, but this is my own personal experience:
-Big Robbins is especially tailored for success in pre-clinical classes due to its level of detail, and often lays things out in ways that make integration and connections easier. Plus its a pretty easy read for being a path book. I made sure I read the Big Rob chapter for each system as we went through. It sounds like a lot but when you break it down like that it is hardly anything on top of your workload.
-RR Path isn't going to help you in classes since its so distilled. And annotating in RR path when you're in immersed in your preclinical classes, you can fall into the trap of adding TOO MUCH minutiae and detail, since its what most classes accentuate but is largely irrelevant for the boards. And really, reading RR path 9 months before your boards isn't going to do jack for you. You're going to forget it all.
-Now, when you're starting to actually GEAR UP for board studying (whether its 5 months or 3 months or 6 weeks before the test), Goljan is golden. But when it comes time to start listening to Goljan audio and familiarizing yourself with the RR path book, you are
not studying for class. You are doing boards studying,
in addition to studying for your classes.
Maybe I just feel this way because the points of emphasis in my preclinical classes had such a large disconnect from USMLE-type questions. Some schools do better than others at focusing exams to be more boards-representative. Ours it wasn't even close. If you used just board materials to study for class exams, you'd fail because they didn't have the minutiae needed in class. If you tried to add class material to boards resources, you'd quickly be unable to separate the forest from the trees. The only way I could really cope was to completely disconnect the two. Studying for class meant pounding esoteric facts, random statistics, and ****. Studying for boards meant big picture, recognizing patterns, and integration.
