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For O-chem I don't read the majority of the book. I take a brief notes of the chapter being presented in lecture BEFORE LECTURE. These include the chapter and name, each section heading name, and each mechanism name + page number. Then I go to lecture. Then I make a neat copy of each mechanism I need to know, referring back to my notes. Then I do a buttload of homework and take the exam.
For my Orgo I and II prof, I had to since his questions were based directly off the textbook and the exams were written like a Biology (although much harder) test.