"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all." - William Osler
The first text book I opened was in my second semester of medical school. I stopped attending lecture, and teach myself from the books (i.e. Robbins) and board materials (pathoma, sketchy) only. Supplement with class handouts and podcasts. Been in the top 5-10% ever since (was right around the median before that). I also have much more free time from not spending 4 hours per day in lecture. My golf game has improved quite a bit.