In case there are other people with the same problem, here is a response I received from our school's director of OSLER:
It sounds like you are in a really good place in terms of content knowledge [told her my score on UWSA]. Given the strength of your knowledge (as demonstrated by the self assessment) my guess is that you are not really picking up a lot of information with the detailed notes. You are likely doing more confirming of what you already know. Not a bad thing but as you have noticed, very time intensive.
A couple of options to speed you up, help you meet your goal of doing more questions but still do the learning if/where it needs to be done. First, I would not take any notes on a questions that you get right. This will be hard (especially with the OCPD tendencies) because you will feel like there is so much good information in the explanations. True, but if you got a question right you knew enough of that information to answer the question. This means that there is very little significant learning to be done. The second thing is instead of writing lots of detailed notes on the things that you miss, read the explanation (without writing anything down) first. Then, boil the explanation down to 2 bullet points – 1) what were they asking me (this may be more detailed than the question stem itself – sometimes you realize they were really asking management of X in a stable vs. unstable patient rather than just management of X) and 2) what is the answer. Those are the things that you want to keep notes on. The process of synthesizing the information in your head will accomplish what the longer notes are helping with and the fact that you have to get every question to two bullet points will help with time and give you a quick reference if you do want to go back to it in your final review in the days immediately prior to your test.
With this process, you should be able to review a module of question (only looking at what you missed) in ~1hour. This will greatly increase the time that you have to spend on questions and help you focus on things that are actually issues rather than everything.
I still don't know if I can skip all the questions I get correct and just review the missed ones... I guess I'll start with just taking notes on the missed questions and see if that speeds me up a bit..
