1) Bolded the important points. After about a week I quit studying with anyone in my class because people go bat**** crazy. If you study around a lot of people from your class, you WILL become paranoid about the fact that classmate_003 spent 12 hours learning the intricacies of disease_9243 even though there was only a slide and a half on it in class. If you study with him, in spite of the fact that you're a smart person and you KNOW that he's wrong, you will get paranoid anyway and it will make you miserable (and a less efficient studier).
2) Study smart. A transcript (or whatever your note-taking service produces) of a bad lecture is still a bad treatment of a material -- simply because some poor schlub had to transcribe and try and organize it doesn't make it better. You can attempt to memorize every word the scripts (as some of your classmates will), and while that might cut it for phys/histo, that strategy won't work for path for most people. If you study to understand the material, you'll a) be happier and b) do better than ~90% of the people who try to memorize the lecture scripts and slides. There will still be 5-10% who will beat you (because, let's face it, a few professors will ask questions that are essentially "What is the third word of the second line on the 43rd slide of my lecture presentation?" and you'll get them wrong), but as long as you're consistently in the top 10-20% of the class, you'll be in great shape.
3) It's all about consistency. You will probably never get the top score on any exam -- but if you're ~1 standard deviation above the mean on every exam, you will be in a phenomenal position with regard to board knowledge and your class rank. The thing to avoid is letting yourself get caught in a cycle of do really well --> procrastinate for the next one --> do poorly --> study really hard --> do well --> procrastinate... etc.
4) Figure out who writes the questions for every single exam. I know some schools use standardized tests (NBME exams) so this may be less applicable, but at my school, the person writing the test made a huge difference. MDs almost never ask questions that are not relevant to clinical practice (probably because they don't remember the information), whereas PhDs tend to be much more "knowledge for the sake of knowledge" and ask silly details. Figure out whether the course director writes the whole test, part of the test and the lecturers write part, or whether the lecturers write all of their own questions. It's a game -- and half the battle is understanding your opponent.
5) Try and avoid pulling late nights before the exam. Extra study time is almost never worth being sleep deprived because you're so much sharper on a good night's sleep. Whenever possible, I tried to stop studying around ~9pm the night before the exam and have a beer and relax.
6) Have fun. It's a lot of work, but if you're smart about the workload you'll have plenty of free time to relax. Make some friends, continue your hobbies, go to a bar every once in a while. It's not the end of life as you know it.
if you feel like amazon-ing it.
