Read a thorough text that you find helpful and highlight the important parts. I recommend selected Barash or Yao and Artusio chapters. Annotate with a few handwritten notes too where useful. Then you can review it a second, third, and fourth time much faster than the initial thorough readthrough because you can skip all the nonhighlighted stuff. Reinforce by doing all TrueLearn questions, flagging useful questions and highlighting useful parts of the explanation. Do these in hour long blocks or whatever the same time limit you get for the ITE so you make yourself finish them and you get used to the timing. Again, review the useful stuff only, saving time and being immensely more efficient. I got a 49/50 raw score as a CA-1 and was garbage in the OR and hadn't done a bit of cardiac, trauma, OB, or pediatric subspecialties yet. I say the score not to brag, but to show how an unremarkable resident in the OR can still blow the top off of a multiple-choice exam by studying a lot.