I've become fond of a few methods as I studied for the USMLE Step 1. I'd recommend using them in the following order:
- Stop. Think. Predict.
- Question-directed searching.
- Answer-directed searching.
Question-directed searching. This strategy is the preferred method by Drs. Walker (Tips for Taking the USMLE) and Dimov (How to Do Well on Boards). Basically, read the question first and look for clues to help guide you. This spares you the frustration of a "bait and switch" question where you read a long stem only to discover that the question is asking you about a basic science topic that's minimally relevant to the stem. I've never ran into this particular scenario myself, so I prefer to read something the way I read a novel -- skipping to the end cheats you out of the pleasure of figuring things out.
Answer-directed searching. Sometimes, you have no idea what the question is asking. Sometimes you have no idea how to guess what the answer is. I've learned a little lesson from Sesame Street. It's called "One of these things is not like the others." :) This proves that ignorance is bliss. Sometimes you can get the right answer even if you totally ignore the question and just look at the answers, isolating the one answer that's different from the others! It might be a drug from a different class than the others or a diagnosis that accounts for that one weird physical finding noted in the stem.
If you've got any other ideas, let me know. I can't think of any other ways to read a question and answers other than top-> bottom, bottom->top->bottom or just bottom...