When I was a resident, I prided myself on being super fast. On the busiest rotations, I always managed to leave at a reasonable time. These are some of the tips I have for those of you who want to be as speedy as me:
1. Never do something twice. If you have something that needs to be written, only write it once. That refers to writing orders, or if you're doing an H&P, take notes from the patient on the actual H&P form. If you can help it, never use a scrap paper as an intermediary.
2. Multitask: If you're making a phone call, you should also be writing a note and eating lunch at the same time. If you're only doing one thing, you're being too slow.
3. Don't get too caught up on details. If you leave something minor out, the patient won't die. But you might be at work till midnight every day if you obsess over leaving something out. Remember that there's an attending, a pharmacy, and a nursing staff to catch mistakes.
4. Checkboxes: Is there anything checkboxes can't do? If you make checkboxes for everything you need to do on Mr. Smith, you won't be searching for his chart 30 minutes later when you realize you forgot to order his AM labs.
5. Interrupt patients. If you don't know how to redirect a patient properly, you will never leave work ever again.
6. Talk fast. Nobody's listening anyway, so you may as well say what you need to say as fast as possible.
7. Show up late to conferences. If you show up on time, you'll be staring at the wall for a guaranteed wasted 15 minutes and also look like a total loser.
8. Never show up early. To anything. Especially to work. I've noticed that when I come in earlier, I end up just doing everything more slowly and finish at the same time.
Most important though is to learn when you need to not go too fast, even when things are crazy busy. Like when an opportunity came up for education, either being on the giving or the receiving end, I'd always make time.