Nuance has released a Medical version of Dragon Dictate http://www.knowbrainer.com/NewStore/pc/viewPrd.asp?idproduct=472&idcategory=14 that includes all the medical vocabularies of the Dragon Medical PC version. Unfortunately they left out the ability to have a non medical user profile making it the best product yet for medical dictation on a Mac but not good for personal E-mail etc. It appears to be the best offering to date though.