Bound AHK hotkeys to flip 1.25x/1.5x and drop in HPI/ROS/PE blocks, which shaved about 8 minutes off a 40‑minute batch, but Word 365 crawls when my med dictionary loads. Anyone have a lightweight, accurate medical dictionary + expander setup (PhraseExpress/Shorthand ok) that stays snappy on long neurology/ortho reports?
Instant Text 7 + a lean custom.dic set has been the snappiest combo for me: I ditched the big add‑in dictionaries and split a about 200k med list into BaseMed (about 55k), Neuro (about 18k), Ortho (about 14k), then only enable the one I need in Word’s Custom Dictionaries. IT7 handles my HPI/ROS/PE blocks without touching Word’s COM layer, so even long neuro notes stay smooth; Breevy was also fast if you want just an expander. Extra win: turn off “check spelling as you type” while drafting and run F7 at the end - cuts UI lag to near zero.
I’ve had the best luck with PhraseExpress + OpenMedSpel as the only Word dictionary, keeping custom.dic tiny and splitting specialty lists into separate.dic files I toggle with AHK; I also turn off “check spelling as you type” while drafting and run F7 at the end, which stops 365 from bogging down. If you prefer Shorthand, keep expansions in small specialty files and only load the set you need per batch for the same snappy feel.
Try OpenMedSpel as the only Word dictionary, keep custom.dic under about 5–10k, and move the big term lists into Shorthand/PhraseExpress — Word stops gasping on long neuro/ortho for me. I also bind an AHK toggle to enable/disable “Check spelling as you type” during heavy expansions, which cuts the stutter. @MayaJobs does that match your split‑dic setup, and how big is your current custom.dic?