The first thing I'd to say, is I've recently upgraded from the 1st gen Bamboo to the Intuos 5 and the difference is noticable immediately, the surface area has been changed and has a smoother feel to it than the Intuos 4 and Bamboo 2nd gen.
Nib wear is present but that's all about how hard you're pressing and all the other factors, but I've had no problems. It feels smooth and natural and the included nibs all have different feel when using them.
The rubber around the tablet is nice to feel and the rubber button do require a little pushing in but are not as bad once getting used to them, the on-screen button display when touching the buttons is a nice addition as it doesn't affect work flow in any negative way.
In all the Intuos 5 Medium (Pen Version) is a wonderful product and I will be enjoying the use I will have with it.