I've been a Wacom user for the lat 7 years but couldn't afford to upgrade to a similar sized Wacom when I needed to change recently. I went for this mid-priced Genius tablet due to its reasonable size, and so far, I'm getting on quite well with it.
The pen is OK, if a little bulky, and the constantly flashing blue 'on' light is a bit of an irritant, but on the whole, it has much to recommend it.
The smart buttons at the top allow you to switch between pen size, volume, zoom and scroll functions, and the left / right hand wheels (depending on whether you're right or left handed!) allow you to change pen size, volume, zoom level or scroll across the page accordingly, which is really handy.
The pressure sensitivity is great, and the drawing area is fine, although it does have a tendency to overlap onto the function keys all around the edge if you stray too far out while drawing.
The drawing surface is harder and slicker than what I was used to on the Wacom, and the pen nib is comparatively thin - but this is only by comparison and I've quickly got used to that. It also comes with a handwriting conversion utility so you can write directly onto the tablet (although I can't see why you'd use this unless you can't type!)
My only real gripe with this tablet is that it does lag from time to time (I don't think it's a deficiency in my system - Win7 64bit with 8GB RAM), meaning that occasionally, the screen is a little behind your actions on the tablet - but only occasionally. The rest of the time it's quite responsive - it's just a little annoying when it happens.
All in all, if you can live with the above, then it's a decent tablet for the price, and a good alternative for those that need a medium tablet size but can't afford Wacom prices.