Renoise

If you grew up with MED, or OctaMED*, you should give Renoise a try: version 1.9 is everything that a good tracker should be, with VST instruments and an intuitive interface.

If it's good enough for Aaron Funk/Venetian Snares, it's good enough for me (5.1MB MP3, inspired by watching the Assembly 2007 demos, especially LifeForce from Andromeda).

* I had a flashback the other day, while thinking about colour schemes, to the feature in MED that let you set a completely customised colour scheme per song.