I can model almost anything in MED. A 3-story complex, taking out the time to draw the textures (creating them, not applying them), it could take me maybe 10 to 20 minutes. Creating the shape of a staircase takes me but 2 minutes (heard of copy paste)? It takes a while to get used to, but I can work wonders with MED. The MED in 6.40.4 (public beta) has several new features. The only experience I lack with MED is animation as I haven't figured it out fully yet. When building levels, it is important to stick with the scale (my tutorial explains this) for all objects in the level.
From benchmarking experiments I've run, the optimal polygon count for maximum performance is from 2000 to 5000. So, in short, build your models using pieces that are in this size range for the best shapes possible and the highest frame rate. My city world (version 5 of it) had 2388 buildings, a beach, water with waves, clouds, and roads. Although it was getting 20 fps, I didn't know the trick for performance. Nowadays, if I optimized it, I could easily get past 60 fps, even 100 and that's without LOD.
This is the best screenshot (from September 2005). All objects you see are nothing but models. I'm now creating the base map of the city world version 6 which will be much more life-like, again, using nothing but models.
For some side notes, don't use the scale feature. It is very inaccurate and I've run across this issue many times myself. I just manually move the vertices (and in 6.4x, you can type in exact positions). If you want it to snap to the grid, click the >|< icon and set the move snap to something other than "off". In many of my cases, 32 at the highest end is too small. 6.4x's MED allows not just powers of two and values beyond this, but screwy values as well (like 3 and 15.625). You can't get much more precise than that....