Obviously many input devices are available for PC's which offer reconfigured keys and buttons. (My favorite is the expensive but unequaled http://www.chproducts.com/retail/mfp.html from CH Products) Many of these also provide GUI's or scripting environments for more finely grained customization, and there are yet more standalone options (eg AutoHotkey) which can be used for far-reaching customization of game input.
Once the time and / or money has been invested in selecting from these tools and devices and setting them up, it's sheer torture to return to a plain old keyboard and mouse for game input, yet even that comparatively primitive combination offers vastly more options for interface input than console controllers.
Now, I have great respect for the clever UI designers who have squeezed from the limitations of console controllers well-crafted UI's. Nonetheless, when multi-platform games force PC users to live with the same limitations enforced by console hardware, because the UI has not been redesigned with PC's in mind, the sacrifice forced on PC players is both nonsensical and maddening.
Truly, a robust hotkey system is not difficult to incorporate into a game. By robust I mean that it leverages the standard input hardware of the PC (and, by extension, the many aftermarket devices and tools available for the PC) to provide the user with options commensurate with the number and variety of keys and buttons available on a standard keyboard and mouse. Modal keys (Control, Alt, etc.) are great, and multiply the number of key layouts usable by a player significantly. They also come in both left- and right- versions. Yet too many games ignore the multiplicative power of hotkeys, or do not provide differentiation between, for example, left-shift and right-shift. It's true that pressing right-shift is difficult with one hand when that hand is anchored in the WASD portion of a keyboard (though no more difficult than pressing, say, F9, which often is a hotkey option in such games). However, the aftermarket devices and tools discussed above make the physical layout of standard keyboards purely optional. Keys can be reassigned, or have been moved into a more ergonomic arrangement, etc. So enabling a robust selection of hotkeys and combinations actually empowers users to customize their own interface far beyond the limits of a standard keyboard, let alone a console controller. (When you get right down to it, ANY key can be used as a modal key; this functionality is not difficult to include in any game.)
Of course, letting the user select from a robust set of hotkeys and combinations is wasted if few in-game events can be hotkeyed. So let me get right down to it: please give us PC users more than a "favorites list" for items and spells, scrollable with a d-pad. Let us hotkey them, many of them.
I realize that the 'ready spell, THEN cast spell' system used for Oblivion may have been designed with gameplay in mind, and not just console-input-device-limitations. I can't fathom that any PC user would not prefer, however, to use instead one of the spell hotkey mods available for Oblivion, which allow a spell to be cast with one step, rather than two.
So. Let us hotkey the World Map. And the Local Map. And twenty, no, 30 spells. And as many swords, cuirasses, staves, scrolls, shouts. Let us hotkey them with Left Control - Right Alt - F12. Let us hotkey a ridiculous number of things. Because we will, and enjoy the game more, with less pausing, and scrolling, and clicking.
PC's are great. Let's use em to their full potential.
P.S. This is a longshot, but nonetheless: Have you considered http://www.naturalpoint.com/trackir/ compatibility?