I use hotkeys that have been placed into the actual keyboard for closer proximity to the Ctrl, Alt, and Shift keys. Mine go something like this:
[Image: http://img151.imageshack.us/img151/4841/keyboard.png]
The numbers on the keyboard above correspond to the numbers next to your skills in the skill window. Speaking of which, my skill window(s):
[Image: http://img121.imageshack.us/img121/9141/skill1tx.jpg]
[Image: http://img707.imageshack.us/img707/4756/skill2j.jpg]
The 'All' tab is what I use most of the time, it's an all around set of skills comprised of the skills that I use the most, for use with any and all weapons. The 'Combat' tab is what I switch to for the use of certain less frequently used skills when I whip out my bow, namely Mirage Missile since I'm an elf. My 'Magic' and 'Alchemy' tabs are very rarely used so I didn't bother with posting those, but I do switch to them in certain very rare cases, so they DO have their own setup.
The remainder of actions that I take frequently but do not require the use of ctrl-targetting go on my F-bar.
[Image: http://img138.imageshack.us/img138/2388/skillbar.jpg]
The rest of my hotkey setup that isn't shown above already:
q - Switch to the 'All' tab in skills
w - Switch to the 'Combat' tab in skills
e - Switch to the 'Magic' tab in skills
r - Switch to the 'Alchemy' tab in skills
1 - Use HP potion
2 - Use MP potion
3 - Use Stamina potion
4 - Use Feather
Shift + # (1 through 9) - Summon pet.
Shift + e - Pet inventory
Shift + z - Sit pet down
Shift + x - Call pet
This is another reason why I have my hotkeys setup like this; assigning anything to do with pets to a combination of shift + another key makes it really easy to do heavy pet manipulation in the middle of combat, since your skill hotkeys are right there and shift and ctrl are right on top of each other, allowing for fast, efficient manipulation and targetting of pet attacks in the middle of your own attacks.