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Gift for Picky MOH?

Hey All, 
I figured I'd pick your collective brains a little because I'm having trouble trying to find a good gift for my slightly picky MOH.
My little sister is my MOH, and unfortunately I have no idea what to get her for a thank-you gift. She's a tomboy through-and-through, and has no use for "typical" bridesmaid gifts. She won't wear any jewlery, has no use for make-up bags or jewelry boxes, has more water bottles and coffee mugs than I can count, and doesn't need another tote bag.

Currently, she's in school to become a physician's assistant and she works on a rescue part-time as an EMT. Medicine is her real passion in life, and she's 100x more comfortable walking around the ER in scrubs than she is in her role as bridesmaid. I've thought about getting her something medicine related, but unfortunately, she already has 2 really nice engraved stethoscopes and a full trauma bag. Past that, it seems like personalized medical stuff starts getting kind of tacky. :(

I can't even go and get her something new to replace old and worn-out things that she's loved to death because she's very resistant to change, and will instantly have me return the new item.

Any suggestions, guys? I'm really running out of ideas and time!

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