As I mentioned in my September Challenge entry, when I do my maps I use a combination of AutoREALM (probably Vector?) and GIMP with a tablet laptop (Fujitsu Lifebook T Series)

Generally the process is:

#1 Stick in all the big features (land, rivers, etc)
#2 Export into JPGs the icons available in AutoREALM (because I don't know how to export the individual icons in AutoREALM so I could use them as brushes in GIMP)
#3 Build a number of layers in GIMP to deal with the different sections of the map (oceans, landscape, roads, structures, map-notes/labels)
#4 Tweak around by inserting layers and fidgeting with their interplay to get the effects I want. Fidget with colouring,etc.