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How come when I run the spell check, it never adds words that I want to add after repeatingly telling it to?

ex. PIPs, MCPs etc.

It has trouble with mixed-case words, but should add others. The examples you gave are all mixed-case, so that may be the issue.

Remember, it only adds words to the computer you are on at the moment. It doesn't add them to the server.

Yes, looks like mixed-case words...

any solution?

Don't use mixed case words.

Sorry. I agree that this is a real PITA, especially with the advent of tall man text (e.g. predniSONE, or my personal fave GOlytely) which are inserted automatically by the prescription writer and cannot be corrected. In your example you could try "MIP s" or "PIP s" as a work around.