On the languages side of things, Spanish a.b. will definitely be easier than German SL. This is because it is an ab initio class, therefore is targeted at students who have no prior knowledge of the language - it'll be much easier than Standard Level language, ergo you'll have a higher chance of getting a 7 for languages if you went w Spanish ab.
To do medicine, HL chemistry and biology are more than enough. If you really do enjoy physics SL, then I'd say go with it but prepare yourself for a shedload of work in Y13. But tbh, your 3 HLs are already perfectly more than enough to get into medical school. I recommend taking the easier route ie SL pyschology & Spanish ab initio, therefore you're likely to get higher overall IB points. You already have the necessary subjects for medicine, now you should focus on getting the highest possible points. It's a point game, and at the end of the day that's the determining factor of whether you get into university or not. SO i defintely would recommend taking the easier route, and aiming for higher points.