The Medium

The Medium presents an unusually heavy load for a modern mobile platform, and the data for the Intel Core Ultra 7 165H paired with the NVIDIA GeForce RTX 5090 reveals a configuration that is dramatically constrained by its processor. At 1080p, the combination produces playable, sometimes excellent frame rates, but the scaling to higher resolutions exposes a significant bottleneck that prevents the flagship GPU from ever reaching its potential. The benchmark results indicate that this is a pairing where the CPU dictates the ceiling, and the RTX 5090 operates far below its demonstrated compute capacity. This analysis will break down the specific roles of each component, the impact of resolution scaling, and the optimal settings for the measured data.

CPU Role — cores, clocks, and how they relate to this game's results

The Intel Core Ultra 7 165H is a 16-core, 22-thread mobile processor based on the Meteor Lake architecture, with a base clock of 3.80 GHz and a boost clock of 5.00 GHz. It features a 24 MB shared L3 cache and supports dual-channel DDR5 memory with a bandwidth of 89.6 GB/s. In synthetic benchmarks, this CPU achieves a Cinebench R23 multi-core score of 14551 and a single-core score of 1759, placing it in the 84th percentile of all CPUs. Its average benchmark score of 34083 is nearly identical to that of the AMD Ryzen 7 3700X, which trails by only 0.5%, and it is slightly ahead of the AMD Ryzen AI 7 350 by 0.4%. This positions the 165H as a capable mid-range performer in general compute tasks.

However, the data from The Medium suggests that raw multi-threaded throughput is not the primary driver of performance. While the CPU has 22 threads, the game’s frame rate at 1080p Low settings hits 146 FPS, but this is the absolute ceiling observed. The single-core performance, reflected in the Cinebench R23 score of 1759, appears to be the limiting factor. When comparing the 1080p Medium result of 98 FPS to the 1440p Medium result of 83 FPS, the drop is only 15 FPS, which is a mere 15.3% decline. This relatively small drop when increasing the pixel count by 78% indicates that the CPU is already near its limit at 1080p, and the additional GPU work at 1440p does not significantly change the outcome because the processor cannot feed frames any faster.

The CPU’s role here is to prepare draw calls and handle game logic, and its performance ceiling is evident in the fact that the RTX 5090’s frame output is capped. The 16 cores and 22 threads provide ample parallel processing for background tasks and the game’s fixed-function logic, but the 5.00 GHz boost clock cannot overcome the per-thread demands of The Medium’s engine. The benchmark results show that at 4K Ultra, the frame rate drops to 37 FPS, but this is not purely a GPU limitation; it is a combination of the CPU struggling to maintain the simulation rate and the GPU being underutilized due to the low instruction throughput. In essence, the Core Ultra 7 165H is a competent processor for productivity, but in this specific game, it acts as a severe bottleneck, preventing the system from achieving high refresh rates even at lower resolutions where the GPU has ample headroom.

GPU Role — VRAM, clocks, and how they relate to this game's results

The NVIDIA GeForce RTX 5090 is a flagship graphics card based on the Blackwell 2.0 architecture, featuring 32 GB of GDDR7 memory on a 512-bit bus, delivering a staggering 1.79 TB/s of bandwidth. Its boost clock of 2407 MHz and 21760 shading units provide a theoretical FP32 performance of 104.8 TFLOPS. In synthetic tests, it scores 39650 in Passmark G3D, placing it in the 92nd percentile of all GPUs. Its average benchmark score of 79842 is 1.1% ahead of the AMD Radeon RX 6850M XT, indicating that in raw compute, it is a top-tier part.

Given this immense compute power, the RTX 5090 should theoretically obliterate a horror title like The Medium. However, the measured FPS tells a different story. At 4K High settings, the card produces an average of 47 FPS. This is a surprisingly low number for a GPU that has 32 GB of VRAM and 1.79 TB/s of bandwidth—more than enough to handle any texture or asset the game can throw at it. The 32 GB VRAM is never a limiting factor here, as even at 4K Ultra, the game’s memory footprint is far below this capacity. The GPU’s role is to render the scene, and its 104.8 TFLOPS of compute should be sufficient for high frame rates, yet the data shows it is being held back.

The discrepancy between the GPU’s theoretical capability and its real-world performance in this pairing is stark. At 1080p Low, the RTX 5090 delivers 146 FPS, but this is a scenario where the GPU is barely exercised. The card’s memory clock of 1750 MHz (28 Gbps effective) and its 512-bit bus are irrelevant when the CPU is the bottleneck. The Passmark G3D score of 39650 suggests a card that should be capable of 200+ FPS in most titles at 1080p, but the CPU’s single-thread limits cap the output. The GPU is effectively idle for a significant portion of each frame, waiting for the CPU to send new draw commands. This is confirmed by the fact that moving from 1440p High (59 FPS) to 4K High (47 FPS) only costs 12 FPS, a 20.3% drop, which is far less than the 2.25x increase in pixel count would suggest. The RTX 5090 is so powerful that it can absorb the extra resolution without a proportional performance hit, but it cannot compensate for the CPU’s inability to increase the frame generation rate.

Resolution Scaling — how FPS drops from 1080p to 4K and what it says about the limiting component

The FPS scaling across resolutions provides a clear diagnostic of system balance. For the Medium preset, the system achieves 98 FPS at 1080p, 83 FPS at 1440p, and 65 FPS at 4K. This represents a 15.3% drop from 1080p to 1440p, and a 33.7% drop from 1080p to 4K. In a perfectly GPU-bound scenario, a jump from 1080p to 4K (a 4x pixel increase) would result in a 75% or greater FPS drop. Here, the drop is only 33.7%, which indicates that the GPU is not the primary constraint at 1080p.

The Low preset shows a similar pattern. It runs at 146 FPS at 1080p, 132 FPS at 1440p, and 104 FPS at 4K. The 1080p to 4K drop is only 42 FPS, or 28.8%. This is surprisingly efficient for a 4x resolution increase, confirming that the CPU is the limiting factor across all resolutions. The GPU has so much headroom that even at 4K Low, it can render the scene quickly, but the frame rate is still capped by the CPU’s ability to issue draw calls.

The High preset shows a drop from 70 FPS at 1080p to 59 FPS at 1440p (15.7% drop) and then to 47 FPS at 4K (32.9% drop from 1080p). The incremental drop from 1440p to 4K is 12 FPS, which is 20.3%. This is a larger relative drop than the Medium preset’s 21.7% drop from 1440p to 4K (83 to 65 FPS), suggesting that as settings increase, the GPU begins to exert more influence, but the CPU is still the dominant bottleneck. The Ultra preset confirms this, with a drop from 56 FPS at 1080p to 47 FPS at 1440p (16.1% drop) and 37 FPS at 4K (33.9% drop from 1080p).

The data uniformly suggests that the system is CPU-bound in all scenarios. The RTX 5090 is capable of rendering these scenes at much higher frame rates, but the Intel Core Ultra 7 165H cannot provide the necessary frame data. The FPS drop from 1080p to 4K is consistently around 30-34%, which is characteristic of a CPU bottleneck, where the resolution increase only adds a minor burden to the GPU, which is already waiting for the CPU. If the GPU were the limiting factor, the 4K FPS would be closer to 25% of the 1080p FPS. Instead, the 4K FPS is roughly 70% of the 1080p FPS, proving that the processor is the ceiling.

Settings Recommendations — which preset gives the best experience per the measured rows

Based on the measured FPS data, there is no single "best" preset, as the optimal choice depends on the target resolution and the user's preference for visual fidelity versus smoothness. The data shows that the Medium preset offers the most balanced frame rate with the only complete min/max data provided.

At 1080p, the Medium preset delivers 98 FPS average with a minimum of 84 FPS and maximum of 113 FPS. This is a highly playable range, with the minimum still well above 60 FPS. The Low preset at 1080p offers 146 FPS, but this comes at a visual quality cost that is unnecessary given the 98 FPS on Medium. The High preset at 1080p drops to 70 FPS, which is still playable, but the 28 FPS loss from Medium is significant for a marginal visual improvement. The Ultra preset at 1080p yields 56 FPS, which is below the 60 FPS threshold and introduces stutter into a game that requires smooth motion for horror atmosphere. Therefore, at 1080p, the Medium preset is the recommended choice, as it provides a 60+ FPS minimum and a 98 FPS average, which is the best balance of smoothness and quality.

At 1440p, the Medium preset produces 83 FPS average with a minimum of 70 FPS. This is the only preset at this resolution that maintains a minimum above 60 FPS. The High preset at 1440p yields 59 FPS, which is just under the 60 FPS line and may cause noticeable drops. The Low preset at 1440p gives 132 FPS, but again, this is overkill. The Ultra preset at 1440p drops to 47 FPS, which is not recommended for a smooth experience. The Medium preset at 1440p is the clear winner here, as it offers a 70 FPS minimum and 83 FPS average, providing a solid high-refresh experience without dipping below playable levels.

At 4K, the situation is more constrained. The Medium preset delivers 65 FPS average with a minimum of 55 FPS. This is the only 4K preset with a minimum near 60 FPS. The Low preset at 4K gives 104 FPS, but this is a visual downgrade that is not ideal for a game with a strong atmospheric focus. The High preset at 4K yields 47 FPS, and the Ultra preset drops to 37 FPS, both of which are below the 60 FPS target. For 4K, the Medium preset is the only viable option for a playable experience, as it has a 55 FPS minimum, which is acceptable for a slow-paced horror game, and a 65 FPS average.

Overall, the Medium preset is the recommended starting point across all resolutions. It provides the most consistent frame rates, with minimums that stay above 55 FPS even at 4K. The data indicates that the system cannot reliably handle High or Ultra settings without dropping below 60 FPS at 1440p and 4K, and the CPU bottleneck means that choosing a higher preset does not translate to better frame pacing. For a game like The Medium, where tension relies on smooth camera movement, the Medium preset’s frame time consistency is more valuable than the visual extras of High or Ultra.

How This Combo Ranks — use comboRankInGame vs other tested combos

In the database of tested combinations for The Medium, this pairing of the Intel Core Ultra 7 165H and NVIDIA GeForce RTX 5090 ranks 548th out of 2911 total combos. This places it in the top 18.8% of all tested systems, which is a respectable position, but it is far below what the GPU alone would suggest. The RTX 5090 is in the 92nd percentile of all GPUs, and the Core Ultra 7 165H is in the 84th percentile of all CPUs, yet their combined performance in this game only lands in the 81st percentile of combos.

This ranking indicates a significant mismatch. The 548th rank out of 2911 means that there are 547 other combinations that perform better, many of which likely have less powerful GPUs but more capable CPUs for gaming. The data shows that the RTX 5090 is being wasted in this configuration. The GPU’s nearest rival, the AMD Radeon RX 6850M XT, has a lower average benchmark score (78940 vs 79842) and is 1.1% slower, but if that GPU were paired with a stronger CPU, it could potentially outperform this combo in The Medium due to the lower CPU bottleneck.

The combo rank is a direct consequence of the CPU limitation. The Core Ultra 7 165H’s average benchmark score of 34083 is only 0.3% higher than the Intel Core Ultra 5 338H, and it is 0.5% slower than the AMD Ryzen 7 3700X, a desktop processor from several generations ago. In a game like The Medium, which is sensitive to single-thread performance, this CPU cannot unlock the RTX 5090’s potential. The 548th rank reflects that the system performs like a mid-range gaming rig, not a flagship one. The 2911 combos are likely dominated by desktop CPUs and high-end mobile parts that do not have the same bottleneck. This pairing is an example of a GPU that is three tiers above the CPU, resulting in a system that cannot achieve its intended performance class. The data clearly shows that the combo’s rank is held back by the processor, not the graphics card.

FAQ

Q: What is the average FPS at 1080p with Medium settings, and is it smooth?

A: The measured average FPS is 98, with a minimum of 84 FPS and a maximum of 113 FPS. This is a smooth experience, as the minimum frame rate stays well above the 60 FPS threshold, ensuring no significant stutter.

Q: Why does the RTX 5090 not deliver higher frame rates in this game?

A: Benchmark results indicate the system is CPU-bound. The Intel Core Ultra 7 165H has a single-core Cinebench R23 score of 1759, which limits the frame generation rate. The 4K FPS is 65 on Medium, which is only 33.7% lower than 1080p, showing the GPU is not the primary constraint.

Q: Is the 32 GB VRAM of the RTX 5090 beneficial for The Medium?

A: No. The game does not require that much memory, and the data shows no frame drops related to VRAM capacity. The 32 GB is never a limiting factor, as the bottleneck is the CPU’s instruction throughput, not memory allocation.

Q: How does this combo rank compared to all tested systems in The Medium?

A: It ranks 548th out of 2911 tested combinations. This places it in the top 18.8% of all systems, but it is a lower rank than expected given the GPU’s 92nd percentile standing, due to the CPU bottleneck.

Q: What is the best preset for 4K gaming on this system?

A: The Medium preset is the only playable option at 4K, delivering 65 FPS average and a 55 FPS minimum. High (47 FPS) and Ultra (37 FPS) presets drop below 60 FPS, which is not recommended for smooth gameplay.

Q: How does the CPU compare to its nearest rival in general benchmarks?

A: The Intel Core Ultra 7 165H has an average benchmark score of 34083, which is 0.3% ahead of the Intel Core Ultra 5 338H and 0.5% behind the AMD Ryzen 7 3700X, indicating it is a mid-pack performer in synthetic tests.