The Medium

The Medium, a fixed-camera horror title built around dual-reality rendering, presents an unusually demanding workload for the Intel Core Ultra 9 290K Plus paired with the AMD Radeon RX 7900 XT. Measured results across four presets and three resolutions show a system that can deliver smooth gameplay but requires careful tuning, as the gap between Low and Ultra settings is substantial. The data indicates that this combination is capable of high refresh rates at 1080p, yet struggles to maintain playable frame rates at 4K on the highest preset, making settings selection the single most important factor in the experience.

Settings Recommendations

The measured FPS data clearly points to Medium as the optimal preset for this CPU-GPU combination across all tested resolutions. At 1920x1080, Medium delivers an average of 101 FPS with a minimum of 86 FPS and a maximum of 116 FPS, which provides a comfortable margin above the 60 FPS threshold while maintaining visual fidelity above the Low preset. The 1440p Medium result of 85 FPS (min 72, max 98) remains smooth, and even at 3840x2160, Medium holds an average of 67 FPS with a minimum of 57 FPS, which is just shy of a locked 60 but far more acceptable than the alternatives.

High settings are a compromise that does not pay off. At 1080p, High averages 72 FPS, which is 29 FPS lower than Medium. The drop from Medium to High at 1440p is 24 FPS (85 to 61), and at 4K it falls 19 FPS (67 to 48), pushing the experience below playable thresholds. The visual uplift from Medium to High is rarely worth such a steep performance penalty, especially in a game where the dual-world mechanic already taxes the GPU heavily. Low settings offer the highest frame rates—161 FPS at 1080p, 136 FPS at 1440p, and 107 FPS at 4K—but the visual degradation is severe, and the game’s atmospheric horror relies on lighting and texture detail that Low largely strips away.

Ultra is not viable with this hardware. The 4K Ultra result of 38 FPS and the 1440p Ultra result of 48 FPS are below standard playability, and even 1080p Ultra at 57 FPS lacks the headroom needed for consistent frame pacing. The data suggests that Medium is the sweet spot: it preserves enough graphical quality to respect the game’s art direction while keeping frame rates high enough for responsive gameplay. For users prioritizing a locked 60 FPS at 4K, the measured 57 FPS minimum at Medium indicates borderline performance, so dropping to 1440p Medium (85 FPS) is the safer recommendation.

FAQ

Q: What is the best preset for a smooth 60 FPS experience at 1440p?

A: Medium is the only preset that guarantees a comfortable margin above 60 FPS at 2560x1440. The measured average is 85 FPS with a minimum of 72 FPS, whereas High drops to 61 FPS average and Ultra falls to 48 FPS. Low reaches 136 FPS but sacrifices significant visual quality.

Q: Can this system handle 4K gaming in The Medium?

A: At 4K, the Medium preset averages 67 FPS with a 57 FPS minimum, which is playable but not locked. High drops to 48 FPS and Ultra to 38 FPS, both below standard thresholds. Low achieves 107 FPS, but the visual trade-off is substantial. The data indicates 4K is only viable on Medium or Low.

Q: How does the 1080p Ultra performance compare to 1080p Medium?

A: The Ultra preset averages 57 FPS at 1920x1080, while Medium averages 101 FPS. The difference of 44 FPS represents a 77% performance increase for Medium, suggesting Ultra’s additional effects are disproportionately expensive relative to their visual impact.

Q: What is the minimum framerate recorded for this combo?

A: The only minimum FPS values recorded in the data are for the Medium preset: 86 FPS at 1080p, 72 FPS at 1440p, and 57 FPS at 4K. These minimums indicate frame pacing stability, with the 4K figure being the only one that dips close to 60.

Q: Is the CPU or GPU the limiting factor at 1080p Low?

A: At 1080p Low, the system reaches 161 FPS on average. This high figure suggests the GPU is not fully saturated, as the Radeon RX 7900 XT’s benchmark scores and the game’s rendering demands indicate a GPU-bound scenario. The CPU’s 24 cores and 5.80 GHz boost clock provide ample headroom.

Q: How does the 4K Low preset compare to 4K Medium?

A: Low averages 107 FPS at 3840x2160, while Medium averages 67 FPS. The 40 FPS gap shows that Medium’s increased texture and shading work has a significant cost at 4K, but Low’s 107 FPS is far above what the game needs for smooth playback.

GPU Role

The AMD Radeon RX 7900 XT is the primary driver of performance in The Medium, given the game’s heavy reliance on GPU-side rendering for its simultaneous world presentation. The GPU’s 20 GB of GDDR6 memory on a 320-bit bus provides 800.0 GB/s of bandwidth, which is crucial for loading the two overlapping camera views that define the game’s signature mechanic. The 5376 shading units and 84 ray accelerators handle the dual-reality compositing, though the measured results show that even this high-end card cannot sustain Ultra settings at 4K.

The GPU’s clock behavior is notable: a base clock of 1387 MHz and a boost clock of 2394 MHz, with a game clock of 2025 MHz. The benchmark results for the card—such as a 3DMark Steel Nomad DX12 score of 5623 and a Passmark G3D score of 29009—indicate strong raw performance, yet the game’s 4K Ultra average of 38 FPS suggests that The Medium’s particular rendering path is exceptionally demanding. The 20 GB VRAM is likely not the bottleneck, as even at 4K the game’s texture loads should fit within that capacity; instead, the compute load from rendering two scenes per frame is what drags performance down.

The GPU’s 55th percentile ranking among all GPUs, based on its average benchmark score of 13745, is misleading in this context. The nearest rivals in the benchmark database—the AMD Radeon 660M, NVIDIA RTX A2000 Mobile, and AMD Radeon RX 570X—are all far less capable cards, yet they have similar average scores due to the inclusion of older DirectX tests. In The Medium, the RX 7900 XT’s actual measured performance shows it is capable of 161 FPS at 1080p Low, proving that the card has ample power for less demanding settings. The issue is that Ultra settings at high resolutions require more than the card’s 51.48 TFLOPS of FP32 compute can deliver in this specific engine.

How This Combo Ranks

The Intel Core Ultra 9 290K Plus and AMD Radeon RX 7900 XT combination ranks 451st out of 2911 tested combos in The Medium, placing it in the top 15.5% of all configurations. This rank is respectable but not elite, reflecting the game’s punishing GPU demands rather than any deficiency in the CPU. The CPU itself is a top-tier part—its average benchmark score of 84003 places it in the 96th percentile of all CPUs, and it outperforms the Intel Core Ultra 9 285K by 0.2% and the AMD EPYC 4584PX by 1.1% in general benchmarks. The GPU, by contrast, sits in the 55th percentile of all GPUs, which drags the combo’s overall standing down.

The rank of 451 indicates that many other combos achieve better frame rates, likely those pairing the RX 7900 XT with even stronger CPUs or using more GPU-focused configurations. However, the data shows that the CPU is not the limiting factor here. The Core Ultra 9 290K Plus’s 24 cores and 24 threads, combined with a 5.80 GHz boost clock, provide more than enough processing power for the game’s CPU-side logic. The measured FPS differences between resolutions and settings are consistent with GPU-bound scaling, meaning the combo’s rank is held back by the GPU’s inability to handle Ultra at 4K, not by any CPU bottleneck.

In the context of the full database, this rank places the combo in the upper tier, but it is far from the top. The 2911 total combos include many lower-end systems that cannot reach 60 FPS at 1080p, so the 451st rank is a strong showing. Yet for a CPU that sits in the 96th percentile and a GPU with 20 GB of VRAM, one might expect a higher placement. The game’s specific rendering demands, which stress the GPU’s shading and ray tracing units, are the clear reason for this rank.

Resolution Scaling

The FPS data reveals a consistent pattern of performance degradation as resolution increases, which is a hallmark of GPU-bound rendering. At the Medium preset, the average FPS drops from 101 at 1080p to 85 at 1440p and then to 67 at 4K. That represents a 15.8% reduction from 1080p to 1440p and a 33.7% reduction from 1080p to 4K. The scaling is not linear, suggesting that the GPU’s memory bandwidth and compute resources are being taxed more heavily at each step.

At the Low preset, the scaling is steeper in absolute terms: 161 FPS at 1080p, 136 FPS at 1440p, and 107 FPS at 4K. The drop from 1080p to 4K is 54 FPS, or 33.5%. This similar percentage drop across Low and Medium indicates that the GPU is consistently the limiting component, as the CPU would show less scaling if it were the bottleneck. At 1080p Low, the system achieves 161 FPS, which is far above what the CPU’s single-thread performance would cap at—the Core Ultra 9 290K Plus scores 7303 in Cinebench R23 single-core, indicating it can handle far more than 161 FPS in CPU-bound scenarios.

The High and Ultra presets show even more dramatic scaling. High goes from 72 FPS at 1080p to 61 FPS at 1440p and 48 FPS at 4K, a 33.3% drop from 1080p to 4K. Ultra goes from 57 FPS at 1080p to 48 FPS at 1440p and 38 FPS at 4K, a 33.3% drop as well. The consistency of this ~33% reduction across all presets strongly suggests that the GPU’s pixel throughput is the limiting factor. The RX 7900 XT’s pixel rate of 459.6 GPixel/s and texture rate of 804.4 GTexel/s are being saturated by the game’s two-scene rendering, and increasing resolution directly multiplies the pixel work required.

Measured FPS Breakdown

At 1920x1080, the full range of presets shows a wide spread. Low settings produce an average of 161 FPS, which is exceptionally high and suitable for high-refresh-rate displays. Medium reduces this to 101 FPS, with a minimum of 86 FPS and a maximum of 116 FPS, providing a balanced experience. High drops further to 72 FPS, which is playable but lacks headroom for demanding scenes. Ultra bottoms out at 57 FPS, which is below the 60 FPS target and shows that even at 1080p, the game’s highest preset is too demanding for consistent smoothness.

At 2560x1440, the pattern repeats with lower absolute numbers. Low averages 136 FPS, still excellent. Medium averages 85 FPS with a minimum of 72 FPS and a maximum of 98 FPS, which is a solid 60+ FPS experience. High falls to 61 FPS, which is right at the edge of playability and would likely drop below 60 in heavy scenes. Ultra averages 48 FPS, which is noticeably stuttery for a game that relies on atmospheric tension. The 1440p Medium results are the most viable for a balance of quality and performance.

At 3840x2160, the GPU’s limits become apparent. Low averages 107 FPS, which is surprisingly high and shows that the card can handle 4K when the visual load is minimized. Medium averages 67 FPS, with a minimum of 57 FPS, which is borderline but playable. High drops to 48 FPS, and Ultra falls to 38 FPS, both of which are too low for a smooth experience. The 4K Medium minimum of 57 FPS is particularly telling: it shows that even the recommended preset can dip below 60, meaning users on 4K displays should consider lowering to 1440p or accepting occasional frame drops.

CPU Role

The Intel Core Ultra 9 290K Plus plays a supporting role in The Medium, as the game’s performance is overwhelmingly GPU-bound. The CPU’s 24 cores and 24 threads, based on the Arrow Lake Refresh architecture on a 3 nm process, provide massive compute headroom. Its base clock of 3.70 GHz and boost clock of 5.80 GHz ensure that even the most demanding CPU-side tasks, such as managing the two simultaneous camera streams and their associated logic, are handled with ease. The CPU’s Cinebench R23 multicore score of 51731 and single-core score of 7303 demonstrate that it is among the fastest processors available.

The data supports the conclusion that the CPU is not a bottleneck in this game. At 1080p Low, the system reaches 161 FPS, and the frame rate scales down as resolution increases, which is the opposite of what would happen if the CPU were limiting. If the CPU were the constraint, the 1080p and 4K frame rates would be similar, as the CPU’s work does not change with resolution. Instead, the 54 FPS drop from 1080p Low to 4K Low proves that the GPU is doing the heavy lifting.

The CPU’s benchmark performance relative to its rivals further confirms its capability. It outperforms the Intel Core Ultra 9 285K by 0.2% in average benchmark score, and it is 1.3% ahead of the AMD EPYC 7F72. In a game like The Medium, which likely uses only a few threads for primary game logic, the CPU’s single-core strength is what matters most, and its 7303 Cinebench R23 single-core score is more than sufficient. The 125 W TDP and support for DDR5 memory with 115.2 GB/s bandwidth ensure that the rest of the system does not constrain the GPU. The conclusion is that users should not expect any CPU-related upgrades to improve frame rates in The Medium; the RX 7900 XT is the sole determinant of the experience.