The Medium

# The Medium with Intel Core Ultra 9 290K Plus + NVIDIA GeForce RTX 5090

This combination of the Intel Core Ultra 9 290K Plus and NVIDIA GeForce RTX 5090 places 28th out of 2,911 tested combos in The Medium, representing the top 1% of all configurations evaluated. The pairing delivers playable frame rates across every resolution and setting tier tested, though the data reveals a clear pattern of GPU-bound scaling at higher resolutions and settings, with the CPU's substantial headroom only becoming apparent at lower graphical loads.

How This Combo Ranks

The combo's rank of 28 out of 2,911 tested configurations places it in the 99th percentile of all systems measured in The Medium. This is a top-tier result, but it is not the absolute fastest combination in the database, suggesting that even this flagship pairing leaves some performance on the table in this particular title. The ranking reflects the measured average FPS across all tested resolution and setting combinations, weighted toward the demanding 4K Ultra scenario where the RTX 5090's 32 GB of GDDR7 memory and 512-bit bus provide substantial bandwidth advantages.

Benchmark results indicate that the Intel Core Ultra 9 290K Plus achieves an average benchmark score of 84,003 across all tested workloads, placing it in the 96th percentile of all CPUs. Its nearest rival, the Intel Core Ultra 9 285K, scores 83,807, a delta of just 0.2 percent — effectively a statistical tie in synthetic testing. The AMD EPYC 4584PX trails by 1.1 percent at 83,090, while the AMD EPYC 9135 is 1.2 percent behind at 82,980. The AMD EPYC 7F72 leads this group at 85,072, placing the 290K Plus 1.3 percent behind that server-class part. These margins are small enough that game-specific performance will depend heavily on how The Medium utilizes the available cores and threads.

The NVIDIA GeForce RTX 5090's average benchmark score of 79,842 puts it in the 92nd percentile of all GPUs. Its nearest rivals include the NVIDIA Tesla P100 PCIe 16 GB at 79,605 (0.3 percent behind), the Tesla P100 PCIe 12 GB at 79,396 (0.6 percent behind), and the AMD Radeon RX 6850M XT at 78,940 (1.1 percent behind). The AMD Radeon Pro Vega 64X leads at 80,959, putting the RTX 5090 1.4 percent behind that workstation card. These synthetic benchmarks show the RTX 5090 in a tightly contested field, which makes its dominant position in The Medium's measured FPS data all the more notable — the game clearly favors this GPU's architecture.

GPU Role

The RTX 5090 brings 32 GB of GDDR7 memory on a 512-bit bus, yielding 1.79 TB/s of memory bandwidth. This is the single most important specification for The Medium at high resolutions, as the game's fixed-camera horror presentation relies on large, detailed textures that consume VRAM aggressively. The GPU's 21,760 shading units, 680 texture mapping units, and 176 raster output processors provide the raw compute throughput needed to drive the game's dual-reality rendering technique, where two simultaneous perspectives are often displayed on screen.

The GPU's base clock runs at 2017 MHz with a boost clock of 2407 MHz. Memory operates at 1750 MHz, delivering 28 Gbps effective throughput. The 104.8 TFLOPS of FP32 compute and 1,636.8 GTexel/s texture rate give this card enormous headroom for the game's particle effects and volumetric lighting. In the measured data, the GPU's performance scales predictably with settings: at 4K, the average FPS drops from 143 on Low to 51 on Ultra, a 64 percent reduction that reflects the exponential cost of higher-quality shadows, reflections, and post-processing effects.

The RTX 5090's 170 ray tracing cores and 680 tensor cores are present, though The Medium's implementation of ray-traced effects appears modest based on the FPS deltas between settings tiers. The 176 ROPs deliver a pixel rate of 423.6 GPixel/s, which proves sufficient for 4K rendering across all settings. The GPU's 92,200 million transistors on a 5 nm TSMC process, with a die size of 750 mm², represent the largest consumer GPU die in the database, and this physical size translates directly into the performance observed in The Medium's measured runs.

CPU Role

The Intel Core Ultra 9 290K Plus provides 24 cores and 24 threads, with a base clock of 3.70 GHz and a boost clock of 5.80 GHz. This Arrow Lake Refresh part, built on TSMC's 3 nm process, carries 17,800 million transistors on a 243 mm² die. The 36 MB of shared L3 cache, alongside 192 KB of L1 and 3 MB of L2 per core, gives the CPU substantial on-die storage for game assets that are frequently accessed during scene transitions.

In synthetic benchmarks, the CPU's multi-core performance is exceptional: Cinebench R23 multi-core scores 51,731, while single-core reaches 7,303. PassMark multi-thread results show 60,860, with single-thread at 4,823. These numbers indicate a processor that can handle The Medium's CPU demands easily, but the measured FPS data reveals that the CPU is rarely the limiting factor in this game. At 1080p Low, the average FPS reaches 202, which approaches the practical ceiling for many display refresh rates but still shows no signs of CPU bottlenecking.

The CPU's 125 W TDP, dual-channel DDR5 memory support with 115.2 GB/s bandwidth, and PCIe Gen 5 with 20 lanes provide a platform that can feed the RTX 5090's 1.79 TB/s memory bandwidth without starvation. The integrated Arc Xe-LPG Graphics 64EU is present but irrelevant for gaming performance with a discrete GPU installed. The CPU's 96th percentile ranking among all CPUs, with an average benchmark score of 84,003, confirms that this processor is among the fastest available, yet the game's frame rates suggest that The Medium's engine does not fully exploit the CPU's 24 threads.

Measured FPS Breakdown

At 3840x2160, the combo delivers 64 FPS on High, 143 FPS on Low, 90 FPS on Medium, and 51 FPS on Ultra. The Medium setting shows a minimum of 76 FPS and a maximum of 103 FPS, indicating a frame time variance of 27 FPS during the measured run. The Ultra preset at 4K dips below the 60 FPS threshold, which may be noticeable on high-refresh displays, while the High preset holds comfortably above 60.

At 2560x1440, performance improves substantially: High averages 82 FPS, Low reaches 182 FPS, Medium hits 114 FPS, and Ultra manages 65 FPS. The Medium preset shows a minimum of 97 FPS and a maximum of 131 FPS, a 34 FPS spread that suggests some scene-to-scene variability in the game's dual-world rendering. The Ultra preset at 1440p just clears the 60 FPS bar, making it viable for players who prioritize visual fidelity over frame rate headroom.

At 1920x1080, the combo reaches 97 FPS on High, 202 FPS on Low, 135 FPS on Medium, and 77 FPS on Ultra. The Medium preset shows a minimum of 115 FPS and a maximum of 156 FPS, providing a 41 FPS window that keeps frame pacing consistent. The Low preset's 202 FPS average indicates that the CPU-GPU combination can push well beyond 200 FPS when graphical load is minimized, though the game's engine may impose its own internal limits at such high frame rates.

Resolution Scaling

The FPS drop from 1080p to 4K reveals where the bottleneck lies in this configuration. At Medium settings, the average FPS falls from 135 at 1080p to 114 at 1440p, a 15.6 percent reduction, then to 90 at 4K, a further 21.1 percent drop. The total scaling from 1080p to 4K at Medium is 33.3 percent, indicating that the GPU is becoming increasingly stressed as pixel count quadruples, but the CPU remains capable of keeping up.

At Ultra settings, the scaling is more dramatic: 77 FPS at 1080p drops to 65 at 1440p (15.6 percent reduction) and then to 51 at 4K (21.5 percent further reduction). The total 33.8 percent drop from 1080p to 4K Ultra shows that the RTX 5090 is the primary limiter at these settings, with the CPU's 24 cores providing sufficient headroom even at the lowest resolution tested. The Low preset shows the smallest absolute scaling: 202 FPS at 1080p falls to 182 at 1440p (9.9 percent) and then to 143 at 4K (21.4 percent further). The 29.2 percent total drop at Low settings suggests that at 1080p Low, the CPU is beginning to approach its limits, though the 202 FPS average indicates no severe bottleneck.

This scaling pattern — with the largest FPS reductions occurring between 1440p and 4K across all settings — confirms that the RTX 5090's 32 GB frame buffer and 1.79 TB/s bandwidth are the determining factors for this combo's performance in The Medium. The CPU's influence is most visible at 1080p Low, where the 202 FPS result approaches what the engine can deliver, but even there the 24-core processor does not become a hard constraint.

FAQ

Q: Is this combo capable of running The Medium at 4K Ultra with playable frame rates?

A: The measured data shows 51 FPS average at 4K Ultra, which is below the 60 FPS target for smooth gameplay. Players seeking 4K Ultra performance would need to accept frame rates in the low 50s or reduce to the High preset, which delivers 64 FPS.

Q: How much performance is lost when moving from Medium to Ultra settings?

A: At 1080p, the drop from Medium (135 FPS) to Ultra (77 FPS) represents a 43 percent reduction. At 1440p, Medium (114 FPS) to Ultra (65 FPS) is a 43 percent reduction. At 4K, Medium (90 FPS) to Ultra (51 FPS) is a 43.3 percent reduction, showing consistent scaling across resolutions.

Q: What is the best resolution and setting combination for a 144 Hz display?

A: The 1080p Medium preset delivers 135 FPS average with a 115 FPS minimum, which can drive a 144 Hz display without dipping below the refresh rate. At 1440p, the Medium preset's 114 FPS average and 97 FPS minimum will also hold on most 144 Hz panels, though occasional drops below 100 FPS may occur.

Q: Does the Intel Core Ultra 9 290K Plus bottleneck the RTX 5090 in this game?

A: The data shows no significant CPU bottleneck. At 1080p Low, the combo reaches 202 FPS average, and the scaling from 1080p to 4K at each setting tier follows a GPU-bound pattern. The CPU's 24 threads and 5.80 GHz boost clock provide ample headroom for The Medium's engine.

Q: How does this combo compare to the nearest rival CPU in synthetic performance?

A: The Intel Core Ultra 9 290K Plus scores 84,003 average, which is 0.2 percent higher than the Intel Core Ultra 9 285K at 83,807. The AMD EPYC 4584PX scores 83,090 (1.1 percent lower), and the AMD EPYC 9135 scores 82,980 (1.2 percent lower). These differences are within normal run-to-run variance.

Q: Is the RTX 5090's 32 GB VRAM necessary for this game?

A: The measured results do not indicate VRAM capacity as a limiting factor at any tested setting. The GPU's 1.79 TB/s bandwidth and 512-bit bus are more likely contributors to performance, though the 32 GB capacity ensures no texture swapping occurs even at 4K Ultra.

Settings Recommendations

The measured data supports the Medium preset as the optimal balance of visual quality and performance across all resolutions. At 1080p, Medium delivers 135 FPS average with a 115 FPS minimum, providing smooth gameplay on high-refresh displays while maintaining the intermediate visual quality tier. At 1440p, Medium's 114 FPS average and 97 FPS minimum keep the experience fluid, and even at 4K, Medium's 90 FPS average with a 76 FPS minimum remains comfortably playable.

The High preset offers a modest visual upgrade over Medium but exacts a significant performance cost: 97 FPS at 1080p (28 percent lower than Medium), 82 FPS at 1440p (28 percent lower), and 64 FPS at 4K (29 percent lower). The Ultra preset, while visually richest, drops to 77 FPS at 1080p, 65 FPS at 1440p, and 51 FPS at 4K — the latter falling below the 60 FPS threshold that many players consider the minimum for acceptable smoothness.

For players prioritizing frame rate stability, the Low preset at 1440p delivers 182 FPS average, and at 4K it reaches 143 FPS, both well above typical display refresh rates. However, the visual compromise is substantial, and the Medium preset's combination of 90+ FPS at 4K and 114+ FPS at 1440p makes it the recommended starting point. The data shows diminishing returns beyond Medium, with the High and Ultra presets consuming 29-43 percent of performance for incremental visual improvements. For this hardware combination, Medium at 4K provides the best experience per measured frame rate, with 1440p Medium offering additional headroom for players who prefer higher refresh rates.