Medical RAG hits VRAM wall, eyes Blackwell

Brute-forcing 1M+ tokens in-context is a hardware trap; professional medical precision depends more on data preprocessing and tiered retrieval than raw GPU power.

• –70B+ models like Meditron or Llama 3.1 are the baseline for medical reasoning, making 48GB+ VRAM (RTX 6000 Ada/Blackwell) the mandatory professional floor.
• –Massive context windows are computationally expensive and prone to retrieval decay; multi-stage retrieval with re-ranking remains more accurate for complex clinical audits.
• –Document ingestion is the "silent killer" of RAG accuracy; converting messy PDFs to unified Markdown or SQL-indexed chunks provides more gains than hardware upgrades.
• –Upcoming NVIDIA Blackwell chips with TEE-I/O represent the first viable "gold standard" for hardware-encrypted, HIPAA-compliant local inference on consumer-accessible workstations.