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The use of medium term scheduler is to improve multiprogramming by allowing multiple processes to reside in main memory by swapping out processes that are waiting (need I/O) or low priority processes and swapping in other processes that were in ready queue. So you can see that we requied medium term scheduler when we have limited memory. This swapping in and out operation does not take place when we are running a single small program and have large memory.
Similary if we are running multiple programs and we have very large memory(larger than the size of all processes plus addition space for other requirements) then medium term scheduler is not needed. Modern operating systems use paging so instead of swapping processes they swap pages in and out of memory.It is same as a system with very large memory(infinite) would not suffer from page faults.
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