A thermomechanical pulping method including: refining pulp with a high consistency refining stage, and a medium consistency refining stage processing the refined pulp discharge from the high consistency refining stage. Chemical pretreatments for improving pulp quality development during medium consistency refining can be optionally added at the pressurized chip press, fiberizer pre-refining step, primary high consistency refining step, and/or the standpipe feeding the medium consistency refiner.