Trim the teres major by removing most of the fat and silver skin. There may not be very much trimming needed.
Liberally sprinkle the teres major with your favorite BBQ rub for beef or steak.
Cover the meat with Saran Wrap and let sit at room temp for about an hour, while you set up the grill/smoker.
Heat your smoker to 250 degrees. We love cooking this over oak, but use whatever wood, pellets, charcoal, etc that you prefer.
Place the meat on the smoker and monitor the internal temp with a meat thermometer. Cook for roughly one hour, when it reaches an internal temp of 100-110 degrees then remove from the grill.
If you are not using a sous vide continue to cook the roast to about 10 degrees below your desired finishing temp, then pull and rest for 5 minutes before proceeding to the searing step.
Let the meat cool for about 5 minutes, then place in a sous vide bag. If you do not have a sous vide bag, vacuum seal bags work well, too. Use zip locks as a last resort, but they can be a pain to get all of the air out, and you should double bag them because they are prone to leakage in the warm water.
Set the sous vide to your desired finishing temp and cook the roast for about 2 hours. We prefer medium rare so we set the sous vide to 131 degrees.
When ready to eat, heat a cast iron pan or skillet over high heat and add a tablespoon of butter. Remove the meat from the sous vide bag and slice to desired thickness, then sear the medallions about 1 minute per side.
Plate and serve with the his and hers sauces.