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Financial Health AssessmentEmergency MedicineNew attending

Alberta

Financial Health Assessment · Published October 21, 2026

Emergency Medicine New attending · 2 years out Married, two kids

Alberta, 31, runs the money for a Nevada household built around her husband, a 35 year old emergency medicine attending two years out of residency. They have two children, ages six and three, and a gross income of about $350,000. The assessment scores the household 43 out of 100, in the Corrections band.

43

FHA score out of 100 · Corrections

$23,000

Student loans left · paid off next month

$3,000/mo

Investing · about 10.3 percent of gross

3 months

Emergency fund · plus one to two months in the bank

Her own summary opens the file: we don't really save. The household does not track where the money goes, while $3,000 a month reaches investments and the retirement accounts are maxed across 401(k)s, a 403(b), an HSA, and backdoor Roth IRAs. The last $23,000 of student loans is paid off next month, inside two years of training ending.

The protection stack is borrowed. Disability and life coverage run through the physician's job only, health coverage is never stated explicitly in the intake, there is no umbrella, and there are no estate documents, with two young children and no guardian stated.

43

FHA score out of 100 · Corrections

About $350,000

Household gross income · about $200,000 after taxes and retirement

$581,000

Total stated debt · about 1.66 times income

55

Score with the four fixes · Corrections band

Key takeaways

  • The score: 43 out of 100, in the Corrections band. The Physician Wealth Equation earns 10 of 14 on a debt anchor of about 1.66 times income, while the Protection Stack earns 4 of 22.
  • The caller said it herself: we don't really save. Nothing is tracked, spending runs in ranges, and the Lifestyle Guardrails earn 8 of 22 while $3,000 a month reaches investments almost by accident.
  • The remaining $23,000 of student loans is being paid off next month, by choice, inside two years of training ending. The loan call earns the full 6 of 6 on the new attending fork.
  • Protection runs through the physician's job only: group disability and group life, no umbrella, no estate documents, and no guardian stated for two children ages six and three.
  • Four fixes move the score 12 points to a 55: individual own occupation disability, an umbrella policy, estate documents, and tracking cash flow until every dollar has a job.

The caller diagnosed the household in one sentence. The assessment just priced it.

The Household

Alberta is 31 and manages the household finances; she is a former teacher, with an old teacher fund of $11,000 sitting uninvested. Her husband is 35, an emergency medicine attending who finished residency two summers ago. They live in Nevada with two children, ages six and three.

Gross income is about $350,000 a year and fluctuates; about $200,000 lands after taxes, retirement, and insurance. The stated goals are ambitious and dated: the house paid off in ten years, her husband able to scale back in ten to fifteen, financial independence in fifteen years or less, and more travel.

We don't really save. Her words, and the first finding of the file.

The debts are nearly finished on one side and large on the other. Student loans are down to $23,000, paid off next month. The mortgage is $528,000 at 3.25 percent on an adjustable rate, $2,956 a month. A car loan of $30,000 at 0.9 percent runs $733 a month. Total stated debt is $581,000, about 1.66 times income.

Cash flow is the open wound. Spending is stated as ranges: utilities somewhere between $600 and $900, groceries $700, $800 for fun, about $2,500 of extras around the house, $1,000 to $2,000 for vacation. The emergency fund holds three months, with one to two more months spread across savings and checking. What does get funded is retirement and investing: $3,000 a month, about 10.3 percent of gross, across 401(k) accounts, a 403(b), an HSA, a taxable account, and two Roth IRAs, about $122,000 invested in total, at a 48 percent US stock, 32 percent international stock, 20 percent bond target.

Protection runs on the employer. Disability insurance and life insurance come through the physician's job only. There is no umbrella policy and no estate planning documents at all.

Household factWhere it stands
CareersEmergency medicine attending, two years out; Alberta manages the household finances
Ages31 and 35
Household incomeAbout $350,000 gross, fluctuating; about $200,000 after taxes, retirement, and insurance
Where they liveNevada
FamilyTwo children, ages six and three
Student loans$23,000 left, paid off next month by choice
Emergency fundThree months, plus one to two months in savings and checking
Saving$3,000 a month into investments, about 10.3 percent of gross; about $122,000 invested across 401(k)s, a 403(b), an HSA, taxable, and Roth accounts
Cash flow systemNone. The household states it does not track where money goes; categories stated as ranges
Other debtMortgage $528,000 at 3.25 percent adjustable, $2,956 a month; car loan $30,000 at 0.9 percent, $733 a month
DisabilityThrough the physician's job only, group coverage
Life insuranceThrough the job only, group coverage; amounts not stated
UmbrellaNone, stated
Estate documentsNone, and no guardian stated for the children
GoalsHouse paid off in ten years, scale back in ten to fifteen, financial independence in fifteen or less, more travel

The Score: 43 out of 100

The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Alberta's household scores 43, in the Corrections band. This household is scored on the attending rubric, on the new attending fork of the Transition framework.

20

Measures graded

7

Frameworks

43

Alberta's household score

The 3-Bucket Framework earns 7 of 20. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 2 at three months plus one to two months in the bank, named lanes earn 2 because expenses are itemized but the household states it does not track where money goes, and goals funded earns 3 with $3,000 a month flowing to investments.

The Physician Wealth Equation earns 10 of 14. The Debt Anchor earns the full 10: total stated debt of $581,000 on $350,000 of income is about 1.66 times, inside the new attending full line of 3.0 times. Stretch saving earns 0: the documented investing rate is about 10.3 percent of gross, under the 12 percent partial line.

The Protection Stack earns 4 of 22: disability and life at 2 each for group coverage through the physician's job only, and nothing else. Health coverage is never stated explicitly in the intake, malpractice type and tail are not stated, and the umbrella and estate documents do not exist. Every box earns 0 or the group only partial.

The Transition framework, on the new attending fork, earns 6 of 10: the loan call earns the full 6, a deliberate payoff of the last $23,000 executed within two years of training, and the contract box earns 0 because no contract review or pay structure understanding is stated.

The Tax Ladder earns 4 of 8: Roth accounts and a backdoor Roth pattern, and deliberate moves including an HSA held and retirement maxing per the hosts' restatement. The Decision Filter earns the full 4 of 4 on four dated goals. The Lifestyle Guardrails earn 8 of 22: the Savings Floor at 6 on the documented 10.3 percent rate, the leak at 0 because the household states it does not know where money goes, and wealth first automation at 2.

FrameworkWhat it coversPoints
02 3-Bucket FrameworkMilestones 0, emergency fund 2 at three months plus, named lanes 2, goals funded 37 of 20
03 Physician Wealth EquationDebt Anchor 10 at about 1.66 times income, stretch saving 0 at about 10.3 percent documented10 of 14
04 Protection StackHealth 0, disability 2, life 2, umbrella 0, malpractice 0, estate documents 04 of 22
05 TransitionLoan call 6, the last $23,000 paid off next month; contract clarity 0, none stated6 of 10
06 Tax LadderRoth against pre tax 2, bracket plus moves 24 of 8
07 Decision FilterGoals written 4, four stated goals including independence in fifteen years4 of 4
08 Lifestyle GuardrailsSavings floor 6 at about 10.3 percent documented, the leak 0, wealth first automation 28 of 22
TotalCorrections band43 out of 100

Read the shape, not just the total. The earning and investing machinery is attending grade. The score is held at 43 by two things a $350,000 household can fix in a quarter: a cash flow system that does not exist, and a protection stack that belongs to the employer instead of the family.

The Two Frameworks Behind the Score

The score grades 20 measures across seven frameworks. Two of them carry this case: the Protection Stack, which scores 4 of 22 because the coverage is borrowed from the employer, and the Lifestyle Guardrails, which score 8 of 22 because no system watches the money leave.

Framework one

The Protection Stack

The Protection Stack grades the coverage that keeps one bad month from ending the plan. Here almost all of it is rented from the physician's employer, and it leaves when the job does.

Disability and life

Both run through the physician's job only, earning 2 of 4 each. For an emergency physician whose income depends on showing up for shifts, group disability is the weakest version of the most important policy in the file, and it is usually taxable.

Partial

Umbrella

There is no umbrella policy, stated outright in the intake. The box earns 0 of 4.

Missing

Estate documents

No will, no powers of attorney, no healthcare directives, and no guardian stated, with children ages six and three. The box earns 0 of 4.

Missing

Framework two

The Lifestyle Guardrails

The Guardrails grade whether today's lifestyle leaves room for the plan: the savings floor, the leak, and whether wealth is paid first. The machinery is bought. The tracking is not.

The savings floor

The documented investing rate is about 10.3 percent of gross, $36,000 a year of stated investing on $350,000, which lands over the 10 percent partial line and earns 6 of 12.

Partial

The leak

The household states it does not know where its money goes. The unaccounted share of a $350,000 income is unmeasured, and the box earns 0 of 6, the only honest grade for a number nobody has.

Missing

Wealth first automation

$3,000 a month reaches investments on a regular pattern, earning 2 of 4. Paid first automation is not stated, and nothing reconciles what happens after the paycheck lands.

Partial

What They Did Right

A 43 with this income is a fixable 43. This is the machinery already in place.

A debt anchor inside the attending line

Total stated debt of $581,000 on about $350,000 of income is about 1.66 times, well inside the new attending full line of 3.0 times. The Debt Anchor earns the full 10 of 10.

The last $23,000 gone next month

The student loans end by choice, on a date, inside two years of training ending. The loan call earns the full 6 of 6.

Retirement accounts kept full

401(k) accounts, a 403(b), an HSA, and backdoor Roth IRAs, with retirement maxing per the hosts' restatement and $3,000 a month still reaching investments on top.

Four goals with dates on them

House paid off in ten years, scale back in ten to fifteen, independence in fifteen or less, more travel. The Decision Filter earns the full 4 of 4.

She said the quiet part first

The intake opens with the diagnosis: we don't really save. A household that names its own leak is one tracking system away from closing it.

The Cash Flow Gap, in Her Own Words

The first deep dive is the missing system. The caller's statement includes the line the whole episode turned on: we don't really save. Then the specifics. Utilities are somewhere between $600 and $900. Extras around the house run about $2,500. Vacation is $1,000 to $2,000. The ranges are honest, and they are the finding: nobody in this household can say where the money went last month.

The hosts pushed on exactly that. Money comes in, roughly $200,000 a year after taxes, retirement, and insurance, and a household aiming at financial independence in fifteen years cannot judge its own progress without knowing its expenses. Independence is expenses, covered by assets. If the expenses are a range, the target is a range, and the plan is a guess.

You cannot fix a leak you refuse to measure. This household has not measured yet.

The score prices the gap precisely. It pays the Savings Floor 6 on the documented rate of about 10.3 percent, $36,000 a year of stated investing on $350,000 of gross. It pays the leak 0, because the unaccounted amount is not a small number nobody bothered with; it is the household's stated position.

The fix is the one the episode named: track the cash flow and give every dollar a job. Ninety days of tracking turns the ranges into numbers, the goals turn into funding schedules, and the independence date turns from a hope into an arithmetic answer.

Borrowed Coverage

The second deep dive is the Protection Stack, and the finding is ownership. Disability insurance: through the physician's job. Life insurance: through the job. Umbrella: none. Estate documents: none. Health coverage is never even stated explicitly in the intake.

The plan depends on one attending income arriving every month, and the only disability coverage standing behind that income is a group policy: employer owned, employer defined, usually taxable, and gone when the job ends.

Group coverage is coverage with a resignation clause.

The episode spent its longest stretch on what the individual policy has to contain: a true own occupation definition from one of the carriers that writes it properly, a partial or residual disability rider, a benefit increase rider, and a non-cancelable guarantee. It also warned against the medical own occupation rider that pays on lost income instead of lost ability, and against the student loan rider that adds cost without adding protection.

The documents are the same story at lower cost. Two children, ages six and three, no will, no guardian stated. The hosts pointed the household at estate planning the same day, and at an umbrella policy behind it. None of this needs a raise. It needs an agent, an attorney, and a week.

Milestones: Scored on What Is Stated

Inside the 3-Bucket Framework, the milestone checklist tracks what a young attending household has already put in place. This checklist earns 0 for Alberta's household, because the intake never states a milestone list the net can be computed from. The box pays only for stated milestones.

The rest of the bucket picture: an emergency fund at 2 of 4, named lanes at 2 of 4 on itemized ranges with no tracking behind them, and goals funded at 3 of 6 on the $3,000 a month. The framework earns 7 of 20, and every lost point in it traces back to the same root: nothing is written down and nothing is reconciled.

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The Prescription

Four fixes, each one traced to points.

1

Take the physician's coverage off the group plan, starting with disability.

This is the Protection Stack, and it gains 2 points, moving disability from 2 to 4. Life and disability both run through the husband's job only, there is no umbrella policy, and there are no estate documents with two children ages six and three. The hosts put individual own occupation disability first, and the scoring agrees.

2

Place an umbrella policy.

This is the Protection Stack, and it gains 4 points, moving umbrella from 0 to 4. A $528,000 mortgage, a car loan, and an attending income is exactly the exposure an umbrella exists to cover, at a few hundred dollars a year.

3

Get estate planning done, with a guardian named.

This is the Protection Stack, and it gains 4 points, moving estate documents from 0 to 4. A will, powers of attorney, healthcare directives, and the guardian decision for two children ages six and three, made by the parents instead of a court.

4

Track cash flow and give every dollar a job.

This is the 3-Bucket Framework, and it gains 2 points, moving named lanes from 2 to 4. The hosts' foundation point: a household aiming at independence in fifteen years has to know its expenses before it can know its number.

Run all four and the arithmetic is 43 plus 12, a score of 55. The gains are 2 for individual own occupation disability, 4 for an umbrella policy, 4 for estate documents, and 2 for tracking cash flow until every dollar has a job. A score of 55 out of 100 keeps the household in the Corrections band.

Individual term life stays an open item beyond the traced target: the record's target basis does not score it, and the group life coverage remains borrowed until it is bought. The adjustable rate mortgage decision rides along with the house payoff goal, and a professional review of the emergency medicine contract is the file's other named gap.

What This Case Teaches

Income is not a system. This household earns about $350,000, maxes its retirement accounts, is about to be done with student loans forever, and still opens its own file with we don't really save. The missing piece was never money. It was a written system for the money between the paycheck and the accounts.

Protection that belongs to the employer protects the household only while the job lasts.

The second lesson is about borrowed protection. Coverage through the job is real coverage with an expiration condition, and for a household that runs on one attending income, with two young children, the disability policy is the plan. Owning it, plus the umbrella and the documents, is what turns a good income into a durable one.

Questions this case answers

What score did Alberta's household receive on the Financial Health Assessment?

Alberta's household scored 43 out of 100, in the Corrections band. The Physician Wealth Equation earns 10 of 14 on a debt anchor of about 1.66 times income, while the Protection Stack earns 4 of 22.

Why is the last $23,000 of student loans being paid off at once?

The remaining $23,000 is being paid off next month, by choice. The household carried the loans into the attending years, shrank them to a final balance, and set a payoff date, which earns the loan call box full marks on the new attending fork.

What is the first fix for Alberta's household?

Take the physician's coverage off the group plan, starting with disability. Life and disability both run through the husband's job only, there is no umbrella policy, and there are no estate documents with two children ages six and three. The hosts put individual own occupation disability first, and the scoring agrees.

What do the fixes do to Alberta's household score?

Run all four and the arithmetic is 43 plus 12, a score of 55. The gains are 2 for individual own occupation disability, 4 for an umbrella policy, 4 for estate documents, and 2 for tracking cash flow until every dollar has a job. A score of 55 out of 100 keeps the household in the Corrections band.

Sources and Basis

This assessment is built from the household's own intake for the Financial Health Assessment and the episode assessment of it. Every figure on this page comes from that record, and the score is traced box by box under the locked attending rubric. The caller's statement was read on air from her written intake.

The attending rubric weights the seven frameworks at 20, 14, 22, 10, 8, 4, and 22, for a total of 100. The bands are Needs a workup from 0 to 39, Corrections from 40 to 69, Stable from 70 to 84, and Healthy from 85 to 100. Attendings are scored on the Transition fork by years since training: the loan call, and the new attending contract.

Written by Ryan Inman, MBA, MAFM. Last updated October 2026.

About

Ryan Inman is a retired financial planner who worked with about 500 physician families. He created the Financial Residency podcast (about 3 million downloads) and is no longer affiliated with it. Financial Fellowship is his sole focus. This guide is educational. Last updated October 2026.

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