Financial Health Assessment
Alissa and Brandon: $352,000 of Student Debt Scores 29 Out of 100
By Ryan Inman
Published · Updated
Pediatrics · Intended matchMedical student · Residency starts JulyCouple, no children stated
Financial Health Assessment score
29 out of 100
Needs a workup
- Needs a workup 0 to 39
- Corrections 40 to 69
- Stable 70 to 84
- Healthy 85 to 100
The score grades the household on 19 measures across seven frameworks. Alissa and Brandon lands at 29, in the Needs a workup band, score 0 to 39.
Brandon is a mechanical engineer earning about $83,000 a year. Alissa is a fourth year medical student, earning nothing now and expecting about $55,000 a year when residency starts in July, aiming at a pediatrics match that is not yet confirmed. The assessment scores the household 29 out of 100, in the Needs a workup band.
The debt is the file. Brandon carries three loans: a $2,000 institution loan at 3 percent, $20,000 of federal loans at about 5 percent, and a refinanced Parent PLUS loan of $56,000 at 4.35 percent. Alissa carries $24,000 of undergraduate debt at 4.5 percent, which her parents agreed to pay, and $250,000 of medical school debt at about 7 percent. The stated total is $352,000.
The household still saved. Cash totals $35,200 across a joint checking account, a joint savings account, a personal checking account, and a high yield savings account, on one income of $83,000, while saving about $600 a month. The protection layer is where the file empties out: no umbrella, no estate documents, no life cover for Alissa, and disability cover that is short term and employer based on one side only.
$352,000
Total stated student debt · two people's loans
$35,200
Cash across four accounts · as stated
$600/mo
Current saving · about 8.7 percent of gross
$83,000
Current household income · one earner today
31
Score with the traced fix · Needs a workup band
The short version
- The score: 29 out of 100, in the Needs a workup band. The Transition framework earns the full 10 of 10, while the Lifestyle Guardrails earn 0 of 22 and the Tax Ladder 0 of 8.
- Stated student debt totals $352,000 across five loans and two people, including a $56,000 refinanced Parent PLUS loan and $250,000 of medical school debt at about 7 percent.
- Cash of $35,200 is saved on one $83,000 income, and the savings accounts alone hold about 11 months of the itemized expenses. The emergency fund box earns the full 6 on the resident path.
- Life cover is a $67,000 whole life policy plus $75,000 of employer cover, on Brandon only. Alissa has no life cover, no disability cover, and is the earner the household's future income depends on.
- One traced fix moves the score 2 points to a 31: term life in place of the whole life policy for Brandon, and term cover for Alissa. A score of 31 stays in the Needs a workup band.
The cash is saved. The incomes are uninsured.
What They Did Right
A 29 with real cash discipline underneath it. This is what is already working.
- $35,200 of cash on one $83,000 income Four accounts holding $35,200 while one earner brings in $83,000 and the other is in medical school. The savings accounts alone cover about 11 months of itemized expenses.
- A federal plan for the big loan The $250,000 of medical school debt sits in federal loans headed for PSLF with income driven repayment, as the hosts urged. The loan strategy box earns the full 6 of 6.
- No consumer debt at all No credit card debt and no other debt is stated, under a $352,000 student loan stack. Cards and other debt earn the full 4.
- Four goals, stated out loud Including the fourth goal in the household's own words: own a farm and several acres, potentially building a home on it. The Decision Filter earns the full 6.
- Disability for Alissa is already on the list She plans to obtain disability cover in training, which is the right order. The gap is that nothing is in place yet, on either income that matters most.
The Score: 29 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Alissa and Brandon scores 29, in the Needs a workup band. This household is scored on the resident and fellow rubric path.
19
Measures graded
7
Frameworks
29
Alissa and Brandon's score
The 3 Bucket Framework earns 9 of 26. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns the full 6: savings accounts of $28,000 against about $2,489 a month of itemized expenses is about 11 months, over the six month full line. Named lanes earn 0, because dollar sorting is not stated. Goals funded earns 3, with saving and an extra Parent PLUS payment flowing to the debt goal while the goals are not fully funded.
The Physician Wealth Equation earns 0 of 6: stated saving of about $600 a month is about 8.7 percent of gross, under the 12 percent partial line on the resident stretch box. Residents are never scored on debt to income. The $352,000 is graded through the loan strategy box instead.
The Protection Stack earns 4 of 22, in two partial boxes. Disability earns 2: employer short term cover for Brandon, and none for Alissa. Life earns 2: permanent and group cover on Brandon only, and none for Alissa. Health earns 0, because Brandon's coverage is not stated. Umbrella, malpractice, and estate documents each earn 0: none, not stated, and none.
The Transition framework earns the full 10 of 10. The loan strategy box earns the full 6: Alissa's federal loans are headed for PSLF and income driven repayment, as the hosts urged. Cards and other debt earn the full 4: no credit card debt is stated, and no other debt is stated.
The Tax Ladder earns 0 of 8: no Roth against pre tax reason is stated, the bracket is not stated, and fewer than two deliberate moves are stated. The Decision Filter earns the full 6 of 6 on four stated household goals.
The Lifestyle Guardrails earn 0 of 22, the emptiest framework in the file. The Savings Floor earns 0 at a rate of about 8.7 percent, under the 10 percent partial line. The leak earns 0, because the unaccounted amount is not stated. Wealth first automation earns 0, because paying wealth first on an automated schedule is not stated.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 6 at about 11 months, named lanes 0, goals funded 3 | 9 of 26 |
| 03 Physician Wealth Equation | Stretch saving 0 at about 8.7 percent of gross. Residents are not scored on debt to income | 0 of 6 |
| 04 Protection Stack | Health 0, disability 2, life 2, umbrella 0, malpractice 0, estate documents 0 | 4 of 22 |
| 05 Transition | Loan strategy 6, federal loans headed for PSLF as the hosts urged. Cards and other debt 4 | 10 of 10 |
| 06 Tax Ladder | Roth against pre tax 0, bracket plus moves 0 | 0 of 8 |
| 07 Decision Filter | Goals written 6, four goals stated including the farm | 6 of 6 |
| 08 Lifestyle Guardrails | Savings floor 0 at about 8.7 percent, the leak 0, wealth first automation 0 | 0 of 22 |
| Total | Needs a workup band | 29 out of 100 |
Read the shape, not just the total. One framework is full and one is empty. The loan strategy earns full marks because the federal plan is the right tool for $250,000 of medical school debt, and the Guardrails earn nothing because the saving rate, the leak, and the automation are all unstated or under the lines. The distance between those two boxes is the whole case: a workable debt plan on top of an unbuilt monthly system.
The Prescription
One traced fix, and the open items behind it.
- Replace the whole life policy with term, and cover Alissa. This is the Protection Stack, and it gains 2 points, moving life insurance from 2 to 4. Individual term life of at least $500,000 to $1,000,000 in place of Brandon's $67,000 whole life policy, and term life obtained for Alissa, who holds none today.
- Obtain disability cover for Alissa first in training. She has none today and plans to obtain it in training. The hosts put this first among her training purchases. No point gain is traced for this item in the record's target.
- Follow the federal plan the hosts urged on the medical school loans. PSLF and income driven repayment on the $250,000 balance, as the hosts urged, with the extra payment continuing to the Parent PLUS loan. The loan strategy box already earns full marks. This item protects them. No point gain is traced for this item.
- State the monthly system when residency income starts. Dollar sorting, the unaccounted amount, and an automated pay first split are all unstated today, and the Guardrails earn 0 partly for that reason. Two incomes in July is the moment to state them. No point gain is traced for this item.
Run the traced fix and the arithmetic is 29 plus 2, a score of 31. The gain is 2 for individual term life on both earners in place of the whole life and group only cover. A score of 31 out of 100 keeps the household in the Needs a workup band.
What This Case Teaches
Debt size is not the score. Debt structure is. This household owes $352,000 and still earns the Transition framework's full 10 of 10, because the largest loan sits in the federal system, headed for the forgiveness route the hosts urged, and there is no consumer debt beside it. The 29 comes from the empty boxes around the debt: saving rate, automation, and cover.
Save the cash first. The cover has to be bought, not assumed.
The second lesson is the order of purchases for a new resident household. This file saved 11 months of expenses before residency and bought a $67,000 whole life policy instead of term cover many times larger. The cash was the hard part. The cover swap is the cheap part, and it is still undone.
Behind the score
The Household
Brandon is a mechanical engineer earning about $83,000 gross a year. Alissa is a fourth year medical student. She earns nothing today and expects about $55,000 a year when residency starts in July. Her intended specialty is pediatrics. The record carries it as an intended match, not a confirmed one, and this page does the same.
The student debt is stated loan by loan. Brandon: a $2,000 institution loan at 3 percent, $20,000 of federal loans at about 5 percent, and a Parent PLUS loan refinanced to $56,000 at 4.35 percent. Alissa: $24,000 of undergraduate loans at 4.5 percent, which her parents agreed to pay, and $250,000 of medical school loans at about 7 percent. Total stated student debt is $352,000. No credit card debt and no other debt is stated.
Eleven months of expenses in savings, and no cover on the future attending income.
Against that, the household holds $35,200 of cash: $5,000 in joint checking, $11,000 in joint savings, $2,200 in a personal checking account, and $17,000 in a high yield savings account. Brandon's 401k holds $27,000. Saving runs about $600 a month on the current income, about 8.7 percent of gross.
The stated expenses the extraction works from run about $2,489 a month itemized. The savings accounts alone, $28,000 across the joint savings and the high yield account, stand at about 11 months of that figure, which is why the emergency fund box earns full marks on the resident path even in a file this far under water on debt.
Protection is thin and one sided. Brandon holds a $67,000 whole life policy and $75,000 of employer life cover, plus employer short term disability only. Alissa has no life cover and no disability cover, and plans to obtain disability cover in training. She pays $300 a month for her health insurance. Brandon's health coverage is not stated. There is no umbrella policy, malpractice type and tail are not stated, and there are no estate planning documents.
| Household fact | Where it stands |
|---|---|
| Careers | Mechanical engineer. Fourth year medical student, residency expected in July at about $55,000 |
| Specialty | Pediatrics, intended match. Not yet matched at recording |
| Household income | About $83,000 today, one earner. About $55,000 expected when residency starts |
| Student loans | $352,000 total stated: $2,000 at 3 percent, $20,000 at about 5 percent, $56,000 Parent PLUS refinance at 4.35 percent, $24,000 at 4.5 percent, $250,000 at about 7 percent |
| Other debt | None stated |
| Cash | $35,200 total: joint checking $5,000, joint savings $11,000, personal checking $2,200, high yield savings $17,000 |
| Emergency fund basis | Savings accounts of $28,000 against about $2,489 a month of itemized stated expenses, about 11 months |
| Saving | About $600 a month, about 8.7 percent of gross. 401k balance $27,000 |
| Disability | Employer short term only for Brandon. None for Alissa, who plans to obtain it in training |
| Life insurance | Brandon: $67,000 whole life plus $75,000 employer cover. Alissa: none |
| Umbrella | None |
| Estate documents | None stated |
| Goals | Four household goals stated, including owning a farm and building a home |
The Two Frameworks Behind the Score
The score grades 19 measures across seven frameworks. Two of them carry this case: the Transition framework, which scores the full 10 of 10 on the federal loan plan, and the Lifestyle Guardrails, which score 0 of 22.
Framework one
The Transition Framework
The Transition framework grades the loan strategy and the state of other debt. For a household carrying $352,000, this is the framework that decides whether the debt has a plan at all. Here it does: 10 of 10.
- Loan strategy Built
- Alissa's federal loans are headed for PSLF and income driven repayment, the route the hosts urged for a $250,000 balance at about 7 percent heading into residency. The box earns the full 6.
- Cards and other debt Built
- No credit card debt is stated and no other debt is stated. The box earns the full 4.
- The five loan stack
- Brandon's three loans and Alissa's two loans are each stated with a rate. The strategy box grades the plan for the medical school debt. The smaller loans get the extra Parent PLUS payment.
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. On one income with residency about to start, all three boxes earn 0: 0 of 22.
- The savings floor Missing
- Saving of about $600 a month is about 8.7 percent of gross, under the 10 percent partial line. The box earns 0 of 12.
- The leak Missing
- The unaccounted amount is not stated, so the box earns 0 of 6.
- Wealth first automation Missing
- Paying wealth first on an automated schedule is not stated. The box earns 0 of 4.
The $352,000 Stack, Loan by Loan
The first close look is the debt itself, because the total hides the structure. Five loans, two people, five rates. Brandon's institution loan is $2,000 at 3 percent. His federal loans are $20,000 at about 5 percent. The Parent PLUS loan he refinanced is $56,000 at 4.35 percent.
Alissa's undergraduate loans are $24,000 at 4.5 percent, and her parents agreed to pay them. Her medical school loans are $250,000 at about 7 percent, and they are the case. One loan is 71 percent of the stack, and it belongs to the earner who has not started earning yet.
The medical school loan is about 71 percent of the total.
The hosts urged confidence in the federal route for that loan: PSLF with income driven repayment, run on purpose through residency and a qualifying attending job. That advice is why the loan strategy box earns full marks. The plan matches the balance: payments sized to a resident's income, forgiveness at the end of qualifying service.
The smaller loans were the second half of the advice: refinance the private side where the math pays, keep the extra payment flowing to the Parent PLUS balance, and let the federal loan run its own track. Five loans, two strategies, no single payoff date. That split is the honest picture of this stack.
A $67,000 Whole Life Policy and No Term Cover
The second close look is the life insurance, because it is the protection box where the household spent money on the wrong tool. Brandon holds a whole life policy with a $67,000 death benefit, plus $75,000 of employer cover. Alissa holds nothing.
The prescription in the record is direct. Replace the whole life policy with individual term life of at least $500,000 to $1,000,000, and obtain term life for Alissa. Term at these ages prices a real death benefit for a small monthly premium. A $67,000 permanent policy prices a small benefit at a permanent premium.
Cover the income that the plan borrows against.
The traced gain runs through the life box only: 2 to 4, worth 2 points, because individual term on both earners is what full marks require.
Disability is the larger gap standing behind this one. Brandon has employer short term cover only, and Alissa has none and plans to obtain it in training. The hosts put her disability cover first in training, ahead of almost everything else in this file, because her future income is the asset the whole plan borrows against.
Milestones: Scored on What Is Stated
Inside the 3 Bucket Framework, the milestone checklist tracks the markers a household at this stage has already hit. This checklist earns 0 for Alissa and Brandon, 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: the emergency fund earns the full 6 at about 11 months of itemized expenses, named lanes earn 0 because dollar sorting is not stated, and goals funded earns 3 of 6. The framework earns 9 of 26, and its full box is the cash this household saved before residency starts.
Questions this case answers
What score did Alissa and Brandon receive on the Financial Health Assessment?
Alissa and Brandon scored 29 out of 100, in the Needs a workup band. The Transition framework earns the full 10 of 10, while the Lifestyle Guardrails earn 0 of 22 and the Protection Stack 4 of 22.
How much student debt do Alissa and Brandon carry?
Total stated student debt is $352,000 across five loans: $2,000 at 3 percent, $20,000 at about 5 percent, a $56,000 refinanced Parent PLUS loan at 4.35 percent, $24,000 at 4.5 percent, and $250,000 of medical school debt at about 7 percent.
Why does the emergency fund earn full marks in a 29 point file?
The savings accounts hold $28,000 against about $2,489 a month of itemized stated expenses, about 11 months. On the resident path, six months or more earns the full 6 points on the emergency fund box.
What do the fixes do to Alissa and Brandon's score?
The traced fix is worth 2 points, a score of 31. The gain is 2 for replacing the whole life policy with individual term life of at least $500,000 to $1,000,000 and obtaining term life for Alissa. A score of 31 out of 100 keeps the household in the Needs a workup 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 resident and fellow rubric. Alissa's specialty is carried as an intended pediatrics match, exactly as the record states it.
The resident and fellow rubric weights the seven frameworks at 26, 6, 22, 10, 8, 6, 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. Residents and fellows are scored on the Transition fork: the loan strategy, and the state of cards and other debt.