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Financial Health AssessmentPhysical Medicine and RehabilitationResident

Andrew and Aida

Financial Health Assessment · Published October 21, 2026

Physical Medicine and Rehabilitation Resident · Transitional year Engaged, no kids

Andrew, 27, is a transitional year intern about to start a PM&R residency. Aida, 24, is a paralegal. They earn about $95,000 between them in a Midwest city, and the assessment scores them 53 out of 100, in the Corrections band.

53

FHA score out of 100 · Corrections

$267,000

Student loans · consolidated at 5.75 percent

25%

Savings rate · stated, of take home pay

$10,000

Emergency fund · about 2.6 months of stated expenses

The loan plan is the strongest part of this file. The $267,000 sits in REPAYE at 5.75 percent with a $0 required payment, the household adds $600 to $700 a month to cover the full interest, and they declined PSLF on purpose, with a refinance planned after residency. The Transition framework earns 10 of 10.

The protection stack is built on one side only. Andrew carries his own disability policy and $2,000,000 of term life. Aida's term policy was being finalized, her disability coverage is not stated, there is no umbrella, and no estate documents are stated, weeks before a wedding.

53

FHA score out of 100 · Corrections

$95,000

Household income · resident and paralegal

$267,000

Student loans · full interest paid monthly

57

Score with the traced fix · the umbrella placed

Key takeaways

  • The score: 53 out of 100, in the Corrections band. Two frameworks earn full marks, the Transition framework at 10 of 10 and the Physician Wealth Equation at 6 of 6, while the Protection Stack earns 10 of 22.
  • The loan call was made on purpose: $267,000 consolidated at 5.75 percent in REPAYE, the subsidy covering half the unpaid interest, the household adding $600 to $700 a month to cover all of it, PSLF declined on purpose, and a refinance planned after residency.
  • Saving runs at a stated 25 percent of take home pay in residency, about $1,900 to $2,000 a month, which earns the Savings Floor full marks at 12 of 12 and stretch saving full marks at 6 of 6.
  • The protection stack stops halfway across the household. Andrew's disability and life coverage are in force. Aida's term policy was being finalized, her disability coverage is not stated, and there is no umbrella and no estate documents are stated.
  • The one fix the record traces to points is the umbrella: placing it moves the score 4 points to a 57. The file's other open items are Aida's term issue, her disability coverage, estate documents, and a deeper emergency fund.

They made the loan call on purpose. Most residents never make it at all.

The Household

Andrew is 27 and finishing a transitional year before a physical medicine and rehabilitation residency, earning $57,000. Aida is 24 and works as a paralegal, earning $38,000. They are engaged, with a wedding planned for January 1, and they rent a one bedroom duplex in a medium cost of living Midwest city.

Take home pay is about $5,700 a month. Stated monthly expenses run about $3,870: rent and utilities $1,270, about $1,600 through credit cards paid in full every month, $600 to $700 of loan payments, and a $350 car payment.

A 25 percent savings rate in residency is not an accident. It is a choice, made monthly.

Out of that income they save $1,900 to $2,000 a month, a stated rate of 25 percent of take home pay. The emergency fund holds $10,000, about 2.6 months of the stated expenses. Her Roth 401(k) holds about $7,000, the two Roth IRAs hold about $7,550 between them, and his HSA holds $500.

The student loans are $267,000, consolidated at 5.75 percent in REPAYE with a $0 required payment. The subsidy covers half the unpaid interest, about $650 a month, and the household adds $600 to $700 a month to cover all of it, because letting the balance grow through residency was an outcome they refused. PSLF was considered and declined on purpose.

Protection is where the file splits in two. Andrew holds an individual own occupation disability policy and $2,000,000 of term life in force. Aida's $1,000,000 term policy was being finalized, her disability coverage is not stated, and the household has no umbrella policy and no estate documents stated.

Household factWhere it stands
CareersPM&R resident (transitional year) and paralegal
Ages27 and 24
Household incomeAbout $95,000 a year, $57,000 plus $38,000; take home about $5,700 a month
Where they liveMidwest city, one bedroom duplex
FamilyEngaged, wedding January 1, no kids
Student loans$267,000 at 5.75 percent in REPAYE, $0 required payment, full interest covered monthly
Emergency fund$10,000, about 2.6 months of stated expenses
Saving$1,900 to $2,000 a month, a stated 25 percent of take home pay
Other debtCar loan $17,000 at 4 percent; cards paid in full monthly
DisabilityAndrew: individual own occupation $5,000 a month plus group $2,200 a month. Aida: not stated
Life insuranceAndrew: $2,000,000 term ladder in force. Aida: $1,000,000 term being finalized, not in force
UmbrellaNone in force; the household was working on getting it bundled
Estate documentsNot stated
GoalsFive stated: 25 percent savings rate, full loan interest, $5,000 wedding fund, good food on purpose, a written plan

The Score: 53 out of 100

The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Andrew and Aida score 53, in the Corrections band. This household is scored on the resident and fellow rubric path.

20

Measures graded

7

Frameworks

53

Andrew and Aida's score

The 3-Bucket Framework earns 5 of 26. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 0 at about 2.6 months of stated expenses, named lanes earn 2 because most dollars sort, and goals funded earns 3 with money flowing monthly but not to every goal.

The Physician Wealth Equation earns the full 6 of 6, all of it stretch saving at the stated rate of 25 percent of take home pay, which clears the full line on the resident path. Residents and fellows are never scored on debt to income.

The Protection Stack earns 10 of 22: health at the full 4, life at the full 4 on Andrew's in force term ladder, disability at 2 because Aida's coverage is not stated, and malpractice at 0 because the type and tail are not stated. Umbrella and estate documents earn 0: no umbrella is in place and no estate documents are stated.

The Transition framework earns the full 10 of 10: the loan strategy is deliberate and documented, and the cards carry no balance. The Tax Ladder earns 2 of 8 for a coherent Roth choice in a low bracket stage, with no bracket stated and the HSA sitting at $500.

The Decision Filter earns the full 6 of 6 on five stated goals. The Lifestyle Guardrails earn 14 of 22: the Savings Floor at the full 12 on the stated 25 percent rate, wealth first automation at 2, and the leak at 0 because the unaccounted amount is not stated, a gap the household names itself.

FrameworkWhat it coversPoints
02 3-Bucket FrameworkMilestones 0, emergency fund 0 at about 2.6 months, named lanes 2, goals funded 35 of 26
03 Physician Wealth EquationStretch saving 6 at a stated 25 percent of take home pay; residents are not scored on debt to income6 of 6
04 Protection StackHealth 4, disability 2, life 4, umbrella 0, malpractice 0, estate documents 010 of 22
05 TransitionLoan strategy 6, a deliberate REPAYE plan with full interest covered; cards and other debt 4, paid in full10 of 10
06 Tax LadderRoth against pre tax 2, bracket plus moves 02 of 8
07 Decision FilterGoals written 6, five goals stated on the intake6 of 6
08 Lifestyle GuardrailsSavings floor 12 at a stated 25 percent, the leak 0, wealth first automation 214 of 22
TotalCorrections band53 out of 100

Read the shape, not just the total. The behavior frameworks are nearly finished: the loan plan, the goals, and the savings rate are the work of a household that decided early. The zeros sit in the protection layer, and every one of them is a purchase or a signature away from closing.

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 a perfect 10 of 10 on a deliberate loan plan, and the Protection Stack, which stalls at 10 of 22 because it covers one earner instead of two.

Framework one

The Transition Framework

In training, the Transition framework grades the two decisions that follow a resident for a decade: the student loan strategy and the state of every other debt. This household made both calls early, and the framework earns 10 of 10.

The loan strategy

$267,000 consolidated at 5.75 percent in REPAYE, full interest covered monthly, PSLF declined on purpose, refinance planned after residency. The box earns 6 of 6.

Built

Cards and other debt

About $1,600 a month runs through credit cards and every statement is paid in full. The only other debt is a $17,000 car loan at 4 percent. The box earns 4 of 4.

Built

Framework two

The Protection Stack

The Protection Stack grades the coverage that keeps one bad month from ending the plan. Here it covers Andrew and stops: health is complete for both, and the rest of the stack earns 6 of the remaining 18 points.

Disability

Andrew holds an individual own occupation policy paying $5,000 a month, plus group coverage of $2,200 a month. Aida's disability coverage is not stated, so the box earns 2 of 4.

Partial

Life insurance

Andrew's $2,000,000 term ladder is in force, which earns the full 4. Aida's $1,000,000 term policy was being finalized at intake; her issued coverage is the file's open item.

Built

Umbrella and estate documents

No umbrella policy is in force, the bundle still being worked on, and no estate documents are stated with a wedding weeks away. The malpractice type and tail are not stated either. All three boxes earn 0.

Missing

What They Did Right

A 53 in residency has real structure under it. This is what is already built.

The loan call was made on purpose

$267,000 consolidated at 5.75 percent in REPAYE, full interest covered every month, PSLF weighed and declined, and a refinance planned for after residency. The Transition framework earns the full 10 of 10.

A 25 percent savings rate in training

Saving $1,900 to $2,000 a month, a stated 25 percent of take home pay, clears the Savings Floor at full marks in residency. The floor box earns the full 12 of 12, and stretch saving earns 6 of 6.

Disability bought during training

Andrew holds an individual own occupation disability policy, $5,000 a month to age 65, bought while he was still in training and cheap to insure.

Cards paid in full, every month

About $1,600 a month of spending runs through credit cards and no balance is ever carried. The only other debt is a $17,000 car loan at 4 percent.

Five goals, stated out loud

A 25 percent savings rate, full loan interest, a $5,000 wedding fund by December 2020, good food on purpose, and a written financial plan. The Decision Filter earns the full 6 of 6.

The Loan Call Most Residents Never Make

The first deep dive is the loan plan, and the finding is a decision made early and on purpose. The $267,000 is consolidated at 5.75 percent in REPAYE. The required payment is $0. The subsidy covers half the unpaid interest, and the household adds $600 to $700 a month of its own money to cover the rest.

Paying full interest in residency is a choice with a price: $600 to $700 a month out of a trainee budget, on top of a $0 required payment. The return is a balance that never grows. The loan they refinance after residency is the loan they borrowed, not the loan plus residency's capitalized interest.

The balance they refinance later is the balance they borrowed.

PSLF was on the table and they declined it, with a plan to refinance after residency. A forgiveness plan declined for stated reasons scores the same as one accepted.

The rest of the debt picture matches the discipline. Credit cards carry the monthly spending and are paid in full, every month. The car loan is $17,000 at 4 percent. There is no consumer debt anywhere in the file.

This is why the Transition framework earns 10 of 10. Nothing about the debt is drifting. Every piece of it was decided, and the decisions are written into the monthly numbers.

A Protection Stack Built for One

The second deep dive is the Protection Stack, and the finding is a line down the middle of the household. Andrew's side is finished. He holds an individual own occupation disability policy paying $5,000 a month, group disability of $2,200 a month behind it, and $2,000,000 of term life in force.

Aida's side is paperwork. Her $1,000,000 term policy was being finalized when the household called in. Her disability coverage is not stated at all, on a $38,000 income the household budget already spends.

An application is not coverage.

The umbrella is the same story at household level: the bundle was being worked on, and no policy was placed. Two incomes, a car, and a rented duplex are exactly the exposure an umbrella exists for, at a few hundred dollars a year.

The estate documents are the last empty box, and the wedding made it urgent. The wedding is January 1. Marriage changes what happens by default if something goes wrong, and wills, powers of attorney, and healthcare directives are the documents that replace the defaults with their own choices.

None of these gaps needs a raise or a new system. Each one closes with an application finished, a policy placed, or an afternoon with an attorney, which is why the prescription below is short.

Milestones: Scored on What Is Stated

Inside the 3-Bucket Framework, the milestone checklist tracks the markers a training household has already hit. This checklist earns 0 for Andrew and Aida, not because the markers are missing, but 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 sits around it: named lanes earn 2 of 4, the emergency fund earns 0 at about 2.6 months of stated expenses, and goals funded earns 3 of 6, with money flowing to the emergency fund, the wedding fund, and retirement.

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The Prescription

One traced fix, and the open items behind it.

1

Finish getting the umbrella policy, bundled with auto and renters.

This is the Protection Stack, and it gains 4 points, moving umbrella from 0 to 4. It is the prescription the episode itself gave, and the only gain in the record's target basis. The household was already working on the bundle at intake; finishing it is the whole step.

2

Issue Aida's term policy.

Her $1,000,000 application was being finalized at intake. The record attaches no point gain to it in the target basis. It is listed because coverage on the second earner of a two income household is the file's most obvious loose end.

3

Put disability coverage in place for Aida.

Her disability position is not stated anywhere in the record, while Andrew's own occupation policy is in force. No point gain is traced for it here. A two income household runs on both incomes, and hers is already spent inside the budget every month.

4

Sign the estate documents around the wedding.

No will, power of attorney, or healthcare directive is stated. The wedding is January 1, and marriage is the moment the legal defaults change. No point gain is traced for the documents in the target basis; they are owed anyway.

5

Build the emergency fund past 2.6 months.

The fund holds $10,000 against about $3,870 of stated monthly expenses. The savings rate that built it can deepen it without touching the loan plan, and residency is exactly when a thin fund gets tested.

The traced arithmetic is 53 plus 4, a score of 57, from the umbrella alone. The other four items carry no traced gains in the record's target basis. They are the file's open items, listed because the household owes them, not because the score needs them.

What This Case Teaches

The loan decision is worth making before it makes itself. Andrew and Aida treated $267,000 as a plan, not a balance: a chosen repayment path, full interest covered, a forgiveness option weighed and declined, and a refinance date on the calendar. The Transition framework pays full marks for decided debt, whatever the decision is.

Coverage on one earner of a two income household protects half the plan.

The second lesson is about halves. A protection stack built for the physician alone leaves the partner's income, and the spending built on it, uncovered. The file's remaining work is not more saving. It is finishing the second half of a stack that is already half built.

Questions this case answers

What score did Andrew and Aida receive on the Financial Health Assessment?

Andrew and Aida scored 53 out of 100, in the Corrections band. The Transition framework earns the full 10 of 10 and the Physician Wealth Equation the full 6 of 6, while the Protection Stack scores 10 of 22.

How did Andrew and Aida handle $267,000 of student loans in residency?

The loans are consolidated at 5.75 percent in REPAYE with a $0 required payment. The subsidy covers half the unpaid interest, and the household adds $600 to $700 a month to cover all of it. They declined PSLF on purpose and plan to refinance after residency.

What is the first fix for Andrew and Aida?

Finish getting the umbrella policy. It is the one fix the record traces to points: placing the umbrella, bundled with auto and renters, moves the score from 53 to 57. The household was already working on the bundle at intake.

What do the fixes do to Andrew and Aida's score?

The traced prescription is the umbrella policy: 53 plus 4, a score of 57. The file also names open items with no traced gain attached: Aida's term application to issue, disability coverage for Aida, estate documents around the wedding, and an emergency fund past its current 2.6 months.

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.

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.

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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