Financial Health Assessment
Boyd and Alfreda: Anesthesiology Resident Household Scores 60 Out of 100
By Ryan Inman
Published · Updated
AnesthesiologyResident · First yearCouple, not yet married
Financial Health Assessment score
60 out of 100
Corrections
- 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. Boyd and Alfreda lands at 60, in the Corrections band, score 40 to 69.
Boyd is a new anesthesiology resident earning about $60,000 a year. Alfreda is a physician assistant earning about $175,000 a year, about 75 percent of it W-2 and the rest 1099 side work. The household earns about $235,000 and has no children. The assessment scores the household 60 out of 100, in the Corrections band.
The saving machine is funded on both incomes. Stated flows run $5,220 a month: Boyd sends $1,625 to a Roth 403b, about $300 to an HSA, and $500 to a Roth IRA. Alfreda sends $1,625 to a traditional 403b, $500 to a backdoor Roth IRA, and $670 to a solo 401k. That is about 26.7 percent of the $235,000 gross income, ahead of the household's own goal of at least 20 percent. Investable accounts stand at about $84,000, including EE savings bonds of about $25,000.
The gaps sit in two places. About $30,000 a year of take home pay is not accounted for by any of the listed numbers, on Boyd's own statement. Alfreda does not budget line by line, and he has agreed not to watch it. And there are no estate documents yet, though the household plans to use a free healthcare worker estate site. The one traced fix in this file is that estate set, and it is worth 4 points.
$5,220 a month
Stated saving flows · about 26.7 percent of gross
$30,000
Take home a year · not accounted for
$34,000
Emergency funds · about 5.4 months of expenses
About $235,000
Household income · resident plus physician assistant
64
Score with the traced fix · Corrections band
The short version
- The score: 60 out of 100, in the Corrections band. The Physician Wealth Equation earns the full 6 of 6 and the Decision Filter the full 6 of 6, while the 3 Bucket Framework earns 8 of 26.
- Stated saving flows of $5,220 a month run at about 26.7 percent of gross income, ahead of the household's own goal of at least 20 percent, with about $84,000 already invested.
- About $30,000 a year of take home pay is not accounted for by any of the listed numbers, which grades the leak at 0 of 6. The hosts' main prescription is behavioral, and the record traces no points to it.
- Protection is split by earner: Boyd holds individual own occupation disability and a $500,000 term policy, while Alfreda holds group disability and group life only. Health cover stands on both, and a $1,000,000 umbrella is in place.
- One traced fix moves the score 4 points to a 64: complete the estate documents the household already plans to obtain. A score of 64 stays in the Corrections band.
Six accounts funded across two incomes, and $30,000 a year unwatched.
What They Did Right
This is the machinery already running.
- Flows at about 26.7 percent Stated saving flows of $5,220 a month run ahead of the household's own goal of at least 20 percent of gross. The stretch box and the savings floor both grade full.
- Six accounts funded across two incomes A Roth 403b, a traditional 403b, an HSA, two Roth IRAs, and a solo 401k across the two incomes, with payroll deferrals maxed first.
- Health cover and umbrella in place Both partners covered at $95 a month combined, and a $1,000,000 umbrella in force during residency. Each box earns the full 4.
- Cards paid in full, always The cards are used for bonuses and cash back and never carry a balance, as stated. Cards and other debt earn the full 4.
- Five goals, written The Decision Filter earns the full 6: the goals are stated, and retirement funding runs at the stated flows.
The Score: 60 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Boyd and Alfreda scores 60, in the Corrections band. This household is scored on the resident and fellow rubric path, driven by Boyd's residency. Alfreda is a practicing physician assistant, and the record states that beside the fork.
19
Measures graded
7
Frameworks
60
Boyd and Alfreda's score
The 3 Bucket Framework earns 8 of 26. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 3: about $34,000 against stated expenses of about $6,330 a month is about 5.4 months, partway up the resident scale. Named lanes earn 2, on Boyd's detailed budgets with Alfreda not budgeting line by line and most dollars in lanes. Goals funded earns 3, with retirement goals funded at the stated flows and no ring or wedding fund stated.
The Physician Wealth Equation earns the full 6 of 6 on the resident stretch box: stated flows of $5,220 a month are about 26.7 percent of the $235,000 gross income, past the 25 percent full line on the resident scale. Residents are never scored on debt to income. The loans are graded through the loan strategy box instead.
The Protection Stack earns 13 of 22. Health earns the full 4, on cover in force on both earners at $95 a month in combined premiums. Disability earns 2: Boyd holds an individual own occupation policy, and Alfreda holds group long term disability only. Life earns 2: Boyd's $500,000 term policy is individual, and Alfreda's cover is group life only. Umbrella earns the full 4, at $1,000,000 against stated home, cash, and investable assets under $1,000,000 in total value. Malpractice earns 1: Alfreda's claims made policy is stated and its tail is not, and Boyd's malpractice cover is not stated. Estate documents earn 0, because none exist yet.
The Transition framework earns 7 of 10. The loan strategy box earns 3: Boyd's federal loans on REPAYE at $0 in the first year are a full strategy, and Alfreda's $80,000 private refinance makes the household strategy mixed. Cards and other debt earn the full 4, because the cards are always paid in full, as stated.
The Tax Ladder earns 4 of 8, at 2 and 2: Roth and pre tax accounts are used side by side on both incomes with no bracket reason stated, and two deliberate moves stand in place, HSA funding and a backdoor Roth, with the federal bracket not stated. The Decision Filter earns the full 6 of 6 on five stated goals.
The Lifestyle Guardrails earn 16 of 22: the Savings Floor at the full 12 on a rate of about 26.7 percent, the leak at 0 because about $30,000 a year of take home pay is stated as not accounted for, and wealth first automation at the full 4, on maxed payroll deferrals coming first, before discretionary spending.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 3 at about 5.4 months, named lanes 2, goals funded 3 | 8 of 26 |
| 03 Physician Wealth Equation | Stretch saving 6 at about 26.7 percent. Residents are not scored on debt to income | 6 of 6 |
| 04 Protection Stack | Health 4, disability 2, life 2, umbrella 4, malpractice 1, estate documents 0 | 13 of 22 |
| 05 Transition | Loan strategy 3, federal plan beside a private refinance. Cards and other debt 4, paid in full | 7 of 10 |
| 06 Tax Ladder | Roth against pre tax 2, bracket plus moves 2 | 4 of 8 |
| 07 Decision Filter | Goals written 6, five goals stated | 6 of 6 |
| 08 Lifestyle Guardrails | Savings floor 12, the leak 0 at about $30,000 unaccounted, wealth first automation 4 | 16 of 22 |
| Total | Corrections band | 60 out of 100 |
Read the shape, not just the total. The flow boxes are finished work: a savings rate past the resident full line, payroll deferrals maxed first, five goals written, health cover and an umbrella in force. Among the zeros are an estate box with no documents in it and a leak box with about $30,000 a year inside it. Between them sits the household's actual project, stated by the hosts: two separate money habits becoming one plan before a wedding.
The Prescription
One traced fix, and the open items behind it.
- Complete the estate documents. This is the Protection Stack, and it gains 4 points, moving estate documents from 0 to 4. A will, a power of attorney, and a healthcare directive for each partner: the set the household already plans to obtain through a free healthcare worker estate site. No children are stated, so the set is the adult set.
- Get both partners on the same financial page. The hosts' main prescription for this household, ahead of the marriage: one budget both partners can see, including the roughly $30,000 a year that sits unaccounted for today. The record traces no point gain for this item, because it maps to no box.
- State the malpractice lines in full. The tail on Alfreda's claims made policy is not stated, and Boyd's malpractice cover is not stated at all, which holds the box at 1 of 2. No point gain is traced for this item.
- Fund the wedding line. Marriage is planned and no ring or wedding fund is stated, which holds goals funded at 3 of 6 beside retirement flows that run at full pace. No point gain is traced for this item.
Run the traced fix and the arithmetic is 60 plus 4, a score of 64. The gain is 4 for completing the estate documents the household already plans to obtain. A score of 64 out of 100 keeps the household in the Corrections band.
What This Case Teaches
A system can be complete and still leave one line unwatched. This household pays itself first through payroll on both incomes, pays its cards in full, holds health cover and an umbrella during residency, and states its flows to the dollar. It also states, in the caller's own words, that about $30,000 a year of take home pay is accounted for by none of those numbers. The boxes grade both facts: full marks for the floor and the automation, zero for the leak.
State the unwatched line, and it can be planned.
The second lesson is where the traced fix sits. The only points the record can promise this household are in the estate box, at 0 of 4, because a target is arithmetic traced from a prescription to a box. The behavioral item the hosts cared about most moves no box at all, and this page says so in the open, next to the one fix it can price.
Behind the score
The Household
Boyd is a new anesthesiology resident at about $60,000 a year. Alfreda is a physician assistant at about $175,000 a year, about 75 percent W-2 and 25 percent 1099 side work. The household earns about $235,000. The couple is not married yet and has no children. Marriage and children are planned. The rubric driver is Boyd as the resident. Alfreda's practicing status is stated here and in the record, per protocol.
Investable accounts total about $84,000, including EE savings bonds of about $25,000. Cash emergency funds stand at about $34,000, about $15,000 of Boyd's and about $19,000 of Alfreda's, beside a $10,000 tax sinking fund. Stated monthly expenses run about $4,180 fixed plus about $2,150 variable, about $6,330 in all, which puts the emergency funds at about 5.4 months.
Six funded accounts on one side, an unwatched $30,000 on the other.
The saving system runs $5,220 a month, stated as forward looking on a new job: Boyd's $1,625 Roth 403b, about $300 HSA, and $500 Roth IRA, and Alfreda's $1,625 traditional 403b, $500 backdoor Roth IRA, and $670 solo 401k. About $30,000 a year of take home pay sits outside the system entirely, not accounted for by any of the listed numbers. The hosts call this one of the most organized assessments they have aired.
Debt sits in four stated lines. Boyd's student loans are $170,000 federal consolidated at 5.875 percent, entering REPAYE with $0 payments in the first year, with PSLF undecided. Alfreda's are an $80,000 private refinance at 3.4 percent fixed over ten years at $820 a month, plus $15,000 of institutional and subsidized federal loans at about $100 a month. The mortgage is $315,000 at 2.375 percent on a 15 year doctor loan, at about $2,600 a month. Alfreda's auto loan runs at 0 percent, $330 a month with three years left. Its balance is not stated. Credit cards are used for bonuses and cash back and always paid off.
Protection is bought in layers and split by earner. Both hold health cover at $95 a month in combined premiums, Boyd on a high deductible plan. Boyd holds an individual own occupation disability policy paying $1,875 a month. Alfreda holds group long term disability only. Boyd holds a 20 year term life policy of $500,000. Alfreda holds group life only, at about four times salary. An umbrella policy of $1,000,000 is in place. Alfreda carries a personal claims made malpractice policy for her 1099 work at about $900 a year, with the tail not stated. Boyd's malpractice cover is not stated. There are no estate documents yet. The household plans to use a free healthcare worker estate site.
| Household fact | Where it stands |
|---|---|
| Careers | Anesthesiology resident, first year. Physician assistant, practicing |
| Household income | About $60,000 plus about $175,000. Household about $235,000. Her pay about 75 percent W-2 and 25 percent 1099 side work |
| Family | Couple, not yet married. No children. Marriage and children planned |
| Student loans | Boyd $170,000 federal at 5.875 percent, REPAYE at $0 in year one, PSLF undecided. Alfreda $80,000 private refinance at 3.4 percent, $820 a month, plus $15,000 institutional and subsidized at $100 a month |
| Mortgage | $315,000 at 2.375 percent on a 15 year doctor loan, under 10 percent down, about $2,600 a month |
| Other debt | Auto loan at 0 percent, $330 a month, three years left, balance not stated. Cards paid in full every month. Stated loan balances about $580,000 |
| Emergency fund | About $34,000 across both partners, plus a $10,000 tax sinking fund. About 5.4 months on stated expenses of about $6,330 a month |
| Saving | $5,220 a month stated: Roth 403b $1,625, HSA about $300, Roth IRA $500, traditional 403b $1,625, backdoor Roth $500, solo 401k $670. About 26.7 percent of gross |
| Balances | Investable about $84,000 including EE savings bonds of about $25,000. Cash emergency funds about $34,000 |
| Disability | Boyd: individual own occupation policy, $1,875 a month benefit. Alfreda: group long term disability only |
| Life insurance | Boyd $500,000 for 20 years, individual term. Alfreda group life only, about four times salary |
| Umbrella | $1,000,000 policy in place |
| Estate documents | None yet. A free healthcare worker estate site is planned. No minors |
| Goals | Five stated goals. Retirement funded at the stated flows. No ring or wedding fund stated |
The Two Frameworks Behind the Score
The score grades 19 measures across seven frameworks. Two of them carry this case: the Lifestyle Guardrails, which score 16 of 22 on a full floor and a zero leak, and the Protection Stack, which scores 13 of 22 with the estate box empty.
Framework one
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 floor and the automation are finished. The leak is the file.
- The savings floor Built
- Stated flows run at about 26.7 percent of gross income, ahead of the household's own goal of at least 20 percent. The box earns the full 12 of 12.
- The leak Missing
- About $30,000 a year of take home pay is stated as not accounted for, past the partial threshold in the stated figures. The box earns 0 of 6.
- Wealth first automation Built
- Maxed payroll deferrals come first, before discretionary spending, on both incomes. The box earns the full 4.
Framework two
The Protection Stack
The Protection Stack grades the coverage that keeps one bad month from ending the plan. Health and umbrella are finished, the earner cover is split, and the documents do not exist yet: 13 of 22.
- Health cover and umbrella Built
- Both partners hold health cover at $95 a month in combined premiums, and a $1,000,000 umbrella policy stands in place. Each box earns the full 4.
- Disability and life, split by earner Partial
- Boyd holds individual own occupation disability and an individual term life policy. Alfreda holds group disability and group life only. Each box earns 2 of 4.
- Estate documents Missing
- No will, no power of attorney, and no healthcare directive exists yet, though the household plans to use a free healthcare worker estate site. The box earns 0 of 4, and completing the set is the file's one traced fix.
Thirty Thousand Dollars a Year, Unaccounted
The first look is the caller's own sentence, timed at 5:09 in the episode: after every listed number, about $30,000 of take home pay a year is left, not accounted for by any of the numbers he listed. The household's flows are otherwise stated to the dollar, which is what makes the sentence stand out.
The record states the arrangement plainly. Boyd budgets in detail. Alfreda does not budget line by line, and he has agreed not to watch the unaccounted money. Named lanes earn 2 of 4 on that split: most dollars sit in lanes, and one partner's spending sits outside them on purpose.
The system is stated to the dollar, except for $30,000 a year.
The leak box grades the result at 0 of 6: the unaccounted amount is stated, and it sits above the partial threshold. The hosts' main prescription for this household is behavioral, getting both partners on the same financial page before the marriage, and the record traces no points to it, because no box grades a conversation.
The item stands here in the open, and it carries no traced fix. The traced fix in this file is paper, and it is the subject of the next section.
The Empty Estate Box
The second look is the estate box, graded at zero because the set does not exist. There is no will, no power of attorney, and no healthcare directive yet. The household plans to use a free healthcare worker estate site, and the score grades what is in force today: 0 of 4.
The set this household needs is the adult set. No children are stated, so no guardian line is open. The documents are a will, a power of attorney, and a healthcare directive for each partner, in a household that is also planning a wedding.
Every account is funded. The paper file is empty.
The record traces the whole box to completing the planned set: 4 points, the file's one traced fix. Around it sit the partial lines: Alfreda's group only disability and life cover, and a malpractice line graded at 1 of 2, her claims made policy in force for the 1099 work with its tail not stated and Boyd's malpractice cover not stated at all.
Set against flows at about 26.7 percent and a plan the hosts called one of the most organized they have aired, the empty box is the pattern: the daily system is built, and the one time paperwork waits.
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 Boyd and Alfreda, 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 3 at about 5.4 stated months, named lanes earn 2 on detailed budgets beside one partner's unbudgeted spending, and goals funded earns 3 of 6 on retirement flows that run at the stated pace while no ring or wedding fund is stated. The framework earns 8 of 26.
Questions this case answers
What score did Boyd and Alfreda receive on the Financial Health Assessment?
Boyd and Alfreda scored 60 out of 100, in the Corrections band. The Physician Wealth Equation earns the full 6 of 6 and the Decision Filter the full 6 of 6, while the 3 Bucket Framework earns 8 of 26.
Where does the unaccounted money sit for Boyd and Alfreda?
About $30,000 a year of take home pay is not accounted for by any of the listed numbers, on the caller's own statement. Boyd budgets in detail. Alfreda does not budget line by line, and he has agreed not to watch the unaccounted money. The leak box grades that at 0 of 6, and the hosts' main prescription, getting both partners on the same financial page before marriage, maps to no box.
What is missing for Boyd and Alfreda?
There are no estate documents yet, though a free healthcare worker estate site is planned. Alfreda's disability cover is group long term disability only, and her life cover is group life only at about four times salary. Boyd's malpractice cover is not stated, and the tail on Alfreda's claims made policy is not stated.
What do the fixes do to Boyd and Alfreda's score?
One traced fix: completing the estate documents moves the score 4 points, from 60 to 64. The gain is 4 for the estate set, a will, a power of attorney, and a healthcare directive, with no minors in the household. A score of 64 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 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.