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Financial Health AssessmentAnesthesiologyEstablished

Brad and Alina

Financial Health Assessment · Published October 22, 2026

Anesthesiology Established attending · Partner Married, one child and one on the way

Brad, 37, is an anesthesiologist who made partner in his group over the summer, and Alina, 34, stays home with their child of four and a half, with a second child about to be born. The household earns $400,000 and bought a newer build on ten acres six months ago. The assessment scores them 44 out of 100, in the Corrections band.

44

FHA score out of 100 · Corrections

$1,117,100

Total stated debt · 2.79 times income

$389,100

Student loans · three loans, 4.52 to 5.63 percent

$728,000

Two mortgages · 4.88 and 6 percent

Start with what is in place. The disability cover on the sole earner is stated as true own occupation. The core estate documents exist: a will, a healthcare directive, a living trust. The 401k takes $20,000 a year, the family HSA $7,000, and the credit card is paid in full every month, with no consumer debt of any kind.

Then the stack. Over $1.1 million of debt in total: $389,100 of student loans across three loans, on top of two mortgages totaling $728,000, at 4.88 and 6 percent. The emergency fund's amount is not stated anywhere. There is no umbrella. And the life cover on a $400,000 sole income is $1.15 million of term, in a file where the hosts put the need at $3 million to $4 million, with no cover at all stated for Alina.

44

FHA score out of 100 · Corrections

$400,000

Household income · one earner, new partner

2.79x

Total debt against income · $1,117,100

48

Score with the two traced fixes · Corrections band

Key takeaways

  • The score: 44 out of 100, in the Corrections band. The Protection Stack earns 14 of 22 and the Decision Filter the full 4 of 4, while the Physician Wealth Equation earns 5 of 14.
  • Total debt is $1,117,100: $389,100 of student loans stacked on $728,000 across two mortgages, 2.79 times the $400,000 income.
  • Both mortgage rates, 4.88 and 6 percent, and all three student loan rates sit above what the hosts priced as the going market on the episode. Refinancing is the largest cash item in the file and carries no traced points.
  • Life cover totals $1.25 million across three policies on the sole earner, against the $3 million to $4 million range the hosts suggested, and no cover is stated for Alina.
  • The two traced fixes are the reserve and the umbrella: build the emergency fund to at least three months, and obtain umbrella coverage. Together, 4 points, to a score of 48.

A partner income with a resident era reserve is a plan with a date on it.

The Household

Brad is 37, an anesthesiologist who made partner in his group over the summer. Alina is 34 and stays home with their child. They are married, with a daughter of four and a half in school and a second child about to be born. Household income is $400,000, all of it his. Their statement was read on air by a proxy reader, because the couple asked to stay anonymous.

Six months ago they bought the house: a newer build on ten acres. It came with two mortgages, not one. The first is $450,000 over 30 years at 4.88 percent, $2,800 a month. The second is $278,000 over 15 years at 6 percent, $2,300 a month. Together $728,000, and $5,100 a month before any other bill is paid.

Ten acres, two mortgages, and one income carrying both.

The student loans are the second stack: three loans totaling $389,100. The large one is $238,000 at 4.52 percent fixed to January 2023, with a payoff date of 2028. The others are $77,500 at 5.63 percent variable, payoff February 2026, and $73,600 at 5.13 percent variable, payoff 2029. The intake does not state whether the loans are federal or private; the hosts read the wording as private loans. Total stated debt across the file is $1,117,100, and the only other line is a credit card paid in full every month.

The monthly list is itemized to the trash bill: energy $350, phone $183, school $410, fuel $150, groceries $500 to $600, eating out and entertainment $100 to $300, retail $200, travel $4,000 to $5,000 a year. Annual flows run $20,000 to the 401k, $7,000 to a family HSA, $200 a month to a 529, and $1,000 to $2,000 a month of saving. Counted at the low end, the stated saving rate is about 10.4 percent. Two Roth IRAs hold $11,000 each, with no current flow stated. The banking runs through Wells Fargo: one joint account for the bills, savings for quarterly taxes and the emergency fund, and a personal checking account of Brad's with a very small balance. The emergency fund exists. Its amount is not stated.

Disability is stated as true own occupation at $550 a month. Life cover is three policies: term of $1,000,000 at $641 a year, term of $150,000 at $93 a year, and an adjustable comp life policy of $100,000 at $417 a year. All three sit on Brad, as far as the statement says. No life cover is stated for Alina. There is no umbrella policy. The estate file holds a will, a healthcare directive, and a living trust. Whether a power of attorney is in it, the caller was not sure, and no guardian is stated for the two children.

Household factWhere it stands
CareersAnesthesiologist, partner in his group since the summer; stay at home parent
Ages37 and 34
Household income$400,000 a year, one earner
Where they liveNewer build on ten acres, bought six months ago
FamilyMarried, one child age four and a half, and one about to be born
Student loans$389,100 across three loans at 4.52, 5.63, and 5.13 percent, payoffs 2026 to 2029; federal or private not stated
MortgagesTwo, totaling $728,000: $450,000 at 4.88 percent over 30 years, and $278,000 at 6 percent over 15 years
Other debtNone stated; credit card paid in full monthly
Emergency fundAccount exists; amount and months not stated
Saving$1,000 to $2,000 a month, plus $20,000 a year to the 401k, $7,000 to a family HSA, and $200 a month to a 529; about 10.4 percent at the low end
Retirement balancesRoth IRAs $11,000 each; contribution flow not stated
DisabilityTrue own occupation stated, $550 a month
Life insuranceTerm $1,000,000 and $150,000, plus an adjustable comp life policy of $100,000, all on the earner as far as stated; no cover stated for Alina
UmbrellaNone, stated
Estate documentsWill, healthcare directive, and living trust stated; power of attorney unsure; guardian not stated
GoalsGet out of student debt, live life fully, handle emergencies, save for retirement and the kids' education, love where we live

The Score: 44 out of 100

The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Brad and Alina score 44, in the Corrections band. This household is scored on the attending rubric path.

20

Measures graded

7

Frameworks

44

Brad and Alina's score

The 3-Bucket Framework earns 5 of 20. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 0, because its amount and its months are not stated. Named lanes earn 2, on an expense list itemized in detail with one personal account unexplained. Goals funded earns 3, with dollars flowing to the 529, retirement, and savings goals without fully funding them.

The Physician Wealth Equation earns 5 of 14. The Debt Anchor earns 5: total stated debt of $1,117,100 against $400,000 of income is 2.79 times income. Stretch saving earns 0, because the rate counted at the low end of the stated flows, about 10.4 percent, sits below the 12 percent partial bar.

The Protection Stack earns 14 of 22, the strongest framework in this file: health, disability, and life at the full 4 each, and estate documents at 2, with the power of attorney unsure and a guardian not stated for two children. Umbrella is absent by the household's own statement, and malpractice type and tail are not stated.

The Transition framework earns 4 of 10: cards and other debt at the full 4, because the card is paid in full and no consumer or vehicle debt exists, and the loan strategy at 0, because the student loans are not paid off and no forgiveness plan is stated. The Tax Ladder earns 4 of 8, 2 for Roth IRAs held beside the pre tax 401k and HSA, and 2 for the family HSA funding as a deliberate move, with the bracket not stated.

The Decision Filter earns the full 4 of 4 on five stated goals. The Lifestyle Guardrails earn 8 of 22: the Savings Floor at 6 on the low end rate, the leak at 0 because the unaccounted amount is not stated as zero, and wealth first automation at 2, because the payroll 401k and HSA run while the monthly saving is a range, not an automated first claim.

FrameworkWhat it coversPoints
02 3-Bucket FrameworkMilestones 0, emergency fund 0 (amount not stated), named lanes 2, goals funded 35 of 20
03 Physician Wealth EquationDebt Anchor 5 at 2.79 times income, stretch saving 0 at about 10.4 percent5 of 14
04 Protection StackHealth 4, disability 4, life 4, umbrella 0, malpractice 0, estate documents 214 of 22
05 TransitionLoan strategy 0, loans open with no forgiveness plan stated; cards and other debt 44 of 10
06 Tax LadderRoth against pre tax 2, bracket plus moves 24 of 8
07 Decision FilterGoals written 4, five goals stated including getting out of student debt4 of 4
08 Lifestyle GuardrailsSavings floor 6 at about 10.4 percent, the leak 0, wealth first automation 28 of 22
TotalCorrections band44 out of 100

Read the shape, not just the total. The protection boxes a sole earner household is graded on are mostly bought, and the goals are written. The missing points sit under the house: a debt stack at 2.79 times income, priced at rates the episode called high for its market, and a reserve whose size nobody stated.

The Two Frameworks Behind the Score

The score grades 20 measures across seven frameworks. Two of them carry this case: the Physician Wealth Equation, which scores 5 of 14 on the weight of the debt stack, and the Protection Stack, which scores 14 of 22 with its two holes in plain sight.

Framework one

The Physician Wealth Equation

The Wealth Equation grades the balance sheet against the income: how much debt the income carries, and how fast the saving moves. At $400,000 of income, this framework is where the stack shows.

The Debt Anchor

Total stated debt of $1,117,100 against $400,000 of income is 2.79 times income. The box earns 5 of 10, the established partial.

Partial

Stretch saving

Counted at the low end of the stated flows, the saving rate is about 10.4 percent, under the 12 percent partial bar. The box earns 0 of 4.

Missing

The rate picture in full

Flows are real: $20,000 to the 401k, $7,000 to the HSA, $200 a month to a 529, and $1,000 to $2,000 a month of saving on top. On $400,000, real is not yet fast.

Partial

Framework two

The Protection Stack

The Protection Stack grades the coverage that keeps one bad month from ending the plan. Fourteen of 22 is a strong stack, and its gaps are specific.

Disability and life

Disability is stated as true own occupation on the sole earner, and term life of $1,150,000 is in force beside it. Both boxes earn the full 4, scored as stated.

Built

Umbrella

Absent by the household's own statement, in a file with ten acres, two mortgages, and a sole income. The box earns 0 of 4.

Missing

Estate documents

A will, a healthcare directive, and a living trust are stated. The power of attorney is unsure per the caller, and no guardian is stated for a child of four and a half and a baby on the way. The box earns 2 of 4.

Partial

What They Did Right

A Corrections score at this income, with this stack of debt, still holds real strengths. These are the load bearing ones.

Disability stated as true own occupation

On the sole earner of a $400,000 household, the disability box earns the full 4 as stated.

Core estate documents exist

A will, a healthcare directive, and a living trust, already done. The open items are the power of attorney and the guardian.

Retirement flows at attending scale

$20,000 a year to the 401k and $7,000 to a family HSA run annually, with a 529 funded at $200 a month and two Roth IRAs open.

No consumer debt of any kind

The card is paid in full monthly and no vehicle or other debt is stated. Cards and other debt earn the full 4 of 4.

Goals written as a household

Five stated goals, and two of them are about living: date nights, yearly vacations, and loving where they live. The Decision Filter earns the full 4.

The $1.1 Million Stack, and Its Rates

The first deep dive is the stack itself, because every other conversation in this file routes around it. Student loans: $389,100 across three loans. Mortgages: $728,000 across two, on a house bought six months ago. Total: $1,117,100, against $400,000 of income, all of it one person's.

The hosts' point was not the size. It was the price. The mortgage rates are 4.88 and 6 percent. The student loans run 4.52, 5.63, and 5.13 percent. On the episode, the hosts priced the rate gap as the largest cash saving in the file. None of that carries a traced point in the score. It is still the first money item in the file.

The stack is not the scandal. The price of the stack is.

Underneath the stack sits the reserve problem. The household's third goal is to handle any medical or financial emergency, and the emergency fund exists as an account whose amount nobody stated. On a sole income carrying $5,100 a month of mortgage payments, the difference between one month of reserve and three is the difference between a bad month and a forced sale of something. The traced prescription starts there.

Cover Priced for a Smaller Household

The second deep dive is the life cover, because the stack scores it at full marks and the hosts still questioned the amount. Both things are true, and the page keeps them separate. The score of record grades what is in force: term of $1,000,000 and $150,000, in force, earning the life box its 4. The episode graded the amount against the income, and found it sized for a smaller household.

The hosts put the need for a sole earner at $400,000 in the $3 million to $4 million range, built as a ladder. Against that range, $1.25 million across three policies, one of them a $100,000 adjustable comp life policy, is cover sized for a smaller household.

The cover is sized for a smaller household. The file earns $400,000 now.

Two more items sit inside the same conversation. Alina has no life cover stated at all. Her work, full time care of two small children, is unpaid and expensive to replace. And the disability policy carries a flag the record keeps visible: it is stated as true own occupation and scored as stated, and the hosts raised the carrier's medical own occupation definition. An independent agent's review of the whole policy set is the open item the file names, before any policy is changed and after any replacement cover is in force.

The umbrella belongs in this conversation too. It is absent, stated plainly, and it is one of the two traced fixes, because at partial credit it is worth 2 points and it is the cover a ten acre property argues for on its own.

Milestones: Scored on What Is Stated

Inside the 3-Bucket Framework, the milestone checklist tracks the markers an established household has already hit. This checklist earns 0 for Brad and Alina, 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 0 because its amount is not stated, named lanes earn 2 on a list itemized down to the trash bill with one personal account unexplained, and goals funded earns 3 of 6. The framework earns 5 of 20, and its shape is a household that lists everything and reserves an amount it never wrote down.

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The Prescription

Two traced fixes, and the open items behind them.

1

Build the emergency fund to at least three months of expenses.

This is the 3-Bucket Framework, and it gains 2 points, moving the emergency fund from 0 to 2. Their own third goal is to handle any emergency; on a sole income with $5,100 a month of mortgage payments, three months of fixed and variable expenses is the floor the record prices.

2

Obtain umbrella coverage.

This is the Protection Stack, and it gains 2 points, moving umbrella from 0 to 2 at partial, because no amount was specified on air. Ten acres, two mortgages, and one income are the file's own argument for the policy.

3

Refinance the stack at market rates.

The student loans and both mortgages, priced on the episode as the largest cash saving in the file. No point gain is traced for this item in the target basis.

4

Have the life policy set reviewed by an independent agent, replacements first.

Laddered cover in the range the hosts suggested, cover for Alina, and a ruling on the disability definition question, in that order, with nothing cancelled before replacements are in force. No point gain is traced for this item.

Run both traced fixes and the arithmetic is 44 plus 4, a score of 48. The gains are 2 for the emergency fund at three months and 2 for umbrella coverage at partial. A score of 48 out of 100 keeps the household in the Corrections band, with the reserve and the liability cover in place.

What This Case Teaches

Income is not a reserve. This household earns $400,000, made partner, bought the ten acres, and scores 44, because the score grades the file, not the salary: a debt stack at 2.79 times income, a reserve nobody sized, cover priced for a smaller household, and rates above what the hosts priced as the going market. A large income raises every one of those stakes. It answers none of them.

The score grades the file, not the salary.

The second lesson is the difference between a score and a review. The life box earns full marks for cover in force, and the hosts still put the need at $3 million to $4 million. Both are printed on this page, in their own places, because a household needs to know what the rubric paid for and what it did not grade.

Questions this case answers

What score did Brad and Alina receive on the Financial Health Assessment?

Brad and Alina scored 44 out of 100, in the Corrections band. The Protection Stack earns 14 of 22 and the Decision Filter the full 4 of 4, while the Physician Wealth Equation earns 5 of 14.

How much debt does the household carry in total?

Total stated debt is $1,117,100: student loans of $389,100 across three loans, plus two mortgages of $450,000 and $278,000. Against $400,000 of income, that is 2.79 times income, which is where the Debt Anchor earns its 5 of 10.

Why do the hosts question life cover that scores full marks?

The rubric grades cover in force, and $1,150,000 of term is in force. The episode graded the amount against a $400,000 sole income and put the need at $3 million to $4 million, laddered, with cover for Alina as well, where none is stated. The page carries the score as recorded and the review as an open item.

What do the fixes do to Brad and Alina's score?

Run both and the arithmetic is 44 plus 4, a score of 48. The gains are 2 for building the emergency fund to at least three months of expenses and 2 for obtaining umbrella coverage. A score of 48 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 household's statement was read on air by a proxy reader, because the couple asked to stay anonymous.

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: the student 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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