Financial Health Assessment
Daphne: Surgical Subspecialty Household Scores 45 Out of 100
By Ryan Inman
Published · Updated
Surgical subspecialtyResident · Second to last yearSingle, no children stated
Financial Health Assessment score
45 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. Daphne lands at 45, in the Corrections band, score 40 to 69.
Daphne is a surgical subspecialty trainee in her second to last year of training, earning $67,900 a year, with take home pay of $1,869 every two weeks. She also receives about $700 a month of rental property income, for total stated income of about $76,300 a year. She is single and 34. The assessment scores the household 45 out of 100, in the Corrections band.
The protection stack is the built side of this file, and the flow is the thin side. Stated wealth saving runs about $8,640 a year, about 11 percent of total stated income: a Roth IRA on track at the intake to max for the first time that year, $60 a pay period to a 403b, and $40 a month to a gifted actively managed mutual fund standing at $30,000. Sinking funds run beside them for moving and licensing, travel, car costs and rental maintenance.
The open items are one empty box and one undecided number. The estate documents do not exist, stated plainly, and malpractice type and tail are not stated. The $650,000 loan decision, forgiveness through PSLF or payoff, waits on a job choice the hosts name: academic practice or private practice. The traced path runs from 45 to a target of 51, and the prescription section shows the two steps that trace.
$650,000
Student debt · federal, in PSLF at 0 percent
$888,000
Total stated debt · loans and two mortgages
$5,000
Own occupation disability per month · all recommended riders
About $76,300
Total stated income · salary plus rent
51
Score with the two traced fixes · Corrections band
The short version
- The score: 45 out of 100, in the Corrections band. The Protection Stack earns 14 of 22 and the Transition framework 8 of 10, while the Physician Wealth Equation earns 0 of 6.
- Student debt is $650,000 of federal loans at 0 percent under COVID relief at the intake, positioned in PSLF. Whether forgiveness or payoff wins depends on the job she takes next, academic or private practice, as the hosts flag.
- The protection stack is nearly finished for a single trainee: own occupation disability with all recommended riders, term life in force with more in underwriting, and a $1,000,000 umbrella.
- Saving is the thin line: about $8,640 a year of counted wealth saving, about 11 percent of total stated income, under the 12 percent partial line on the resident scale.
- Two traced fixes are worth 6 points and take the score to 51: a deliberate pre tax move tied to income and PSLF payments (+2), and the estate documents written while single (+4).
A protection stack built in training, and the loan waits on a job.
What They Did Right
A single trainee with the protection bought in training. This is the machinery already running.
- Own occupation disability, all riders A MassMutual policy paying $5,000 a month at $166 a month, bought during training with every recommended rider stated.
- Term life in force, more coming A 30 year $500,000 policy at $28 a month in force, with additional coverage already in underwriting.
- An umbrella bought while single $1,000,000 of cover at $19 a month, bought before the attending income arrives.
- Lanes graded at full marks A spreadsheet kept for years, every category itemized, named Ally buckets for each sinking fund.
- The loan positioned, not ignored $650,000 of federal loans held at 0 percent under COVID relief at the intake, inside PSLF, with the job choice that decides it named.
The Score: 45 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Daphne scores 45, in the Corrections band. This household is scored on the resident and fellow rubric path.
19
Measures graded
7
Frameworks
45
Daphne's score
The 3 Bucket Framework earns 7 of 26. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 0: its balance is not totaled, only a $50 a month flow. Named lanes earn the full 4, on a spreadsheet kept for years with every category itemized and named Ally buckets. Goals funded earns 3, with the goals carrying stated flows while the student loan payoff goal carries no current payment flow.
The Physician Wealth Equation earns 0 of 6 on the resident stretch box: counted wealth saving of about $8,640 a year is about 11 percent of total stated income, under the 12 percent partial line. Residents are never scored on debt to income. The $650,000 loan is graded through the loan strategy box instead.
The Protection Stack earns 14 of 22. Health earns the full 4, on medical and dental cover deducted from pay. Disability earns the full 4, on an individual own occupation policy with all recommended riders. Life earns the full 4, on individual term in force. Umbrella earns 2: a $1,000,000 policy stands, and its adequacy is not verified because total assets are not stated. Malpractice earns 0, type and tail not stated. Estate documents earn 0, stated absent.
The Transition framework earns 8 of 10. The loan strategy box earns the full 6: the $650,000 is federal, positioned in PSLF with a $0 payment under COVID relief at the intake. Cards and other debt earn 2: the credit card is paid in full monthly, and a $23,000 car loan is carried.
The Tax Ladder earns 2 of 8, at 2 and 0: the Roth against pre tax choice is graded partial, and the bracket and deliberate tax moves are not stated. The Decision Filter earns the full 6 of 6 on five stated goals.
The Lifestyle Guardrails earn 8 of 22: the Savings Floor at 6 on a rate of about 11 percent, the leak at 0 because the unaccounted amount is not stated, and wealth first automation at 2, on stated pay period and monthly flows with automation not stated.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 0 (balance not totaled), named lanes 4, goals funded 3 | 7 of 26 |
| 03 Physician Wealth Equation | Stretch saving 0 at about 11 percent. Residents are not scored on debt to income | 0 of 6 |
| 04 Protection Stack | Health 4, disability 4, life 4, umbrella 2, malpractice 0, estate documents 0 | 14 of 22 |
| 05 Transition | Loan strategy 6, federal loans positioned in PSLF. Cards and other debt 2, a car loan carried | 8 of 10 |
| 06 Tax Ladder | Roth against pre tax 2, bracket plus moves 0 | 2 of 8 |
| 07 Decision Filter | Goals written 6, five goals stated | 6 of 6 |
| 08 Lifestyle Guardrails | Savings floor 6, the leak 0, wealth first automation 2 | 8 of 22 |
| Total | Corrections band | 45 out of 100 |
Read the shape, not just the total. The protection side is built work: disability, life and umbrella bought during training, on a trainee salary, beside lanes graded at full marks. The drag sits in the flow and in one empty box: a savings rate under the partial line while $650,000 of loans sits at $0 payments, and an estate box at zero.
The Prescription
Two traced fixes, and the open items behind them.
- Use pre tax accounts deliberately against the loan. This is the Tax Ladder, and it gains 2 points, moving Roth against pre tax from 2 to 4. The hosts prescribe deliberately using tax deferred accounts to lower income and PSLF payments, a bracket and income reason tied to the Roth against pre tax choice.
- Write the estate documents while single. 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 complete the box for a single adult with no minors.
- Verify the umbrella against total assets. A $1,000,000 policy stands in force and its adequacy is not verified, because total assets are not stated across two properties. No point gain is traced for this item.
- Decide the gifted fund's job. The hosts prescribe considering the gifted $30,000 mutual fund as a source for maxing the 403b and for the car loan. No point gain is traced for this item in the record's target.
Run both traced fixes and the arithmetic is 45 plus 6, a score of 51. The gains are 2 for the deliberate pre tax move and 4 for the estate documents. A score of 51 out of 100 keeps the household in the Corrections band.
What This Case Teaches
Cover can be finished before income arrives. This trainee bought the full protection pattern, disability with every rider, term life, an umbrella, on $67,900 of salary and rental income, while carrying $650,000 of loans at a $0 payment. The stack does not wait for the attending contract, and neither did she.
The stack was built on a trainee's pay. The documents are the layer left.
The second lesson is the graded wait. A $650,000 loan at 0 percent with a forgiveness path is not an emergency in the score. It is a strategy at full marks, and its outcome rides on one decision, the sector of the first job. Files can hold a very large number calmly when the plan for it is stated. The pricing waits on the job choice, and the page carries it as waiting.
Behind the score
The Household
Daphne is 34, single, and a trainee in a surgical subspecialty, in her second to last year of training. Her salary is $67,900 a year, with take home pay of $1,869 every two weeks. She also receives about $700 a month of rental income from an investment property, for total stated income of about $76,300 a year.
Balances are stated account by account. A Roth IRA stands at $8,000 and was on track at the intake to max for the first time that year. A 403b stands at $2,000, taking $60 a pay period. A gifted actively managed mutual fund stands at $30,000, taking $40 a month. A car fund holds $21,000 in a high yield account after the car down payment. The emergency fund takes $50 a month and is split across Ally and a high yield account. Its total is not stated.
Every account has a name. The biggest number has a question.
The caller tracks spending in a spreadsheet, kept for years, with every category itemized and named Ally buckets, which is what the named lanes box grades at full marks. Sinking funds run $175 a pay period for moving and licensing, $200 a month for travel, $75 a month for car expenses and $200 a month of rental cash flow held for property maintenance. She states these are not true savings. Counted wealth saving is about $8,640 a year, about 11 percent of total stated income.
Debt totals $888,000 stated. The student loans are $650,000 federal at 0 percent under COVID relief at the intake, positioned in the Public Service Loan Forgiveness program, with a PSLF qualifying job hoped for next. Two mortgages stand at 3.5 percent: $165,000 on the investment property and $50,000 on her primary residence. A car loan of $23,000 runs at 0 percent for 54 months. The credit card is paid in full monthly.
Protection is the finished side. Health cover stands, medical and dental deducted from pay. Disability is an individual own occupation policy through MassMutual paying $5,000 a month at $166 a month, with all recommended riders stated. Life is an individual 30 year term policy of $500,000 at $28 a month, in force, with additional coverage in underwriting. An umbrella policy of $1,000,000 stands at $19 a month. Its adequacy is not verified, because total assets are not stated. There are no estate planning documents, stated. Malpractice type and tail are not stated.
| Household fact | Where it stands |
|---|---|
| Careers | Surgical subspecialty trainee, second to last year of training. The subspecialty is not named |
| Household income | $67,900 salary, take home $1,869 every two weeks. Plus about $700 a month of rental income. Total stated income about $76,300 |
| Family | Single, 34. No children stated |
| Student loans | $650,000 federal at 0 percent under COVID relief at the intake, positioned in PSLF. A PSLF qualifying job hoped for next |
| Mortgages | Investment property $165,000 at 3.5 percent. Primary residence $50,000 at 3.5 percent |
| Other debt | Car loan $23,000 at 0 percent for 54 months. Credit card paid in full monthly. Total stated debt $888,000 |
| Emergency fund | Balance not totaled, split across Ally and a high yield account. $50 a month flowing in |
| Saving | Counted wealth saving about $8,640 a year, about 11 percent of total stated income: Roth IRA on track at the intake to max for the first time that year, 403b $60 a pay period, gifted mutual fund $40 a month |
| Balances | Roth IRA $8,000. 403b $2,000. Gifted actively managed mutual fund $30,000. Car fund $21,000 in a high yield account |
| Disability | Individual own occupation through MassMutual, $5,000 a month at $166 a month, all recommended riders stated |
| Life insurance | Individual 30 year term $500,000 at $28 a month, in force. Additional coverage in underwriting |
| Umbrella | $1,000,000 policy at $19 a month. Adequacy not verified, total assets not stated |
| Estate documents | None. The caller states she has no estate planning documents |
| Goals | Five stated goals |
The Two Frameworks Behind the Score
The score grades 19 measures across seven frameworks. Two of them carry this case: the Protection Stack, which scores 14 of 22, and the Physician Wealth Equation, which scores 0 of 6 on a savings rate under the partial line.
Framework one
The Protection Stack
The Protection Stack grades the coverage that keeps one bad month from ending the plan. Three boxes are full and a fourth stands bought. The documents do not exist: 14 of 22.
- Disability, the full pattern Built
- An individual own occupation policy through MassMutual, $5,000 a month with all recommended riders stated. The box earns the full 4 of 4.
- Life and umbrella, bought Partial
- A 30 year term policy of $500,000 in force with more in underwriting, and a $1,000,000 umbrella whose adequacy is not verified against unstated total assets. Life earns the full 4. Umbrella earns 2.
- Estate documents Missing
- No documents exist, stated. The box earns 0 of 4, and writing the set while single is a traced fix.
Framework two
The Physician Wealth Equation
The Wealth Equation grades the rate at which income becomes wealth, and for residents nothing else: there is no debt to income box on this path. The rate here sits under the line: 0 of 6.
- The stretch box Missing
- Counted wealth saving of about $8,640 a year is about 11 percent of total stated income, under the 12 percent partial line. The box earns 0 of 6.
- The savings floor, in the Guardrails Partial
- The same rate earns 6 of 12 on the floor, the partial half of the resident scale.
- What the rate excludes Partial
- Sinking funds for moving, licensing, travel, car costs and rental maintenance run beside the counted saving, and the caller states they are not true savings.
$650,000 Riding on a Job Choice
The first look is $650,000 of federal student debt on total stated income of about $76,300. At the intake the loans sat at 0 percent under COVID relief, positioned in the Public Service Loan Forgiveness program, with no payment due. The loan strategy box grades that position at the full 6.
The hosts name the fork the balance rides on. An academic job keeps PSLF alive and points the $650,000 at forgiveness. A private practice job points the same balance at payoff. The choice of employer, made in her final training years, decides which of those futures the loan has.
The loan is not behind. It is waiting on a job offer.
The hosts add the two levers that sit beside the choice. The gifted mutual fund, $30,000 of actively managed money, is named as a possible source for maxing the 403b and for the car loan. And the tax line connects to the loan line: deliberate pre tax contributions lower income, and lower income lowers PSLF payments, which is the move the record traces at +2.
What the score grades today is the position, not the outcome. Federal loans, a forgiveness program, no payment due under COVID relief at the time of the intake, and a borrower who can state her balances to the account: the strategy box pays for the setup. The outcome belongs to a job offer that has not arrived.
A Built Stack, and the Paper Missing
The second look is how finished the protection stack is, and how single its gap is. Health cover stands. Disability is the full pattern, own occupation with all recommended riders. Life is in force with more in underwriting. An umbrella policy of $1,000,000 stands at $19 a month. Malpractice is unstated. The estate documents do not exist.
The record traces the full estate pattern at +4 for a single adult with no minors: a will, a power of attorney and a healthcare directive. Here there is no second earner and no stated reason to wait, and the box is the stack's only zero beside malpractice.
Everything bought, in training, except the paper.
The umbrella carries the stack's one partial mark: $1,000,000 in force, graded 2 of 4 because its adequacy cannot be verified. Total assets are not stated, and she owns two properties, an investment property with a $165,000 mortgage and a primary residence with a $50,000 mortgage, so the cover's fit is a question the stated file cannot answer.
The stack's shape is the point. A trainee who bought cover in the order the rubric teaches, disability first, then life, then umbrella, left the documents that say who decides and who receives.
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 Daphne, 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 with its balance not totaled, named lanes earn the full 4 on a spreadsheet and named buckets, and goals funded earns 3 of 6 on stated flows to the goals while the student loan payoff goal carries no current payment flow. The framework earns 7 of 26.
Questions this case answers
What score did Daphne receive on the Financial Health Assessment?
Daphne scored 45 out of 100, in the Corrections band. The Protection Stack earns 14 of 22 and the Transition framework 8 of 10, while the Physician Wealth Equation earns 0 of 6.
What decides whether the $650,000 is forgiven or paid?
The job she takes next. The loans are federal and positioned in the Public Service Loan Forgiveness program at 0 percent under COVID relief at the time of the intake. An academic job keeps the forgiveness path alive. A private practice job points the balance at payoff. The hosts flag the choice as the one that decides the loan.
What is missing for Daphne?
Estate planning documents, stated absent. Malpractice type and tail are not stated, the emergency fund's total balance is not stated, and the umbrella policy's adequacy is not verified because total assets are not stated. Additional life coverage is in underwriting.
What do the fixes do to Daphne's score?
Two traced fixes move the score 6 points, from 45 to 51. The gains are 2 for deliberately using tax deferred accounts to lower income and PSLF payments, and 4 for writing the estate documents, a will, a power of attorney and a healthcare directive, while single. A score of 51 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.