Financial Health Assessment
Meera and Derek: Gastroenterology Fellow Household Scores 38 Out of 100
By Ryan Inman
Published · Updated
GastroenterologyFellow · Third yearCouple, no children stated
Financial Health Assessment score
38 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. Meera and Derek lands at 38, in the Needs a workup band, score 0 to 39.
Meera is a third year gastroenterology fellow earning $68,000 a year, about $4,481 of take home pay a month. Derek is a part time emergency medicine attending earning about $200,000 a year, about $12,500 of take home pay a month. The household earns about $268,000. The assessment scores the household 38 out of 100, in the Needs a workup band.
The retirement machine is funded. Stated saving flows run $4,450 a month: $3,250 to retirement, $1,000 to Roth accounts, and $200 to the emergency fund, about 19.9 percent of the $268,000 gross income. Investable accounts total about $201,000 across a 403b at $82,909, two Roth IRAs at $41,130 and $36,201, a 401k at $16,326, and a joint taxable account at $24,874. Cash stands at about $11,000 in checking and about $14,000 in savings, including an emergency fund of about $10,000.
The gap the hosts named is a goal with no bucket. The household's number two goal is buying a house in two years, and there is no down payment savings account for it at all. Derek's student loan stands at $334,000, refinanced at a variable 2.3 percent with a payment of about $3,144 a month. There are no estate documents, health cover is not stated, and one of the two $2,000,000 life policies is still in underwriting.
$334,000
Student loan · private refinance at a variable rate
$201,000
Investable accounts · five accounts stated
$0
House down payment savings · no bucket stated
About $268,000
Household income · fellow plus part time attending
44
Score with the two traced fixes · Corrections band
The short version
- The score: 38 out of 100, in the Needs a workup band. The Protection Stack earns 10 of 22 and the Decision Filter the full 6 of 6, while the 3 Bucket Framework earns 5 of 26.
- Saving flows of $4,450 a month run at about 19.9 percent of gross income, with about $201,000 already in investable accounts.
- The number two goal, buying a house in two years, has no savings bucket at all. The hosts named that gap on the episode.
- Disability cover is the strong box: own occupation policies on both earners earn the full 4. Life cover is split, one $2,000,000 policy in force and one still in underwriting.
- Two traced fixes move the score 6 points to a 44: complete the estate documents, and the second life policy taking effect. A score of 44 moves the household into the Corrections band.
Two physician incomes, and the house goal has no bucket.
What They Did Right
A training household with attending money already moving. This is the machinery already running.
- Disability cover on both earners Own occupation policies on the fellow and the attending alike. The box earns the full 4.
- $201,000 invested during training Five investable accounts stated to the dollar, from a $82,909 403b to a $24,874 joint taxable account, built on a fellow and part time attending income.
- Flows at about 19.9 percent $4,450 a month runs to retirement, Roth accounts, and the emergency fund before Meera's attending income arrives.
- No credit card debt, stated The only debts are the refinanced student loan and a $12,000 family car loan at 0 percent. Cards and other debt earn the full 4.
- Five goals, written and ranked The house sits at goal two, named and dated at two years. The Decision Filter earns the full 6. The missing part is the bucket.
The Score: 38 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Meera and Derek scores 38, in the Needs a workup band. This household is scored on the resident and fellow rubric path, driven by Meera's fellowship. Derek is already an attending part time, and the record states that beside the fork.
19
Measures graded
7
Frameworks
38
Meera and Derek'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: about $10,000 against stated expenses of $7,345 a month is about 1.4 months, under the 3 month partial line on the resident scale. Named lanes earn 2, on detailed expense lists and Ally buckets, with the hosts identifying about $3,500 a month unaccounted. Goals funded earns 3, with retirement and travel funded and no house down payment bucket and college not funded.
The Physician Wealth Equation earns 3 of 6 on the resident stretch box: a savings rate of about 19.9 percent sits between the 12 percent partial line and the 25 percent full line. Residents are never scored on debt to income. The $334,000 loan is graded through the loan strategy box instead.
The Protection Stack earns 10 of 22. Health earns 0, because cover is not stated. Disability earns the full 4, on own occupation policies on both earners. Life earns 2: Meera's $2,000,000 term is in force, and Derek's $2,000,000 term is still in underwriting. Umbrella earns the full 4, at $1,000,000 against about $226,000 of cash and investable assets. Malpractice earns 0, type and tail not stated. Estate documents earn 0, because none exist.
The Transition framework earns 4 of 10. The loan strategy box earns 0: Derek's loan is a private refinance, not federal and not on an income driven plan, and the resident box scores private loans at zero. Cards and other debt earn the full 4, because no credit card debt is stated.
The Tax Ladder earns 2 of 8, at 2 and 0: pre tax retirement and Roth accounts are used side by side with no bracket reason stated, 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 19.9 percent, the leak at 0 because the hosts identify missing money and unclear tracking in the stated figures, and wealth first automation at 2, on regular retirement, Roth, and emergency fund flows with automation not stated.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 0 at about 1.4 months, named lanes 2, goals funded 3 | 5 of 26 |
| 03 Physician Wealth Equation | Stretch saving 3 at about 19.9 percent. Residents are not scored on debt to income | 3 of 6 |
| 04 Protection Stack | Health 0 (not stated), disability 4, life 2, umbrella 4, malpractice 0, estate documents 0 | 10 of 22 |
| 05 Transition | Loan strategy 0, private refinance. Cards and other debt 4, no card debt stated | 4 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 at about 19.9 percent, the leak 0, wealth first automation 2 | 8 of 22 |
| Total | Needs a workup band | 38 out of 100 |
Read the shape, not just the total. The funded boxes are the retirement boxes: flows at about 19.9 percent, $201,000 invested, disability at full marks, and five goals written down. The zeros are: an emergency fund at about 1.4 months, a loan strategy box that grades a private refinance at zero, and an estate box at zero with the documents planned after a move. And one goal, the house, has flows of exactly nothing, which no framework in the file can grade as funded.
The Prescription
Two traced fixes, and the open items behind them.
- 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: the set the household plans to finish after the move, done on the record's prescription. No children are stated, so the set is the adult set.
- Let the second life policy take effect. This is the Protection Stack, and it gains 2 points, moving life from 2 to 4. Derek's $2,000,000 term policy is already in underwriting. The gain lands when it is in force beside Meera's.
- Open the house bucket. Goal two is a house in two years, and no flow or balance carries its name. A named down payment line is the fix the hosts named on the episode. No point gain is traced for this item in the record's target.
- State the health cover and build the emergency fund past three months. Health cover is not stated, so the box grades 0, and the emergency fund stands at about 1.4 months on stated expenses. No point gain is traced for this item.
Run both traced fixes and the arithmetic is 38 plus 6, a score of 44. The gains are 4 for completing estate documents and 2 for the second term life policy taking effect. A score of 44 out of 100 moves the household into the Corrections band.
What This Case Teaches
Ranking a goal is not funding it. This household wrote five goals, ranked the house second, dated it at two years, and sends it no money at all, while $4,450 a month flows to other lines. The Decision Filter grades the writing at full marks and the goals funded box grades the flows at half. Both grades are correct, and the space between them is where plans stall.
Name the bucket when you name the goal.
The second lesson is timing paper. A life policy in underwriting and an estate plan scheduled after a move are both real progress, and the score grades both at the value of what is in force today: half marks and zero. Paper counts when it is signed, in force, and filed. Until then the file carries the intent and the grade separately, and this page keeps them separate.
Behind the score
The Household
Meera is a third year gastroenterology fellow at $68,000 a year. Derek is a part time emergency medicine attending at about $200,000 a year. The household earns about $268,000 and rents at $1,750 a month. There are no children stated. The rubric driver is Meera as the fellow. Derek's attending status is stated here and in the record, per protocol.
Investable accounts total about $201,000: a 403b at $82,909, Meera's Roth IRA at $41,130, Derek's 401k at $16,326, Derek's Roth IRA at $36,201, and a joint taxable account at $24,874. Cash stands at about $11,000 in checking and about $14,000 in savings, including an emergency fund of about $10,000. Stated monthly expenses run $6,810 fixed plus $535 variable, $7,345 in all, which puts the emergency fund at about 1.4 months.
The retirement flows are funded. The number two goal is not.
The saving system runs $4,450 a month: $3,250 to retirement, $1,000 to Roth accounts, and $200 to the emergency fund. The household keeps detailed expense lists and Ally buckets for its spending, and the hosts still identify about $3,500 a month unaccounted in the stated figures, and question whether the stated variable expenses are complete. Both facts stand in the record, and the boxes grade them as traced.
Debt is one large loan and one small one. Derek's student loan is $334,000, refinanced with Earnest at a variable 2.3 percent, with a payment of about $3,144 a month, and it is not on PSLF. Meera states no student debt. A car loan of $12,000 from Meera's parents runs at 0 percent, at $400 a month. No credit card debt is stated. There is no mortgage. The household rents.
Protection is half strong and half pending. Own occupation disability policies stand on both earners, the full box. Meera holds a $2,000,000 term policy for 15 years, in force. Derek's $2,000,000 term policy for 15 years is still in underwriting, so life cover grades partial. An umbrella policy of $1,000,000 is in place. Health cover is not stated, and malpractice type and tail are not stated. There are no estate documents. The household plans to complete them after a move in the next year.
| Household fact | Where it stands |
|---|---|
| Careers | Gastroenterology fellow, third year. Emergency medicine attending, part time |
| Household income | $68,000 plus about $200,000. Household about $268,000. Take home about $4,481 and about $12,500 a month |
| Family | Couple, no children stated. Renting at $1,750 a month |
| Student loans | Derek $334,000, refinanced at a variable 2.3 percent, about $3,144 a month, not PSLF. Meera $0 stated |
| Other debt | Car loan $12,000 from Meera's parents at 0 percent, $400 a month. No credit card debt stated. No mortgage |
| Emergency fund | About $10,000, inside about $14,000 of savings. About 1.4 months on stated expenses of $7,345 a month |
| Saving | $4,450 a month stated: $3,250 retirement, $1,000 Roth, $200 emergency fund. About 19.9 percent of gross |
| Balances | Investable about $201,000: 403b $82,909. Roth IRAs $41,130 and $36,201. 401k $16,326. Joint taxable $24,874. Cash about $25,000 in checking and savings |
| Disability | Own occupation policies on both earners |
| Life insurance | Meera $2,000,000 for 15 years, in force. Derek $2,000,000 for 15 years, still in underwriting |
| Umbrella | $1,000,000 policy in place |
| Estate documents | None. Planned after a move in the next year |
| Goals | Five stated goals. Buying a house in two years is goal two, with no down payment bucket |
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 10 of 22 on a strong disability box and a split life box, and the Lifestyle Guardrails, which score 8 of 22 because the leak sits inside an otherwise funded flow.
Framework one
The Protection Stack
The Protection Stack grades the coverage that keeps one bad month from ending the plan. Here the disability layer is finished, the life layer is half in force, and the document layer waits on a move: 10 of 22.
- Disability, on both earners Built
- Own occupation disability policies stand on both the fellow and the attending. The box earns the full 4 of 4.
- Life, one in force and one pending Partial
- Meera's $2,000,000 term policy is in force. Derek's $2,000,000 term policy is still in underwriting. The box earns 2 of 4, and the policy taking effect is a traced fix.
- Estate documents Missing
- No documents exist. The household plans to complete them after a move in the next year. The box earns 0 of 4, and completing them is the other traced fix.
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. The floor is close to the line and the leak is named by the hosts.
- The savings floor Partial
- Stated flows of $4,450 a month are about 19.9 percent of the $268,000 gross income, just under the 20 percent full line. The box earns 6 of 12.
- The leak Missing
- The hosts identify about $3,500 a month unaccounted in the stated figures and question whether the variable expenses are complete. The box earns 0 of 6.
- Wealth first automation Partial
- Regular flows run to retirement, Roth accounts, and the emergency fund, with automation not stated. The box earns 2 of 4.
The Number Two Goal With No Bucket
The first look is the sentence the hosts landed on: the household has no down payment savings account for the house. The goal itself is stated and ranked: buying a house in two years is goal two of five. What does not exist is a flow or a balance with the house's name on it.
The money that could carry the goal is visible. Taxable investments hold $24,874. Savings hold about $14,000, of which about $10,000 is the emergency fund. The stated flows send $3,250 a month to retirement, $1,000 to Roth accounts, and $200 to the emergency fund. None of these lines names the house.
A goal with no bucket is a hope with a date on it.
The boxes grade the shape of the plan as it stands. Goals funded earns 3 of 6: retirement and travel are funded, the house down payment bucket does not exist, and college is not funded. The Decision Filter still earns the full 6, because the goals are written and ranked. The gap between those two boxes is this page in one line: the plan is stated, and one of its parts has no money moving toward it.
No point gain is traced for a house bucket in the record's target. The traced fixes sit in the Protection Stack. The bucket stands here as the file's clearest open item, named by the hosts on the episode and carried on this page without a score attached.
One Policy in Force, One in Underwriting
The second look is the life box, graded at half marks for a timing reason. Meera holds a $2,000,000 term policy for 15 years, in force. Derek holds a $2,000,000 term policy for 15 years that is still in underwriting. In force is what the box grades, so the box earns 2 of 4, and the record traces the other 2 points to the day the second policy takes effect.
The rest of the stack splits the same way. Disability is finished: own occupation policies on both earners, the full 4. Umbrella is finished: $1,000,000 in place, the full 4 against about $226,000 of cash and investable assets. Health cover is not stated at all, malpractice type and tail are not stated, and there are no estate documents, with a plan to complete them after a move in the next year.
One policy is in force. The other is still in underwriting.
The estate plan timing deserves its sentence. The household plans the documents after the move, and the score grades today: no will, no power of attorney, no healthcare directive, 0 of 4. The record's prescription is to complete the set the household already plans, and it traces the full 4 points to doing so. No children are stated, so the set is the adult set.
Add the two traced items together and the file's path is short: documents completed, second policy in force, 6 points. The rest of this page, the house bucket, the unstated health cover, the 1.4 month emergency fund, takes work the score does not price in advance.
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 Meera and Derek, 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 at about 1.4 stated months, named lanes earn 2 on detailed lists and buckets with money the hosts could not account for, and goals funded earns 3 of 6 on flows that fund retirement and travel while the house goal stands unfunded. The framework earns 5 of 26.
Questions this case answers
What score did Meera and Derek receive on the Financial Health Assessment?
Meera and Derek scored 38 out of 100, in the Needs a workup band. The Protection Stack earns 10 of 22 and the Decision Filter the full 6 of 6, while the 3 Bucket Framework earns 5 of 26.
Why does a household earning about $268,000 land in Needs a workup?
The band grades the boxes on the page. The emergency fund stands at about 1.4 months, the loan strategy box grades the $334,000 private refinance at zero, there are no estate documents, and health cover is not stated. The funded retirement flows are real, and they sit beside those zeros.
What is missing for the house goal?
A bucket. Buying a house in two years is the household's second stated goal, and no savings account, flow, or balance carries the house's name. The hosts named the gap on the episode: there is no down payment savings account for the house at all.
What do the fixes do to Meera and Derek's score?
Run both and the arithmetic is 38 plus 6, a score of 44. The gains are 4 for completing estate documents and 2 for Derek's $2,000,000 term life policy, already in underwriting, taking effect. A score of 44 out of 100 moves the household into 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.