Financial Health Assessment
Noelle and Bill: Two New Attendings Score 59 Out of 100
By Ryan Inman
Published · Updated
Radiology · Surgical subspecialtyNew attending · Both fresh out of trainingCouple, no children stated
Financial Health Assessment score
59 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 20 measures across seven frameworks. Noelle and Bill lands at 59, in the Corrections band, score 40 to 69.
Noelle is a radiologist earning $350,000 a year. Bill is a surgical subspecialist earning $280,000. The household earns $630,000, both earners fresh out of training, with higher incomes expected in several years. The assessment scores the household 59 out of 100, in the Corrections band.
Start with the sentence the household led with on air: we do not have any student debt. One earner's $115,000 of medical school debt was paid off during residency and fellowship. The other earner's tuition was covered by his parents. Credit cards are paid in full every month, and no mortgage, vehicle, or other debt is stated. Total stated debt is $0 against $630,000 of income, which puts the Debt Anchor at 0.0 times and earns the full 10.
The saving matches the starting line. Stated investable assets total $455,000: Roth IRAs of $105,000, defined contribution plans of $95,000, 403b and 401k accounts of $80,000, and taxable accounts of $175,000. Both earners max backdoor Roth IRAs each year and max pre tax retirement contributions. The hosts stated the savings rate at almost 75 percent, with stated monthly spending of about $8,306. The missing layer is documents: no estate planning documents at all, behind a $2,000,000 umbrella policy and term life on both earners.
$630,000
Household income · $350,000 plus $280,000
$0
Total stated debt · 0.0 times income
$455,000
Stated investable assets · across four account groups
63
Score with the traced fix · Corrections band
The short version
- The score: 59 out of 100, in the Corrections band. The Physician Wealth Equation earns the full 14 of 14, while the Protection Stack earns 10 of 22.
- Total stated debt is $0 on $630,000 of income. One earner's $115,000 of medical school debt was paid off inside training. The other earner's tuition was covered by his parents.
- The hosts stated the savings rate at almost 75 percent, on stated monthly spending of about $8,306. The Savings Floor and the stretch box both earn full marks.
- Protection is bought and uneven: term life on both earners and a $2,000,000 umbrella policy earn full marks, disability on both earners earns 2 because own occupation status is not stated, and health cover is not stated at all.
- One traced fix moves the score 4 points to a 63: estate planning done now, a will, a power of attorney, and a healthcare directive. No minors are stated, so the set is the adult set.
Zero debt and a 75 percent savings rate, with no will.
What They Did Right
This is what full marks look like in practice.
- Student debt finished inside training One earner paid off $115,000 of medical school debt during residency and fellowship. The other never carried any. The loan call earns the full 6.
- A savings rate the hosts called near 75 percent Stated spending of about $8,306 a month on $630,000 of income. The stretch box and the Savings Floor both earn full marks.
- $455,000 invested, this early Roth IRAs of $105,000, defined contribution plans of $95,000, 403b and 401k accounts of $80,000, and taxable accounts of $175,000, fresh out of training.
- Both tax moves, every year Max backdoor Roth IRAs and max pre tax retirement contributions for both earners, with unspent money moving to taxable accounts.
- Umbrella bought at full size A $2,000,000 umbrella policy against $455,000 of stated investable assets plus cash. The box earns the full 4.
The Score: 59 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Noelle and Bill scores 59, in the Corrections band. This household is scored on the attending rubric, on the new attending fork of the Transition framework.
20
Measures graded
7
Frameworks
59
Noelle and Bill's score
The 3 Bucket Framework earns 7 of 20. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 2: a three month fund stated, in the 3 to 5 month partial band. Named lanes earn 2: separate savings are held for the emergency fund and a future down payment with bills paid from checking, and full dollar sorting is not stated. Goals funded earns 3, with max retirement contributions and down payment saving flowing to goals that are not fully funded.
The Physician Wealth Equation earns the full 14 of 14. The Debt Anchor earns the full 10: total stated debt of $0 against $630,000 of income is 0.0 times, at or under the new attending full line of 3.0 times. Stretch saving earns the full 4: the host stated rate of almost 75 percent is at or above the 25 percent full line, with investable assets under $1,000,000.
The Protection Stack earns 10 of 22. Life earns the full 4, individual term in force on both earners. Umbrella earns the full 4: a $2,000,000 policy against $455,000 of stated investable assets plus cash savings. Disability earns 2: cover in force on both earners with stated benefits, and own occupation status not stated. Health earns 0, not stated. Malpractice earns 0, type and tail not stated. Estate documents earn 0, because none exist.
The Transition framework, on the new attending fork, earns 6 of 10. The loan call earns the full 6: student debt finished before the attending transition, one earner's loans paid off in training and the other earner carrying none. Contract clarity earns 0: contract or compensation professional review and full pay structure understanding are not stated.
The Tax Ladder earns 4 of 8, at 2 and 2: both earners max backdoor Roth IRAs and max pre tax contributions by stated practice, with the bracket tied reason not stated, and one deliberate move stated, the annual backdoor Roth conversions, with the bracket not stated. The Decision Filter earns the full 4 of 4 on five stated household goals.
The Lifestyle Guardrails earn 14 of 22: the Savings Floor at the full 12 on the host stated rate of almost 75 percent, the leak at 0 because the unaccounted amount is not stated, and wealth first automation at 2, on max payroll retirement contributions with leftover money planned to taxable investments, and automation of the full split not stated.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 2 at three months stated, named lanes 2, goals funded 3 | 7 of 20 |
| 03 Physician Wealth Equation | Debt Anchor 10 at 0.0 times income. Stretch saving 4 at almost 75 percent as stated by the hosts | 14 of 14 |
| 04 Protection Stack | Health 0, disability 2, life 4, umbrella 4, malpractice 0, estate documents 0 | 10 of 22 |
| 05 Transition | Loan call 6, student debt finished before the transition. Contract clarity 0, none stated | 6 of 10 |
| 06 Tax Ladder | Roth against pre tax 2, bracket plus moves 2 | 4 of 8 |
| 07 Decision Filter | Goals written 4, five goals stated | 4 of 4 |
| 08 Lifestyle Guardrails | Savings floor 12 at almost 75 percent as stated, the leak 0, wealth first automation 2 | 14 of 22 |
| Total | Corrections band | 59 out of 100 |
Read the shape, not just the total. The offense is at full marks and the defense is at half. The Wealth Equation is 14 of 14, while milestones, health cover as stated, malpractice as stated, estate documents, contract clarity, and the spending leak all sit at zero or unstated. The largest single purchase left is a house the hosts warned could undo the rate that built the score.
The Prescription
One traced fix, and the open items behind it.
- Get estate planning done now. 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. No minors are stated in this household, so the set is the adult set.
- Size the house against the cut back income. The first two stated goals interact: a large house purchase and cutting back after children. Price the house so the savings rate survives both. No point gain is traced for this item.
- Diversify the concentrated stock positions the hosts flagged. The hosts flagged concentrated individual stock exposure in the Roth and taxable accounts as the main investment nitpick. The accounts named hold $105,000 and $175,000 today. No point gain is traced for this item.
- State the unstated boxes. Health coverage, malpractice type and tail, contract review, and the disability policies' own occupation status are all not stated in the record. Stating them is what lets the next reading of this file grade them. No point gain is traced for this item.
Run the traced fix and the arithmetic is 59 plus 4, a score of 63. The gain is 4 for completing estate planning. A score of 63 out of 100 keeps the household in the Corrections band.
What This Case Teaches
A perfect flow can still be one purchase from ordinary. This household did the two hardest things in physician finance before the attending years began: it finished its student debt inside training and it kept spending near $8,306 a month on $630,000 of income. The risk left in the file is not a rate or a balance. It is a single large house, bought at the wrong size, resetting the flow that built everything else.
Earn the rate first. Then defend it from the house.
The second lesson is the price of the last box. Estate documents are the only traced fix, worth 4 points, and they cost an afternoon.
Behind the score
The Household
Noelle is a radiologist earning $350,000 a year. Bill is a surgical subspecialist earning $280,000 a year. Both are fresh out of training, and the record states that higher incomes are expected in several years. No children are stated. Stated monthly spending is about $8,306.
The household stated it plainly on air: we do not have any student debt. One earner carried $115,000 of medical school debt and paid it off during residency and fellowship. The other earner's tuition was covered by his parents, and he carried none. Credit cards are paid off in full every month. No mortgage, vehicle, or other debt is stated. The record states no other debt.
$455,000 invested fresh out of training, and no will behind it.
The accounts are full for a household this early. Roth IRAs hold $105,000. Defined contribution plans hold $95,000. The 403b and 401k accounts hold $80,000. Taxable accounts hold $175,000. Total stated investable assets are $455,000. Each year both earners max backdoor Roth IRAs and max pre tax retirement contributions, $19,500 stated for Noelle and $39,000 stated for Bill, and unspent money moves to taxable investments. A three month emergency fund is stated, held in savings alongside future down payment savings.
The hosts put the savings rate at almost 75 percent, with stated spending of about $8,306 a month. The rubric scores the host stated rate: the stretch box and the Savings Floor both take full marks from it.
Protection is half stated. Both earners hold disability policies, Noelle at a $3,000 a month benefit and Bill at $5,000 a month, and Noelle is increasing her benefit. Own occupation status is not stated for either policy. Both hold individual term life, 30 year and 20 year policies of $1,000,000 and $2,000,000 as transcribed. An umbrella policy of $2,000,000 is in place. Health coverage is not stated. Malpractice type and tail are not stated. There are no estate planning documents.
| Household fact | Where it stands |
|---|---|
| Careers | Radiologist, $350,000. Surgical subspecialist, $280,000. Both fresh out of training |
| Household income | $630,000, with higher incomes expected in several years |
| Family | Couple. No children stated |
| Student loans | None: $115,000 of medical school debt paid off during residency and fellowship. The other earner's tuition covered by his parents |
| Other debt | None stated. Credit cards paid in full every month |
| Emergency fund | Three months stated, held in savings with future down payment savings |
| Saving | Hosts stated almost 75 percent. Stated monthly spending about $8,306. Max backdoor Roth and max pre tax contributions each year |
| Balances | Roth IRAs $105,000. Defined contribution plans $95,000. 403b and 401k $80,000. Taxable $175,000. Total stated investable $455,000 |
| Disability | Policies on both earners, $3,000 and $5,000 a month benefits. Own occupation status not stated. One benefit being increased |
| Life insurance | Individual term on both earners: 30 year and 20 year, $1,000,000 and $2,000,000 as transcribed |
| Umbrella | $2,000,000 policy in place |
| Estate documents | None |
| Goals | Five household goals stated, including a large house purchase and cutting back after children |
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 the full 14 of 14, and the Protection Stack, which scores 10 of 22 because two layers are bought in full and three are missing or unstated.
Framework one
The Physician Wealth Equation
The Wealth Equation grades the debt anchor and the stretch saving rate. With no debt and a host stated rate near 75 percent, both boxes take full marks: 14 of 14.
- The Debt Anchor Built
- Total stated debt of $0 against $630,000 of income is 0.0 times, at or under the new attending full line of 3.0 times. The box earns the full 10.
- Stretch saving Built
- The hosts stated almost a 75 percent savings rate, at or above the 25 percent full line with investable assets under $1,000,000. The box earns the full 4.
- The Savings Floor, next door Built
- The same stated rate earns the full 12 on the Guardrails floor. Two frameworks pay full marks on one stated figure, which is why the figure is carried on this page as the hosts stated it.
Framework two
The Protection Stack
The Protection Stack grades the coverage that keeps one bad month from ending the plan. Life and umbrella are bought at full size, disability is partial, and health cover, malpractice, and estate documents are not stated or not in place: 10 of 22.
- Life and umbrella Built
- Individual term on both earners and a $2,000,000 umbrella policy against $455,000 of stated investable assets. Both boxes earn the full 4.
- Disability Partial
- Policies in force on both earners at $3,000 and $5,000 a month, one benefit being increased, with own occupation status not stated for either. The box earns 2 of 4.
- Estate documents, health, and malpractice Missing
- No estate documents exist. Health coverage is not stated, and malpractice type and tail are not stated. Those boxes earn 0.
The House That Could Undo the Rate
The first close look is the warning the hosts attached to the praise. The household's first two goals interact: a large house purchase, and cutting back after children arrive. Together, they spend the same surplus twice.
The arithmetic is the rate. A savings rate near 75 percent rests on spending of about $8,306 a month. A large house raises the fixed floor under that spending every month for decades, and cutting back lowers the income the rate is computed on. The score the household earned is a flow score. A house that resets the flow resets the score's engine.
Price the house against the income you plan to keep.
The file already holds the counterweight: down payment savings sit in the savings accounts beside the three month emergency fund, which means the purchase is being saved for rather than improvised. The hosts' point was sizing, not abstinence. A house priced against the cut back income keeps the plan. A house priced against today's $630,000 spends the future raise and the future schedule at once.
No box in the score grades a house that has not been bought. This dive carries the warning because the hosts gave it, and because the goals are stated in the household's own list of five.
Full Marks, One Nitpick, No Documents
The second close look is the hosts' one investment criticism, stated in the record's notes: concentrated individual stock exposure inside the Roth and taxable accounts. On a household saving near 75 percent, the accounts compound fast, and a concentrated position compounds its own risk at the same speed.
The amounts make the point concrete. The Roth IRAs hold $105,000 and the taxable accounts $175,000.
The largest accounts get the concentration. The smallest purchase gets skipped.
The rest of the stack is a study in contrast. Life cover: bought, on both earners, at seven figures. Umbrella: bought, at $2,000,000. Disability: bought on both, with one benefit already being increased, and partial credit only because own occupation status is not stated. Estate documents: none at all.
That last line is the cheapest fix in the file and the only traced one. Two attending incomes, $455,000 of investable assets, and no will, no power of attorney, and no healthcare directive. The documents are an afternoon of attorney time against a plan measured in decades.
Milestones: Scored on What Is Stated
Inside the 3 Bucket Framework, the milestone checklist tracks the markers a new attending household has already hit. This checklist earns 0 for Noelle and Bill, 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 2 at three months stated, named lanes earn 2 on the separated savings with full sorting not stated, and goals funded earns 3 of 6. The framework earns 7 of 20, the one framework in this file that reads like a young household's.
Questions this case answers
What score did Noelle and Bill receive on the Financial Health Assessment?
Noelle and Bill scored 59 out of 100, in the Corrections band. The Physician Wealth Equation earns the full 14 of 14, while the Protection Stack earns 10 of 22 and the 3 Bucket Framework 7 of 20.
How do two new attendings have no student debt?
One earner's $115,000 of medical school debt was paid off during residency and fellowship. The other earner's tuition was covered by his parents, and he carried no student debt. The household stated it on air: we do not have any student debt.
What savings rate do Noelle and Bill run?
The hosts stated almost a 75 percent savings rate, on stated monthly spending of about $8,306 against $630,000 of household income. Both earners max backdoor Roth IRAs and max pre tax retirement contributions each year.
What do the fixes do to Noelle and Bill's score?
The traced fix is worth 4 points, a score of 63. The gain is 4 for completing estate planning: a will, a power of attorney, and a healthcare directive. A score of 63 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. Life insurance amounts are carried as transcribed in the record, as the record itself flags.
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 by years since training: the loan call, and the new attending contract.