Tamara and Marcus: A Family Medicine Resident Household, Scored

Tamara is 29, a PGY-3 family medicine resident earning about $65,000. Her husband Marcus is 30 and works in IT support, earning about $75,000. They have been married three years, have no kids yet, and live in a large metro area in the Southeast. Household income is about $140,000.

Item	Where it stands
Student debt	$280,000 federal, on an income driven plan with $0 payments, chosen deliberately in PGY-1
Other debt	None. Credit cards are paid in full every month
Emergency fund	About one month of expenses, roughly $5,000
Saving	About 12 percent of income, into Roth IRAs for both spouses, automated
Taxes	22 percent federal bracket, known to them, with the Roth IRAs as the deliberate move
Health insurance	Employer plan, both covered
Disability	Residency program group long term disability only. No individual own occupation policy
Life insurance	None
Umbrella	None
Malpractice	Covered through the residency program, occurrence policy
Estate documents	None
Total assets	Roughly $30,000
Goals	Two or three written down, including paying off the loans and buying a house after residency, funded in part

Residents get their own version of the Financial Vital Signs scale. Nobody on a resident salary is graded on debt to income, because that anchor does not enter the score until the attending years. What the resident scale grades is the starting line: the loan strategy, the savings system, the protection layers, and whether the goals exist in writing.

The 51 points arrive in five groups, and the groups tell the story better than the total does. The decisions this household made deliberately score almost perfectly. The layers they have not gotten to yet score almost nothing.

Group	Points	What earned them
The debt decisions	10	Full credit for the loan strategy and for cards paid in full with no other debt
The savings system	16	The savings floor, full automation, a tracked spending leak under 3 percent, and stretch saving credit at 12 percent
Protection	8	Health coverage in full, malpractice through the program, and partial credit for the group disability policy
The buckets	10	Milestones met for a resident household, most dollars sorted into named lanes, money flowing toward goals
Taxes and goals	7	Roth chosen deliberately for both spouses, the bracket known, goals written down

What they did well deserves saying plainly. The loan strategy got decided in PGY-1, on purpose, instead of drifting into default payments. The credit cards are paid in full. The Roth IRAs run for both spouses on a resident household income, and the automation means nobody has to remember. Spending is tracked monthly and the leak is under 3 percent. Health coverage and malpractice are handled through their employers and program. That is a stronger foundation than most attending households show.

The Decision Filter is the framework that decides what a household says yes and no to, and it runs on stated goals with amounts and dates. Tamara and Marcus have the raw material and not the aim: two or three goals, written down, with money flowing toward them and none of them fully funded or priced. Pay off the loans is a direction, not a goal. A goal is a number and a date: this balance, retired by this year, through this program.

The fix costs nothing but an evening. Write four or more goals with dollar amounts and dates, fund them in order, and run every large purchase through the filter before it happens. On its own, that work is worth points in the goals boxes and the funding boxes at once, because aimed money counts twice in this household's score: once for existing, and once for being aimed.

The Physician Wealth Equation scores the forces that build wealth, and the force this household owns outright is time. Family medicine is the lowest paid specialty on this site, and Tamara is 29 with more than thirty years of compounding in front of her. The late start penalty that crushes longer training pathways barely exists here. Every year of stretch saving now is worth years of it later, which is why the prescription pushes the savings rate toward 25 percent while the household is young, healthy, and still living on a resident shaped budget.

The window cuts both ways. The same youth and health that make compounding powerful make disability coverage cheap, and this is the year to buy it. An individual own occupation policy in PGY-3 is priced on a healthy 29 year old. The group policy through the program is a start, and this household's score shows exactly what a start is worth: partial credit, and a hole everywhere else in the protection stack.

Five moves, in order, each one named with the framework it belongs to:

1. Write four or more goals with dollar amounts and dates (Decision Filter). Aim the dollars that are already flowing.

2. Push stretch saving toward 25 percent (Physician Wealth Equation). The resident window never comes back, and this household already proved it can run the system at 12 percent.

3. Build the emergency fund to three months (3 Bucket Framework). One month is a wish. Three months is a Safety Net that lets the rest of the plan survive a bad season.

4. Buy individual own occupation disability coverage now, in PGY-3 (Protection Stack). It will never be cheaper than it is this year.

5. Buy a $1 million, 30 year term life policy (Protection Stack). This household runs on two incomes, and right now neither one is insured. Lock the rate while it is priced on two healthy people in their early thirties.

The math closes cleanly. Those five moves add 24 points across the goals, savings, reserve, disability, and life boxes: 51 becomes 75, and the household leaves the Corrections band with nothing but residency sized steps. No windfall, no inheritance, no attending paycheck required. That is what a good starting line is worth.

Family medicine residents do not lose points on income. The scale knows what residency pays. They lose points the way this household did: protection layers postponed because the program provides something, goals left vague because the attending decisions feel far away, and a reserve that stays at one month because nothing has gone wrong yet. The wins are equally repeatable: decide the loan strategy in the first year, automate Roth saving for both spouses before the attending money arrives, and buy coverage while it is priced on your training age. The stage page for residents works through the same moves in order: family medicine resident and fellow finances. The loan fork Tamara will face at graduation is worked in full on the student loans page, and the coverage gaps in her score are the subject of the insurance page.

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.