Physician and professional mortgages: what doctor loans give you, and what they cost

A doctor loan swaps the usual 20% down or PMI for a relationship with one bank: the fine print lives in the rate, the ARM reset and the account you must open.

Physician mortgages exist because the standard rulebook misreads a specific borrower: high expected income, almost no savings, six figures of student debt, and a job that starts in two months in another state. Banks built portfolio products around that profile. They solve real problems, and they are not free.

Who these programs are written for

The core audience is medical doctors (MD, DO) in residency, fellowship or their first years as attendings, plus dentists (DDS, DMD), veterinarians (DVM), pharmacists (PharmD), podiatrists (DPM) and optometrists (OD). Some lenders extend the same terms to nurse anesthetists, physician assistants, attorneys (JD) and CPAs, usually with a lower loan ceiling and a stricter down payment. Most programs set an experience window — typically within ten years of completing training — and require a primary residence, not a second home or rental.

What unites these borrowers is a mismatch in timing: income is about to jump several-fold, but the down payment is not saved, the credit file is thin, and the contract has not started. A conforming loan underwrites the present; a doctor loan underwrites the contract.

The product, in concrete terms

Physician loans are portfolio loans: the bank keeps them on its own balance sheet instead of selling them to Fannie Mae or Freddie Mac, so it writes its own rules. The typical shape in 2026 looks like this, with wide variation between lenders:

Down payment: 0% up to roughly $750,000 to $1 million; 5% up to about $1.25 to $1.5 million; 10% up to $2 million or more at some banks. Closing costs are still due unless the seller or lender covers them.
No private mortgage insurance at any loan-to-value, which on a 95% to 100% LTV conventional loan would otherwise add a meaningful monthly charge.
Contract as income: a signed, non-contingent employment contract generally allows closing 60 to 90 days before the start date (a few lenders stretch to 120). Residents can often qualify on their current stipend plus documented moonlighting.
Student loans: payments in an income-driven plan are usually counted at the actual amount, including $0; loans deferred or in forbearance for at least twelve months are often excluded from the debt ratio entirely.
Debt-to-income ceilings of 43% to 50%, sometimes on the future salary.
Structures: 30-year fixed, or 5/6, 7/6 and 10/6 ARMs, which often carry the best headline rate.

Compare the alternatives. A 3% down conventional loan caps at the conforming limit, charges PMI, and counts deferred student loans at a percentage of the balance. A jumbo loan usually wants 10% to 20% down, six to twelve months of reserves and a two-year income history. Fannie Mae accepts an offer letter only when the start date falls within 90 days after the note date, under narrow conditions. The doctor loan removes all three obstacles at once; that convenience is what you pay for.

How underwriting actually treats you

Income. The contract must be signed by both parties, state the salary, and usually be free of contingencies such as pending board certification or credentialing; some lenders want proof the state license is issued or in process. Sign-on bonuses and production incentives are generally excluded until received. Residents using future income should expect the lender to verify the match letter or contract and may face a shorter start-date window.

Assets. Reserve requirements are lighter than jumbo norms but rarely zero: two to six months of the full housing payment is common, and gift funds are widely accepted with a gift letter. With no down payment, the asset review concentrates on closing costs and on funding the account you must open.

Credit. Minimum scores cluster around 700, with a few programs at 680 and the best pricing above 740. A thin file is acceptable; recent collections or high card utilization during residency are the usual stumbling blocks. Read our guide on the credit score needed to buy a house before the lender pulls your report.

Occupancy. Primary residence only, occupied within 60 days of closing in most programs. Buying with the intent to convert to a rental after training is not the stated use, and the occupancy affidavit you sign is a federal document.

The pitfalls that show up later

The first is price. Because there is no mortgage insurance premium to cancel, the extra risk is priced into the rate, often a fraction of a point above a comparable conforming loan, for the life of the loan. The second is the ARM: a 7/6 ARM looks cheap until the first adjustment, and the ARM versus fixed-rate math depends entirely on whether you still own the home in year eight. The third is leverage: 100% financing on a $900,000 house leaves no equity cushion if a fellowship or a partnership track moves you two years later. The fourth is the relationship requirement — a checking account with direct deposit, sometimes a minimum balance — which is allowed but should be read as part of the cost. The fifth is escrow: many doctor loans waive tax and insurance escrows, so the first property tax bill arrives as a lump sum you must have planned for.

Questions worth asking before you apply

Is the no-PMI structure priced into the rate, or is it lender-paid mortgage insurance disclosed as such?
What is the rate difference between your doctor loan and your conforming or jumbo loan at the same down payment today?
How far before my start date can I close, and what exactly must the contract say?
How do you treat my income-driven student loan payment, and what if it is $0?
Does the program require an account, a balance or autopay, and what happens to the rate if I close the account later?
On the ARM, what are the index, margin, first-adjustment cap and lifetime cap?
Will you service the loan, or sell it? Will taxes and insurance be escrowed?

Get those answers on Loan Estimates from two lenders, including one conforming quote, and run both through our affordability math on your current salary, not the contract’s.

What matters most

Doctor loans are bank portfolio products, so terms vary widely: 0% down to roughly $1 million at some lenders, 5% to 10% down above that, always primary residence only.
No PMI means no premium to cancel, but the risk is priced into the note rate for the life of the loan — compare the APR, not the absence of a line item.
A signed, non-contingent employment contract generally replaces pay stubs for closings 60 to 90 days before the start date; bonuses and RVU incentives usually do not count yet.
Income-driven student loan payments are typically used as reported, including $0, and loans deferred twelve months or more are often excluded from DTI.
ARMs carry the best headline pricing; know the index, margin and caps, and decide based on how long training and partnership tracks will keep you in the home.
Relationship requirements (checking account, direct deposit, minimum balance) are legal and common — treat them as part of the price and ask what happens if you leave the bank.
Ask whether escrows are waived: with no PMI and no escrow, the monthly payment looks low, and the first property tax bill arrives all at once.

Federal rules, read for physicians and licensed professionals

Frequently asked questions

Can I get a physician mortgage during residency?

Often, yes. Many programs accept residents and fellows on their current stipend plus documented moonlighting, and some qualify you on a signed attending contract starting within 60 to 90 days. Loan ceilings and down payment tiers are usually lower for residents, reserves are still required, and a few lenders want the state license issued before closing. Terms differ enough that two quotes are worth the effort.

Is a doctor loan cheaper than a conventional loan with PMI?

Not automatically. PMI on a 95% conventional loan can run roughly 0.3% to 1% of the balance per year, but it is cancellable once you reach 80% loan-to-value. A doctor loan removes that charge and instead prices risk into a higher rate that never goes away. Over five years the doctor loan often wins; over fifteen the cancellable PMI may win. Compare the two Loan Estimates line by line.

Do physician loans count student loans in the debt-to-income ratio?

Generally they use the actual payment from your income-driven repayment plan, including $0 when that is what the servicer reports, and many exclude loans deferred or in forbearance for at least twelve months. Conforming loans are stricter: a $0 or missing payment is replaced by a percentage of the balance. Bring the servicer statement showing the plan and the payment amount.

Are doctor loans available to dentists, veterinarians, lawyers or CPAs?

Dentists and veterinarians are included at most physician-loan lenders. Pharmacists, podiatrists and optometrists are common additions. Attorneys and CPAs are covered by a smaller set of “professional” programs, usually with lower maximum loan amounts and a minimum down payment of 5% to 10%. Eligibility lists change; ask for the current list of accepted degrees before you spend time on an application.