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Moving Medicine
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St. Louis, MO 63131
If you're a medical student, resident, fellow, or attending physician planning a move, one question comes up almost immediately: how do I buy a home with six figures of student debt and a salary that hasn't started yet?
That's exactly the gap physician mortgage loans were built to close. This page walks through how they work, who qualifies, what they cost, and how to decide if one is right for your move , written specifically for physicians relocating for residency, fellowship, or a new attending position, and reviewed by the Moving Medicine Partners network of physician-focused agents and lenders.
Looking for a lender in a specific state?
Jump to our state-by-state physician loan directory once you've read this guide, or connect with a Moving Medicine agent who already works with physician-loan lenders in your destination city.
A physician mortgage loan, sometimes called a "doctor loan" or "doctor mortgage", is a specialized home loan designed for licensed medical professionals. It can help solve three specific problems that conventional mortgages handle poorly for physicians:
Limited savings for a down payment, after years of training on a resident's salary
High student loan balances that inflate debt-to-income ratios under conventional underwriting
Little or no traditional employment history, especially for residents, fellows, and new attendings starting a job they haven't begun yet
Physician loans address all three by allowing low-or-no down payment, waiving private mortgage insurance (PMI), and underwriting based on a signed employment contract and career trajectory rather than a conventional pay-stub history.
Feature | Conventional Loan | Physician Loan |
|---|---|---|
Down payment | Typically 5–20% | Often 0–10%, sometimes 0% up to $1–2M |
PMI (under 20% down) | Required | Typically waived entirely |
Student loan treatment | Often counted at a flat % of total balance | Often counted at actual IDR/IBR payment |
Income verification | Pay stubs, W-2 history | Signed employment contract accepted |
Employment start | Must already be employed | Can close before start date (many lenders allow 60–150+ days early) |
Loan limits | Conforming limits unless jumbo | Often $1–2M+ with no down payment |
A physician loan solves the financing side of your move. The other half, finding the right home, in the right neighborhood, on a relocation timeline that doesn't bend for Match Day or a fellowship start date, is where a physician-experienced agent matters just as much as the right lender.
Moving Medicine Partners connects relocating physicians and their families with vetted agents who already understand your timeline, lifestyle, commute needs and more.
Answers to the most commonly asked questions about physician loans below.
Most physician loan programs allow 0% down on loans up to $1 million, with some lenders extending 103% financed with some loan limits up to $2 million for well-qualified borrowers. This preserves cash for relocation costs, moving expenses, or an emergency fund instead of tying it up in a down payment. Exact thresholds vary by lender, connect with one of our preferred lenders to confirm current terms in your state.
No. This is the single biggest financial advantage of a physician loan. On a conventional mortgage with less than 20% down, PMI (mortgage insurance- an extra fee that is paid to your lender monthly) typically runs 0.5–1.0% of the loan amount annually. On a $600,000 loan, that's roughly $250–$475 a month. Physician loan borrowers typically pay none of that, regardless of how little they put down.
Eligibility varies by lender. Some physician mortgage lenders limit the program to physicians who are currently in training or within a certain number of years after training. Others offer doctor loan options to physicians at any career stage, including established attending physicians. Others will offer no PMI loans, but the interest rates are much higher than market standard, so you aren't really getting much of a deal.
Because guidelines can vary significantly, it is important to work with a lender who regularly handles physician mortgage loans and understands medical training, employment contracts, student loans, and relocation timelines.
Conventional underwriting often calculates your debt-to-income ratio using a flat percentage of your total student loan balance, a method that can disqualify a high-earning physician carrying $200,000+ in loans. Physician loan programs typically use your actual monthly payment under an income-driven repayment plan instead, which is often a fraction of what conventional underwriting would assume.
Yes, in most cases. Most physician loan programs accept a fully executed employment contract as income verification, and many lenders allow closing 60 to 150+ days before your start date. This matters enormously for moves where housing needs to be settled before the first paycheck from the new position.
Doctor loan interest rates should be competitive with conforming conventional loan rates, but they are not always identical. Some lenders offering physician mortgage products may quote a slightly higher rate, often around 0.125% to 0.50% higher than a comparable conventional loan.
That rate difference is often the lender’s way of offsetting the additional risk of a reduced down payment, flexible debt-to-income guidelines, and waived private mortgage insurance.
This is one of the most important questions to ask when comparing physician loan lenders. A strong physician mortgage product should offer meaningful benefits, not just use the phrase “doctor loan” as marketing.
For many physicians with significant student debt or limited cash available after training, the PMI savings and lower down payment requirement may still outweigh a small rate premium. However, it is always worth asking your lender to compare both options side by side:
Even a 0.25% rate difference on a $700,000 loan can add up over time, so physicians should compare quotes before accepting the first loan option presented.
A physician loan likely makes sense if you:
A conventional loan may be the better choice if you:
The honest answer is to run both scenarios with a lender before committing, rather than assuming the physician-specific product automatically wins.
Yes. Most major physician loan programs are specifically designed for residents and fellows, using a signed training contract as income verification, even on a training-level salary of $60,000–$85,000.
Most programs require a degree in hand or an active residency match, though a few lenders make exceptions case-by-case. If you're still in medical school, reach out to us directly and we can point you toward lenders who work with your specific situation.
No. Many programs also extend to dentists, pharmacists, veterinarians, podiatrists, CRNAs, nurse practitioners, physician assistants, and other advanced clinical professions. Eligibility varies by lender.
No. Physician loans generally require the home to be your primary residence. If you later want to convert it to a rental, you'll typically need to refinance into a different loan type first.
In most cases, no, the large majority of physician loan programs are restricted to a primary residence only. That said, a handful of lenders do offer second-home or vacation-home options for physicians, typically with stricter terms than a primary-residence physician loan: a down payment (often 10%+), the full student loan payment counted in your DTI rather than the reduced IDR figure, and a modest rate premium over primary-residence pricing. Because this is one of the more lender-specific physician loan questions, it's worth confirming directly with a preferred lender whether their second-home program is a fit for your situation before you fall in love with a property.
We'd recommend at least three. Physician loan rate, fee, and point spreads between lenders are wider than they are for conventional mortgages — multiple rate-shopping inquiries within a short window (typically 14–45 days, depending on the credit scoring model) are generally counted as a single inquiry for credit-score purposes, so shopping around doesn't meaningfully cost you anything. Comparing rate, fees, and points side-by-side across at least three lenders is one of the simplest ways to make sure you're getting the program that actually fits your situation, not just the first offer you received.
Often, yes, but it depends heavily on the lender and your specific visa status. Many physician loan programs work with visa holders (common categories include H-1B, J-1, O-1, TN, and others), Permanent Resident Aliens, and in some cases foreign nationals, though documentation requirements are more involved and not every lender participates. If you're on a visa, this is a question to raise directly and early with a preferred lender so they can confirm whether their specific program supports your visa category.
Generally, yes, there's typically no limit on how many times you can use a physician loan over your career, though most lenders won't let you carry two physician loans at the same time at their institution. Meaning, you can currently have a loan a Bank A, and purchase your new home with a loan from Bank B. They can overlap.
Some banks will allow two simultaneously under specific conditions (for example, meaningful equity in your current home or a down payment on the new one), but this varies considerably by lender, and several require your existing physician loan to be paid off or refinanced before issuing a new one.
For most programs, no — physician loans are typically available to attendings at any career stage, not just those fresh out of residency or fellowship. Some individual lender programs do set a years-out-of-training cap for their most aggressive terms (for example, a specific 0%-down tier), so if you're well established in your career, it's worth confirming whether a given lender's standard program or a more limited tier applies to you.
Locum and 1099 income is generally treated more flexibly under physician loan underwriting than under conventional underwriting, but it does require more documentation. Lenders typically want to see a signed locum agreement or assignment letter, recent bank statements showing consistent income, and — depending on the lender — anywhere from 0 to 24 months of income history. Borrowers with little or no 1099 track record sometimes need a lender that specifically markets itself as "1099-friendly" for physicians, since not every physician loan program is built to evaluate self-employed or contract income the same way.
Moving Medicine
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St. Louis, MO 63131