Do I qualify?
The honest version, including the parts that are not in your favor. Physicians are analytical buyers and deserve the real matrix rather than a promise to call.
Stop Cryin', Call Ryan. Ryan Mandley · NMLS #1181993
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Residents, fellows and interns holding these degrees qualify too. Greyed codes appear inconsistently in the guidelines — worth a call, not a promise. Chiropractors are specifically excluded.
How much you can finance
| Credit score | Loan up to | Mortgage insurance | |
|---|---|---|---|
| 720+ | $2,000,000 | None | Smallest down payment available at every loan size |
| 680+ | $2,000,000 | None | Smallest down payment available up to a lower loan size |
There is a floor as well as a ceiling. This program is only for buyers putting a small amount down — so if you have a large down payment saved, this is not your program and a conventional loan is probably cheaper. Loan amounts run $100,000 to $2,000,000. Terms change without notice; ask me for today's matrix before you plan around a number.
What underwriting actually looks at
Student loan debt
If you are currently in residency or a clinical fellowship and qualifying on your training income, student loans in deferment, forbearance, or reporting $0 under an income-driven plan can be excluded from your debt ratio entirely. Outside of training, the documented income-driven payment is used instead — and if nothing is documented, a deferred loan is counted at 1% of the balance.
Read that carefully, because the full exclusion is narrower than most marketing implies: it is a residency-and-fellowship benefit. As an attending you still get favorable treatment through the documented IDR payment, but not a zero.
Employment contract
A fully executed contract or offer letter can be used with a start date up to 150 days after the note date. It has to state your title, start date and compensation, and the only contingencies allowed are receipt of your medical license or normal administrative items like a background check, drug screen or fingerprinting.
One hundred fifty days is roughly five months. That is a whole match-to-start-date window, and it is considerably more room than the 90 days most physician programs allow. If you are a 1099 or contracted physician the rule is tighter — the start date must fall within 60 days of closing.
Mortgage insurance
Not required, on any loan this program writes.
On a $1.5M loan with a small down payment, conventional financing is not even an option, and any high-leverage alternative would carry insurance. This is the feature you are actually buying.
Down payment
Your minimum down payment depends on your credit score and loan size, and I will give you the exact figure on a call. There is also a maximum: this program is only for buyers putting a small amount down, so a large down payment takes you out of it.
This is the rule that surprises people. It is a high-leverage product by design. If you have a large down payment saved, you are not a candidate — you are a conventional borrower, and that is usually the cheaper answer anyway.
Debt-to-income
Up to 50%, tightening to 45% at the smallest down payments. Adjustable-rate and 15-year fixed loans cap at 45% regardless.
Reserves
With a larger down payment: none required up to $1.5M, three months above it. At the smallest down payments: three months up to $1.5M, six months above. Gift funds count toward reserves.
If you are closing before your job starts, add one more month of full payment in reserves for every month between your first payment and your start date. Plan for that early — it is the requirement most likely to catch a resident short at the last minute.
How it is underwritten
Manually, by a person, following the Fannie Mae Selling Guide with the lender’s own overlays on top. Automated approvals are not accepted on this program.
It means full documentation and no algorithmic shortcut, so build a little more time into your contract. It also means a human reads your file in context, which usually works in a physician’s favor.
Property and purpose
Primary residence only, one unit. Purchase or rate-and-term refinance. Fixed terms of 15, 20, 25 or 30 years, or 5/6, 7/6 and 10/6 adjustable-rate options.
No cash-out refinances, no second homes, no rentals, no duplexes.
Escrows and second liens
Escrow (impound) accounts are required unless your state prohibits them, and secondary financing is not permitted.
No piggyback second to get around the down payment — the first mortgage stands alone.
Co-borrowers
A non-occupying co-borrower is allowed, but their income can make up no more than half of the total qualifying income.
Useful when a parent helps a resident qualify. It has a hard ceiling.
When a physician loan is the wrong answer
Any loan officer who tells you this program is always the best option is selling, not advising.
If you have a large down payment saved, you cannot use this program — it is built only for buyers putting a small amount down. That is not a drawback, it is a signal: with a real down payment, a conventional loan is usually cheaper anyway. I will run it that way and tell you.
The full student loan exclusion applies while you are in residency or fellowship, not for the rest of your career. As an attending you get the documented income-driven payment, which still helps enormously — but it is not zero, and anyone implying otherwise is overselling.
Purchase and rate-and-term refinance only, primary residence, one unit. No cash-out, no second homes, no investment property, no duplexes.
It is not a VA loan. If you are a physician who also served, VA is frequently the better answer, and I originate those too.
Common questions
What exactly is a physician loan?
A mortgage program written around the fact that a doctor’s early-career finances look bad on paper and are not. It allows a small down payment on loans up to $2M, charges no mortgage insurance, excludes student loans from your debt ratio while you are in residency or fellowship, and lets a signed employment contract stand in for pay stubs with a start date up to 150 days after closing.
Do I need to have started working?
No. A fully executed contract or offer letter works with a start date up to 150 days after closing — close to five months. It has to state your title, start date and compensation, and the only contingencies allowed are your medical license coming through or routine items like a background check. If you are contracted as a 1099 physician the window is tighter, at 60 days.
Is the rate higher than a conventional loan?
Often slightly, and that is the honest trade for a low down payment and no mortgage insurance. Whether it is the better deal depends on how much you would otherwise put down. With a large down payment saved, a conventional loan sometimes wins outright. I will quote both and show you the comparison rather than steering you to the one that is easier for me.
How much student loan debt is too much?
There is rarely a hard cutoff, because what matters is how the payment is counted rather than the size of the balance. In residency or fellowship, loans in deferment, forbearance or reporting $0 on an income-driven plan can be excluded from the ratio altogether — a $400,000 balance and a $150,000 balance look the same at that point. After training the documented income-driven payment is used, which still beats the 1%-of-balance math that sinks conventional files.
Is it only for MDs?
No. DO, DDS, DMD, DPM, PharmD, VMD and CRNA are all eligible, along with residents, fellows and interns holding those degrees. Dentists, podiatrists and veterinarians assume they are excluded more often than any other group and they are not. Chiropractors, however, are specifically ineligible.
Can I use it for a second home or a rental?
No. Primary residence only, one unit, purchase or rate-and-term refinance. No cash-out, no second homes, no rentals, no duplexes. If you are buying an investment property that is a different conversation and a different loan, and I am happy to have it.
What do you need from me to start?
A conversation. Nothing is required to get a realistic answer about what is possible — not a credit pull, not an application. When you are ready to move forward, the usual documents are your employment contract or offer letter, your student loan servicer statement, and recent pay history if you have any.
Get a straight answer
Tell me where you are in training or practice and I will tell you what is realistic — before you look at houses.