Doctor Loans: How Medical Professionals Buy Homes With Zero Down (and No Mortgage Insurance)

You spent a decade in school. Then residency. Maybe a fellowship after that.

And now that you're finally earning real money (or about to), you're hearing the same thing from lenders: your student loan balance is too high, your employment history is too short, or you need 20% down to buy anything worth living in.

Here's what most lenders won't tell you. There's a loan program built specifically for medical professionals that lets you buy a home with zero money down, no mortgage insurance, and loan amounts up to $2 million. It works for residents, new attendings, and established practitioners. And most doctors have no idea it exists.

I'm going to walk you through how it works, who qualifies, and what the catch is (spoiler: there's really only one, and it's manageable).

What Is a Doctor Loan?

A doctor loan (sometimes called a physician mortgage) is a specialized home loan designed for medical professionals. It's not FHA. It's not conventional. It's a standalone program with its own set of rules that account for the unique financial profile of doctors: high future earning potential, heavy student loan debt, and limited savings early in your career.

The big headlines:

100% financing up to $1.5 million (680 credit score minimum). Up to $2 million with a 720 score. No mortgage insurance. Period. Not upfront, not monthly, not ever. Student loans can be excluded from your debt-to-income ratio if you're in residency. You can qualify on a future employment contract up to 150 days before your start date. Every dollar of your down payment, closing costs, and reserves can be gifted.

That last point is worth repeating. The lender does not need to see a single dollar from the borrower. Everything can come from a family gift. That is extremely unusual for what is essentially a jumbo loan product.

Who Actually Qualifies?

The eligibility list is wider than most people expect. You don't have to be an MD.

At least one borrower on the loan needs to hold one of these designations: Medical Doctor (MD), Doctor of Osteopathy (DO), Dentist (DDS or DMD), Ophthalmologist, Psychiatrist, Pharmacist (PharmD), Veterinarian (DVM or VMD), Podiatrist (DPM), or Certified Registered Nurse Anesthetist (CRNA with a DNAP or DNP degree).

Medical residents, fellows, and interns with any of those degrees are also eligible.

A couple of designations that don't qualify: chiropractors and nurse practitioners. If you're a nurse, PA, or other medical professional who doesn't hold one of the degrees listed above, there are other programs I can help with (including DPA programs with no income limits), but this specific product won't be the fit.

Only one borrower on the loan needs the medical designation. So if you're a dentist married to someone who isn't in healthcare, you still qualify. The non-medical spouse can be on the loan.

The Student Loan Problem (and How This Solves It)

This is where the program really shines for residents and fellows.

If you're in residency or a clinical fellowship, student loans that are in deferment, forbearance, or showing a $0 payment under an income-based repayment plan can be excluded entirely from your debt-to-income ratio.

Read that again. Your $300K, $400K, even $500K in student debt doesn't count against you while you're in training.

For doctors who have finished residency and are in active repayment, the student loans do count. But the program allows a DTI up to 50% (45% if you're above 95% LTV), which is more generous than most jumbo products. And if your IBR payment is reported on your credit report, that's the number we use, not some hypothetical fully amortized payment.

This is the single biggest reason doctors who think they can't qualify actually can.

Qualifying on Future Income (The 150-Day Rule)

Here's the scenario I see all the time. A resident is finishing up training. They've signed an offer letter with a hospital or private practice. Their start date is a couple months out. Their resident salary is $65K. Their attending salary will be $350K.

Most lenders will qualify them on the $65K. This program lets us qualify them on the $350K.

The rules: you need a fully executed employment contract or offer letter that specifies your position, start date, and compensation. The start date has to be within 150 days of the loan closing. The only contingencies allowed are things like getting your state medical license or routine background checks.

The compensation has to cover at least 12 months. And the income has to be a guaranteed base (not variable bonuses or production-based pay).

This is a game-changer for residents transitioning to practice. Instead of renting for another year while you "build up income history," you can buy immediately using the income you've already locked in.

The ARM vs. Fixed Rate Question

This is something I talk to every doctor about.

A 30-year fixed on this product right now runs roughly 7% to 7.5% on a $2 million loan at 100% LTV. A 7/6 ARM comes in around 6.625% to 7.125%.

Here's the thing about a doctor's first home. It's almost never their last home. You're buying at the start of your career. Your income is going to climb. You're going to want a bigger house, a different neighborhood, or a different city within 5 to 7 years.

A 7-year ARM gives you a lower rate for the period you're actually likely to own the home. The rate is fixed for the first 7 years, then adjusts every 6 months after that (based on the SOFR index plus a 3.5% margin, with a 5/1/5 cap structure). But by the time that first adjustment hits, most of my physician clients have either sold, refinanced, or upgraded.

The 5-year ARM pricing is almost identical to the 7-year, which makes the 7-year the obvious choice. You get two extra years of rate protection for essentially the same cost.

I'm not saying the ARM is always the right call. If you're buying your forever home and you know you're staying put for 15+ years, the 30-year fixed gives you certainty. But for a first home purchase out of residency? The ARM deserves a serious look.

Reserves and Down Payment: The Full Picture

The reserve requirements on this program are lighter than anything you'd find on a conventional jumbo loan.

If your loan is $1.5 million or less and your LTV is 95% or below, there are zero reserve requirements. Nothing. That means you don't need months of mortgage payments sitting in a bank account after closing.

If your loan is above $1.5 million, or your LTV is above 95%, you'll need 3 to 6 months of reserves depending on the combination. And those reserves can be gifted by a family member.

For down payment, the minimum is technically 0% (up to $1.5M with a 680 score, or up to $2M with a 720 score). If you're putting 5% to 10% down, you're in the 90.01% to 95% LTV tier, which opens up even more flexibility on DTI (up to 50%).

Important note: this program does not allow secondary financing. No piggyback second mortgages, no HELOCs at closing. It's a single first lien with the LTV it comes with.

A Real Example: From Residency to Homeowner

I recently worked with a resident finishing training at a hospital in Southern California. Married, one income, with over $300K in student loan debt. They'd been renting and assumed homeownership was years away.

They had a signed offer letter from a practice with a start date about three months out. We used that future income to qualify them. The student loans were excluded from their debt ratio because they were still in the residency window. Their parents gifted the closing costs.

We closed on a $900K home at 100% financing. No down payment. No mortgage insurance. No money from the borrower's own accounts.

Total out of pocket from the doctor: zero.

That's not a marketing pitch. That's how this program is designed to work.

What About Doctors Transitioning to 1099?

This comes up a lot. A physician leaves a hospital W-2 position and starts working as an independent contractor or joins a group on a 1099 basis.

If you have a guaranteed employment contract with a stated salary or hourly rate and the number of hours you'll work, and the contract covers at least 12 months, you can qualify even without a 2-year self-employment history.

The hospital or clinic does need to confirm in writing that you won't have out-of-pocket expenses to perform your duties. And if you've already filed a tax return showing 1099 income with business deductions, those returns become part of the file and standard self-employment rules apply.

This is a common situation for locum tenens physicians or doctors joining a private practice as a contractor. It's doable, but the contract details matter. Bring it to me early so we can make sure the paperwork is right before you're under contract on a house.

Why Working With a Broker Matters Here

Doctor loan programs exist at multiple lenders. But the terms, pricing, and overlays vary a lot. Some cap at $1 million. Some require 5% down. Some don't allow the student loan exclusion. Some don't offer ARM options.

As a mortgage broker-vs-bank), I have access to 150+ wholesale lenders. I can compare doctor loan programs across multiple sources, find the one with the best rate and terms for your specific situation, and shop it the same way I'd shop any other loan.

That's different from walking into your bank. Your bank offers one version of this product with one set of terms. I can show you what's out there.