Underwritten for the career, not just the pay stub.
Physician and medical professional programs are built around the way your career actually starts: heavy student debt, a signed contract before day one, and income that climbs fast once you are practicing.
Also called doctor loans or physician loans. Eligible degrees vary by lender, so ask before you assume you are out.
Why a standard loan reads your file wrong
A conventional underwriter looks at two things that work against a new physician, dentist, or advanced practice clinician. First, student loan balances that would sink almost any debt-to-income calculation. Second, a short or nonexistent history of the income you are about to earn.
Neither one reflects your actual risk. Default rates in these professions are low, income is durable, and the earnings curve is steep and predictable. Lenders noticed that a long time ago.
So a number of them built portfolio programs specifically for medical professionals. These are not government programs and there is no single national rule book. Each lender writes its own: which degrees qualify, how student debt is counted, how much you put down, and what it costs. That variation is exactly why this is worth shopping rather than accepting whatever your hospital's preferred lender hands you.
What these programs typically offer
Low or no down payment
Many programs allow far less down than a conventional loan of the same size, and some go to zero at lower loan amounts. The requirement usually steps up as the loan gets larger, in tiers each lender sets itself.
No mortgage insurance
This is usually the headline. Putting less than 20% down on a conventional or FHA loan normally adds mortgage insurance to the payment. Most physician programs waive it entirely, which is often where the real monthly savings live.
Student loans counted differently
The single biggest reason these programs exist. Depending on the lender, your qualifying payment may come from an income-driven plan, a small percentage of the balance, or be excluded while loans are deferred. The spread between lenders here is enormous.
Close on your employment contract
Most of these programs will let you close before your first paycheck using a signed contract with a defined start date, provided the start falls inside the lender's window. That is what makes relocating for a residency, fellowship, or new position workable.
Residents and fellows are often eligible
Some lenders open these programs during training rather than only after you are attending. Terms are usually tighter at that stage, but the door is not necessarily closed.
Not only physicians
Eligibility by degree varies widely, and the lists run longer than most people expect. Beyond MD and DO, at least one program I place reaches dentists and oral surgeons, optometrists, podiatrists, veterinarians, physician assistants, nurse practitioners (including CRNA, CNS, and CNM), registered pharmacists, chiropractors, attorneys, and CPAs.
Where this needs an honest look
A physician loan is a good tool, not an automatic answer. These are the places it gets oversold.
It is not always cheaper than conventional
Portfolio pricing can run above conventional pricing. If you have a real down payment and manageable student debt, a conventional loan sometimes wins outright. The only way to know is to price both, which is what I do before recommending either.
Debt-to-income limits still exist
Softer student loan treatment is not unlimited buying power. The lender still measures the payment against your contracted income, and a first-year salary supports a smaller house than the offer letter feels like it should.
Occupancy is usually restricted
These programs are generally aimed at a primary residence. Some lenders allow a second home, few allow investment property. If the plan is to rent it out later, say so at the start rather than after closing.
The contract window is real
Closing ahead of your start date depends on that date falling inside the lender's allowed window, commonly measured in weeks rather than months. Start the file early enough that the window is not the thing that breaks the closing.
How this goes
Tell me the three things that matter
Your degree and license, your start date or current position, and roughly what your student loans look like. That is enough to tell which programs you actually fit.
I price the physician program against conventional
Side by side, same loan amount, same day. Down payment, mortgage insurance, rate, and monthly payment, so you can see which one is genuinely better rather than which one sounds better.
We close around your start date
Contract in hand, timed to the move rather than to your first pay stub. If a relocation is involved, that sequencing gets planned at the beginning.
Common questions
What exactly is a physician loan? +
A portfolio mortgage program that a lender designed for medical professionals and keeps on its own books instead of selling to Fannie Mae or Freddie Mac. Because the lender holds the risk, it gets to write the rules, which is how features like no mortgage insurance and softer student loan treatment become possible.
Do I have to be a physician? +
Not necessarily, and this is where people count themselves out too early. Eligible professions are set by each lender. One program I place covers medical residents, interns, and fellows, MD, DO, DPM, optometrists, DMD and DDS dentists including orthodontists and oral surgeons, doctors of veterinary medicine, physician assistants, nurse practitioners including CRNA, CNS, and CNM, registered pharmacists, chiropractors, attorneys, and CPAs. Only one borrower on the loan has to meet the professional definition on that one. Not every credential makes every list, and that same program excludes psychologists and non-medical PhDs, so tell me your license and I will check rather than guess.
What happens to my student loans? +
It depends entirely on the lender, and it is the question worth shopping hardest. Some use your documented income-driven payment. Some use a set percentage of the outstanding balance. Some disregard loans that are deferred for a defined period. On a large balance, the difference between those approaches can change your approval, not just your rate.
Can I buy before I start the job? +
In most of these programs, yes, with a signed employment contract and a start date inside the lender's allowed window. This is one of the main reasons the programs exist, since almost everyone in this field is buying while relocating for a position that has not started.
Is a physician loan always the better deal? +
No, and anyone telling you otherwise is selling. When you have 20% down and modest student debt, conventional financing frequently comes out ahead on total cost. The physician program earns its keep when the down payment is small, the student debt is large, or you are closing before you start work. I run both and show you the numbers.
Can I use one during residency? +
Often yes, though not with every lender and usually with tighter limits on loan amount. It is worth asking, particularly if the alternative is renting for three to seven more years in a market where you plan to stay.
Does it work for a refinance? +
Some lenders offer these terms on a refinance and some restrict the program to purchases only. If you already own and want out of mortgage insurance, that is a specific thing to shop for, and it is not the same list of lenders.
Who do I call with questions? +
Me, directly. Rich Preston at (448) 202-7711 or rich@prestonlending.com. Ask me anything before you apply. There is no cost and no obligation.
Send me the offer letter.
Your degree, your start date, and your student loan picture are enough for me to tell you which programs fit and what they cost. No application required to find out.
Physician and medical professional loan programs are portfolio products offered at the discretion of individual lenders. They are not government programs and are not guaranteed or insured by any federal agency. Eligible degrees and professions, occupancy restrictions, loan amount tiers, down payment requirements, student loan calculation methods, employment contract start-date windows, credit score minimums, reserve requirements, and pricing are set by each lender and vary significantly. Program availability is subject to change without notice. This page is for informational purposes and is not an offer or commitment to lend. All loans are subject to credit approval, income and asset verification, and property appraisal. Rich Preston, Branch Manager, NMLS 1735238. NEXA Lending, AZ Broker License 0944059, NMLS 1660690. Equal Housing Lender.